hospital_name,last_updated_on,version,hospital_location,hospital_address,license_number|CA,"To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated.",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
Wallowa Memorial Hospital,12/30/2024,2.0.0,Wallowa Memorial Hospital,"601 Medical Parkway, Enterprise, OR 97828",14-0068,TRUE,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
description,code|1,code|1|type,code|2,code|2|type,code|3,code|3|type,modifiers,setting,drug_unit_of_measurement,drug_type_of_measurement,standard_charge|gross,standard_charge|discounted_cash,standard_charge|MODA|COMMERCIAL|negotiated_dollar,standard_charge|MODA|COMMERCIAL|negotiated_percentage,standard_charge|MODA|COMMERCIAL|negotiated_algorithm,estimated_amount|MODA|COMMERCIAL,standard_charge|MODA|COMMERCIAL|methodology,additional_payer_notes|MODA|COMMERCIAL,standard_charge|PROVIDENCE HEALTH PLAN|COMMERCIAL|negotiated_dollar,standard_charge|PROVIDENCE HEALTH PLAN|COMMERCIAL|negotiated_percentage,standard_charge|PROVIDENCE HEALTH PLAN|COMMERCIAL|negotiated_algorithm,estimated_amount|PROVIDENCE HEALTH PLAN|COMMERCIAL,standard_charge|PROVIDENCE HEALTH PLAN|COMMERCIAL|methodology,additional_payer_notes|PROVIDENCE HEALTH PLAN|COMMERCIAL,standard_charge|CIGNA|COMMERCIAL|negotiated_dollar,standard_charge|CIGNA|COMMERCIAL|negotiated_percentage,standard_charge|CIGNA|COMMERCIAL|negotiated_algorithm,estimated_amount|CIGNA|COMMERCIAL,standard_charge|CIGNA|COMMERCIAL|methodology,additional_payer_notes|CIGNA|COMMERCIAL,standard_charge|PACIFICSOURCE|COMMERCIAL|negotiated_dollar,standard_charge|PACIFICSOURCE|COMMERCIAL|negotiated_percentage,standard_charge|PACIFICSOURCE|COMMERCIAL|negotiated_algorithm,estimated_amount|PACIFICSOURCE|COMMERCIAL,standard_charge|PACIFICSOURCE|COMMERCIAL|methodology,additional_payer_notes|PACIFICSOURCE|COMMERCIAL,standard_charge|BCBS OR|COMMERCIAL|negotiated_dollar,standard_charge|BCBS OR|COMMERCIAL|negotiated_percentage,standard_charge|BCBS OR|COMMERCIAL|negotiated_algorithm,estimated_amount|BCBS OR|COMMERCIAL,standard_charge|BCBS OR|COMMERCIAL|methodology,additional_payer_notes|BCBS OR|COMMERCIAL,standard_charge|MULTIPLAN|COMMERCIAL|negotiated_dollar,standard_charge|MULTIPLAN|COMMERCIAL|negotiated_percentage,standard_charge|MULTIPLAN|COMMERCIAL|negotiated_algorithm,estimated_amount|MULTIPLAN|COMMERCIAL,standard_charge|MULTIPLAN|COMMERCIAL|methodology,additional_payer_notes|MULTIPLAN|COMMERCIAL,standard_charge|AETNA|COMMERCIAL|negotiated_dollar,standard_charge|AETNA|COMMERCIAL|negotiated_percentage,standard_charge|AETNA|COMMERCIAL|negotiated_algorithm,estimated_amount|AETNA|COMMERCIAL,standard_charge|AETNA|COMMERCIAL|methodology,additional_payer_notes|AETNA|COMMERCIAL,standard_charge|AETNA ER|COMMERCIAL|negotiated_dollar,standard_charge|AETNA ER|COMMERCIAL|negotiated_percentage,standard_charge|AETNA ER|COMMERCIAL|negotiated_algorithm,estimated_amount|AETNA ER|COMMERCIAL,standard_charge|AETNA ER|COMMERCIAL|methodology,additional_payer_notes|AETNA ER|COMMERCIAL,standard_charge|UNITED HEALTHCARE|COMMERCIAL|negotiated_dollar,standard_charge|UNITED HEALTHCARE|COMMERCIAL|negotiated_percentage,standard_charge|UNITED HEALTHCARE|COMMERCIAL|negotiated_algorithm,estimated_amount|UNITED HEALTHCARE|COMMERCIAL,standard_charge|UNITED HEALTHCARE|COMMERCIAL|methodology,additional_payer_notes|UNITED HEALTHCARE|COMMERCIAL,standard_charge|min,standard_charge|max,additional_generic_notes
HC PR 98925 9 Osteopathic Manipulation - 1-2 Body Regions,PX-98310134,CDM,98925,CPT,983,RC,,inpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
HC PR 98925 9 Osteopathic Manipulation - 1-2 Body Regions,PX-98310134,CDM,98925,CPT,983,RC,,outpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
HC PR 98926 Osteopathic Manipulation - 3-4 Body Regions,PX-98310135,CDM,98926,CPT,983,RC,,inpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
HC PR 98926 Osteopathic Manipulation - 3-4 Body Regions,PX-98310135,CDM,98926,CPT,983,RC,,outpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
HC PR 98927 Osteopathic Manipulation - 5-6 Body Regions,PX-98310136,CDM,98927,CPT,983,RC,,inpatient,,,145,130.5,,0.95,,137.75,Percent of total billed charges,,,0.98,,142.1,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,0.97,,140.65,Percent of total billed charges,,,0.97,,140.65,Percent of total billed charges,,,0.96,,139.2,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,137.75,Percent of total billed charges,,137.75,142.1,
HC PR 98927 Osteopathic Manipulation - 5-6 Body Regions,PX-98310136,CDM,98927,CPT,983,RC,,outpatient,,,145,130.5,,0.95,,137.75,Percent of total billed charges,,,0.98,,142.1,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,0.97,,140.65,Percent of total billed charges,,,0.96,,139.2,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,137.75,Percent of total billed charges,,137.75,142.1,
HC PR 98928 Osteopathic Manipulation - 7-8 Body Regions,PX-98310137,CDM,98928,CPT,983,RC,,inpatient,,,177,159.3,,0.95,,168.15,Percent of total billed charges,,,0.98,,173.46,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.96,,169.92,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,168.15,Percent of total billed charges,,168.15,173.46,
HC PR 98928 Osteopathic Manipulation - 7-8 Body Regions,PX-98310137,CDM,98928,CPT,983,RC,,outpatient,,,177,159.3,,0.95,,168.15,Percent of total billed charges,,,0.98,,173.46,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.96,,169.92,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,168.15,Percent of total billed charges,,168.15,173.46,
HC PR 98929 Osteopathic Manipulation - 9-10 Body Regions,PX-98310138,CDM,98929,CPT,983,RC,,inpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
HC PR 98929 Osteopathic Manipulation - 9-10 Body Regions,PX-98310138,CDM,98929,CPT,983,RC,,outpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
"HC Comprehensive Community Supp Svc, per Diem",PX-91410118,CDM,H2016,HCPCS,914,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
"HC Comprehensive Community Supp Svc, per Diem",PX-91410118,CDM,H2016,HCPCS,914,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
HC Malyugin Ring,PX-3254096WWM,CDM,3254096WWM,LOCAL,270,RC,,inpatient,,,408,367.2,,0.95,,387.6,Percent of total billed charges,,,0.98,,399.84,Percent of total billed charges,,,0.95,,387.6,Percent of total billed charges,,,0.97,,395.76,Percent of total billed charges,,,0.97,,395.76,Percent of total billed charges,,,0.96,,391.68,Percent of total billed charges,,,0.95,,387.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,387.6,Percent of total billed charges,,387.6,399.84,
HC Malyugin Ring,PX-3254096WWM,CDM,3254096WWM,LOCAL,270,RC,,outpatient,,,408,367.2,,0.95,,387.6,Percent of total billed charges,,,0.98,,399.84,Percent of total billed charges,,,0.95,,387.6,Percent of total billed charges,,,0.95,,387.6,Percent of total billed charges,,,0.97,,395.76,Percent of total billed charges,,,0.96,,391.68,Percent of total billed charges,,,0.95,,387.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,387.6,Percent of total billed charges,,387.6,399.84,
HC PR 99455 Cc Acp Dot Px,PX-98311330,CDM,99455,CPT,983,RC,,inpatient,,,272,244.8,,0.95,,258.4,Percent of total billed charges,,,0.98,,266.56,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,0.97,,263.84,Percent of total billed charges,,,0.97,,263.84,Percent of total billed charges,,,0.96,,261.12,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,258.4,Percent of total billed charges,,258.4,266.56,
HC PR 99455 Cc Acp Dot Px,PX-98311330,CDM,99455,CPT,983,RC,,outpatient,,,272,244.8,,0.95,,258.4,Percent of total billed charges,,,0.98,,266.56,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,0.97,,263.84,Percent of total billed charges,,,0.96,,261.12,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,258.4,Percent of total billed charges,,258.4,266.56,
Closed treat broken and/or dislocated pelvis and/or sacrum,PX-45010139,CDM,27197,CPT,450,RC,,inpatient,,,1884,1695.6,,0.95,,1789.8,Percent of total billed charges,,,0.98,,1846.32,Percent of total billed charges,,,0.95,,1789.8,Percent of total billed charges,,,0.97,,1827.48,Percent of total billed charges,,,0.97,,1827.48,Percent of total billed charges,,,0.96,,1808.64,Percent of total billed charges,,,0.95,,1789.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1789.8,Percent of total billed charges,,1789.8,3950,
Closed treat broken and/or dislocated pelvis and/or sacrum,PX-45010139,CDM,27197,CPT,450,RC,,outpatient,,,1884,1695.6,,0.95,,1789.8,Percent of total billed charges,,,0.98,,1846.32,Percent of total billed charges,,,0.95,,1789.8,Percent of total billed charges,,,0.95,,1789.8,Percent of total billed charges,,,0.97,,1827.48,Percent of total billed charges,,,0.96,,1808.64,Percent of total billed charges,,,0.95,,1789.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1789.8,Percent of total billed charges,,1789.8,3950,
HC PR ED 27198 Closed Tx Pelvic Ring Fx W/Manip Cdm,PX-98110142,CDM,27198,CPT,981,RC,,inpatient,,,839,755.1,,0.95,,797.05,Percent of total billed charges,,,0.98,,822.22,Percent of total billed charges,,,0.95,,797.05,Percent of total billed charges,,,0.97,,813.83,Percent of total billed charges,,,0.97,,813.83,Percent of total billed charges,,,0.96,,805.44,Percent of total billed charges,,,0.95,,797.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,797.05,Percent of total billed charges,,797.05,822.22,
HC PR ED 27198 Closed Tx Pelvic Ring Fx W/Manip Cdm,PX-98110142,CDM,27198,CPT,981,RC,,outpatient,,,839,755.1,,0.95,,797.05,Percent of total billed charges,,,0.98,,822.22,Percent of total billed charges,,,0.95,,797.05,Percent of total billed charges,,,0.95,,797.05,Percent of total billed charges,,,0.97,,813.83,Percent of total billed charges,,,0.96,,805.44,Percent of total billed charges,,,0.95,,797.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,797.05,Percent of total billed charges,,797.05,822.22,
Closed treatment of broken and/or dislocated pelvis sacrum,PX-45010140,CDM,27198,CPT,450,RC,,inpatient,,,3578,3220.2,,0.95,,3399.1,Percent of total billed charges,,,0.98,,3506.44,Percent of total billed charges,,,0.95,,3399.1,Percent of total billed charges,,,0.97,,3470.66,Percent of total billed charges,,,0.97,,3470.66,Percent of total billed charges,,,0.96,,3434.88,Percent of total billed charges,,,0.95,,3399.1,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,3399.1,Percent of total billed charges,,3399.1,3950,
Closed treatment of broken and/or dislocated pelvis sacrum,PX-45010140,CDM,27198,CPT,450,RC,,outpatient,,,3578,3220.2,,0.95,,3399.1,Percent of total billed charges,,,0.98,,3506.44,Percent of total billed charges,,,0.95,,3399.1,Percent of total billed charges,,,0.95,,3399.1,Percent of total billed charges,,,0.97,,3470.66,Percent of total billed charges,,,0.96,,3434.88,Percent of total billed charges,,,0.95,,3399.1,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,3399.1,Percent of total billed charges,,3399.1,3950,
HC PR 62320 Inj Interlaminar Crv/Thrc W/O Img,PX-96310267,CDM,62320,CPT,963,RC,,inpatient,,,1150,1035,,0.95,,1092.5,Percent of total billed charges,,,0.98,,1127,Percent of total billed charges,,,0.95,,1092.5,Percent of total billed charges,,,0.97,,1115.5,Percent of total billed charges,,,0.97,,1115.5,Percent of total billed charges,,,0.96,,1104,Percent of total billed charges,,,0.95,,1092.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1092.5,Percent of total billed charges,,1092.5,1127,
HC PR 62320 Inj Interlaminar Crv/Thrc W/O Img,PX-96310267,CDM,62320,CPT,963,RC,,outpatient,,,1150,1035,,0.95,,1092.5,Percent of total billed charges,,,0.98,,1127,Percent of total billed charges,,,0.95,,1092.5,Percent of total billed charges,,,0.95,,1092.5,Percent of total billed charges,,,0.97,,1115.5,Percent of total billed charges,,,0.96,,1104,Percent of total billed charges,,,0.95,,1092.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1092.5,Percent of total billed charges,,1092.5,1127,
Injection of substance into middle or upper spine canal,PX-36114046,CDM,62320,CPT,361,RC,,inpatient,,,1185,1066.5,,0.95,,1125.75,Percent of total billed charges,,,0.98,,1161.3,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,0.97,,1149.45,Percent of total billed charges,,,0.97,,1149.45,Percent of total billed charges,,,0.96,,1137.6,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1125.75,Percent of total billed charges,,1125.75,1161.3,
Injection of substance into middle or upper spine canal,PX-36114046,CDM,62320,CPT,361,RC,,outpatient,,,1185,1066.5,,0.95,,1125.75,Percent of total billed charges,,,0.98,,1161.3,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,0.97,,1149.45,Percent of total billed charges,,,0.96,,1137.6,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1125.75,Percent of total billed charges,,1125.75,1161.3,
Insert tube/inject substance into middle/upper spine canal,PX-36114049,CDM,62324,CPT,361,RC,,inpatient,,,1185,1066.5,,0.95,,1125.75,Percent of total billed charges,,,0.98,,1161.3,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,0.97,,1149.45,Percent of total billed charges,,,0.97,,1149.45,Percent of total billed charges,,,0.96,,1137.6,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1125.75,Percent of total billed charges,,1125.75,1161.3,
Insert tube/inject substance into middle/upper spine canal,PX-36114049,CDM,62324,CPT,361,RC,,outpatient,,,1185,1066.5,,0.95,,1125.75,Percent of total billed charges,,,0.98,,1161.3,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,0.97,,1149.45,Percent of total billed charges,,,0.96,,1137.6,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1125.75,Percent of total billed charges,,1125.75,1161.3,
Insert tube/inject substance into lower spine canal,PX-36114051,CDM,62326,CPT,361,RC,,inpatient,,,1150,1035,,0.95,,1092.5,Percent of total billed charges,,,0.98,,1127,Percent of total billed charges,,,0.95,,1092.5,Percent of total billed charges,,,0.97,,1115.5,Percent of total billed charges,,,0.97,,1115.5,Percent of total billed charges,,,0.96,,1104,Percent of total billed charges,,,0.95,,1092.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1092.5,Percent of total billed charges,,1092.5,1127,
Insert tube/inject substance into lower spine canal,PX-36114051,CDM,62326,CPT,361,RC,,outpatient,,,1150,1035,,0.95,,1092.5,Percent of total billed charges,,,0.98,,1127,Percent of total billed charges,,,0.95,,1092.5,Percent of total billed charges,,,0.95,,1092.5,Percent of total billed charges,,,0.97,,1115.5,Percent of total billed charges,,,0.96,,1104,Percent of total billed charges,,,0.95,,1092.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1092.5,Percent of total billed charges,,1092.5,1127,
Ultrasound scan of abdominal aorta,PX-40210142,CDM,76706,CPT,402,RC,,inpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,440.8,Percent of total billed charges,,440.8,454.72,
Ultrasound scan of abdominal aorta,PX-40210142,CDM,76706,CPT,402,RC,,outpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,440.8,Percent of total billed charges,,440.8,454.72,
Diagnostic mammography of both breasts,PX-40110024,CDM,77066,CPT,401,RC,,inpatient,,,451,405.9,,0.95,,428.45,Percent of total billed charges,,,0.98,,441.98,Percent of total billed charges,,,0.95,,428.45,Percent of total billed charges,,,0.97,,437.47,Percent of total billed charges,,,0.97,,437.47,Percent of total billed charges,,,0.96,,432.96,Percent of total billed charges,,,0.95,,428.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,428.45,Percent of total billed charges,,428.45,441.98,
Diagnostic mammography of both breasts,PX-40110024,CDM,77066,CPT,401,RC,,outpatient,,,451,405.9,,0.95,,428.45,Percent of total billed charges,,,0.98,,441.98,Percent of total billed charges,,,0.95,,428.45,Percent of total billed charges,,,0.95,,428.45,Percent of total billed charges,,,0.97,,437.47,Percent of total billed charges,,,0.96,,432.96,Percent of total billed charges,,,0.95,,428.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,428.45,Percent of total billed charges,,428.45,441.98,
Screening mammography,PX-40310012,CDM,77067,CPT,403,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,332.5,Percent of total billed charges,,332.5,343,
Screening mammography,PX-40310012,CDM,77067,CPT,403,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"Drug testing, read by direct observation",PX-30114379,CDM,80305,CPT,301,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Drug testing, read by direct observation",PX-30114379,CDM,80305,CPT,301,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Drug testing, read by tool assisted observation",PX-30114380,CDM,80306,CPT,301,RC,,inpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
"Drug testing, read by tool assisted observation",PX-30114380,CDM,80306,CPT,301,RC,,outpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
"Testing for drug presence, by chemistry analyzers",PX-30114381,CDM,80307,CPT,301,RC,,inpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
"Testing for drug presence, by chemistry analyzers",PX-30114381,CDM,80307,CPT,301,RC,,outpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
"Testing for drug presence, by chemistry analyzers",PX-30114382,CDM,80307,CPT,301,RC,,inpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
"Testing for drug presence, by chemistry analyzers",PX-30114382,CDM,80307,CPT,301,RC,,outpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
HC Drug Test Prsmv Chem Anlyzr Alcohol per Dos,PX-30114383,CDM,80307,CPT,301,RC,,inpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
HC Drug Test Prsmv Chem Anlyzr Alcohol per Dos,PX-30114383,CDM,80307,CPT,301,RC,,outpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
HC Drug Test Prsmv Chem Anlyzr Amphetamines per Dos,PX-30114384,CDM,80307,CPT,301,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
HC Drug Test Prsmv Chem Anlyzr Amphetamines per Dos,PX-30114384,CDM,80307,CPT,301,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
HC Drug Test Prsmv Chem Anlyzr Barbiturates per Dos,PX-30114385,CDM,80307,CPT,301,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
HC Drug Test Prsmv Chem Anlyzr Barbiturates per Dos,PX-30114385,CDM,80307,CPT,301,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Testing for drug presence, by chemistry analyzers",PX-30114386,CDM,80307,CPT,301,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Testing for drug presence, by chemistry analyzers",PX-30114386,CDM,80307,CPT,301,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
HC Drug Test Prsmv Chem Anlyzr per Dos,PX-30114387,CDM,80307,CPT,301,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
HC Drug Test Prsmv Chem Anlyzr per Dos,PX-30114387,CDM,80307,CPT,301,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Testing for drug presence, by chemistry analyzers",PX-30114388,CDM,80307,CPT,301,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Testing for drug presence, by chemistry analyzers",PX-30114388,CDM,80307,CPT,301,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
HC Drug Test Prsmv Chem Anlyzr Cordstat per Dos,PX-30114389,CDM,80307,CPT,301,RC,,inpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
HC Drug Test Prsmv Chem Anlyzr Cordstat per Dos,PX-30114389,CDM,80307,CPT,301,RC,,outpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
Testing for drug presence by chemistry analyzers,PX-30114390,CDM,80307,CPT,301,RC,,inpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
Testing for drug presence by chemistry analyzers,PX-30114390,CDM,80307,CPT,301,RC,,outpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
Testing for drug presence by chemistry analyzers,PX-30114391,CDM,80307,CPT,301,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
Testing for drug presence by chemistry analyzers,PX-30114391,CDM,80307,CPT,301,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Testing for drug presence, by chemistry analyzers",PX-30114392,CDM,80307,CPT,301,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Testing for drug presence, by chemistry analyzers",PX-30114392,CDM,80307,CPT,301,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
Testing for drug presence by chemistry analyzers,PX-30114393,CDM,80307,CPT,301,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
Testing for drug presence by chemistry analyzers,PX-30114393,CDM,80307,CPT,301,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Testing for drug presence, by chemistry analyzers",PX-30114394,CDM,80307,CPT,301,RC,,inpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
"Testing for drug presence, by chemistry analyzers",PX-30114394,CDM,80307,CPT,301,RC,,outpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
Testing for drug presence by chemistry analyzers,PX-30114395,CDM,80307,CPT,301,RC,,inpatient,,,290,261,,0.95,,275.5,Percent of total billed charges,,,0.98,,284.2,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.96,,278.4,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,275.5,Percent of total billed charges,,275.5,284.2,
Testing for drug presence by chemistry analyzers,PX-30114395,CDM,80307,CPT,301,RC,,outpatient,,,290,261,,0.95,,275.5,Percent of total billed charges,,,0.98,,284.2,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.96,,278.4,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,275.5,Percent of total billed charges,,275.5,284.2,
"Testing for drug presence, by chemistry analyzers",PX-30114396,CDM,80307,CPT,301,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Testing for drug presence, by chemistry analyzers",PX-30114396,CDM,80307,CPT,301,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
HC Drug Test Prsmv Chem Anlyzr Nonchromo Drugs of Abuse 6 per Dos,PX-30114397,CDM,80307,CPT,301,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
HC Drug Test Prsmv Chem Anlyzr Nonchromo Drugs of Abuse 6 per Dos,PX-30114397,CDM,80307,CPT,301,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Testing for drug presence, by chemistry analyzers",PX-30114398,CDM,80307,CPT,301,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Testing for drug presence, by chemistry analyzers",PX-30114398,CDM,80307,CPT,301,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Testing for drug presence, by chemistry analyzers",PX-30114399,CDM,80307,CPT,301,RC,,inpatient,,,291,261.9,,0.95,,276.45,Percent of total billed charges,,,0.98,,285.18,Percent of total billed charges,,,0.95,,276.45,Percent of total billed charges,,,0.97,,282.27,Percent of total billed charges,,,0.97,,282.27,Percent of total billed charges,,,0.96,,279.36,Percent of total billed charges,,,0.95,,276.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,276.45,Percent of total billed charges,,276.45,285.18,
"Testing for drug presence, by chemistry analyzers",PX-30114399,CDM,80307,CPT,301,RC,,outpatient,,,291,261.9,,0.95,,276.45,Percent of total billed charges,,,0.98,,285.18,Percent of total billed charges,,,0.95,,276.45,Percent of total billed charges,,,0.95,,276.45,Percent of total billed charges,,,0.97,,282.27,Percent of total billed charges,,,0.96,,279.36,Percent of total billed charges,,,0.95,,276.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,276.45,Percent of total billed charges,,276.45,285.18,
Testing for drug presence by chemistry analyzers,PX-30114400,CDM,80307,CPT,301,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
Testing for drug presence by chemistry analyzers,PX-30114400,CDM,80307,CPT,301,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
Testing for drug presence by chemistry analyzers,PX-30114401,CDM,80307,CPT,301,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
Testing for drug presence by chemistry analyzers,PX-30114401,CDM,80307,CPT,301,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Testing for drug presence, by chemistry analyzers",PX-30114402,CDM,80307,CPT,301,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Testing for drug presence, by chemistry analyzers",PX-30114402,CDM,80307,CPT,301,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Testing for drug presence, by chemistry analyzers",PX-30114403,CDM,80307,CPT,301,RC,,inpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
"Testing for drug presence, by chemistry analyzers",PX-30114403,CDM,80307,CPT,301,RC,,outpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
"Testing for drug presence, by chemistry analyzers",PX-30114404,CDM,80307,CPT,301,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Testing for drug presence, by chemistry analyzers",PX-30114404,CDM,80307,CPT,301,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
Testing for drug presence by chemistry analyzers,PX-30114405,CDM,80307,CPT,301,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
Testing for drug presence by chemistry analyzers,PX-30114405,CDM,80307,CPT,301,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Testing for drug presence, by chemistry analyzers",PX-30114406,CDM,80307,CPT,301,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Testing for drug presence, by chemistry analyzers",PX-30114406,CDM,80307,CPT,301,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
Test for detecting genes associated with heart disease,PX-31010710,CDM,81413,CPT,310,RC,,inpatient,,,2826,2543.4,,0.95,,2684.7,Percent of total billed charges,,,0.98,,2769.48,Percent of total billed charges,,,0.95,,2684.7,Percent of total billed charges,,,0.97,,2741.22,Percent of total billed charges,,,0.97,,2741.22,Percent of total billed charges,,,0.96,,2712.96,Percent of total billed charges,,,0.95,,2684.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2684.7,Percent of total billed charges,,2684.7,2769.48,
Test for detecting genes associated with heart disease,PX-31010710,CDM,81413,CPT,310,RC,,outpatient,,,2826,2543.4,,0.95,,2684.7,Percent of total billed charges,,,0.98,,2769.48,Percent of total billed charges,,,0.95,,2684.7,Percent of total billed charges,,,0.95,,2684.7,Percent of total billed charges,,,0.97,,2741.22,Percent of total billed charges,,,0.96,,2712.96,Percent of total billed charges,,,0.95,,2684.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2684.7,Percent of total billed charges,,2684.7,2769.48,
Test for detecting genes associated with heart disease,PX-31010711,CDM,81414,CPT,310,RC,,inpatient,,,2826,2543.4,,0.95,,2684.7,Percent of total billed charges,,,0.98,,2769.48,Percent of total billed charges,,,0.95,,2684.7,Percent of total billed charges,,,0.97,,2741.22,Percent of total billed charges,,,0.97,,2741.22,Percent of total billed charges,,,0.96,,2712.96,Percent of total billed charges,,,0.95,,2684.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2684.7,Percent of total billed charges,,2684.7,2769.48,
Test for detecting genes associated with heart disease,PX-31010711,CDM,81414,CPT,310,RC,,outpatient,,,2826,2543.4,,0.95,,2684.7,Percent of total billed charges,,,0.98,,2769.48,Percent of total billed charges,,,0.95,,2684.7,Percent of total billed charges,,,0.95,,2684.7,Percent of total billed charges,,,0.97,,2741.22,Percent of total billed charges,,,0.96,,2712.96,Percent of total billed charges,,,0.95,,2684.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2684.7,Percent of total billed charges,,2684.7,2769.48,
Test for nucleic acid of organism infecting nervous system,PX-30610971,CDM,87483,CPT,306,RC,,inpatient,,,1755,1579.5,,0.95,,1667.25,Percent of total billed charges,,,0.98,,1719.9,Percent of total billed charges,,,0.95,,1667.25,Percent of total billed charges,,,0.97,,1702.35,Percent of total billed charges,,,0.97,,1702.35,Percent of total billed charges,,,0.96,,1684.8,Percent of total billed charges,,,0.95,,1667.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1667.25,Percent of total billed charges,,1667.25,1719.9,
Test for nucleic acid of organism infecting nervous system,PX-30610971,CDM,87483,CPT,306,RC,,outpatient,,,1755,1579.5,,0.95,,1667.25,Percent of total billed charges,,,0.98,,1719.9,Percent of total billed charges,,,0.95,,1667.25,Percent of total billed charges,,,0.95,,1667.25,Percent of total billed charges,,,0.97,,1702.35,Percent of total billed charges,,,0.96,,1684.8,Percent of total billed charges,,,0.95,,1667.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1667.25,Percent of total billed charges,,1667.25,1719.9,
HC PR Rx Influenza Quadrivalent (Riv4) Pf Im 0.5 Ml,PX-63610235,CDM,90682,HCPCS,636,RC,,inpatient,,,36,32.4,,0.95,,34.2,Percent of total billed charges,,,0.98,,35.28,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.96,,34.56,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,34.2,Percent of total billed charges,,34.2,35.28,
HC PR Rx Influenza Quadrivalent (Riv4) Pf Im 0.5 Ml,PX-63610235,CDM,90682,HCPCS,636,RC,,outpatient,,,36,32.4,,0.95,,34.2,Percent of total billed charges,,,0.98,,35.28,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.96,,34.56,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,34.2,Percent of total billed charges,,34.2,35.28,
HC PR Rx Hzv Zoster Vaccine Recombinant Adjuvanted Im 0.5 Ml,PX-63610248,CDM,90750,HCPCS,636,RC,,inpatient,,,280,252,,0.95,,266,Percent of total billed charges,,,0.98,,274.4,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,0.97,,271.6,Percent of total billed charges,,,0.97,,271.6,Percent of total billed charges,,,0.96,,268.8,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,266,Percent of total billed charges,,266,274.4,
HC PR Rx Hzv Zoster Vaccine Recombinant Adjuvanted Im 0.5 Ml,PX-63610248,CDM,90750,HCPCS,636,RC,,outpatient,,,280,252,,0.95,,266,Percent of total billed charges,,,0.98,,274.4,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,0.97,,271.6,Percent of total billed charges,,,0.96,,268.8,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,266,Percent of total billed charges,,266,274.4,
"Evaluation for physical therapy, low complexity",PX-42410066,CDM,97161,CPT,424,RC,,inpatient,,,247,222.3,,0.95,,234.65,Percent of total billed charges,,,0.98,,242.06,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.96,,237.12,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,234.65,Percent of total billed charges,,234.65,242.06,
"Evaluation for physical therapy, low complexity",PX-42410066,CDM,97161,CPT,424,RC,,outpatient,,,247,222.3,,0.95,,234.65,Percent of total billed charges,,,0.98,,242.06,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.96,,237.12,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,234.65,Percent of total billed charges,,234.65,242.06,
"Evaluation for physical therapy, mod complexity",PX-42410067,CDM,97162,CPT,424,RC,,inpatient,,,247,222.3,,0.95,,234.65,Percent of total billed charges,,,0.98,,242.06,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.96,,237.12,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,234.65,Percent of total billed charges,,234.65,242.06,
"Evaluation for physical therapy, mod complexity",PX-42410067,CDM,97162,CPT,424,RC,,outpatient,,,247,222.3,,0.95,,234.65,Percent of total billed charges,,,0.98,,242.06,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.96,,237.12,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,234.65,Percent of total billed charges,,234.65,242.06,
"Evaluation for physical therapy,high complexity",PX-42410068,CDM,97163,CPT,424,RC,,inpatient,,,247,222.3,,0.95,,234.65,Percent of total billed charges,,,0.98,,242.06,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.96,,237.12,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,234.65,Percent of total billed charges,,234.65,242.06,
"Evaluation for physical therapy,high complexity",PX-42410068,CDM,97163,CPT,424,RC,,outpatient,,,247,222.3,,0.95,,234.65,Percent of total billed charges,,,0.98,,242.06,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.96,,237.12,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,234.65,Percent of total billed charges,,234.65,242.06,
"Re-evaluation for physical therapy, typically 20m",PX-42410069,CDM,97164,CPT,424,RC,,inpatient,,,246,221.4,,0.95,,233.7,Percent of total billed charges,,,0.98,,241.08,Percent of total billed charges,,,0.95,,233.7,Percent of total billed charges,,,0.97,,238.62,Percent of total billed charges,,,0.97,,238.62,Percent of total billed charges,,,0.96,,236.16,Percent of total billed charges,,,0.95,,233.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,233.7,Percent of total billed charges,,233.7,241.08,
"Re-evaluation for physical therapy, typically 20m",PX-42410069,CDM,97164,CPT,424,RC,,outpatient,,,246,221.4,,0.95,,233.7,Percent of total billed charges,,,0.98,,241.08,Percent of total billed charges,,,0.95,,233.7,Percent of total billed charges,,,0.95,,233.7,Percent of total billed charges,,,0.97,,238.62,Percent of total billed charges,,,0.96,,236.16,Percent of total billed charges,,,0.95,,233.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,233.7,Percent of total billed charges,,233.7,241.08,
"Evaluation for occupational therapy, low complexity",PX-43410045,CDM,97165,CPT,434,RC,,inpatient,,,249,224.1,,0.95,,236.55,Percent of total billed charges,,,0.98,,244.02,Percent of total billed charges,,,0.95,,236.55,Percent of total billed charges,,,0.97,,241.53,Percent of total billed charges,,,0.97,,241.53,Percent of total billed charges,,,0.96,,239.04,Percent of total billed charges,,,0.95,,236.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,236.55,Percent of total billed charges,,236.55,244.02,
"Evaluation for occupational therapy, low complexity",PX-43410045,CDM,97165,CPT,434,RC,,outpatient,,,249,224.1,,0.95,,236.55,Percent of total billed charges,,,0.98,,244.02,Percent of total billed charges,,,0.95,,236.55,Percent of total billed charges,,,0.95,,236.55,Percent of total billed charges,,,0.97,,241.53,Percent of total billed charges,,,0.96,,239.04,Percent of total billed charges,,,0.95,,236.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,236.55,Percent of total billed charges,,236.55,244.02,
"Evaluation for occupational therapy, mod complexity",PX-43410046,CDM,97166,CPT,434,RC,,inpatient,,,249,224.1,,0.95,,236.55,Percent of total billed charges,,,0.98,,244.02,Percent of total billed charges,,,0.95,,236.55,Percent of total billed charges,,,0.97,,241.53,Percent of total billed charges,,,0.97,,241.53,Percent of total billed charges,,,0.96,,239.04,Percent of total billed charges,,,0.95,,236.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,236.55,Percent of total billed charges,,236.55,244.02,
"Evaluation for occupational therapy, mod complexity",PX-43410046,CDM,97166,CPT,434,RC,,outpatient,,,249,224.1,,0.95,,236.55,Percent of total billed charges,,,0.98,,244.02,Percent of total billed charges,,,0.95,,236.55,Percent of total billed charges,,,0.95,,236.55,Percent of total billed charges,,,0.97,,241.53,Percent of total billed charges,,,0.96,,239.04,Percent of total billed charges,,,0.95,,236.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,236.55,Percent of total billed charges,,236.55,244.02,
"Evaluation for occupational therapy, high complexity",PX-43410047,CDM,97167,CPT,434,RC,,inpatient,,,249,224.1,,0.95,,236.55,Percent of total billed charges,,,0.98,,244.02,Percent of total billed charges,,,0.95,,236.55,Percent of total billed charges,,,0.97,,241.53,Percent of total billed charges,,,0.97,,241.53,Percent of total billed charges,,,0.96,,239.04,Percent of total billed charges,,,0.95,,236.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,236.55,Percent of total billed charges,,236.55,244.02,
"Evaluation for occupational therapy, high complexity",PX-43410047,CDM,97167,CPT,434,RC,,outpatient,,,249,224.1,,0.95,,236.55,Percent of total billed charges,,,0.98,,244.02,Percent of total billed charges,,,0.95,,236.55,Percent of total billed charges,,,0.95,,236.55,Percent of total billed charges,,,0.97,,241.53,Percent of total billed charges,,,0.96,,239.04,Percent of total billed charges,,,0.95,,236.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,236.55,Percent of total billed charges,,236.55,244.02,
Re-evaluation for occupational therapy,PX-43410048,CDM,97168,CPT,434,RC,,inpatient,,,258,232.2,,0.95,,245.1,Percent of total billed charges,,,0.98,,252.84,Percent of total billed charges,,,0.95,,245.1,Percent of total billed charges,,,0.97,,250.26,Percent of total billed charges,,,0.97,,250.26,Percent of total billed charges,,,0.96,,247.68,Percent of total billed charges,,,0.95,,245.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,245.1,Percent of total billed charges,,245.1,252.84,
Re-evaluation for occupational therapy,PX-43410048,CDM,97168,CPT,434,RC,,outpatient,,,258,232.2,,0.95,,245.1,Percent of total billed charges,,,0.98,,252.84,Percent of total billed charges,,,0.95,,245.1,Percent of total billed charges,,,0.95,,245.1,Percent of total billed charges,,,0.97,,250.26,Percent of total billed charges,,,0.96,,247.68,Percent of total billed charges,,,0.95,,245.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,245.1,Percent of total billed charges,,245.1,252.84,
HC PR ED 99151 Mod Sed Same Phys/Qhp <5yrs 1st 15 Min Cdm,PX-98110144,CDM,99151,CPT,981,RC,,inpatient,,,424,381.6,,0.95,,402.8,Percent of total billed charges,,,0.98,,415.52,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,0.97,,411.28,Percent of total billed charges,,,0.97,,411.28,Percent of total billed charges,,,0.96,,407.04,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,402.8,Percent of total billed charges,,402.8,415.52,
HC PR ED 99151 Mod Sed Same Phys/Qhp <5yrs 1st 15 Min Cdm,PX-98110144,CDM,99151,CPT,981,RC,,outpatient,,,424,381.6,,0.95,,402.8,Percent of total billed charges,,,0.98,,415.52,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,0.97,,411.28,Percent of total billed charges,,,0.96,,407.04,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,402.8,Percent of total billed charges,,402.8,415.52,
HC PR ED 99152 Mod Sed Same Phys/Qhp 5/>Yrs 1st 15 Min Cdm,PX-98110145,CDM,99152,CPT,981,RC,,inpatient,,,424,381.6,,0.95,,402.8,Percent of total billed charges,,,0.98,,415.52,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,0.97,,411.28,Percent of total billed charges,,,0.97,,411.28,Percent of total billed charges,,,0.96,,407.04,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,402.8,Percent of total billed charges,,402.8,415.52,
HC PR ED 99152 Mod Sed Same Phys/Qhp 5/>Yrs 1st 15 Min Cdm,PX-98110145,CDM,99152,CPT,981,RC,,outpatient,,,424,381.6,,0.95,,402.8,Percent of total billed charges,,,0.98,,415.52,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,0.97,,411.28,Percent of total billed charges,,,0.96,,407.04,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,402.8,Percent of total billed charges,,402.8,415.52,
HC PR ED 99153 Mod Sed Same Phys/Qhp Ea Addl 15 Min Cdm,PX-98110146,CDM,99153,CPT,981,RC,,inpatient,,,232,208.8,,0.95,,220.4,Percent of total billed charges,,,0.98,,227.36,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,0.97,,225.04,Percent of total billed charges,,,0.97,,225.04,Percent of total billed charges,,,0.96,,222.72,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,220.4,Percent of total billed charges,,220.4,227.36,
HC PR ED 99153 Mod Sed Same Phys/Qhp Ea Addl 15 Min Cdm,PX-98110146,CDM,99153,CPT,981,RC,,outpatient,,,232,208.8,,0.95,,220.4,Percent of total billed charges,,,0.98,,227.36,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,0.97,,225.04,Percent of total billed charges,,,0.96,,222.72,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,220.4,Percent of total billed charges,,220.4,227.36,
HC PR ED 99156 Mod Sed Oth Phys/Qhp 5/>Yrs 1st 15 Min Cdm,PX-98110149,CDM,99156,CPT,981,RC,,inpatient,,,424,381.6,,0.95,,402.8,Percent of total billed charges,,,0.98,,415.52,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,0.97,,411.28,Percent of total billed charges,,,0.97,,411.28,Percent of total billed charges,,,0.96,,407.04,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,402.8,Percent of total billed charges,,402.8,415.52,
HC PR ED 99156 Mod Sed Oth Phys/Qhp 5/>Yrs 1st 15 Min Cdm,PX-98110149,CDM,99156,CPT,981,RC,,outpatient,,,424,381.6,,0.95,,402.8,Percent of total billed charges,,,0.98,,415.52,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,0.97,,411.28,Percent of total billed charges,,,0.96,,407.04,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,402.8,Percent of total billed charges,,402.8,415.52,
HC PR 62322 Inj Interlaminar Lmbr/Sac W/O Img,PX-96310270,CDM,62322,CPT,963,RC,,inpatient,,,1095,985.5,,0.95,,1040.25,Percent of total billed charges,,,0.98,,1073.1,Percent of total billed charges,,,0.95,,1040.25,Percent of total billed charges,,,0.97,,1062.15,Percent of total billed charges,,,0.97,,1062.15,Percent of total billed charges,,,0.96,,1051.2,Percent of total billed charges,,,0.95,,1040.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1040.25,Percent of total billed charges,,1040.25,1073.1,
HC PR 62322 Inj Interlaminar Lmbr/Sac W/O Img,PX-96310270,CDM,62322,CPT,963,RC,,outpatient,,,1095,985.5,,0.95,,1040.25,Percent of total billed charges,,,0.98,,1073.1,Percent of total billed charges,,,0.95,,1040.25,Percent of total billed charges,,,0.95,,1040.25,Percent of total billed charges,,,0.97,,1062.15,Percent of total billed charges,,,0.96,,1051.2,Percent of total billed charges,,,0.95,,1040.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1040.25,Percent of total billed charges,,1040.25,1073.1,
Injection of substance into lower spine canal,PX-36114054,CDM,62322,CPT,361,RC,,inpatient,,,1150,1035,,0.95,,1092.5,Percent of total billed charges,,,0.98,,1127,Percent of total billed charges,,,0.95,,1092.5,Percent of total billed charges,,,0.97,,1115.5,Percent of total billed charges,,,0.97,,1115.5,Percent of total billed charges,,,0.96,,1104,Percent of total billed charges,,,0.95,,1092.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1092.5,Percent of total billed charges,,1092.5,1127,
Injection of substance into lower spine canal,PX-36114054,CDM,62322,CPT,361,RC,,outpatient,,,1150,1035,,0.95,,1092.5,Percent of total billed charges,,,0.98,,1127,Percent of total billed charges,,,0.95,,1092.5,Percent of total billed charges,,,0.95,,1092.5,Percent of total billed charges,,,0.97,,1115.5,Percent of total billed charges,,,0.96,,1104,Percent of total billed charges,,,0.95,,1092.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1092.5,Percent of total billed charges,,1092.5,1127,
HC PR ED 99155 Mod Sed Oth Phys/Qhp <5 Yrs 1st 15 Min Cdm,PX-98110147,CDM,99155,CPT,981,RC,,inpatient,,,424,381.6,,0.95,,402.8,Percent of total billed charges,,,0.98,,415.52,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,0.97,,411.28,Percent of total billed charges,,,0.97,,411.28,Percent of total billed charges,,,0.96,,407.04,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,402.8,Percent of total billed charges,,402.8,415.52,
HC PR ED 99155 Mod Sed Oth Phys/Qhp <5 Yrs 1st 15 Min Cdm,PX-98110147,CDM,99155,CPT,981,RC,,outpatient,,,424,381.6,,0.95,,402.8,Percent of total billed charges,,,0.98,,415.52,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,0.97,,411.28,Percent of total billed charges,,,0.96,,407.04,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,402.8,Percent of total billed charges,,402.8,415.52,
HC PR ED 99157 Mod Sed Other Phys/Qhp Ea Addl 15 Min Cdm,PX-98110148,CDM,99157,CPT,981,RC,,inpatient,,,239,215.1,,0.95,,227.05,Percent of total billed charges,,,0.98,,234.22,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,0.97,,231.83,Percent of total billed charges,,,0.97,,231.83,Percent of total billed charges,,,0.96,,229.44,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,227.05,Percent of total billed charges,,227.05,234.22,
HC PR ED 99157 Mod Sed Other Phys/Qhp Ea Addl 15 Min Cdm,PX-98110148,CDM,99157,CPT,981,RC,,outpatient,,,239,215.1,,0.95,,227.05,Percent of total billed charges,,,0.98,,234.22,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,0.97,,231.83,Percent of total billed charges,,,0.96,,229.44,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,227.05,Percent of total billed charges,,227.05,234.22,
HC Convatec Surfit Natura Wafer,PX-3261001WWM,CDM,A4407,HCPCS,270,RC,,inpatient,,,145,130.5,,0.95,,137.75,Percent of total billed charges,,,0.98,,142.1,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,0.97,,140.65,Percent of total billed charges,,,0.97,,140.65,Percent of total billed charges,,,0.96,,139.2,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,137.75,Percent of total billed charges,,137.75,142.1,
HC Convatec Surfit Natura Wafer,PX-3261001WWM,CDM,A4407,HCPCS,270,RC,,outpatient,,,145,130.5,,0.95,,137.75,Percent of total billed charges,,,0.98,,142.1,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,0.97,,140.65,Percent of total billed charges,,,0.96,,139.2,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,137.75,Percent of total billed charges,,137.75,142.1,
HC Convatec Natura Pouch 1.25-1.75,PX-3261002WWM,CDM,A4425,HCPCS,270,RC,,inpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC Convatec Natura Pouch 1.25-1.75,PX-3261002WWM,CDM,A4425,HCPCS,270,RC,,outpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC Convatec Adapter Ring 2.25,PX-3261003WWM,CDM,A4421,HCPCS,270,RC,,inpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
HC Convatec Adapter Ring 2.25,PX-3261003WWM,CDM,A4421,HCPCS,270,RC,,outpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
HC Medline Optiform Gentle 4x4 Foam Dressing,PX-3261004WWM,CDM,A6212,HCPCS,270,RC,,inpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
HC Medline Optiform Gentle 4x4 Foam Dressing,PX-3261004WWM,CDM,A6212,HCPCS,270,RC,,outpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
HC PR Rx Triamcinolone Acetate Inj 10 Mg,PX-63610250,CDM,J3301,HCPCS,636,RC,,inpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
HC PR Rx Triamcinolone Acetate Inj 10 Mg,PX-63610250,CDM,J3301,HCPCS,636,RC,,outpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
HC PR Inj W/Ndl or Cath Plcmnt Epidrl L/S W/Img,PX-96310272,CDM,62323,CPT,963,RC,,inpatient,,,1460,1314,,0.95,,1387,Percent of total billed charges,,,0.98,,1430.8,Percent of total billed charges,,,0.95,,1387,Percent of total billed charges,,,0.97,,1416.2,Percent of total billed charges,,,0.97,,1416.2,Percent of total billed charges,,,0.96,,1401.6,Percent of total billed charges,,,0.95,,1387,Percent of total billed charges,,,,,,,,,0.95,,1387,Percent of total billed charges,,1387,1430.8,
HC PR Inj W/Ndl or Cath Plcmnt Epidrl L/S W/Img,PX-96310272,CDM,62323,CPT,963,RC,,outpatient,,,1460,1314,,0.95,,1387,Percent of total billed charges,,,0.98,,1430.8,Percent of total billed charges,,,0.95,,1387,Percent of total billed charges,,,0.95,,1387,Percent of total billed charges,,,0.97,,1416.2,Percent of total billed charges,,,0.96,,1401.6,Percent of total billed charges,,,0.95,,1387,Percent of total billed charges,,,,,,,,,0.95,,1387,Percent of total billed charges,,1387,1430.8,
HC PR 99487 Cmplx Chron Care Mgmt W/O Pt Vst 1st Hr per Mo,PX-96010066,CDM,99487,CPT,960,RC,,inpatient,,,339,305.1,,0.95,,322.05,Percent of total billed charges,,,0.98,,332.22,Percent of total billed charges,,,0.95,,322.05,Percent of total billed charges,,,0.97,,328.83,Percent of total billed charges,,,0.97,,328.83,Percent of total billed charges,,,0.96,,325.44,Percent of total billed charges,,,0.95,,322.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,322.05,Percent of total billed charges,,322.05,332.22,
HC PR 99487 Cmplx Chron Care Mgmt W/O Pt Vst 1st Hr per Mo,PX-96010066,CDM,99487,CPT,960,RC,,outpatient,,,339,305.1,,0.95,,322.05,Percent of total billed charges,,,0.98,,332.22,Percent of total billed charges,,,0.95,,322.05,Percent of total billed charges,,,0.95,,322.05,Percent of total billed charges,,,0.97,,328.83,Percent of total billed charges,,,0.96,,325.44,Percent of total billed charges,,,0.95,,322.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,322.05,Percent of total billed charges,,322.05,332.22,
HC PR 99489 Cmplx Chron Care Mgmt Ea Addl 30 Min per Month,PX-96010067,CDM,99489,CPT,960,RC,,inpatient,,,178,160.2,,0.95,,169.1,Percent of total billed charges,,,0.98,,174.44,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,0.97,,172.66,Percent of total billed charges,,,0.97,,172.66,Percent of total billed charges,,,0.96,,170.88,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,169.1,Percent of total billed charges,,169.1,174.44,
HC PR 99489 Cmplx Chron Care Mgmt Ea Addl 30 Min per Month,PX-96010067,CDM,99489,CPT,960,RC,,outpatient,,,178,160.2,,0.95,,169.1,Percent of total billed charges,,,0.98,,174.44,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,0.97,,172.66,Percent of total billed charges,,,0.96,,170.88,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,169.1,Percent of total billed charges,,169.1,174.44,
HC PR 00142 Anesth Lens Surgery,PX-96310009,CDM,142,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00142 Anesth Lens Surgery,PX-96310009,CDM,142,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00160 Anesthesia Nose & Accessory Sinuses Nos^,PX-96310014,CDM,160,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00160 Anesthesia Nose & Accessory Sinuses Nos^,PX-96310014,CDM,160,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00170 Anesthesia Intraoral With Biopsy Nos^,PX-96310017,CDM,170,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00170 Anesthesia Intraoral With Biopsy Nos^,PX-96310017,CDM,170,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00300 Anesth Head/Neck/Ptrunk,PX-96310023,CDM,300,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00300 Anesth Head/Neck/Ptrunk,PX-96310023,CDM,300,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00320 Anes Esoph Thyrd Larynx Trach & Lymph Neck 1yr,PX-96310024,CDM,320,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00320 Anes Esoph Thyrd Larynx Trach & Lymph Neck 1yr,PX-96310024,CDM,320,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00322 Anesth Biopsy of Thyroid,PX-96310025,CDM,322,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00322 Anesth Biopsy of Thyroid,PX-96310025,CDM,322,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00350 Anesth Neck Vessel Surgery,PX-96310026,CDM,350,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00350 Anesth Neck Vessel Surgery,PX-96310026,CDM,350,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00400 Anesth Skin Ext/per/Atrunk,PX-96310028,CDM,400,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00400 Anesth Skin Ext/per/Atrunk,PX-96310028,CDM,400,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00402 Anesth Surgery of Breast,PX-96310029,CDM,402,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00402 Anesth Surgery of Breast,PX-96310029,CDM,402,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00404 Anesth Surgery of Breast; Radical,PX-96310030,CDM,404,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00404 Anesth Surgery of Breast; Radical,PX-96310030,CDM,404,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00406 Anesth Surgery of Breast; Rad or Mod W/ Int Mam,PX-96310031,CDM,406,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00406 Anesth Surgery of Breast; Rad or Mod W/ Int Mam,PX-96310031,CDM,406,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00410 Anesth Correct Heart Rhythm,PX-96310032,CDM,410,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00410 Anesth Correct Heart Rhythm,PX-96310032,CDM,410,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00450 Anesth Surgery of Shoulder,PX-96310033,CDM,450,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00450 Anesth Surgery of Shoulder,PX-96310033,CDM,450,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00520 Anesth Chest Procedure,PX-96310039,CDM,520,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00520 Anesth Chest Procedure,PX-96310039,CDM,520,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00524 Anesth Chest Drainage,PX-96310041,CDM,524,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00524 Anesth Chest Drainage,PX-96310041,CDM,524,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00532 Anesth Vascular Access,PX-96310045,CDM,532,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00532 Anesth Vascular Access,PX-96310045,CDM,532,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00534 Anesth Cardioverter/Defib,PX-96310046,CDM,534,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00534 Anesth Cardioverter/Defib,PX-96310046,CDM,534,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00635 Anesth Lumbar Puncture,PX-96310053,CDM,635,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00635 Anesth Lumbar Puncture,PX-96310053,CDM,635,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00700 Anesth Abdominal Wall Surg,PX-96310055,CDM,700,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00700 Anesth Abdominal Wall Surg,PX-96310055,CDM,700,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00702 Anesth for Liver Biopsy,PX-96310056,CDM,702,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00702 Anesth for Liver Biopsy,PX-96310056,CDM,702,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00730 Anesth Abdominal Wall Surg,PX-96310057,CDM,730,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00730 Anesth Abdominal Wall Surg,PX-96310057,CDM,730,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00750 Anesth Repair of Upper Hernia,PX-96310059,CDM,750,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00750 Anesth Repair of Upper Hernia,PX-96310059,CDM,750,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
Anesth Repair of Hernia Ventril &Incision,PX-96310060,CDM,752,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
Anesth Repair of Hernia Ventril &Incision,PX-96310060,CDM,752,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00790 Anesth Surg Upper Abdomen,PX-96310064,CDM,790,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00790 Anesth Surg Upper Abdomen,PX-96310064,CDM,790,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00800 Anesth Abdominal Wall Surg,PX-96310068,CDM,800,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00800 Anesth Abdominal Wall Surg,PX-96310068,CDM,800,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00820 Anesth Abdominal Wall Surg,PX-96310071,CDM,820,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00820 Anesth Abdominal Wall Surg,PX-96310071,CDM,820,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00830 Anesth Repair of Inguinal Hernia,PX-96310072,CDM,830,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00830 Anesth Repair of Inguinal Hernia,PX-96310072,CDM,830,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00832 Anesth Repair of Hernia Ventri&Incision,PX-96310073,CDM,832,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00832 Anesth Repair of Hernia Ventri&Incision,PX-96310073,CDM,832,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00834 Anesth Hernia Repair < 1 Yr,PX-96310074,CDM,834,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00834 Anesth Hernia Repair < 1 Yr,PX-96310074,CDM,834,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00840 Anesth Surg Lower Abdomen,PX-96310075,CDM,840,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00840 Anesth Surg Lower Abdomen,PX-96310075,CDM,840,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00846 Anesth Hysterectomy,PX-96310077,CDM,846,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00846 Anesth Hysterectomy,PX-96310077,CDM,846,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00851 Anesth Tubal Ligation,PX-96310079,CDM,851,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00851 Anesth Tubal Ligation,PX-96310079,CDM,851,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00860 Anesth Surgery of Abdomen,PX-96310080,CDM,860,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00860 Anesth Surgery of Abdomen,PX-96310080,CDM,860,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00902 Anesth Anorectal Surgery,PX-96310089,CDM,902,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00902 Anesth Anorectal Surgery,PX-96310089,CDM,902,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00910 Anesth Bladder Surgery,PX-96310093,CDM,910,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00910 Anesth Bladder Surgery,PX-96310093,CDM,910,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00918 Anesth Stone Removal,PX-96310097,CDM,918,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00918 Anesth Stone Removal,PX-96310097,CDM,918,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00920 Anesth Genitalia Surgery,PX-96310098,CDM,920,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00920 Anesth Genitalia Surgery,PX-96310098,CDM,920,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00924 Anesth Testis Exploration,PX-96310099,CDM,924,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00924 Anesth Testis Exploration,PX-96310099,CDM,924,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00940 Anesth Vaginal Procedures,PX-96310104,CDM,940,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00940 Anesth Vaginal Procedures,PX-96310104,CDM,940,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00942 Anesth Surg on Vag/Urethral,PX-96310105,CDM,942,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00942 Anesth Surg on Vag/Urethral,PX-96310105,CDM,942,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01112 Anesth Bone Aspirate/Bx,PX-96310110,CDM,1112,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01112 Anesth Bone Aspirate/Bx,PX-96310110,CDM,1112,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01200 Anesth Hip Joint Procedure,PX-96310112,CDM,1200,CPT,963,RC,,inpatient,,,121,108.9,,0.95,,114.95,Percent of total billed charges,,,0.98,,118.58,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.96,,116.16,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114.95,Percent of total billed charges,,114.95,118.58,
HC PR 01200 Anesth Hip Joint Procedure,PX-96310112,CDM,1200,CPT,963,RC,,outpatient,,,121,108.9,,0.95,,114.95,Percent of total billed charges,,,0.98,,118.58,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.96,,116.16,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114.95,Percent of total billed charges,,114.95,118.58,
HC PR 01210 Anesth Hip Joint Surgery,PX-96310114,CDM,1210,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01210 Anesth Hip Joint Surgery,PX-96310114,CDM,1210,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01214 Anesth Hip Arthroplasty,PX-96310116,CDM,1214,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01214 Anesth Hip Arthroplasty,PX-96310116,CDM,1214,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01220 Anesth Procedure on Femur,PX-96310118,CDM,1220,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01220 Anesth Procedure on Femur,PX-96310118,CDM,1220,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01230 Anesth Surgery of Femur,PX-96310119,CDM,1230,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01230 Anesth Surgery of Femur,PX-96310119,CDM,1230,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01250 Anesth Upper Leg Surgery,PX-96310122,CDM,1250,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01250 Anesth Upper Leg Surgery,PX-96310122,CDM,1250,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01260 Anesth Upper Leg Veins Surg,PX-96310123,CDM,1260,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01260 Anesth Upper Leg Veins Surg,PX-96310123,CDM,1260,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01320 Anesth Knee Area Surgery,PX-96310127,CDM,1320,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01320 Anesth Knee Area Surgery,PX-96310127,CDM,1320,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01340 Anesth Knee Area Procedure,PX-96310128,CDM,1340,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01340 Anesth Knee Area Procedure,PX-96310128,CDM,1340,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01360 Anesth Knee Area Surgery,PX-96310129,CDM,1360,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01360 Anesth Knee Area Surgery,PX-96310129,CDM,1360,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01380 Anesth Knee Joint Procedure,PX-96310130,CDM,1380,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01380 Anesth Knee Joint Procedure,PX-96310130,CDM,1380,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01382 Anesth Dx Knee Arthroscopy,PX-96310131,CDM,1382,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01382 Anesth Dx Knee Arthroscopy,PX-96310131,CDM,1382,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01392 Anesth Knee Area Surgery Tib/Fib/Upper,PX-96310133,CDM,1392,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01392 Anesth Knee Area Surgery Tib/Fib/Upper,PX-96310133,CDM,1392,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01400 Anesth Knee Area Surgery Arthroscopy,PX-96310134,CDM,1400,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01400 Anesth Knee Area Surgery Arthroscopy,PX-96310134,CDM,1400,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01402 Anesth Total Knee Arthroplasty,PX-96310135,CDM,1402,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01402 Anesth Total Knee Arthroplasty,PX-96310135,CDM,1402,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01462 Anesth Lower Leg Procedure,PX-96310142,CDM,1462,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01462 Anesth Lower Leg Procedure,PX-96310142,CDM,1462,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01470 Anesth Lower Leg Surgery,PX-96310144,CDM,1470,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01470 Anesth Lower Leg Surgery,PX-96310144,CDM,1470,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01474 Anesth Lower Leg Surgery,PX-96310146,CDM,1474,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01474 Anesth Lower Leg Surgery,PX-96310146,CDM,1474,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01480 Anesth Lower Leg Bone Surg,PX-96310147,CDM,1480,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01480 Anesth Lower Leg Bone Surg,PX-96310147,CDM,1480,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01482 Anesth Radical Leg Surgery,PX-96310148,CDM,1482,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01482 Anesth Radical Leg Surgery,PX-96310148,CDM,1482,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01520 Anesth Lower Leg Vein Surg,PX-96310154,CDM,1520,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01520 Anesth Lower Leg Vein Surg,PX-96310154,CDM,1520,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01610 Anesth Surgery of Shoulder and Axilla,PX-96310156,CDM,1610,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01610 Anesth Surgery of Shoulder and Axilla,PX-96310156,CDM,1610,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01620 Anesth Shoulder Procedure,PX-96310157,CDM,1620,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01620 Anesth Shoulder Procedure,PX-96310157,CDM,1620,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01622 Anes Dx Shoulder Arthroscopy,PX-96310158,CDM,1622,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01622 Anes Dx Shoulder Arthroscopy,PX-96310158,CDM,1622,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01630 Anesth Surgery of Shoulder Open or Surgical Arthro,PX-96310159,CDM,1630,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01630 Anesth Surgery of Shoulder Open or Surgical Arthro,PX-96310159,CDM,1630,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01710 Anesth Elbow Area Surgery,PX-96310165,CDM,1710,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01710 Anesth Elbow Area Surgery,PX-96310165,CDM,1710,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01716 Anesth Biceps Tendon Repair,PX-96310168,CDM,1716,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01716 Anesth Biceps Tendon Repair,PX-96310168,CDM,1716,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01730 Anesth Uppr Arm Procedure,PX-96310169,CDM,1730,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01730 Anesth Uppr Arm Procedure,PX-96310169,CDM,1730,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01740 Anesth Upper Arm Surgery,PX-96310171,CDM,1740,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01740 Anesth Upper Arm Surgery,PX-96310171,CDM,1740,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01744 Anesth Humerus Repair,PX-96310173,CDM,1744,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01744 Anesth Humerus Repair,PX-96310173,CDM,1744,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01810 Anesth Lower Arm Surgery,PX-96310179,CDM,1810,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01810 Anesth Lower Arm Surgery,PX-96310179,CDM,1810,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01820 Anesth Lower Arm Procedure,PX-96310180,CDM,1820,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01820 Anesth Lower Arm Procedure,PX-96310180,CDM,1820,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01830 Anesth Lower Arm Surgery,PX-96310182,CDM,1830,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01830 Anesth Lower Arm Surgery,PX-96310182,CDM,1830,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01860 Anesth Lower Arm Casting,PX-96310188,CDM,1860,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01860 Anesth Lower Arm Casting,PX-96310188,CDM,1860,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01922 Anesth Cat or MRI Scan,PX-96310190,CDM,1922,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01922 Anesth Cat or MRI Scan,PX-96310190,CDM,1922,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01958 Anesth Antepartum Manipul,PX-96310193,CDM,1958,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01958 Anesth Antepartum Manipul,PX-96310193,CDM,1958,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01960 Anesth Vaginal Delivery,PX-96310194,CDM,1960,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01960 Anesth Vaginal Delivery,PX-96310194,CDM,1960,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01961 Anesth Cs Delivery,PX-96310195,CDM,1961,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01961 Anesth Cs Delivery,PX-96310195,CDM,1961,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01962 Anesth Emer Hysterectomy,PX-96310196,CDM,1962,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01962 Anesth Emer Hysterectomy,PX-96310196,CDM,1962,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01963 Anesth Cs Hysterectomy,PX-96310197,CDM,1963,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01963 Anesth Cs Hysterectomy,PX-96310197,CDM,1963,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01965 Anesth Inc/Missed Ab Proc,PX-96310198,CDM,1965,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01965 Anesth Inc/Missed Ab Proc,PX-96310198,CDM,1965,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01967 Anesth/Analg Vag Delivery,PX-96310199,CDM,1967,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01967 Anesth/Analg Vag Delivery,PX-96310199,CDM,1967,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01968 Anes/Analg Cs Deliver Add-On,PX-96310200,CDM,1968,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01968 Anes/Analg Cs Deliver Add-On,PX-96310200,CDM,1968,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01969 Anesth/Analg Cs Hyst Add-On,PX-96310201,CDM,1969,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01969 Anesth/Analg Cs Hyst Add-On,PX-96310201,CDM,1969,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01992 Anesth N Block/Inj Prone,PX-96310204,CDM,1992,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01992 Anesth N Block/Inj Prone,PX-96310204,CDM,1992,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 01996 Hosp Manage Cont Drug Admin Aa,PX-96310205,CDM,1996,CPT,963,RC,,inpatient,,,128,115.2,,0.95,,121.6,Percent of total billed charges,,,0.98,,125.44,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.96,,122.88,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,121.6,Percent of total billed charges,,121.6,125.44,
HC PR 01996 Hosp Manage Cont Drug Admin Aa,PX-96310205,CDM,1996,CPT,963,RC,,outpatient,,,128,115.2,,0.95,,121.6,Percent of total billed charges,,,0.98,,125.44,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.96,,122.88,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,121.6,Percent of total billed charges,,121.6,125.44,
HC PR 99100 Special Anesthesia Service,PX-96310207,CDM,99100,CPT,963,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
HC PR 99100 Special Anesthesia Service,PX-96310207,CDM,99100,CPT,963,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
HC PR 99140 Emergency Anesthesia,PX-96310209,CDM,99140,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 99140 Emergency Anesthesia,PX-96310209,CDM,99140,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
"Therapy procedure nutrition management, each 15m",PX-94210001,CDM,97802,CPT,942,RC,,inpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
"Therapy procedure nutrition management, each 15m",PX-94210001,CDM,97802,CPT,942,RC,,outpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
Therapy reassessment nutrition management each 15m,PX-94210013,CDM,97803,CPT,942,RC,,inpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
Therapy reassessment nutrition management each 15m,PX-94210013,CDM,97803,CPT,942,RC,,outpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
"Therapy procedure nutrition management group, 30m",PX-94210049,CDM,97804,CPT,942,RC,,inpatient,,,43,38.7,,0.95,,40.85,Percent of total billed charges,,,0.98,,42.14,Percent of total billed charges,,,0.95,,40.85,Percent of total billed charges,,,0.97,,41.71,Percent of total billed charges,,,0.97,,41.71,Percent of total billed charges,,,0.96,,41.28,Percent of total billed charges,,,0.95,,40.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,40.85,Percent of total billed charges,,40.85,42.14,
"Therapy procedure nutrition management group, 30m",PX-94210049,CDM,97804,CPT,942,RC,,outpatient,,,43,38.7,,0.95,,40.85,Percent of total billed charges,,,0.98,,42.14,Percent of total billed charges,,,0.95,,40.85,Percent of total billed charges,,,0.95,,40.85,Percent of total billed charges,,,0.97,,41.71,Percent of total billed charges,,,0.96,,41.28,Percent of total billed charges,,,0.95,,40.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,40.85,Percent of total billed charges,,40.85,42.14,
Established office or other outpatient visit L1,PX-94210100,CDM,99211,CPT,761,RC,,inpatient,,,86,77.4,,0.95,,81.7,Percent of total billed charges,,,0.98,,84.28,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,0.97,,83.42,Percent of total billed charges,,,0.97,,83.42,Percent of total billed charges,,,0.96,,82.56,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,81.7,Percent of total billed charges,,81.7,84.28,
Established office or other outpatient visit L1,PX-94210100,CDM,99211,CPT,761,RC,,outpatient,,,86,77.4,,0.95,,81.7,Percent of total billed charges,,,0.98,,84.28,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,0.97,,83.42,Percent of total billed charges,,,0.96,,82.56,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,81.7,Percent of total billed charges,,81.7,84.28,
Biopsy of bone marrow,PX-36010406,CDM,38221,CPT,361,RC,,inpatient,,,672,604.8,,0.95,,638.4,Percent of total billed charges,,,0.98,,658.56,Percent of total billed charges,,,0.95,,638.4,Percent of total billed charges,,,0.97,,651.84,Percent of total billed charges,,,0.97,,651.84,Percent of total billed charges,,,0.96,,645.12,Percent of total billed charges,,,0.95,,638.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,638.4,Percent of total billed charges,,638.4,658.56,
Biopsy of bone marrow,PX-36010406,CDM,38221,CPT,361,RC,,outpatient,,,672,604.8,,0.95,,638.4,Percent of total billed charges,,,0.98,,658.56,Percent of total billed charges,,,0.95,,638.4,Percent of total billed charges,,,0.95,,638.4,Percent of total billed charges,,,0.97,,651.84,Percent of total billed charges,,,0.96,,645.12,Percent of total billed charges,,,0.95,,638.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,638.4,Percent of total billed charges,,638.4,658.56,
HC Gastric Lavage,PX-75010048,CDM,75010048,LOCAL,750,RC,,inpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
HC Gastric Lavage,PX-75010048,CDM,75010048,LOCAL,750,RC,,outpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
HC Sigmoidoscopy W/ Snare Removal,PX-75010118,CDM,75010118,LOCAL,750,RC,,inpatient,,,1098,988.2,,0.95,,1043.1,Percent of total billed charges,,,0.98,,1076.04,Percent of total billed charges,,,0.95,,1043.1,Percent of total billed charges,,,0.97,,1065.06,Percent of total billed charges,,,0.97,,1065.06,Percent of total billed charges,,,0.96,,1054.08,Percent of total billed charges,,,0.95,,1043.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1043.1,Percent of total billed charges,,1043.1,1076.04,
HC Sigmoidoscopy W/ Snare Removal,PX-75010118,CDM,75010118,LOCAL,750,RC,,outpatient,,,1098,988.2,,0.95,,1043.1,Percent of total billed charges,,,0.98,,1076.04,Percent of total billed charges,,,0.95,,1043.1,Percent of total billed charges,,,0.95,,1043.1,Percent of total billed charges,,,0.97,,1065.06,Percent of total billed charges,,,0.96,,1054.08,Percent of total billed charges,,,0.95,,1043.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1043.1,Percent of total billed charges,,1043.1,1076.04,
HC Hospital Observation per Hr Cdm,PX-76210001,CDM,G0378,HCPCS,762,RC,,inpatient,,,744,669.6,,0.95,,706.8,Percent of total billed charges,,,0.98,,729.12,Percent of total billed charges,,,0.95,,706.8,Percent of total billed charges,,,0.97,,721.68,Percent of total billed charges,,,0.97,,721.68,Percent of total billed charges,,,0.96,,714.24,Percent of total billed charges,,,0.95,,706.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,706.8,Percent of total billed charges,,706.8,729.12,
HC Hospital Observation per Hr Cdm,PX-76210001,CDM,G0378,HCPCS,762,RC,,outpatient,,,744,669.6,,0.95,,706.8,Percent of total billed charges,,,0.98,,729.12,Percent of total billed charges,,,0.95,,706.8,Percent of total billed charges,,,0.95,,706.8,Percent of total billed charges,,,0.97,,721.68,Percent of total billed charges,,,0.96,,714.24,Percent of total billed charges,,,0.95,,706.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,706.8,Percent of total billed charges,,706.8,729.12,
HC Initial observ/low cmplx w/Telemetry,PX-76210002,CDM,G0378,HCPCS,762,RC,,inpatient,,,722,649.8,,0.95,,685.9,Percent of total billed charges,,,0.98,,707.56,Percent of total billed charges,,,0.95,,685.9,Percent of total billed charges,,,0.97,,700.34,Percent of total billed charges,,,0.97,,700.34,Percent of total billed charges,,,0.96,,693.12,Percent of total billed charges,,,0.95,,685.9,Percent of total billed charges,,,,,,,,,0.95,,685.9,Percent of total billed charges,,685.9,707.56,
HC Initial observ/low cmplx w/Telemetry,PX-76210002,CDM,G0378,HCPCS,762,RC,,outpatient,,,722,649.8,,0.95,,685.9,Percent of total billed charges,,,0.98,,707.56,Percent of total billed charges,,,0.95,,685.9,Percent of total billed charges,,,0.95,,685.9,Percent of total billed charges,,,0.97,,700.34,Percent of total billed charges,,,0.96,,693.12,Percent of total billed charges,,,0.95,,685.9,Percent of total billed charges,,,,,,,,,0.95,,685.9,Percent of total billed charges,,685.9,707.56,
HC Initial Observ/Mod Cmplx,PX-76210005,CDM,G0378,HCPCS,762,RC,,inpatient,,,722,649.8,,0.95,,685.9,Percent of total billed charges,,,0.98,,707.56,Percent of total billed charges,,,0.95,,685.9,Percent of total billed charges,,,0.97,,700.34,Percent of total billed charges,,,0.97,,700.34,Percent of total billed charges,,,0.96,,693.12,Percent of total billed charges,,,0.95,,685.9,Percent of total billed charges,,,,,,,,,0.95,,685.9,Percent of total billed charges,,685.9,707.56,
HC Initial Observ/Mod Cmplx,PX-76210005,CDM,G0378,HCPCS,762,RC,,outpatient,,,722,649.8,,0.95,,685.9,Percent of total billed charges,,,0.98,,707.56,Percent of total billed charges,,,0.95,,685.9,Percent of total billed charges,,,0.95,,685.9,Percent of total billed charges,,,0.97,,700.34,Percent of total billed charges,,,0.96,,693.12,Percent of total billed charges,,,0.95,,685.9,Percent of total billed charges,,,,,,,,,0.95,,685.9,Percent of total billed charges,,685.9,707.56,
HC PR 99234 Hospital IP/Obs Care Same Date Sf/Low Mdm 45 Min Cdm,PX-98710024,CDM,99234,CPT,987,RC,,inpatient,,,356,320.4,,0.95,,338.2,Percent of total billed charges,,,0.98,,348.88,Percent of total billed charges,,,0.95,,338.2,Percent of total billed charges,,,0.97,,345.32,Percent of total billed charges,,,0.97,,345.32,Percent of total billed charges,,,0.96,,341.76,Percent of total billed charges,,,0.95,,338.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,338.2,Percent of total billed charges,,338.2,348.88,
HC PR 99234 Hospital IP/Obs Care Same Date Sf/Low Mdm 45 Min Cdm,PX-98710024,CDM,99234,CPT,987,RC,,outpatient,,,356,320.4,,0.95,,338.2,Percent of total billed charges,,,0.98,,348.88,Percent of total billed charges,,,0.95,,338.2,Percent of total billed charges,,,0.95,,338.2,Percent of total billed charges,,,0.97,,345.32,Percent of total billed charges,,,0.96,,341.76,Percent of total billed charges,,,0.95,,338.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,338.2,Percent of total billed charges,,338.2,348.88,
HC PR 99235 Hospital IP/Obs Care Same Date Mod Mdm 70 Min Cdm,PX-98710025,CDM,99235,CPT,987,RC,,inpatient,,,450,405,,0.95,,427.5,Percent of total billed charges,,,0.98,,441,Percent of total billed charges,,,0.95,,427.5,Percent of total billed charges,,,0.97,,436.5,Percent of total billed charges,,,0.97,,436.5,Percent of total billed charges,,,0.96,,432,Percent of total billed charges,,,0.95,,427.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,427.5,Percent of total billed charges,,427.5,441,
HC PR 99235 Hospital IP/Obs Care Same Date Mod Mdm 70 Min Cdm,PX-98710025,CDM,99235,CPT,987,RC,,outpatient,,,450,405,,0.95,,427.5,Percent of total billed charges,,,0.98,,441,Percent of total billed charges,,,0.95,,427.5,Percent of total billed charges,,,0.95,,427.5,Percent of total billed charges,,,0.97,,436.5,Percent of total billed charges,,,0.96,,432,Percent of total billed charges,,,0.95,,427.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,427.5,Percent of total billed charges,,427.5,441,
HC PR 99236 Hospital IP/Obs Care Same Date High Mdm 85 Min Cdm,PX-98710026,CDM,99236,CPT,987,RC,,inpatient,,,579,521.1,,0.95,,550.05,Percent of total billed charges,,,0.98,,567.42,Percent of total billed charges,,,0.95,,550.05,Percent of total billed charges,,,0.97,,561.63,Percent of total billed charges,,,0.97,,561.63,Percent of total billed charges,,,0.96,,555.84,Percent of total billed charges,,,0.95,,550.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,550.05,Percent of total billed charges,,550.05,567.42,
HC PR 99236 Hospital IP/Obs Care Same Date High Mdm 85 Min Cdm,PX-98710026,CDM,99236,CPT,987,RC,,outpatient,,,579,521.1,,0.95,,550.05,Percent of total billed charges,,,0.98,,567.42,Percent of total billed charges,,,0.95,,550.05,Percent of total billed charges,,,0.95,,550.05,Percent of total billed charges,,,0.97,,561.63,Percent of total billed charges,,,0.96,,555.84,Percent of total billed charges,,,0.95,,550.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,550.05,Percent of total billed charges,,550.05,567.42,
HC R&B-Semi-Private,PX-12010001,CDM,12010001,LOCAL,120,RC,,inpatient,,,2977,2679.3,,0.95,,2828.15,Percent of total billed charges,,,0.98,,2917.46,Percent of total billed charges,,,0.95,,2828.15,Percent of total billed charges,,,0.97,,2887.69,Percent of total billed charges,,,0.97,,2887.69,Percent of total billed charges,,,0.96,,2857.92,Percent of total billed charges,,,0.95,,2828.15,Percent of total billed charges,,,,,,,,,0.95,,2828.15,Percent of total billed charges,,2828.15,2917.46,
HC R&B-Semi-Private,PX-12010001,CDM,12010001,LOCAL,120,RC,,outpatient,,,2977,2679.3,,0.95,,2828.15,Percent of total billed charges,,,0.98,,2917.46,Percent of total billed charges,,,0.95,,2828.15,Percent of total billed charges,,,0.95,,2828.15,Percent of total billed charges,,,0.97,,2887.69,Percent of total billed charges,,,0.96,,2857.92,Percent of total billed charges,,,0.95,,2828.15,Percent of total billed charges,,,,,,,,,0.95,,2828.15,Percent of total billed charges,,2828.15,2917.46,
HC R&B-Semi-Private Swing Bed,PX-12010004,CDM,12010004,LOCAL,120,RC,,inpatient,,,2195,1975.5,,0.95,,2085.25,Percent of total billed charges,,,0.98,,2151.1,Percent of total billed charges,,,0.95,,2085.25,Percent of total billed charges,,,0.97,,2129.15,Percent of total billed charges,,,0.97,,2129.15,Percent of total billed charges,,,0.96,,2107.2,Percent of total billed charges,,,0.95,,2085.25,Percent of total billed charges,,,,,,,,,0.95,,2085.25,Percent of total billed charges,,2085.25,2151.1,
HC R&B-Semi-Private Swing Bed,PX-12010004,CDM,12010004,LOCAL,120,RC,,outpatient,,,2195,1975.5,,0.95,,2085.25,Percent of total billed charges,,,0.98,,2151.1,Percent of total billed charges,,,0.95,,2085.25,Percent of total billed charges,,,0.95,,2085.25,Percent of total billed charges,,,0.97,,2129.15,Percent of total billed charges,,,0.96,,2107.2,Percent of total billed charges,,,0.95,,2085.25,Percent of total billed charges,,,,,,,,,0.95,,2085.25,Percent of total billed charges,,2085.25,2151.1,
HC R&B-Semi-Private Respite,PX-12010007,CDM,12010007,LOCAL,120,RC,,inpatient,,,257,231.3,,0.95,,244.15,Percent of total billed charges,,,0.98,,251.86,Percent of total billed charges,,,0.95,,244.15,Percent of total billed charges,,,0.97,,249.29,Percent of total billed charges,,,0.97,,249.29,Percent of total billed charges,,,0.96,,246.72,Percent of total billed charges,,,0.95,,244.15,Percent of total billed charges,,,,,,,,,0.95,,244.15,Percent of total billed charges,,244.15,251.86,
HC R&B-Semi-Private Respite,PX-12010007,CDM,12010007,LOCAL,120,RC,,outpatient,,,257,231.3,,0.95,,244.15,Percent of total billed charges,,,0.98,,251.86,Percent of total billed charges,,,0.95,,244.15,Percent of total billed charges,,,0.95,,244.15,Percent of total billed charges,,,0.97,,249.29,Percent of total billed charges,,,0.96,,246.72,Percent of total billed charges,,,0.95,,244.15,Percent of total billed charges,,,,,,,,,0.95,,244.15,Percent of total billed charges,,244.15,251.86,
HC R&B-Semi-Private OB,PX-12210001,CDM,12210001,LOCAL,122,RC,,inpatient,,,2954,2658.6,,0.95,,2806.3,Percent of total billed charges,,,0.98,,2894.92,Percent of total billed charges,,,0.95,,2806.3,Percent of total billed charges,,,0.97,,2865.38,Percent of total billed charges,,,0.97,,2865.38,Percent of total billed charges,,,0.96,,2835.84,Percent of total billed charges,,,0.95,,2806.3,Percent of total billed charges,,,,,,,,,0.95,,2806.3,Percent of total billed charges,,2806.3,2894.92,
HC R&B-Semi-Private OB,PX-12210001,CDM,12210001,LOCAL,122,RC,,outpatient,,,2954,2658.6,,0.95,,2806.3,Percent of total billed charges,,,0.98,,2894.92,Percent of total billed charges,,,0.95,,2806.3,Percent of total billed charges,,,0.95,,2806.3,Percent of total billed charges,,,0.97,,2865.38,Percent of total billed charges,,,0.96,,2835.84,Percent of total billed charges,,,0.95,,2806.3,Percent of total billed charges,,,,,,,,,0.95,,2806.3,Percent of total billed charges,,2806.3,2894.92,
HC R&B Nursery/Level 1,PX-17110001,CDM,17110001,LOCAL,171,RC,,inpatient,,,2643,2378.7,,0.95,,2510.85,Percent of total billed charges,,,0.98,,2590.14,Percent of total billed charges,,,0.95,,2510.85,Percent of total billed charges,,,0.97,,2563.71,Percent of total billed charges,,,0.97,,2563.71,Percent of total billed charges,,,0.96,,2537.28,Percent of total billed charges,,,0.95,,2510.85,Percent of total billed charges,,,,,,,,,0.95,,2510.85,Percent of total billed charges,,2510.85,2590.14,
HC R&B Nursery/Level 1,PX-17110001,CDM,17110001,LOCAL,171,RC,,outpatient,,,2643,2378.7,,0.95,,2510.85,Percent of total billed charges,,,0.98,,2590.14,Percent of total billed charges,,,0.95,,2510.85,Percent of total billed charges,,,0.95,,2510.85,Percent of total billed charges,,,0.97,,2563.71,Percent of total billed charges,,,0.96,,2537.28,Percent of total billed charges,,,0.95,,2510.85,Percent of total billed charges,,,,,,,,,0.95,,2510.85,Percent of total billed charges,,2510.85,2590.14,
HC R&B Nursery/Level 2,PX-17210001,CDM,17210001,LOCAL,172,RC,,inpatient,,,4242,3817.8,,0.95,,4029.9,Percent of total billed charges,,,0.98,,4157.16,Percent of total billed charges,,,0.95,,4029.9,Percent of total billed charges,,,0.97,,4114.74,Percent of total billed charges,,,0.97,,4114.74,Percent of total billed charges,,,0.96,,4072.32,Percent of total billed charges,,,0.95,,4029.9,Percent of total billed charges,,,,,,,,,0.95,,4029.9,Percent of total billed charges,,4029.9,4157.16,
HC R&B Nursery/Level 2,PX-17210001,CDM,17210001,LOCAL,172,RC,,outpatient,,,4242,3817.8,,0.95,,4029.9,Percent of total billed charges,,,0.98,,4157.16,Percent of total billed charges,,,0.95,,4029.9,Percent of total billed charges,,,0.95,,4029.9,Percent of total billed charges,,,0.97,,4114.74,Percent of total billed charges,,,0.96,,4072.32,Percent of total billed charges,,,0.95,,4029.9,Percent of total billed charges,,,,,,,,,0.95,,4029.9,Percent of total billed charges,,4029.9,4157.16,
HC R&B Nursery/Level 3,PX-17310001,CDM,17310001,LOCAL,173,RC,,inpatient,,,5986,5387.4,,0.95,,5686.7,Percent of total billed charges,,,0.98,,5866.28,Percent of total billed charges,,,0.95,,5686.7,Percent of total billed charges,,,0.97,,5806.42,Percent of total billed charges,,,0.97,,5806.42,Percent of total billed charges,,,0.96,,5746.56,Percent of total billed charges,,,0.95,,5686.7,Percent of total billed charges,,,,,,,,,0.95,,5686.7,Percent of total billed charges,,5686.7,5866.28,
HC R&B Nursery/Level 3,PX-17310001,CDM,17310001,LOCAL,173,RC,,outpatient,,,5986,5387.4,,0.95,,5686.7,Percent of total billed charges,,,0.98,,5866.28,Percent of total billed charges,,,0.95,,5686.7,Percent of total billed charges,,,0.95,,5686.7,Percent of total billed charges,,,0.97,,5806.42,Percent of total billed charges,,,0.96,,5746.56,Percent of total billed charges,,,0.95,,5686.7,Percent of total billed charges,,,,,,,,,0.95,,5686.7,Percent of total billed charges,,5686.7,5866.28,
HC Intensive Care Intermediate,PX-20610001,CDM,20610001,LOCAL,206,RC,,inpatient,,,5822,5239.8,,0.95,,5530.9,Percent of total billed charges,,,0.98,,5705.56,Percent of total billed charges,,,0.95,,5530.9,Percent of total billed charges,,,0.97,,5647.34,Percent of total billed charges,,,0.97,,5647.34,Percent of total billed charges,,,0.96,,5589.12,Percent of total billed charges,,,0.95,,5530.9,Percent of total billed charges,,,,,,,,,0.95,,5530.9,Percent of total billed charges,,5530.9,5705.56,
HC Intensive Care Intermediate,PX-20610001,CDM,20610001,LOCAL,206,RC,,outpatient,,,5822,5239.8,,0.95,,5530.9,Percent of total billed charges,,,0.98,,5705.56,Percent of total billed charges,,,0.95,,5530.9,Percent of total billed charges,,,0.95,,5530.9,Percent of total billed charges,,,0.97,,5647.34,Percent of total billed charges,,,0.96,,5589.12,Percent of total billed charges,,,0.95,,5530.9,Percent of total billed charges,,,,,,,,,0.95,,5530.9,Percent of total billed charges,,5530.9,5705.56,
HC Intensive Care Intermediate W/Telemetry,PX-20610002,CDM,20610002,LOCAL,206,RC,,inpatient,,,4484,4035.6,,0.95,,4259.8,Percent of total billed charges,,,0.98,,4394.32,Percent of total billed charges,,,0.95,,4259.8,Percent of total billed charges,,,0.97,,4349.48,Percent of total billed charges,,,0.97,,4349.48,Percent of total billed charges,,,0.96,,4304.64,Percent of total billed charges,,,0.95,,4259.8,Percent of total billed charges,,,,,,,,,0.95,,4259.8,Percent of total billed charges,,4259.8,4394.32,
HC Intensive Care Intermediate W/Telemetry,PX-20610002,CDM,20610002,LOCAL,206,RC,,outpatient,,,4484,4035.6,,0.95,,4259.8,Percent of total billed charges,,,0.98,,4394.32,Percent of total billed charges,,,0.95,,4259.8,Percent of total billed charges,,,0.95,,4259.8,Percent of total billed charges,,,0.97,,4349.48,Percent of total billed charges,,,0.96,,4304.64,Percent of total billed charges,,,0.95,,4259.8,Percent of total billed charges,,,,,,,,,0.95,,4259.8,Percent of total billed charges,,4259.8,4394.32,
HC Cardioversion Elective Arrhythmia External,PX-48010001,CDM,92960,CPT,480,RC,,inpatient,,,947,852.3,,0.95,,899.65,Percent of total billed charges,,,0.98,,928.06,Percent of total billed charges,,,0.95,,899.65,Percent of total billed charges,,,0.97,,918.59,Percent of total billed charges,,,0.97,,918.59,Percent of total billed charges,,,0.96,,909.12,Percent of total billed charges,,,0.95,,899.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,899.65,Percent of total billed charges,,899.65,928.06,
HC Cardioversion Elective Arrhythmia External,PX-48010001,CDM,92960,CPT,480,RC,,outpatient,,,947,852.3,,0.95,,899.65,Percent of total billed charges,,,0.98,,928.06,Percent of total billed charges,,,0.95,,899.65,Percent of total billed charges,,,0.95,,899.65,Percent of total billed charges,,,0.97,,918.59,Percent of total billed charges,,,0.96,,909.12,Percent of total billed charges,,,0.95,,899.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,899.65,Percent of total billed charges,,899.65,928.06,
HC PR ED 92960 Cardioversion Elective External Cdm,PX-98110102,CDM,92960,CPT,981,RC,,inpatient,,,577,519.3,,0.95,,548.15,Percent of total billed charges,,,0.98,,565.46,Percent of total billed charges,,,0.95,,548.15,Percent of total billed charges,,,0.97,,559.69,Percent of total billed charges,,,0.97,,559.69,Percent of total billed charges,,,0.96,,553.92,Percent of total billed charges,,,0.95,,548.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,548.15,Percent of total billed charges,,548.15,565.46,
HC PR ED 92960 Cardioversion Elective External Cdm,PX-98110102,CDM,92960,CPT,981,RC,,outpatient,,,577,519.3,,0.95,,548.15,Percent of total billed charges,,,0.98,,565.46,Percent of total billed charges,,,0.95,,548.15,Percent of total billed charges,,,0.95,,548.15,Percent of total billed charges,,,0.97,,559.69,Percent of total billed charges,,,0.96,,553.92,Percent of total billed charges,,,0.95,,548.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,548.15,Percent of total billed charges,,548.15,565.46,
Ultrasound of heart,PX-48010057,CDM,93307,CPT,480,RC,,inpatient,,,1101,990.9,,0.95,,1045.95,Percent of total billed charges,,,0.98,,1078.98,Percent of total billed charges,,,0.95,,1045.95,Percent of total billed charges,,,0.97,,1067.97,Percent of total billed charges,,,0.97,,1067.97,Percent of total billed charges,,,0.96,,1056.96,Percent of total billed charges,,,0.95,,1045.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1045.95,Percent of total billed charges,,1045.95,1078.98,
Ultrasound of heart,PX-48010057,CDM,93307,CPT,480,RC,,outpatient,,,1101,990.9,,0.95,,1045.95,Percent of total billed charges,,,0.98,,1078.98,Percent of total billed charges,,,0.95,,1045.95,Percent of total billed charges,,,0.95,,1045.95,Percent of total billed charges,,,0.97,,1067.97,Percent of total billed charges,,,0.96,,1056.96,Percent of total billed charges,,,0.95,,1045.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1045.95,Percent of total billed charges,,1045.95,1078.98,
"Ultrasound of heart, follow-up",PX-48010059,CDM,93308,CPT,480,RC,,inpatient,,,1055,949.5,,0.95,,1002.25,Percent of total billed charges,,,0.98,,1033.9,Percent of total billed charges,,,0.95,,1002.25,Percent of total billed charges,,,0.97,,1023.35,Percent of total billed charges,,,0.97,,1023.35,Percent of total billed charges,,,0.96,,1012.8,Percent of total billed charges,,,0.95,,1002.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1002.25,Percent of total billed charges,,1002.25,1033.9,
"Ultrasound of heart, follow-up",PX-48010059,CDM,93308,CPT,480,RC,,outpatient,,,1055,949.5,,0.95,,1002.25,Percent of total billed charges,,,0.98,,1033.9,Percent of total billed charges,,,0.95,,1002.25,Percent of total billed charges,,,0.95,,1002.25,Percent of total billed charges,,,0.97,,1023.35,Percent of total billed charges,,,0.96,,1012.8,Percent of total billed charges,,,0.95,,1002.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1002.25,Percent of total billed charges,,1002.25,1033.9,
Ultrasound of heart with color-depicted blood flow,PX-48010067,CDM,93325,CPT,480,RC,,inpatient,,,521,468.9,,0.95,,494.95,Percent of total billed charges,,,0.98,,510.58,Percent of total billed charges,,,0.95,,494.95,Percent of total billed charges,,,0.97,,505.37,Percent of total billed charges,,,0.97,,505.37,Percent of total billed charges,,,0.96,,500.16,Percent of total billed charges,,,0.95,,494.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,494.95,Percent of total billed charges,,494.95,510.58,
Ultrasound of heart with color-depicted blood flow,PX-48010067,CDM,93325,CPT,480,RC,,outpatient,,,521,468.9,,0.95,,494.95,Percent of total billed charges,,,0.98,,510.58,Percent of total billed charges,,,0.95,,494.95,Percent of total billed charges,,,0.95,,494.95,Percent of total billed charges,,,0.97,,505.37,Percent of total billed charges,,,0.96,,500.16,Percent of total billed charges,,,0.95,,494.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,494.95,Percent of total billed charges,,494.95,510.58,
"Ultrasound of heart blood flow, valves and chambers",PX-48010074,CDM,93320,CPT,480,RC,,inpatient,,,737,663.3,,0.95,,700.15,Percent of total billed charges,,,0.98,,722.26,Percent of total billed charges,,,0.95,,700.15,Percent of total billed charges,,,0.97,,714.89,Percent of total billed charges,,,0.97,,714.89,Percent of total billed charges,,,0.96,,707.52,Percent of total billed charges,,,0.95,,700.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,700.15,Percent of total billed charges,,700.15,722.26,
"Ultrasound of heart blood flow, valves and chambers",PX-48010074,CDM,93320,CPT,480,RC,,outpatient,,,737,663.3,,0.95,,700.15,Percent of total billed charges,,,0.98,,722.26,Percent of total billed charges,,,0.95,,700.15,Percent of total billed charges,,,0.95,,700.15,Percent of total billed charges,,,0.97,,714.89,Percent of total billed charges,,,0.96,,707.52,Percent of total billed charges,,,0.95,,700.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,700.15,Percent of total billed charges,,700.15,722.26,
"Ultrasound heart during rest, exercise, drug stress",PX-48010075,CDM,93350,CPT,480,RC,,inpatient,,,1280,1152,,0.95,,1216,Percent of total billed charges,,,0.98,,1254.4,Percent of total billed charges,,,0.95,,1216,Percent of total billed charges,,,0.97,,1241.6,Percent of total billed charges,,,0.97,,1241.6,Percent of total billed charges,,,0.96,,1228.8,Percent of total billed charges,,,0.95,,1216,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1216,Percent of total billed charges,,1216,1254.4,
"Ultrasound heart during rest, exercise, drug stress",PX-48010075,CDM,93350,CPT,480,RC,,outpatient,,,1280,1152,,0.95,,1216,Percent of total billed charges,,,0.98,,1254.4,Percent of total billed charges,,,0.95,,1216,Percent of total billed charges,,,0.95,,1216,Percent of total billed charges,,,0.97,,1241.6,Percent of total billed charges,,,0.96,,1228.8,Percent of total billed charges,,,0.95,,1216,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1216,Percent of total billed charges,,1216,1254.4,
"Ultrasound heart w/color flow, rate, direction and valve",PX-48010077,CDM,C8929,HCPCS,483,RC,,inpatient,,,3300,2970,,0.95,,3135,Percent of total billed charges,,,0.98,,3234,Percent of total billed charges,,,0.95,,3135,Percent of total billed charges,,,0.97,,3201,Percent of total billed charges,,,0.97,,3201,Percent of total billed charges,,,0.96,,3168,Percent of total billed charges,,,0.95,,3135,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3135,Percent of total billed charges,,3135,3234,
"Ultrasound heart w/color flow, rate, direction and valve",PX-48010077,CDM,C8929,HCPCS,483,RC,,outpatient,,,3300,2970,,0.95,,3135,Percent of total billed charges,,,0.98,,3234,Percent of total billed charges,,,0.95,,3135,Percent of total billed charges,,,0.95,,3135,Percent of total billed charges,,,0.97,,3201,Percent of total billed charges,,,0.96,,3168,Percent of total billed charges,,,0.95,,3135,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3135,Percent of total billed charges,,3135,3234,
Ultrasound of heart for congenital defect,PX-48310001,CDM,93303,CPT,483,RC,,inpatient,,,1621,1458.9,,0.95,,1539.95,Percent of total billed charges,,,0.98,,1588.58,Percent of total billed charges,,,0.95,,1539.95,Percent of total billed charges,,,0.97,,1572.37,Percent of total billed charges,,,0.97,,1572.37,Percent of total billed charges,,,0.96,,1556.16,Percent of total billed charges,,,0.95,,1539.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1539.95,Percent of total billed charges,,1539.95,1588.58,
Ultrasound of heart for congenital defect,PX-48310001,CDM,93303,CPT,483,RC,,outpatient,,,1621,1458.9,,0.95,,1539.95,Percent of total billed charges,,,0.98,,1588.58,Percent of total billed charges,,,0.95,,1539.95,Percent of total billed charges,,,0.95,,1539.95,Percent of total billed charges,,,0.97,,1572.37,Percent of total billed charges,,,0.96,,1556.16,Percent of total billed charges,,,0.95,,1539.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1539.95,Percent of total billed charges,,1539.95,1588.58,
"Ultrasound heart for congenital defect, follow-up",PX-48310002,CDM,93304,CPT,483,RC,,inpatient,,,1196,1076.4,,0.95,,1136.2,Percent of total billed charges,,,0.98,,1172.08,Percent of total billed charges,,,0.95,,1136.2,Percent of total billed charges,,,0.97,,1160.12,Percent of total billed charges,,,0.97,,1160.12,Percent of total billed charges,,,0.96,,1148.16,Percent of total billed charges,,,0.95,,1136.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1136.2,Percent of total billed charges,,1136.2,1172.08,
"Ultrasound heart for congenital defect, follow-up",PX-48310002,CDM,93304,CPT,483,RC,,outpatient,,,1196,1076.4,,0.95,,1136.2,Percent of total billed charges,,,0.98,,1172.08,Percent of total billed charges,,,0.95,,1136.2,Percent of total billed charges,,,0.95,,1136.2,Percent of total billed charges,,,0.97,,1160.12,Percent of total billed charges,,,0.96,,1148.16,Percent of total billed charges,,,0.95,,1136.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1136.2,Percent of total billed charges,,1136.2,1172.08,
"Ultrasound heart w/color blood flow, rate, direction",PX-48310003,CDM,93306,CPT,483,RC,,inpatient,,,2500,2250,,0.95,,2375,Percent of total billed charges,,,0.98,,2450,Percent of total billed charges,,,0.95,,2375,Percent of total billed charges,,,0.97,,2425,Percent of total billed charges,,,0.97,,2425,Percent of total billed charges,,,0.96,,2400,Percent of total billed charges,,,0.95,,2375,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2375,Percent of total billed charges,,2375,2450,
"Ultrasound heart w/color blood flow, rate, direction",PX-48310003,CDM,93306,CPT,483,RC,,outpatient,,,2500,2250,,0.95,,2375,Percent of total billed charges,,,0.98,,2450,Percent of total billed charges,,,0.95,,2375,Percent of total billed charges,,,0.95,,2375,Percent of total billed charges,,,0.97,,2425,Percent of total billed charges,,,0.96,,2400,Percent of total billed charges,,,0.95,,2375,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2375,Percent of total billed charges,,2375,2450,
"Ultrasound heart blood flow, valves and chambers, follow-up",PX-48310013,CDM,93321,CPT,483,RC,,inpatient,,,356,320.4,,0.95,,338.2,Percent of total billed charges,,,0.98,,348.88,Percent of total billed charges,,,0.95,,338.2,Percent of total billed charges,,,0.97,,345.32,Percent of total billed charges,,,0.97,,345.32,Percent of total billed charges,,,0.96,,341.76,Percent of total billed charges,,,0.95,,338.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,338.2,Percent of total billed charges,,338.2,348.88,
"Ultrasound heart blood flow, valves and chambers, follow-up",PX-48310013,CDM,93321,CPT,483,RC,,outpatient,,,356,320.4,,0.95,,338.2,Percent of total billed charges,,,0.98,,348.88,Percent of total billed charges,,,0.95,,338.2,Percent of total billed charges,,,0.95,,338.2,Percent of total billed charges,,,0.97,,345.32,Percent of total billed charges,,,0.96,,341.76,Percent of total billed charges,,,0.95,,338.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,338.2,Percent of total billed charges,,338.2,348.88,
"Ultrasound heart w/ECG during rest, exercise, drug stress",PX-48310016,CDM,93351,CPT,483,RC,,inpatient,,,935,841.5,,0.95,,888.25,Percent of total billed charges,,,0.98,,916.3,Percent of total billed charges,,,0.95,,888.25,Percent of total billed charges,,,0.97,,906.95,Percent of total billed charges,,,0.97,,906.95,Percent of total billed charges,,,0.96,,897.6,Percent of total billed charges,,,0.95,,888.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,888.25,Percent of total billed charges,,888.25,916.3,
"Ultrasound heart w/ECG during rest, exercise, drug stress",PX-48310016,CDM,93351,CPT,483,RC,,outpatient,,,935,841.5,,0.95,,888.25,Percent of total billed charges,,,0.98,,916.3,Percent of total billed charges,,,0.95,,888.25,Percent of total billed charges,,,0.95,,888.25,Percent of total billed charges,,,0.97,,906.95,Percent of total billed charges,,,0.96,,897.6,Percent of total billed charges,,,0.95,,888.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,888.25,Percent of total billed charges,,888.25,916.3,
Injection of X-ray contrast during ultrasound of heart,PX-48310017,CDM,93352,CPT,483,RC,,inpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
Injection of X-ray contrast during ultrasound of heart,PX-48310017,CDM,93352,CPT,483,RC,,outpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
"Ultrasound heart during rest, exercise/drug-induced stress",PX-48310024,CDM,C8928,HCPCS,483,RC,,inpatient,,,1412,1270.8,,0.95,,1341.4,Percent of total billed charges,,,0.98,,1383.76,Percent of total billed charges,,,0.95,,1341.4,Percent of total billed charges,,,0.97,,1369.64,Percent of total billed charges,,,0.97,,1369.64,Percent of total billed charges,,,0.96,,1355.52,Percent of total billed charges,,,0.95,,1341.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1341.4,Percent of total billed charges,,1341.4,1383.76,
"Ultrasound heart during rest, exercise/drug-induced stress",PX-48310024,CDM,C8928,HCPCS,483,RC,,outpatient,,,1412,1270.8,,0.95,,1341.4,Percent of total billed charges,,,0.98,,1383.76,Percent of total billed charges,,,0.95,,1341.4,Percent of total billed charges,,,0.95,,1341.4,Percent of total billed charges,,,0.97,,1369.64,Percent of total billed charges,,,0.96,,1355.52,Percent of total billed charges,,,0.95,,1341.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1341.4,Percent of total billed charges,,1341.4,1383.76,
HC PR 93351 Echo Stress W/Interp Rept & Monitor,PX-98510024,CDM,93351,CPT,985,RC,,inpatient,,,570,513,,0.95,,541.5,Percent of total billed charges,,,0.98,,558.6,Percent of total billed charges,,,0.95,,541.5,Percent of total billed charges,,,0.97,,552.9,Percent of total billed charges,,,0.97,,552.9,Percent of total billed charges,,,0.96,,547.2,Percent of total billed charges,,,0.95,,541.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,541.5,Percent of total billed charges,,541.5,558.6,
HC PR 93351 Echo Stress W/Interp Rept & Monitor,PX-98510024,CDM,93351,CPT,985,RC,,outpatient,,,570,513,,0.95,,541.5,Percent of total billed charges,,,0.98,,558.6,Percent of total billed charges,,,0.95,,541.5,Percent of total billed charges,,,0.95,,541.5,Percent of total billed charges,,,0.97,,552.9,Percent of total billed charges,,,0.96,,547.2,Percent of total billed charges,,,0.95,,541.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,541.5,Percent of total billed charges,,541.5,558.6,
Exercise or drug-induced heart stress test with ECG,PX-48210003,CDM,93017,CPT,482,RC,,inpatient,,,849,764.1,,0.95,,806.55,Percent of total billed charges,,,0.98,,832.02,Percent of total billed charges,,,0.95,,806.55,Percent of total billed charges,,,0.97,,823.53,Percent of total billed charges,,,0.97,,823.53,Percent of total billed charges,,,0.96,,815.04,Percent of total billed charges,,,0.95,,806.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,806.55,Percent of total billed charges,,806.55,832.02,
Exercise or drug-induced heart stress test with ECG,PX-48210003,CDM,93017,CPT,482,RC,,outpatient,,,849,764.1,,0.95,,806.55,Percent of total billed charges,,,0.98,,832.02,Percent of total billed charges,,,0.95,,806.55,Percent of total billed charges,,,0.95,,806.55,Percent of total billed charges,,,0.97,,823.53,Percent of total billed charges,,,0.96,,815.04,Percent of total billed charges,,,0.95,,806.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,806.55,Percent of total billed charges,,806.55,832.02,
Routine electrocardiogram using at least 12 leads w/tracing,PX-73010002,CDM,93005,CPT,730,RC,,inpatient,,,253,227.7,,0.95,,240.35,Percent of total billed charges,,,0.98,,247.94,Percent of total billed charges,,,0.95,,240.35,Percent of total billed charges,,,0.97,,245.41,Percent of total billed charges,,,0.97,,245.41,Percent of total billed charges,,,0.96,,242.88,Percent of total billed charges,,,0.95,,240.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,240.35,Percent of total billed charges,,240.35,247.94,
Routine electrocardiogram using at least 12 leads w/tracing,PX-73010002,CDM,93005,CPT,730,RC,,outpatient,,,253,227.7,,0.95,,240.35,Percent of total billed charges,,,0.98,,247.94,Percent of total billed charges,,,0.95,,240.35,Percent of total billed charges,,,0.95,,240.35,Percent of total billed charges,,,0.97,,245.41,Percent of total billed charges,,,0.96,,242.88,Percent of total billed charges,,,0.95,,240.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,240.35,Percent of total billed charges,,240.35,247.94,
Electrocardiogram (ECG) 1 to 3 leads,PX-73010003,CDM,93041,CPT,730,RC,,inpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
Electrocardiogram (ECG) 1 to 3 leads,PX-73010003,CDM,93041,CPT,730,RC,,outpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
Electrocardiogram (ECG) 2-day continuous,PX-73110001,CDM,93225,CPT,731,RC,,inpatient,,,505,454.5,,0.95,,479.75,Percent of total billed charges,,,0.98,,494.9,Percent of total billed charges,,,0.95,,479.75,Percent of total billed charges,,,0.97,,489.85,Percent of total billed charges,,,0.97,,489.85,Percent of total billed charges,,,0.96,,484.8,Percent of total billed charges,,,0.95,,479.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,479.75,Percent of total billed charges,,479.75,494.9,
Electrocardiogram (ECG) 2-day continuous,PX-73110001,CDM,93225,CPT,731,RC,,outpatient,,,505,454.5,,0.95,,479.75,Percent of total billed charges,,,0.98,,494.9,Percent of total billed charges,,,0.95,,479.75,Percent of total billed charges,,,0.95,,479.75,Percent of total billed charges,,,0.97,,489.85,Percent of total billed charges,,,0.96,,484.8,Percent of total billed charges,,,0.95,,479.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,479.75,Percent of total billed charges,,479.75,494.9,
Electrocardiogram (ECG) 2-day continuous with report,PX-73110002,CDM,93226,CPT,731,RC,,inpatient,,,486,437.4,,0.95,,461.7,Percent of total billed charges,,,0.98,,476.28,Percent of total billed charges,,,0.95,,461.7,Percent of total billed charges,,,0.97,,471.42,Percent of total billed charges,,,0.97,,471.42,Percent of total billed charges,,,0.96,,466.56,Percent of total billed charges,,,0.95,,461.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,461.7,Percent of total billed charges,,461.7,476.28,
Electrocardiogram (ECG) 2-day continuous with report,PX-73110002,CDM,93226,CPT,731,RC,,outpatient,,,486,437.4,,0.95,,461.7,Percent of total billed charges,,,0.98,,476.28,Percent of total billed charges,,,0.95,,461.7,Percent of total billed charges,,,0.95,,461.7,Percent of total billed charges,,,0.97,,471.42,Percent of total billed charges,,,0.96,,466.56,Percent of total billed charges,,,0.95,,461.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,461.7,Percent of total billed charges,,461.7,476.28,
Electrocardiogram (ECG) up to 30 days continuous,PX-73210001,CDM,93270,CPT,730,RC,,inpatient,,,335,301.5,,0.95,,318.25,Percent of total billed charges,,,0.98,,328.3,Percent of total billed charges,,,0.95,,318.25,Percent of total billed charges,,,0.97,,324.95,Percent of total billed charges,,,0.97,,324.95,Percent of total billed charges,,,0.96,,321.6,Percent of total billed charges,,,0.95,,318.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,318.25,Percent of total billed charges,,318.25,328.3,
Electrocardiogram (ECG) up to 30 days continuous,PX-73210001,CDM,93270,CPT,730,RC,,outpatient,,,335,301.5,,0.95,,318.25,Percent of total billed charges,,,0.98,,328.3,Percent of total billed charges,,,0.95,,318.25,Percent of total billed charges,,,0.95,,318.25,Percent of total billed charges,,,0.97,,324.95,Percent of total billed charges,,,0.96,,321.6,Percent of total billed charges,,,0.95,,318.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,318.25,Percent of total billed charges,,318.25,328.3,
Ecg/Monitoring and Analysis Pt Home Activated Up to 30days,PX-73210002,CDM,93271,CPT,730,RC,,inpatient,,,352,316.8,,0.95,,334.4,Percent of total billed charges,,,0.98,,344.96,Percent of total billed charges,,,0.95,,334.4,Percent of total billed charges,,,0.97,,341.44,Percent of total billed charges,,,0.97,,341.44,Percent of total billed charges,,,0.96,,337.92,Percent of total billed charges,,,0.95,,334.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,334.4,Percent of total billed charges,,334.4,344.96,
Ecg/Monitoring and Analysis Pt Home Activated Up to 30days,PX-73210002,CDM,93271,CPT,730,RC,,outpatient,,,352,316.8,,0.95,,334.4,Percent of total billed charges,,,0.98,,344.96,Percent of total billed charges,,,0.95,,334.4,Percent of total billed charges,,,0.95,,334.4,Percent of total billed charges,,,0.97,,341.44,Percent of total billed charges,,,0.96,,337.92,Percent of total billed charges,,,0.95,,334.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,334.4,Percent of total billed charges,,334.4,344.96,
HC PR 93015 Cardio Stress Testsupv Interp & Rept,PX-96910011,CDM,93015,CPT,983,RC,,inpatient,,,177,159.3,,0.95,,168.15,Percent of total billed charges,,,0.98,,173.46,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.96,,169.92,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,168.15,Percent of total billed charges,,168.15,173.46,
HC PR 93015 Cardio Stress Testsupv Interp & Rept,PX-96910011,CDM,93015,CPT,983,RC,,outpatient,,,177,159.3,,0.95,,168.15,Percent of total billed charges,,,0.98,,173.46,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.96,,169.92,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,168.15,Percent of total billed charges,,168.15,173.46,
HC PR 93017 Cardio Stress Test Tracing Only,PX-97610022,CDM,93017,CPT,976,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 93017 Cardio Stress Test Tracing Only,PX-97610022,CDM,93017,CPT,976,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR ED 93005 Ecg 12 Lead Tracing Only Cdm,PX-98110605,CDM,93005,CPT,981,RC,,inpatient,,,186,167.4,,0.95,,176.7,Percent of total billed charges,,,0.98,,182.28,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.96,,178.56,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,176.7,Percent of total billed charges,,176.7,182.28,
HC PR ED 93005 Ecg 12 Lead Tracing Only Cdm,PX-98110605,CDM,93005,CPT,981,RC,,outpatient,,,186,167.4,,0.95,,176.7,Percent of total billed charges,,,0.98,,182.28,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.96,,178.56,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,176.7,Percent of total billed charges,,176.7,182.28,
Ecg 12 Lead Interp & Rept Mcare Scn,PX-98310167,CDM,G0405,HCPCS,983,RC,,inpatient,,,21,18.9,,0.95,,19.95,Percent of total billed charges,,,0.98,,20.58,Percent of total billed charges,,,0.95,,19.95,Percent of total billed charges,,,0.97,,20.37,Percent of total billed charges,,,0.97,,20.37,Percent of total billed charges,,,0.96,,20.16,Percent of total billed charges,,,0.95,,19.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19.95,Percent of total billed charges,,19.95,20.58,
Ecg 12 Lead Interp & Rept Mcare Scn,PX-98310167,CDM,G0405,HCPCS,983,RC,,outpatient,,,21,18.9,,0.95,,19.95,Percent of total billed charges,,,0.98,,20.58,Percent of total billed charges,,,0.95,,19.95,Percent of total billed charges,,,0.95,,19.95,Percent of total billed charges,,,0.97,,20.37,Percent of total billed charges,,,0.96,,20.16,Percent of total billed charges,,,0.95,,19.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19.95,Percent of total billed charges,,19.95,20.58,
HC PR G0404 Ecg 12 Lead Tracing Mcare Screen,PX-98310302,CDM,G0404,HCPCS,983,RC,,inpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19,Percent of total billed charges,,19,19.6,
HC PR G0404 Ecg 12 Lead Tracing Mcare Screen,PX-98310302,CDM,G0404,HCPCS,983,RC,,outpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19,Percent of total billed charges,,19,19.6,
Routine ECG with at least 12 leads; interpretation and report,PX-98510001,CDM,93010,CPT,985,RC,,inpatient,,,23,20.7,,0.95,,21.85,Percent of total billed charges,,,0.98,,22.54,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.96,,22.08,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,21.85,Percent of total billed charges,,21.85,22.54,
Routine ECG with at least 12 leads; interpretation and report,PX-98510001,CDM,93010,CPT,985,RC,,outpatient,,,23,20.7,,0.95,,21.85,Percent of total billed charges,,,0.98,,22.54,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.96,,22.08,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,21.85,Percent of total billed charges,,21.85,22.54,
HC PR 93016 Cardio Stress Test Phys Supv Only,PX-98510002,CDM,93016,CPT,985,RC,,inpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
HC PR 93016 Cardio Stress Test Phys Supv Only,PX-98510002,CDM,93016,CPT,985,RC,,outpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
HC PR 93018 Cardio Stress Test Interp & Rept,PX-98510003,CDM,93018,CPT,985,RC,,inpatient,,,66,59.4,,0.95,,62.7,Percent of total billed charges,,,0.98,,64.68,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,0.97,,64.02,Percent of total billed charges,,,0.97,,64.02,Percent of total billed charges,,,0.96,,63.36,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,62.7,Percent of total billed charges,,62.7,64.68,
HC PR 93018 Cardio Stress Test Interp & Rept,PX-98510003,CDM,93018,CPT,985,RC,,outpatient,,,66,59.4,,0.95,,62.7,Percent of total billed charges,,,0.98,,64.68,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,0.97,,64.02,Percent of total billed charges,,,0.96,,63.36,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,62.7,Percent of total billed charges,,62.7,64.68,
HC PR 93042 Rhythm Ecg Interp & Rept Only,PX-98510004,CDM,93042,CPT,985,RC,,inpatient,,,18,16.2,,0.95,,17.1,Percent of total billed charges,,,0.98,,17.64,Percent of total billed charges,,,0.95,,17.1,Percent of total billed charges,,,0.97,,17.46,Percent of total billed charges,,,0.97,,17.46,Percent of total billed charges,,,0.96,,17.28,Percent of total billed charges,,,0.95,,17.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,17.1,Percent of total billed charges,,17.1,17.64,
HC PR 93042 Rhythm Ecg Interp & Rept Only,PX-98510004,CDM,93042,CPT,985,RC,,outpatient,,,18,16.2,,0.95,,17.1,Percent of total billed charges,,,0.98,,17.64,Percent of total billed charges,,,0.95,,17.1,Percent of total billed charges,,,0.95,,17.1,Percent of total billed charges,,,0.97,,17.46,Percent of total billed charges,,,0.96,,17.28,Percent of total billed charges,,,0.95,,17.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,17.1,Percent of total billed charges,,17.1,17.64,
HC PR 93000 Ecg 12 Lead W/Interp & Report,PX-98510009,CDM,93000,CPT,985,RC,,inpatient,,,186,167.4,,0.95,,176.7,Percent of total billed charges,,,0.98,,182.28,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.96,,178.56,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,176.7,Percent of total billed charges,,176.7,182.28,
HC PR 93000 Ecg 12 Lead W/Interp & Report,PX-98510009,CDM,93000,CPT,985,RC,,outpatient,,,186,167.4,,0.95,,176.7,Percent of total billed charges,,,0.98,,182.28,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.96,,178.56,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,176.7,Percent of total billed charges,,176.7,182.28,
HC Pacu Acuity Lvl 1 per Min,PX-71010231,CDM,71010231,LOCAL,710,RC,,inpatient,,,13,11.7,,0.95,,12.35,Percent of total billed charges,,,0.98,,12.74,Percent of total billed charges,,,0.95,,12.35,Percent of total billed charges,,,0.97,,12.61,Percent of total billed charges,,,0.97,,12.61,Percent of total billed charges,,,0.96,,12.48,Percent of total billed charges,,,0.95,,12.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,12.35,Percent of total billed charges,,12.35,12.74,
HC Pacu Acuity Lvl 1 per Min,PX-71010231,CDM,71010231,LOCAL,710,RC,,outpatient,,,13,11.7,,0.95,,12.35,Percent of total billed charges,,,0.98,,12.74,Percent of total billed charges,,,0.95,,12.35,Percent of total billed charges,,,0.95,,12.35,Percent of total billed charges,,,0.97,,12.61,Percent of total billed charges,,,0.96,,12.48,Percent of total billed charges,,,0.95,,12.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,12.35,Percent of total billed charges,,12.35,12.74,
HC Pacu Acuity Lvl 2 per Min,PX-71010232,CDM,71010232,LOCAL,710,RC,,inpatient,,,13,11.7,,0.95,,12.35,Percent of total billed charges,,,0.98,,12.74,Percent of total billed charges,,,0.95,,12.35,Percent of total billed charges,,,0.97,,12.61,Percent of total billed charges,,,0.97,,12.61,Percent of total billed charges,,,0.96,,12.48,Percent of total billed charges,,,0.95,,12.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,12.35,Percent of total billed charges,,12.35,12.74,
HC Pacu Acuity Lvl 2 per Min,PX-71010232,CDM,71010232,LOCAL,710,RC,,outpatient,,,13,11.7,,0.95,,12.35,Percent of total billed charges,,,0.98,,12.74,Percent of total billed charges,,,0.95,,12.35,Percent of total billed charges,,,0.95,,12.35,Percent of total billed charges,,,0.97,,12.61,Percent of total billed charges,,,0.96,,12.48,Percent of total billed charges,,,0.95,,12.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,12.35,Percent of total billed charges,,12.35,12.74,
HC Pacu Acuity Lvl 3 per Min,PX-71010233,CDM,71010233,LOCAL,710,RC,,inpatient,,,13,11.7,,0.95,,12.35,Percent of total billed charges,,,0.98,,12.74,Percent of total billed charges,,,0.95,,12.35,Percent of total billed charges,,,0.97,,12.61,Percent of total billed charges,,,0.97,,12.61,Percent of total billed charges,,,0.96,,12.48,Percent of total billed charges,,,0.95,,12.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,12.35,Percent of total billed charges,,12.35,12.74,
HC Pacu Acuity Lvl 3 per Min,PX-71010233,CDM,71010233,LOCAL,710,RC,,outpatient,,,13,11.7,,0.95,,12.35,Percent of total billed charges,,,0.98,,12.74,Percent of total billed charges,,,0.95,,12.35,Percent of total billed charges,,,0.95,,12.35,Percent of total billed charges,,,0.97,,12.61,Percent of total billed charges,,,0.96,,12.48,Percent of total billed charges,,,0.95,,12.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,12.35,Percent of total billed charges,,12.35,12.74,
HC Pacu Acuity Lvl 4 per Min,PX-71010234,CDM,71010234,LOCAL,710,RC,,inpatient,,,13,11.7,,0.95,,12.35,Percent of total billed charges,,,0.98,,12.74,Percent of total billed charges,,,0.95,,12.35,Percent of total billed charges,,,0.97,,12.61,Percent of total billed charges,,,0.97,,12.61,Percent of total billed charges,,,0.96,,12.48,Percent of total billed charges,,,0.95,,12.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,12.35,Percent of total billed charges,,12.35,12.74,
HC Pacu Acuity Lvl 4 per Min,PX-71010234,CDM,71010234,LOCAL,710,RC,,outpatient,,,13,11.7,,0.95,,12.35,Percent of total billed charges,,,0.98,,12.74,Percent of total billed charges,,,0.95,,12.35,Percent of total billed charges,,,0.95,,12.35,Percent of total billed charges,,,0.97,,12.61,Percent of total billed charges,,,0.96,,12.48,Percent of total billed charges,,,0.95,,12.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,12.35,Percent of total billed charges,,12.35,12.74,
HC Pc Phase II Recovery Level 1,PX-71010243,CDM,71010243,LOCAL,710,RC,,inpatient,,,147,132.3,,0.95,,139.65,Percent of total billed charges,,,0.98,,144.06,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,0.97,,142.59,Percent of total billed charges,,,0.97,,142.59,Percent of total billed charges,,,0.96,,141.12,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,139.65,Percent of total billed charges,,139.65,144.06,
HC Pc Phase II Recovery Level 1,PX-71010243,CDM,71010243,LOCAL,710,RC,,outpatient,,,147,132.3,,0.95,,139.65,Percent of total billed charges,,,0.98,,144.06,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,0.97,,142.59,Percent of total billed charges,,,0.96,,141.12,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,139.65,Percent of total billed charges,,139.65,144.06,
HC Pc Phase II Recovery Level 2,PX-71010244,CDM,71010244,LOCAL,710,RC,,inpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
HC Pc Phase II Recovery Level 2,PX-71010244,CDM,71010244,LOCAL,710,RC,,outpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
Newborn Stabilization at Delivery,PX-36010965,CDM,99465,CPT,722,RC,,inpatient,,,403,362.7,,0.95,,382.85,Percent of total billed charges,,,0.98,,394.94,Percent of total billed charges,,,0.95,,382.85,Percent of total billed charges,,,0.97,,390.91,Percent of total billed charges,,,0.97,,390.91,Percent of total billed charges,,,0.96,,386.88,Percent of total billed charges,,,0.95,,382.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,382.85,Percent of total billed charges,,382.85,394.94,
Newborn Stabilization at Delivery,PX-36010965,CDM,99465,CPT,722,RC,,outpatient,,,403,362.7,,0.95,,382.85,Percent of total billed charges,,,0.98,,394.94,Percent of total billed charges,,,0.95,,382.85,Percent of total billed charges,,,0.95,,382.85,Percent of total billed charges,,,0.97,,390.91,Percent of total billed charges,,,0.96,,386.88,Percent of total billed charges,,,0.95,,382.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,382.85,Percent of total billed charges,,382.85,394.94,
Remove cerebrospinal fluid w/ lower back spinal tap,PX-36110071,CDM,62270,CPT,361,RC,,inpatient,,,537,483.3,,0.95,,510.15,Percent of total billed charges,,,0.98,,526.26,Percent of total billed charges,,,0.95,,510.15,Percent of total billed charges,,,0.97,,520.89,Percent of total billed charges,,,0.97,,520.89,Percent of total billed charges,,,0.96,,515.52,Percent of total billed charges,,,0.95,,510.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,510.15,Percent of total billed charges,,510.15,526.26,
Remove cerebrospinal fluid w/ lower back spinal tap,PX-36110071,CDM,62270,CPT,361,RC,,outpatient,,,537,483.3,,0.95,,510.15,Percent of total billed charges,,,0.98,,526.26,Percent of total billed charges,,,0.95,,510.15,Percent of total billed charges,,,0.95,,510.15,Percent of total billed charges,,,0.97,,520.89,Percent of total billed charges,,,0.96,,515.52,Percent of total billed charges,,,0.95,,510.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,510.15,Percent of total billed charges,,510.15,526.26,
Injection of blood or blood clot into spinal canal,PX-36110072,CDM,62273,CPT,361,RC,,inpatient,,,126,113.4,,0.95,,119.7,Percent of total billed charges,,,0.98,,123.48,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.96,,120.96,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,119.7,Percent of total billed charges,,119.7,123.48,
Injection of blood or blood clot into spinal canal,PX-36110072,CDM,62273,CPT,361,RC,,outpatient,,,126,113.4,,0.95,,119.7,Percent of total billed charges,,,0.98,,123.48,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.96,,120.96,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,119.7,Percent of total billed charges,,119.7,123.48,
Delivery of placenta,PX-45010119,CDM,59414,CPT,450,RC,,inpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,0.01,Percent of total billed charges,,0.01,3950,
Delivery of placenta,PX-45010119,CDM,59414,CPT,450,RC,,outpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,0.01,Percent of total billed charges,,0.01,3950,
HC Intra Acuity per Hr Class 1,PX-72010068,CDM,72010068,LOCAL,720,RC,,inpatient,,,194,174.6,,0.95,,184.3,Percent of total billed charges,,,0.98,,190.12,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,0.97,,188.18,Percent of total billed charges,,,0.97,,188.18,Percent of total billed charges,,,0.96,,186.24,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,184.3,Percent of total billed charges,,184.3,190.12,
HC Intra Acuity per Hr Class 1,PX-72010068,CDM,72010068,LOCAL,720,RC,,outpatient,,,194,174.6,,0.95,,184.3,Percent of total billed charges,,,0.98,,190.12,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,0.97,,188.18,Percent of total billed charges,,,0.96,,186.24,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,184.3,Percent of total billed charges,,184.3,190.12,
HC Ante Acuity per Hr Class 2,PX-72010070,CDM,72010070,LOCAL,720,RC,,inpatient,,,220,198,,0.95,,209,Percent of total billed charges,,,0.98,,215.6,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,0.97,,213.4,Percent of total billed charges,,,0.97,,213.4,Percent of total billed charges,,,0.96,,211.2,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,209,Percent of total billed charges,,209,215.6,
HC Ante Acuity per Hr Class 2,PX-72010070,CDM,72010070,LOCAL,720,RC,,outpatient,,,220,198,,0.95,,209,Percent of total billed charges,,,0.98,,215.6,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,0.97,,213.4,Percent of total billed charges,,,0.96,,211.2,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,209,Percent of total billed charges,,209,215.6,
HC Intra Acuity per Hr Class 2,PX-72010071,CDM,72010071,LOCAL,720,RC,,inpatient,,,201,180.9,,0.95,,190.95,Percent of total billed charges,,,0.98,,196.98,Percent of total billed charges,,,0.95,,190.95,Percent of total billed charges,,,0.97,,194.97,Percent of total billed charges,,,0.97,,194.97,Percent of total billed charges,,,0.96,,192.96,Percent of total billed charges,,,0.95,,190.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,190.95,Percent of total billed charges,,190.95,196.98,
HC Intra Acuity per Hr Class 2,PX-72010071,CDM,72010071,LOCAL,720,RC,,outpatient,,,201,180.9,,0.95,,190.95,Percent of total billed charges,,,0.98,,196.98,Percent of total billed charges,,,0.95,,190.95,Percent of total billed charges,,,0.95,,190.95,Percent of total billed charges,,,0.97,,194.97,Percent of total billed charges,,,0.96,,192.96,Percent of total billed charges,,,0.95,,190.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,190.95,Percent of total billed charges,,190.95,196.98,
HC Ante Acuity per Hr Class 3,PX-72010073,CDM,72010073,LOCAL,720,RC,,inpatient,,,243,218.7,,0.95,,230.85,Percent of total billed charges,,,0.98,,238.14,Percent of total billed charges,,,0.95,,230.85,Percent of total billed charges,,,0.97,,235.71,Percent of total billed charges,,,0.97,,235.71,Percent of total billed charges,,,0.96,,233.28,Percent of total billed charges,,,0.95,,230.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,230.85,Percent of total billed charges,,230.85,238.14,
HC Ante Acuity per Hr Class 3,PX-72010073,CDM,72010073,LOCAL,720,RC,,outpatient,,,243,218.7,,0.95,,230.85,Percent of total billed charges,,,0.98,,238.14,Percent of total billed charges,,,0.95,,230.85,Percent of total billed charges,,,0.95,,230.85,Percent of total billed charges,,,0.97,,235.71,Percent of total billed charges,,,0.96,,233.28,Percent of total billed charges,,,0.95,,230.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,230.85,Percent of total billed charges,,230.85,238.14,
HC Intra Acuity per Hr Class 3,PX-72010074,CDM,72010074,LOCAL,720,RC,,inpatient,,,206,185.4,,0.95,,195.7,Percent of total billed charges,,,0.98,,201.88,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.96,,197.76,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,195.7,Percent of total billed charges,,195.7,201.88,
HC Intra Acuity per Hr Class 3,PX-72010074,CDM,72010074,LOCAL,720,RC,,outpatient,,,206,185.4,,0.95,,195.7,Percent of total billed charges,,,0.98,,201.88,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.96,,197.76,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,195.7,Percent of total billed charges,,195.7,201.88,
HC Intra Acuity per Hr Class 4,PX-72010077,CDM,72010077,LOCAL,720,RC,,inpatient,,,211,189.9,,0.95,,200.45,Percent of total billed charges,,,0.98,,206.78,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,0.97,,204.67,Percent of total billed charges,,,0.97,,204.67,Percent of total billed charges,,,0.96,,202.56,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,200.45,Percent of total billed charges,,200.45,206.78,
HC Intra Acuity per Hr Class 4,PX-72010077,CDM,72010077,LOCAL,720,RC,,outpatient,,,211,189.9,,0.95,,200.45,Percent of total billed charges,,,0.98,,206.78,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,0.97,,204.67,Percent of total billed charges,,,0.96,,202.56,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,200.45,Percent of total billed charges,,200.45,206.78,
HC Vaginal Delivery Level 1 Cdm,PX-72210001,CDM,72210001,LOCAL,722,RC,,inpatient,,,1432,1288.8,,0.95,,1360.4,Percent of total billed charges,,,0.98,,1403.36,Percent of total billed charges,,,0.95,,1360.4,Percent of total billed charges,,,0.97,,1389.04,Percent of total billed charges,,,0.97,,1389.04,Percent of total billed charges,,,0.96,,1374.72,Percent of total billed charges,,,0.95,,1360.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1360.4,Percent of total billed charges,,1360.4,1403.36,
HC Vaginal Delivery Level 1 Cdm,PX-72210001,CDM,72210001,LOCAL,722,RC,,outpatient,,,1432,1288.8,,0.95,,1360.4,Percent of total billed charges,,,0.98,,1403.36,Percent of total billed charges,,,0.95,,1360.4,Percent of total billed charges,,,0.95,,1360.4,Percent of total billed charges,,,0.97,,1389.04,Percent of total billed charges,,,0.96,,1374.72,Percent of total billed charges,,,0.95,,1360.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1360.4,Percent of total billed charges,,1360.4,1403.36,
HC Vaginal Delivery Level 2 Cdm,PX-72210002,CDM,72210002,LOCAL,722,RC,,inpatient,,,1963,1766.7,,0.95,,1864.85,Percent of total billed charges,,,0.98,,1923.74,Percent of total billed charges,,,0.95,,1864.85,Percent of total billed charges,,,0.97,,1904.11,Percent of total billed charges,,,0.97,,1904.11,Percent of total billed charges,,,0.96,,1884.48,Percent of total billed charges,,,0.95,,1864.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1864.85,Percent of total billed charges,,1864.85,1923.74,
HC Vaginal Delivery Level 2 Cdm,PX-72210002,CDM,72210002,LOCAL,722,RC,,outpatient,,,1963,1766.7,,0.95,,1864.85,Percent of total billed charges,,,0.98,,1923.74,Percent of total billed charges,,,0.95,,1864.85,Percent of total billed charges,,,0.95,,1864.85,Percent of total billed charges,,,0.97,,1904.11,Percent of total billed charges,,,0.96,,1884.48,Percent of total billed charges,,,0.95,,1864.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1864.85,Percent of total billed charges,,1864.85,1923.74,
Removal of foreskin using clamp or device,PX-72310001,CDM,54150,CPT,723,RC,,inpatient,,,281,252.9,,0.95,,266.95,Percent of total billed charges,,,0.98,,275.38,Percent of total billed charges,,,0.95,,266.95,Percent of total billed charges,,,0.97,,272.57,Percent of total billed charges,,,0.97,,272.57,Percent of total billed charges,,,0.96,,269.76,Percent of total billed charges,,,0.95,,266.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,266.95,Percent of total billed charges,,266.95,275.38,
Removal of foreskin using clamp or device,PX-72310001,CDM,54150,CPT,723,RC,,outpatient,,,281,252.9,,0.95,,266.95,Percent of total billed charges,,,0.98,,275.38,Percent of total billed charges,,,0.95,,266.95,Percent of total billed charges,,,0.95,,266.95,Percent of total billed charges,,,0.97,,272.57,Percent of total billed charges,,,0.96,,269.76,Percent of total billed charges,,,0.95,,266.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,266.95,Percent of total billed charges,,266.95,275.38,
Established office or other outpatient visit L1,PX-76110507,CDM,99211,CPT,761,RC,,inpatient,,,87,78.3,,0.95,,82.65,Percent of total billed charges,,,0.98,,85.26,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.96,,83.52,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,82.65,Percent of total billed charges,,82.65,85.26,
Established office or other outpatient visit L1,PX-76110507,CDM,99211,CPT,761,RC,,outpatient,,,87,78.3,,0.95,,82.65,Percent of total billed charges,,,0.98,,85.26,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.96,,83.52,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,82.65,Percent of total billed charges,,82.65,85.26,
Established office or other outpatient visit L3,PX-76110533,CDM,99213,CPT,761,RC,,inpatient,,,219,197.1,,0.95,,208.05,Percent of total billed charges,,,0.98,,214.62,Percent of total billed charges,,,0.95,,208.05,Percent of total billed charges,,,0.97,,212.43,Percent of total billed charges,,,0.97,,212.43,Percent of total billed charges,,,0.96,,210.24,Percent of total billed charges,,,0.95,,208.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,208.05,Percent of total billed charges,,208.05,214.62,
Established office or other outpatient visit L3,PX-76110533,CDM,99213,CPT,761,RC,,outpatient,,,219,197.1,,0.95,,208.05,Percent of total billed charges,,,0.98,,214.62,Percent of total billed charges,,,0.95,,208.05,Percent of total billed charges,,,0.95,,208.05,Percent of total billed charges,,,0.97,,212.43,Percent of total billed charges,,,0.96,,210.24,Percent of total billed charges,,,0.95,,208.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,208.05,Percent of total billed charges,,208.05,214.62,
Established office or other outpatient visit L4,PX-76110534,CDM,99214,CPT,761,RC,,inpatient,,,280,252,,0.95,,266,Percent of total billed charges,,,0.98,,274.4,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,0.97,,271.6,Percent of total billed charges,,,0.97,,271.6,Percent of total billed charges,,,0.96,,268.8,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,266,Percent of total billed charges,,266,274.4,
Established office or other outpatient visit L4,PX-76110534,CDM,99214,CPT,761,RC,,outpatient,,,280,252,,0.95,,266,Percent of total billed charges,,,0.98,,274.4,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,0.97,,271.6,Percent of total billed charges,,,0.96,,268.8,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,266,Percent of total billed charges,,266,274.4,
Established office or other outpatient visit L5,PX-76110551,CDM,99215,CPT,761,RC,,inpatient,,,352,316.8,,0.95,,334.4,Percent of total billed charges,,,0.98,,344.96,Percent of total billed charges,,,0.95,,334.4,Percent of total billed charges,,,0.97,,341.44,Percent of total billed charges,,,0.97,,341.44,Percent of total billed charges,,,0.96,,337.92,Percent of total billed charges,,,0.95,,334.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,334.4,Percent of total billed charges,,334.4,344.96,
Established office or other outpatient visit L5,PX-76110551,CDM,99215,CPT,761,RC,,outpatient,,,352,316.8,,0.95,,334.4,Percent of total billed charges,,,0.98,,344.96,Percent of total billed charges,,,0.95,,334.4,Percent of total billed charges,,,0.95,,334.4,Percent of total billed charges,,,0.97,,341.44,Percent of total billed charges,,,0.96,,337.92,Percent of total billed charges,,,0.95,,334.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,334.4,Percent of total billed charges,,334.4,344.96,
Complicated insertion of bladder tube,PX-45010424,CDM,51703,CPT,450,RC,,inpatient,,,427,384.3,,0.95,,405.65,Percent of total billed charges,,,0.98,,418.46,Percent of total billed charges,,,0.95,,405.65,Percent of total billed charges,,,0.97,,414.19,Percent of total billed charges,,,0.97,,414.19,Percent of total billed charges,,,0.96,,409.92,Percent of total billed charges,,,0.95,,405.65,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,405.65,Percent of total billed charges,,405.65,3950,
Complicated insertion of bladder tube,PX-45010424,CDM,51703,CPT,450,RC,,outpatient,,,427,384.3,,0.95,,405.65,Percent of total billed charges,,,0.98,,418.46,Percent of total billed charges,,,0.95,,405.65,Percent of total billed charges,,,0.95,,405.65,Percent of total billed charges,,,0.97,,414.19,Percent of total billed charges,,,0.96,,409.92,Percent of total billed charges,,,0.95,,405.65,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,405.65,Percent of total billed charges,,405.65,3950,
HC Meas Post-Voiding Residual Urine&/Bladder Cap,PX-76110564,CDM,51798,CPT,761,RC,,inpatient,,,254,228.6,,0.95,,241.3,Percent of total billed charges,,,0.98,,248.92,Percent of total billed charges,,,0.95,,241.3,Percent of total billed charges,,,0.97,,246.38,Percent of total billed charges,,,0.97,,246.38,Percent of total billed charges,,,0.96,,243.84,Percent of total billed charges,,,0.95,,241.3,Percent of total billed charges,,,,,,,,,0.95,,241.3,Percent of total billed charges,,241.3,248.92,
HC Meas Post-Voiding Residual Urine&/Bladder Cap,PX-76110564,CDM,51798,CPT,761,RC,,outpatient,,,254,228.6,,0.95,,241.3,Percent of total billed charges,,,0.98,,248.92,Percent of total billed charges,,,0.95,,241.3,Percent of total billed charges,,,0.95,,241.3,Percent of total billed charges,,,0.97,,246.38,Percent of total billed charges,,,0.96,,243.84,Percent of total billed charges,,,0.95,,241.3,Percent of total billed charges,,,,,,,,,0.95,,241.3,Percent of total billed charges,,241.3,248.92,
Fetal test,PX-92010032,CDM,59025,CPT,920,RC,,inpatient,,,940,846,,0.95,,893,Percent of total billed charges,,,0.98,,921.2,Percent of total billed charges,,,0.95,,893,Percent of total billed charges,,,0.97,,911.8,Percent of total billed charges,,,0.97,,911.8,Percent of total billed charges,,,0.96,,902.4,Percent of total billed charges,,,0.95,,893,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,893,Percent of total billed charges,,893,921.2,
Fetal test,PX-92010032,CDM,59025,CPT,920,RC,,outpatient,,,940,846,,0.95,,893,Percent of total billed charges,,,0.98,,921.2,Percent of total billed charges,,,0.95,,893,Percent of total billed charges,,,0.95,,893,Percent of total billed charges,,,0.97,,911.8,Percent of total billed charges,,,0.96,,902.4,Percent of total billed charges,,,0.95,,893,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,893,Percent of total billed charges,,893,921.2,
Insertion of temporary bladder tube,PX-94010050,CDM,51701,CPT,761,RC,,inpatient,,,245,220.5,,0.95,,232.75,Percent of total billed charges,,,0.98,,240.1,Percent of total billed charges,,,0.95,,232.75,Percent of total billed charges,,,0.97,,237.65,Percent of total billed charges,,,0.97,,237.65,Percent of total billed charges,,,0.96,,235.2,Percent of total billed charges,,,0.95,,232.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,232.75,Percent of total billed charges,,232.75,240.1,
Insertion of temporary bladder tube,PX-94010050,CDM,51701,CPT,761,RC,,outpatient,,,245,220.5,,0.95,,232.75,Percent of total billed charges,,,0.98,,240.1,Percent of total billed charges,,,0.95,,232.75,Percent of total billed charges,,,0.95,,232.75,Percent of total billed charges,,,0.97,,237.65,Percent of total billed charges,,,0.96,,235.2,Percent of total billed charges,,,0.95,,232.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,232.75,Percent of total billed charges,,232.75,240.1,
Simple insertion of temporary bladder tube,PX-94010051,CDM,51702,CPT,761,RC,,inpatient,,,280,252,,0.95,,266,Percent of total billed charges,,,0.98,,274.4,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,0.97,,271.6,Percent of total billed charges,,,0.97,,271.6,Percent of total billed charges,,,0.96,,268.8,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,266,Percent of total billed charges,,266,274.4,
Simple insertion of temporary bladder tube,PX-94010051,CDM,51702,CPT,761,RC,,outpatient,,,280,252,,0.95,,266,Percent of total billed charges,,,0.98,,274.4,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,0.97,,271.6,Percent of total billed charges,,,0.96,,268.8,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,266,Percent of total billed charges,,266,274.4,
Application of ultraviolet light to skin,PX-94010052,CDM,96900,CPT,940,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Application of ultraviolet light to skin,PX-94010052,CDM,96900,CPT,940,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Established office or other outpatient visit L1,PX-94210105,CDM,99211,CPT,761,RC,,inpatient,,,63,56.7,,0.95,,59.85,Percent of total billed charges,,,0.98,,61.74,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.96,,60.48,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,59.85,Percent of total billed charges,,59.85,61.74,
Established office or other outpatient visit L1,PX-94210105,CDM,99211,CPT,761,RC,,outpatient,,,63,56.7,,0.95,,59.85,Percent of total billed charges,,,0.98,,61.74,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.96,,60.48,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,59.85,Percent of total billed charges,,59.85,61.74,
Established office or other outpatient visit L1,PX-94210108,CDM,99211,CPT,761,RC,,inpatient,,,85,76.5,,0.95,,80.75,Percent of total billed charges,,,0.98,,83.3,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.96,,81.6,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,80.75,Percent of total billed charges,,80.75,83.3,
Established office or other outpatient visit L1,PX-94210108,CDM,99211,CPT,761,RC,,outpatient,,,85,76.5,,0.95,,80.75,Percent of total billed charges,,,0.98,,83.3,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.96,,81.6,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,80.75,Percent of total billed charges,,80.75,83.3,
HC PR 59025 Fetal Non-Stress Test,PX-96910601,CDM,59025,CPT,983,RC,,inpatient,,,278,250.2,,0.95,,264.1,Percent of total billed charges,,,0.98,,272.44,Percent of total billed charges,,,0.95,,264.1,Percent of total billed charges,,,0.97,,269.66,Percent of total billed charges,,,0.97,,269.66,Percent of total billed charges,,,0.96,,266.88,Percent of total billed charges,,,0.95,,264.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,264.1,Percent of total billed charges,,264.1,272.44,
HC PR 59025 Fetal Non-Stress Test,PX-96910601,CDM,59025,CPT,983,RC,,outpatient,,,278,250.2,,0.95,,264.1,Percent of total billed charges,,,0.98,,272.44,Percent of total billed charges,,,0.95,,264.1,Percent of total billed charges,,,0.95,,264.1,Percent of total billed charges,,,0.97,,269.66,Percent of total billed charges,,,0.96,,266.88,Percent of total billed charges,,,0.95,,264.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,264.1,Percent of total billed charges,,264.1,272.44,
HC PR 59410 Vag Delivery W/Postpartum,PX-96910609,CDM,59410,CPT,983,RC,,inpatient,,,2852,2566.8,,0.95,,2709.4,Percent of total billed charges,,,0.98,,2794.96,Percent of total billed charges,,,0.95,,2709.4,Percent of total billed charges,,,0.97,,2766.44,Percent of total billed charges,,,0.97,,2766.44,Percent of total billed charges,,,0.96,,2737.92,Percent of total billed charges,,,0.95,,2709.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2709.4,Percent of total billed charges,,2709.4,2794.96,
HC PR 59410 Vag Delivery W/Postpartum,PX-96910609,CDM,59410,CPT,983,RC,,outpatient,,,2852,2566.8,,0.95,,2709.4,Percent of total billed charges,,,0.98,,2794.96,Percent of total billed charges,,,0.95,,2709.4,Percent of total billed charges,,,0.95,,2709.4,Percent of total billed charges,,,0.97,,2766.44,Percent of total billed charges,,,0.96,,2737.92,Percent of total billed charges,,,0.95,,2709.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2709.4,Percent of total billed charges,,2709.4,2794.96,
HC PR 99460 1st Hosp/Birthing Center Care per Day Nml Nb,PX-96910630,CDM,99460,CPT,987,RC,,inpatient,,,265,238.5,,0.95,,251.75,Percent of total billed charges,,,0.98,,259.7,Percent of total billed charges,,,0.95,,251.75,Percent of total billed charges,,,0.97,,257.05,Percent of total billed charges,,,0.97,,257.05,Percent of total billed charges,,,0.96,,254.4,Percent of total billed charges,,,0.95,,251.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,251.75,Percent of total billed charges,,251.75,259.7,
HC PR 99460 1st Hosp/Birthing Center Care per Day Nml Nb,PX-96910630,CDM,99460,CPT,987,RC,,outpatient,,,265,238.5,,0.95,,251.75,Percent of total billed charges,,,0.98,,259.7,Percent of total billed charges,,,0.95,,251.75,Percent of total billed charges,,,0.95,,251.75,Percent of total billed charges,,,0.97,,257.05,Percent of total billed charges,,,0.96,,254.4,Percent of total billed charges,,,0.95,,251.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,251.75,Percent of total billed charges,,251.75,259.7,
HC PR 99462 Newborn Hospital Visit,PX-96910631,CDM,99462,CPT,987,RC,,inpatient,,,112,100.8,,0.95,,106.4,Percent of total billed charges,,,0.98,,109.76,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.96,,107.52,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,106.4,Percent of total billed charges,,106.4,109.76,
HC PR 99462 Newborn Hospital Visit,PX-96910631,CDM,99462,CPT,987,RC,,outpatient,,,112,100.8,,0.95,,106.4,Percent of total billed charges,,,0.98,,109.76,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.96,,107.52,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,106.4,Percent of total billed charges,,106.4,109.76,
HC PR 99463 Newborn Discharge Same Day,PX-96910632,CDM,99463,CPT,987,RC,,inpatient,,,319,287.1,,0.95,,303.05,Percent of total billed charges,,,0.98,,312.62,Percent of total billed charges,,,0.95,,303.05,Percent of total billed charges,,,0.97,,309.43,Percent of total billed charges,,,0.97,,309.43,Percent of total billed charges,,,0.96,,306.24,Percent of total billed charges,,,0.95,,303.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,303.05,Percent of total billed charges,,303.05,312.62,
HC PR 99463 Newborn Discharge Same Day,PX-96910632,CDM,99463,CPT,987,RC,,outpatient,,,319,287.1,,0.95,,303.05,Percent of total billed charges,,,0.98,,312.62,Percent of total billed charges,,,0.95,,303.05,Percent of total billed charges,,,0.95,,303.05,Percent of total billed charges,,,0.97,,309.43,Percent of total billed charges,,,0.96,,306.24,Percent of total billed charges,,,0.95,,303.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,303.05,Percent of total billed charges,,303.05,312.62,
HC PR 99464 Attendance/Delivery,PX-96910633,CDM,99464,CPT,983,RC,,inpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
HC PR 99464 Attendance/Delivery,PX-96910633,CDM,99464,CPT,983,RC,,outpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
HC PR 99465 Critical Care - Newborn,PX-96910634,CDM,99465,CPT,983,RC,,inpatient,,,421,378.9,,0.95,,399.95,Percent of total billed charges,,,0.98,,412.58,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,0.97,,408.37,Percent of total billed charges,,,0.97,,408.37,Percent of total billed charges,,,0.96,,404.16,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,399.95,Percent of total billed charges,,399.95,412.58,
HC PR 99465 Critical Care - Newborn,PX-96910634,CDM,99465,CPT,983,RC,,outpatient,,,421,378.9,,0.95,,399.95,Percent of total billed charges,,,0.98,,412.58,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,0.97,,408.37,Percent of total billed charges,,,0.96,,404.16,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,399.95,Percent of total billed charges,,399.95,412.58,
HC PR 59514 Cesarean Delivery Only,PX-96910638,CDM,59514,CPT,975,RC,,inpatient,,,2511,2259.9,,0.95,,2385.45,Percent of total billed charges,,,0.98,,2460.78,Percent of total billed charges,,,0.95,,2385.45,Percent of total billed charges,,,0.97,,2435.67,Percent of total billed charges,,,0.97,,2435.67,Percent of total billed charges,,,0.96,,2410.56,Percent of total billed charges,,,0.95,,2385.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2385.45,Percent of total billed charges,,2385.45,2460.78,
HC PR 59514 Cesarean Delivery Only,PX-96910638,CDM,59514,CPT,975,RC,,outpatient,,,2511,2259.9,,0.95,,2385.45,Percent of total billed charges,,,0.98,,2460.78,Percent of total billed charges,,,0.95,,2385.45,Percent of total billed charges,,,0.95,,2385.45,Percent of total billed charges,,,0.97,,2435.67,Percent of total billed charges,,,0.96,,2410.56,Percent of total billed charges,,,0.95,,2385.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2385.45,Percent of total billed charges,,2385.45,2460.78,
HC PR 59160 D & C After Delivery,PX-97510605,CDM,59160,CPT,975,RC,,inpatient,,,505,454.5,,0.95,,479.75,Percent of total billed charges,,,0.98,,494.9,Percent of total billed charges,,,0.95,,479.75,Percent of total billed charges,,,0.97,,489.85,Percent of total billed charges,,,0.97,,489.85,Percent of total billed charges,,,0.96,,484.8,Percent of total billed charges,,,0.95,,479.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,479.75,Percent of total billed charges,,479.75,494.9,
HC PR 59160 D & C After Delivery,PX-97510605,CDM,59160,CPT,975,RC,,outpatient,,,505,454.5,,0.95,,479.75,Percent of total billed charges,,,0.98,,494.9,Percent of total billed charges,,,0.95,,479.75,Percent of total billed charges,,,0.95,,479.75,Percent of total billed charges,,,0.97,,489.85,Percent of total billed charges,,,0.96,,484.8,Percent of total billed charges,,,0.95,,479.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,479.75,Percent of total billed charges,,479.75,494.9,
HC PR ED 59409 Vaginal Delivery Cdm,PX-98110602,CDM,59409,CPT,981,RC,,inpatient,,,2346,2111.4,,0.95,,2228.7,Percent of total billed charges,,,0.98,,2299.08,Percent of total billed charges,,,0.95,,2228.7,Percent of total billed charges,,,0.97,,2275.62,Percent of total billed charges,,,0.97,,2275.62,Percent of total billed charges,,,0.96,,2252.16,Percent of total billed charges,,,0.95,,2228.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2228.7,Percent of total billed charges,,2228.7,2299.08,
HC PR ED 59409 Vaginal Delivery Cdm,PX-98110602,CDM,59409,CPT,981,RC,,outpatient,,,2346,2111.4,,0.95,,2228.7,Percent of total billed charges,,,0.98,,2299.08,Percent of total billed charges,,,0.95,,2228.7,Percent of total billed charges,,,0.95,,2228.7,Percent of total billed charges,,,0.97,,2275.62,Percent of total billed charges,,,0.96,,2252.16,Percent of total billed charges,,,0.95,,2228.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2228.7,Percent of total billed charges,,2228.7,2299.08,
HC PR 59426 Antepartum Care Only (7 or More),PX-98310401,CDM,59426,CPT,983,RC,,inpatient,,,2546,2291.4,,0.95,,2418.7,Percent of total billed charges,,,0.98,,2495.08,Percent of total billed charges,,,0.95,,2418.7,Percent of total billed charges,,,0.97,,2469.62,Percent of total billed charges,,,0.97,,2469.62,Percent of total billed charges,,,0.96,,2444.16,Percent of total billed charges,,,0.95,,2418.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2418.7,Percent of total billed charges,,2418.7,2495.08,
HC PR 59426 Antepartum Care Only (7 or More),PX-98310401,CDM,59426,CPT,983,RC,,outpatient,,,2546,2291.4,,0.95,,2418.7,Percent of total billed charges,,,0.98,,2495.08,Percent of total billed charges,,,0.95,,2418.7,Percent of total billed charges,,,0.95,,2418.7,Percent of total billed charges,,,0.97,,2469.62,Percent of total billed charges,,,0.96,,2444.16,Percent of total billed charges,,,0.95,,2418.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2418.7,Percent of total billed charges,,2418.7,2495.08,
HC PR 59400 Total OB/Vaginal Delivery/Pp Care,PX-98310432,CDM,59400,CPT,983,RC,,inpatient,,,5976,5378.4,,0.95,,5677.2,Percent of total billed charges,,,0.98,,5856.48,Percent of total billed charges,,,0.95,,5677.2,Percent of total billed charges,,,0.97,,5796.72,Percent of total billed charges,,,0.97,,5796.72,Percent of total billed charges,,,0.96,,5736.96,Percent of total billed charges,,,0.95,,5677.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,5677.2,Percent of total billed charges,,5677.2,5856.48,
HC PR 59400 Total OB/Vaginal Delivery/Pp Care,PX-98310432,CDM,59400,CPT,983,RC,,outpatient,,,5976,5378.4,,0.95,,5677.2,Percent of total billed charges,,,0.98,,5856.48,Percent of total billed charges,,,0.95,,5677.2,Percent of total billed charges,,,0.95,,5677.2,Percent of total billed charges,,,0.97,,5796.72,Percent of total billed charges,,,0.96,,5736.96,Percent of total billed charges,,,0.95,,5677.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,5677.2,Percent of total billed charges,,5677.2,5856.48,
HC PR 59510 Total OB/Cesarean Delivery/Pp Car,PX-98310434,CDM,59510,CPT,983,RC,,inpatient,,,6645,5980.5,,0.95,,6312.75,Percent of total billed charges,,,0.98,,6512.1,Percent of total billed charges,,,0.95,,6312.75,Percent of total billed charges,,,0.97,,6445.65,Percent of total billed charges,,,0.97,,6445.65,Percent of total billed charges,,,0.96,,6379.2,Percent of total billed charges,,,0.95,,6312.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,6312.75,Percent of total billed charges,,6312.75,6512.1,
HC PR 59510 Total OB/Cesarean Delivery/Pp Car,PX-98310434,CDM,59510,CPT,983,RC,,outpatient,,,6645,5980.5,,0.95,,6312.75,Percent of total billed charges,,,0.98,,6512.1,Percent of total billed charges,,,0.95,,6312.75,Percent of total billed charges,,,0.95,,6312.75,Percent of total billed charges,,,0.97,,6445.65,Percent of total billed charges,,,0.96,,6379.2,Percent of total billed charges,,,0.95,,6312.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,6312.75,Percent of total billed charges,,6312.75,6512.1,
HC PR 59425 Antepartum Care Only OB Visits (4-6),PX-98310437,CDM,59425,CPT,983,RC,,inpatient,,,1392,1252.8,,0.95,,1322.4,Percent of total billed charges,,,0.98,,1364.16,Percent of total billed charges,,,0.95,,1322.4,Percent of total billed charges,,,0.97,,1350.24,Percent of total billed charges,,,0.97,,1350.24,Percent of total billed charges,,,0.96,,1336.32,Percent of total billed charges,,,0.95,,1322.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1322.4,Percent of total billed charges,,1322.4,1364.16,
HC PR 59425 Antepartum Care Only OB Visits (4-6),PX-98310437,CDM,59425,CPT,983,RC,,outpatient,,,1392,1252.8,,0.95,,1322.4,Percent of total billed charges,,,0.98,,1364.16,Percent of total billed charges,,,0.95,,1322.4,Percent of total billed charges,,,0.95,,1322.4,Percent of total billed charges,,,0.97,,1350.24,Percent of total billed charges,,,0.96,,1336.32,Percent of total billed charges,,,0.95,,1322.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1322.4,Percent of total billed charges,,1322.4,1364.16,
HC PR 51701 Insert Bladder Catheter,PX-98310440,CDM,51701,CPT,983,RC,,inpatient,,,153,137.7,,0.95,,145.35,Percent of total billed charges,,,0.98,,149.94,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.96,,146.88,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,145.35,Percent of total billed charges,,145.35,149.94,
HC PR 51701 Insert Bladder Catheter,PX-98310440,CDM,51701,CPT,983,RC,,outpatient,,,153,137.7,,0.95,,145.35,Percent of total billed charges,,,0.98,,149.94,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.96,,146.88,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,145.35,Percent of total billed charges,,145.35,149.94,
HC PR 59514 Cesarean Delivery Only Asst,PX-98310448,CDM,59514,CPT,983,RC,,inpatient,,,2274,2046.6,,0.95,,2160.3,Percent of total billed charges,,,0.98,,2228.52,Percent of total billed charges,,,0.95,,2160.3,Percent of total billed charges,,,0.97,,2205.78,Percent of total billed charges,,,0.97,,2205.78,Percent of total billed charges,,,0.96,,2183.04,Percent of total billed charges,,,0.95,,2160.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2160.3,Percent of total billed charges,,2160.3,2228.52,
HC PR 59514 Cesarean Delivery Only Asst,PX-98310448,CDM,59514,CPT,983,RC,,outpatient,,,2274,2046.6,,0.95,,2160.3,Percent of total billed charges,,,0.98,,2228.52,Percent of total billed charges,,,0.95,,2160.3,Percent of total billed charges,,,0.95,,2160.3,Percent of total billed charges,,,0.97,,2205.78,Percent of total billed charges,,,0.96,,2183.04,Percent of total billed charges,,,0.95,,2160.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2160.3,Percent of total billed charges,,2160.3,2228.52,
HC PR ED 76536 Head and Neck Soft Tissues Cdm,PX-98110955,CDM,76536,CPT,981,RC,,inpatient,,,271,243.9,,0.95,,257.45,Percent of total billed charges,,,0.98,,265.58,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,0.97,,262.87,Percent of total billed charges,,,0.97,,262.87,Percent of total billed charges,,,0.96,,260.16,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,257.45,Percent of total billed charges,,257.45,265.58,
HC PR ED 76536 Head and Neck Soft Tissues Cdm,PX-98110955,CDM,76536,CPT,981,RC,,outpatient,,,271,243.9,,0.95,,257.45,Percent of total billed charges,,,0.98,,265.58,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,0.97,,262.87,Percent of total billed charges,,,0.96,,260.16,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,257.45,Percent of total billed charges,,257.45,265.58,
Use drug to induce consciousness depression by MD,PX-37010151,CDM,99151,CPT,370,RC,,inpatient,,,424,381.6,,0.95,,402.8,Percent of total billed charges,,,0.98,,415.52,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,0.97,,411.28,Percent of total billed charges,,,0.97,,411.28,Percent of total billed charges,,,0.96,,407.04,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,402.8,Percent of total billed charges,,402.8,415.52,
Use drug to induce consciousness depression by MD,PX-37010151,CDM,99151,CPT,370,RC,,outpatient,,,424,381.6,,0.95,,402.8,Percent of total billed charges,,,0.98,,415.52,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,0.97,,411.28,Percent of total billed charges,,,0.96,,407.04,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,402.8,Percent of total billed charges,,402.8,415.52,
Use drug to induce consciousness depression by MD,PX-37010152,CDM,99152,CPT,370,RC,,inpatient,,,423,380.7,,0.95,,401.85,Percent of total billed charges,,,0.98,,414.54,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,0.97,,410.31,Percent of total billed charges,,,0.97,,410.31,Percent of total billed charges,,,0.96,,406.08,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,401.85,Percent of total billed charges,,401.85,414.54,
Use drug to induce consciousness depression by MD,PX-37010152,CDM,99152,CPT,370,RC,,outpatient,,,423,380.7,,0.95,,401.85,Percent of total billed charges,,,0.98,,414.54,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,0.97,,410.31,Percent of total billed charges,,,0.96,,406.08,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,401.85,Percent of total billed charges,,401.85,414.54,
Use drug to induce consciousness depression by MD,PX-37010153,CDM,99153,CPT,370,RC,,inpatient,,,230,207,,0.95,,218.5,Percent of total billed charges,,,0.98,,225.4,Percent of total billed charges,,,0.95,,218.5,Percent of total billed charges,,,0.97,,223.1,Percent of total billed charges,,,0.97,,223.1,Percent of total billed charges,,,0.96,,220.8,Percent of total billed charges,,,0.95,,218.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,218.5,Percent of total billed charges,,218.5,225.4,
Use drug to induce consciousness depression by MD,PX-37010153,CDM,99153,CPT,370,RC,,outpatient,,,230,207,,0.95,,218.5,Percent of total billed charges,,,0.98,,225.4,Percent of total billed charges,,,0.95,,218.5,Percent of total billed charges,,,0.95,,218.5,Percent of total billed charges,,,0.97,,223.1,Percent of total billed charges,,,0.96,,220.8,Percent of total billed charges,,,0.95,,218.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,218.5,Percent of total billed charges,,218.5,225.4,
Use drug to induce consciousness depression by MD,PX-37010154,CDM,99155,CPT,370,RC,,inpatient,,,437,393.3,,0.95,,415.15,Percent of total billed charges,,,0.98,,428.26,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,0.97,,423.89,Percent of total billed charges,,,0.97,,423.89,Percent of total billed charges,,,0.96,,419.52,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,415.15,Percent of total billed charges,,415.15,428.26,
Use drug to induce consciousness depression by MD,PX-37010154,CDM,99155,CPT,370,RC,,outpatient,,,437,393.3,,0.95,,415.15,Percent of total billed charges,,,0.98,,428.26,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,0.97,,423.89,Percent of total billed charges,,,0.96,,419.52,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,415.15,Percent of total billed charges,,415.15,428.26,
Use drug to induce consciousness depression by MD,PX-37010155,CDM,99156,CPT,370,RC,,inpatient,,,424,381.6,,0.95,,402.8,Percent of total billed charges,,,0.98,,415.52,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,0.97,,411.28,Percent of total billed charges,,,0.97,,411.28,Percent of total billed charges,,,0.96,,407.04,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,402.8,Percent of total billed charges,,402.8,415.52,
Use drug to induce consciousness depression by MD,PX-37010155,CDM,99156,CPT,370,RC,,outpatient,,,424,381.6,,0.95,,402.8,Percent of total billed charges,,,0.98,,415.52,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,0.97,,411.28,Percent of total billed charges,,,0.96,,407.04,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,402.8,Percent of total billed charges,,402.8,415.52,
Use of a drug to induce consciousness depression,PX-37010156,CDM,99157,CPT,370,RC,,inpatient,,,239,215.1,,0.95,,227.05,Percent of total billed charges,,,0.98,,234.22,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,0.97,,231.83,Percent of total billed charges,,,0.97,,231.83,Percent of total billed charges,,,0.96,,229.44,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,227.05,Percent of total billed charges,,227.05,234.22,
Use of a drug to induce consciousness depression,PX-37010156,CDM,99157,CPT,370,RC,,outpatient,,,239,215.1,,0.95,,227.05,Percent of total billed charges,,,0.98,,234.22,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,0.97,,231.83,Percent of total billed charges,,,0.96,,229.44,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,227.05,Percent of total billed charges,,227.05,234.22,
"Detection test for candida species (yeast), amplified probe",PX-30610058,CDM,87481,CPT,306,RC,,inpatient,,,165,148.5,,0.95,,156.75,Percent of total billed charges,,,0.98,,161.7,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.96,,158.4,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,156.75,Percent of total billed charges,,156.75,161.7,
"Detection test for candida species (yeast), amplified probe",PX-30610058,CDM,87481,CPT,306,RC,,outpatient,,,165,148.5,,0.95,,156.75,Percent of total billed charges,,,0.98,,161.7,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.96,,158.4,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,156.75,Percent of total billed charges,,156.75,161.7,
"HC PR G0490 Home Visit Rn, Lpn by Rhc/Fq",PX-5270001,CDM,G0490,HCPCS,527,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
"HC PR G0490 Home Visit Rn, Lpn by Rhc/Fq",PX-5270001,CDM,G0490,HCPCS,527,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
HC Vest Restraint #3311xl,PX-3254124WWM,CDM,3254124WWM,LOCAL,270,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
HC Vest Restraint #3311xl,PX-3254124WWM,CDM,3254124WWM,LOCAL,270,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
HC Vest Restraint Lg #24663-060,PX-3254123WWM,CDM,3254123WWM,LOCAL,270,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
HC Vest Restraint Lg #24663-060,PX-3254123WWM,CDM,3254123WWM,LOCAL,270,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
HC Vest Restraint MD #24663-030,PX-3254122WWM,CDM,3254122WWM,LOCAL,270,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
HC Vest Restraint MD #24663-030,PX-3254122WWM,CDM,3254122WWM,LOCAL,270,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
HC Vest Restraintsm #24663-020,PX-3254121WWM,CDM,3254121WWM,LOCAL,270,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
HC Vest Restraintsm #24663-020,PX-3254121WWM,CDM,3254121WWM,LOCAL,270,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
HC or Tightrope Rt W/ Su,PX-3254120WWM,CDM,3254120WWM,LOCAL,270,RC,,inpatient,,,926,833.4,,0.95,,879.7,Percent of total billed charges,,,0.98,,907.48,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,0.97,,898.22,Percent of total billed charges,,,0.97,,898.22,Percent of total billed charges,,,0.96,,888.96,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,879.7,Percent of total billed charges,,879.7,907.48,
HC or Tightrope Rt W/ Su,PX-3254120WWM,CDM,3254120WWM,LOCAL,270,RC,,outpatient,,,926,833.4,,0.95,,879.7,Percent of total billed charges,,,0.98,,907.48,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,0.97,,898.22,Percent of total billed charges,,,0.96,,888.96,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,879.7,Percent of total billed charges,,879.7,907.48,
HC OB Postpartum Balloon #G24237,PX-3254119WWM,CDM,3254119WWM,LOCAL,270,RC,,inpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
HC OB Postpartum Balloon #G24237,PX-3254119WWM,CDM,3254119WWM,LOCAL,270,RC,,outpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
HC W/F Long R/Lg #410105,PX-3254117WWM,CDM,3254117WWM,LOCAL,270,RC,,inpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
HC W/F Long R/Lg #410105,PX-3254117WWM,CDM,3254117WWM,LOCAL,270,RC,,outpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
HC W/F Long R/Med #410104,PX-3254116WWM,CDM,3254116WWM,LOCAL,270,RC,,inpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
HC W/F Long R/Med #410104,PX-3254116WWM,CDM,3254116WWM,LOCAL,270,RC,,outpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
HC W/F Long R/Sm #410103,PX-3254115WWM,CDM,3254115WWM,LOCAL,270,RC,,inpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
HC W/F Long R/Sm #410103,PX-3254115WWM,CDM,3254115WWM,LOCAL,270,RC,,outpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
HC W/F Long L/Xl #410110,PX-3254114WWM,CDM,3254114WWM,LOCAL,270,RC,,inpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
HC W/F Long L/Xl #410110,PX-3254114WWM,CDM,3254114WWM,LOCAL,270,RC,,outpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
HC W/F Long L/Lg #410109,PX-3254113WWM,CDM,3254113WWM,LOCAL,270,RC,,inpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
HC W/F Long L/Lg #410109,PX-3254113WWM,CDM,3254113WWM,LOCAL,270,RC,,outpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
HC W/F Long L/Med #410108,PX-3254112WWM,CDM,3254112WWM,LOCAL,270,RC,,inpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
HC W/F Long L/Med #410108,PX-3254112WWM,CDM,3254112WWM,LOCAL,270,RC,,outpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
HC W/F Long L/Sm #410108,PX-3254111WWM,CDM,3254111WWM,LOCAL,270,RC,,inpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
HC W/F Long L/Sm #410108,PX-3254111WWM,CDM,3254111WWM,LOCAL,270,RC,,outpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
HC Rt Flutter Valve #58-62510,PX-3254110WWM,CDM,3254110WWM,LOCAL,270,RC,,inpatient,,,165,148.5,,0.95,,156.75,Percent of total billed charges,,,0.98,,161.7,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.96,,158.4,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,156.75,Percent of total billed charges,,156.75,161.7,
HC Rt Flutter Valve #58-62510,PX-3254110WWM,CDM,3254110WWM,LOCAL,270,RC,,outpatient,,,165,148.5,,0.95,,156.75,Percent of total billed charges,,,0.98,,161.7,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.96,,158.4,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,156.75,Percent of total billed charges,,156.75,161.7,
HC Drsg Optifoam Adh 4x4 #Msc1244ep,PX-3254109WWM,CDM,3254109WWM,LOCAL,270,RC,,inpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19,Percent of total billed charges,,19,19.6,
HC Drsg Optifoam Adh 4x4 #Msc1244ep,PX-3254109WWM,CDM,3254109WWM,LOCAL,270,RC,,outpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19,Percent of total billed charges,,19,19.6,
HC Drsg Optifoam Adh 6x6 #Msc1244ep,PX-3254108WWM,CDM,3254108WWM,LOCAL,270,RC,,inpatient,,,31,27.9,,0.95,,29.45,Percent of total billed charges,,,0.98,,30.38,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.96,,29.76,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,29.45,Percent of total billed charges,,29.45,30.38,
HC Drsg Optifoam Adh 6x6 #Msc1244ep,PX-3254108WWM,CDM,3254108WWM,LOCAL,270,RC,,outpatient,,,31,27.9,,0.95,,29.45,Percent of total billed charges,,,0.98,,30.38,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.96,,29.76,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,29.45,Percent of total billed charges,,29.45,30.38,
HC or Apollo Rf 90 #AR-9811,PX-3254107WWM,CDM,3254107WWM,LOCAL,270,RC,,inpatient,,,476,428.4,,0.95,,452.2,Percent of total billed charges,,,0.98,,466.48,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,0.97,,461.72,Percent of total billed charges,,,0.97,,461.72,Percent of total billed charges,,,0.96,,456.96,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,452.2,Percent of total billed charges,,452.2,466.48,
HC or Apollo Rf 90 #AR-9811,PX-3254107WWM,CDM,3254107WWM,LOCAL,270,RC,,outpatient,,,476,428.4,,0.95,,452.2,Percent of total billed charges,,,0.98,,466.48,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,0.97,,461.72,Percent of total billed charges,,,0.96,,456.96,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,452.2,Percent of total billed charges,,452.2,466.48,
HC or Reload Vasc 45 #Tr45w,PX-3254106WWM,CDM,3254106WWM,LOCAL,270,RC,,inpatient,,,304,273.6,,0.95,,288.8,Percent of total billed charges,,,0.98,,297.92,Percent of total billed charges,,,0.95,,288.8,Percent of total billed charges,,,0.97,,294.88,Percent of total billed charges,,,0.97,,294.88,Percent of total billed charges,,,0.96,,291.84,Percent of total billed charges,,,0.95,,288.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,288.8,Percent of total billed charges,,288.8,297.92,
HC or Reload Vasc 45 #Tr45w,PX-3254106WWM,CDM,3254106WWM,LOCAL,270,RC,,outpatient,,,304,273.6,,0.95,,288.8,Percent of total billed charges,,,0.98,,297.92,Percent of total billed charges,,,0.95,,288.8,Percent of total billed charges,,,0.95,,288.8,Percent of total billed charges,,,0.97,,294.88,Percent of total billed charges,,,0.96,,291.84,Percent of total billed charges,,,0.95,,288.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,288.8,Percent of total billed charges,,288.8,297.92,
HC or Reload Hernia #174007,PX-3254105WWM,CDM,3254105WWM,LOCAL,270,RC,,inpatient,,,338,304.2,,0.95,,321.1,Percent of total billed charges,,,0.98,,331.24,Percent of total billed charges,,,0.95,,321.1,Percent of total billed charges,,,0.97,,327.86,Percent of total billed charges,,,0.97,,327.86,Percent of total billed charges,,,0.96,,324.48,Percent of total billed charges,,,0.95,,321.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,321.1,Percent of total billed charges,,321.1,331.24,
HC or Reload Hernia #174007,PX-3254105WWM,CDM,3254105WWM,LOCAL,270,RC,,outpatient,,,338,304.2,,0.95,,321.1,Percent of total billed charges,,,0.98,,331.24,Percent of total billed charges,,,0.95,,321.1,Percent of total billed charges,,,0.95,,321.1,Percent of total billed charges,,,0.97,,327.86,Percent of total billed charges,,,0.96,,324.48,Percent of total billed charges,,,0.95,,321.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,321.1,Percent of total billed charges,,321.1,331.24,
HC Drsg Quik Clot Combat Gauze #Zm198b,PX-3254104WWM,CDM,3254104WWM,LOCAL,270,RC,,inpatient,,,161,144.9,,0.95,,152.95,Percent of total billed charges,,,0.98,,157.78,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.96,,154.56,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,152.95,Percent of total billed charges,,152.95,157.78,
HC Drsg Quik Clot Combat Gauze #Zm198b,PX-3254104WWM,CDM,3254104WWM,LOCAL,270,RC,,outpatient,,,161,144.9,,0.95,,152.95,Percent of total billed charges,,,0.98,,157.78,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.96,,154.56,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,152.95,Percent of total billed charges,,152.95,157.78,
HC OB Cerv Ripen Ballon #G19891,PX-3254103WWM,CDM,3254103WWM,LOCAL,270,RC,,inpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
HC OB Cerv Ripen Ballon #G19891,PX-3254103WWM,CDM,3254103WWM,LOCAL,270,RC,,outpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
HC Tube Gastrostomy #0120241-7,PX-3254102WWM,CDM,3254102WWM,LOCAL,270,RC,,inpatient,,,234,210.6,,0.95,,222.3,Percent of total billed charges,,,0.98,,229.32,Percent of total billed charges,,,0.95,,222.3,Percent of total billed charges,,,0.97,,226.98,Percent of total billed charges,,,0.97,,226.98,Percent of total billed charges,,,0.96,,224.64,Percent of total billed charges,,,0.95,,222.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,222.3,Percent of total billed charges,,222.3,229.32,
HC Tube Gastrostomy #0120241-7,PX-3254102WWM,CDM,3254102WWM,LOCAL,270,RC,,outpatient,,,234,210.6,,0.95,,222.3,Percent of total billed charges,,,0.98,,229.32,Percent of total billed charges,,,0.95,,222.3,Percent of total billed charges,,,0.95,,222.3,Percent of total billed charges,,,0.97,,226.98,Percent of total billed charges,,,0.96,,224.64,Percent of total billed charges,,,0.95,,222.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,222.3,Percent of total billed charges,,222.3,229.32,
HC or Tightrope Rt W/ Su #AR-1588rt-J,PX-3254118WWM,CDM,3254118WWM,LOCAL,270,RC,,inpatient,,,926,833.4,,0.95,,879.7,Percent of total billed charges,,,0.98,,907.48,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,0.97,,898.22,Percent of total billed charges,,,0.97,,898.22,Percent of total billed charges,,,0.96,,888.96,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,879.7,Percent of total billed charges,,879.7,907.48,
HC or Tightrope Rt W/ Su #AR-1588rt-J,PX-3254118WWM,CDM,3254118WWM,LOCAL,270,RC,,outpatient,,,926,833.4,,0.95,,879.7,Percent of total billed charges,,,0.98,,907.48,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,0.97,,898.22,Percent of total billed charges,,,0.96,,888.96,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,879.7,Percent of total billed charges,,879.7,907.48,
HC or Drill Cann 9.5mm #AR-1218-95,PX-3254125WWM,CDM,3254125WWM,LOCAL,270,RC,,inpatient,,,611,549.9,,0.95,,580.45,Percent of total billed charges,,,0.98,,598.78,Percent of total billed charges,,,0.95,,580.45,Percent of total billed charges,,,0.97,,592.67,Percent of total billed charges,,,0.97,,592.67,Percent of total billed charges,,,0.96,,586.56,Percent of total billed charges,,,0.95,,580.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,580.45,Percent of total billed charges,,580.45,598.78,
HC or Drill Cann 9.5mm #AR-1218-95,PX-3254125WWM,CDM,3254125WWM,LOCAL,270,RC,,outpatient,,,611,549.9,,0.95,,580.45,Percent of total billed charges,,,0.98,,598.78,Percent of total billed charges,,,0.95,,580.45,Percent of total billed charges,,,0.95,,580.45,Percent of total billed charges,,,0.97,,592.67,Percent of total billed charges,,,0.96,,586.56,Percent of total billed charges,,,0.95,,580.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,580.45,Percent of total billed charges,,580.45,598.78,
HC or Reamer Low #Ar1409lp-90,PX-3254126WWM,CDM,3254126WWM,LOCAL,270,RC,,inpatient,,,611,549.9,,0.95,,580.45,Percent of total billed charges,,,0.98,,598.78,Percent of total billed charges,,,0.95,,580.45,Percent of total billed charges,,,0.97,,592.67,Percent of total billed charges,,,0.97,,592.67,Percent of total billed charges,,,0.96,,586.56,Percent of total billed charges,,,0.95,,580.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,580.45,Percent of total billed charges,,580.45,598.78,
HC or Reamer Low #Ar1409lp-90,PX-3254126WWM,CDM,3254126WWM,LOCAL,270,RC,,outpatient,,,611,549.9,,0.95,,580.45,Percent of total billed charges,,,0.98,,598.78,Percent of total billed charges,,,0.95,,580.45,Percent of total billed charges,,,0.95,,580.45,Percent of total billed charges,,,0.97,,592.67,Percent of total billed charges,,,0.96,,586.56,Percent of total billed charges,,,0.95,,580.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,580.45,Percent of total billed charges,,580.45,598.78,
HC or Tightrope Acl Closed Eye #Ar1595tc,PX-3254127WWM,CDM,3254127WWM,LOCAL,270,RC,,inpatient,,,392,352.8,,0.95,,372.4,Percent of total billed charges,,,0.98,,384.16,Percent of total billed charges,,,0.95,,372.4,Percent of total billed charges,,,0.97,,380.24,Percent of total billed charges,,,0.97,,380.24,Percent of total billed charges,,,0.96,,376.32,Percent of total billed charges,,,0.95,,372.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,372.4,Percent of total billed charges,,372.4,384.16,
HC or Tightrope Acl Closed Eye #Ar1595tc,PX-3254127WWM,CDM,3254127WWM,LOCAL,270,RC,,outpatient,,,392,352.8,,0.95,,372.4,Percent of total billed charges,,,0.98,,384.16,Percent of total billed charges,,,0.95,,372.4,Percent of total billed charges,,,0.95,,372.4,Percent of total billed charges,,,0.97,,380.24,Percent of total billed charges,,,0.96,,376.32,Percent of total billed charges,,,0.95,,372.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,372.4,Percent of total billed charges,,372.4,384.16,
HC or Graftbolt Tibial 8mm #AR-5100-08,PX-3254128WWM,CDM,3254128WWM,LOCAL,270,RC,,inpatient,,,989,890.1,,0.95,,939.55,Percent of total billed charges,,,0.98,,969.22,Percent of total billed charges,,,0.95,,939.55,Percent of total billed charges,,,0.97,,959.33,Percent of total billed charges,,,0.97,,959.33,Percent of total billed charges,,,0.96,,949.44,Percent of total billed charges,,,0.95,,939.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,939.55,Percent of total billed charges,,939.55,969.22,
HC or Graftbolt Tibial 8mm #AR-5100-08,PX-3254128WWM,CDM,3254128WWM,LOCAL,270,RC,,outpatient,,,989,890.1,,0.95,,939.55,Percent of total billed charges,,,0.98,,969.22,Percent of total billed charges,,,0.95,,939.55,Percent of total billed charges,,,0.95,,939.55,Percent of total billed charges,,,0.97,,959.33,Percent of total billed charges,,,0.96,,949.44,Percent of total billed charges,,,0.95,,939.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,939.55,Percent of total billed charges,,939.55,969.22,
HC or Graftbolt Tibial 9mm #AR-5100-09,PX-3254129WWM,CDM,3254129WWM,LOCAL,270,RC,,inpatient,,,989,890.1,,0.95,,939.55,Percent of total billed charges,,,0.98,,969.22,Percent of total billed charges,,,0.95,,939.55,Percent of total billed charges,,,0.97,,959.33,Percent of total billed charges,,,0.97,,959.33,Percent of total billed charges,,,0.96,,949.44,Percent of total billed charges,,,0.95,,939.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,939.55,Percent of total billed charges,,939.55,969.22,
HC or Graftbolt Tibial 9mm #AR-5100-09,PX-3254129WWM,CDM,3254129WWM,LOCAL,270,RC,,outpatient,,,989,890.1,,0.95,,939.55,Percent of total billed charges,,,0.98,,969.22,Percent of total billed charges,,,0.95,,939.55,Percent of total billed charges,,,0.95,,939.55,Percent of total billed charges,,,0.97,,959.33,Percent of total billed charges,,,0.96,,949.44,Percent of total billed charges,,,0.95,,939.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,939.55,Percent of total billed charges,,939.55,969.22,
HC or Fiberloop #2 Blue #AR-7234,PX-3254130WWM,CDM,3254130WWM,LOCAL,270,RC,,inpatient,,,220,198,,0.95,,209,Percent of total billed charges,,,0.98,,215.6,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,0.97,,213.4,Percent of total billed charges,,,0.97,,213.4,Percent of total billed charges,,,0.96,,211.2,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,209,Percent of total billed charges,,209,215.6,
HC or Fiberloop #2 Blue #AR-7234,PX-3254130WWM,CDM,3254130WWM,LOCAL,270,RC,,outpatient,,,220,198,,0.95,,209,Percent of total billed charges,,,0.98,,215.6,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,0.97,,213.4,Percent of total billed charges,,,0.96,,211.2,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,209,Percent of total billed charges,,209,215.6,
HC PR Rx Incobotulinumtoxin a Inj 1 Unit,PX-63610258,CDM,J0588,HCPCS,636,RC,,inpatient,,,15,13.5,,0.95,,14.25,Percent of total billed charges,,,0.98,,14.7,Percent of total billed charges,,,0.95,,14.25,Percent of total billed charges,,,0.97,,14.55,Percent of total billed charges,,,0.97,,14.55,Percent of total billed charges,,,0.96,,14.4,Percent of total billed charges,,,0.95,,14.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,14.25,Percent of total billed charges,,14.25,14.7,
HC PR Rx Incobotulinumtoxin a Inj 1 Unit,PX-63610258,CDM,J0588,HCPCS,636,RC,,outpatient,,,15,13.5,,0.95,,14.25,Percent of total billed charges,,,0.98,,14.7,Percent of total billed charges,,,0.95,,14.25,Percent of total billed charges,,,0.95,,14.25,Percent of total billed charges,,,0.97,,14.55,Percent of total billed charges,,,0.96,,14.4,Percent of total billed charges,,,0.95,,14.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,14.25,Percent of total billed charges,,14.25,14.7,
HC R&B-Semi-Private Respite Level 3,PX-12010006,CDM,12010006,LOCAL,120,RC,,inpatient,,,525,472.5,,0.95,,498.75,Percent of total billed charges,,,0.98,,514.5,Percent of total billed charges,,,0.95,,498.75,Percent of total billed charges,,,0.97,,509.25,Percent of total billed charges,,,0.97,,509.25,Percent of total billed charges,,,0.96,,504,Percent of total billed charges,,,0.95,,498.75,Percent of total billed charges,,,,,,,,,0.95,,498.75,Percent of total billed charges,,498.75,514.5,
HC R&B-Semi-Private Respite Level 3,PX-12010006,CDM,12010006,LOCAL,120,RC,,outpatient,,,525,472.5,,0.95,,498.75,Percent of total billed charges,,,0.98,,514.5,Percent of total billed charges,,,0.95,,498.75,Percent of total billed charges,,,0.95,,498.75,Percent of total billed charges,,,0.97,,509.25,Percent of total billed charges,,,0.96,,504,Percent of total billed charges,,,0.95,,498.75,Percent of total billed charges,,,,,,,,,0.95,,498.75,Percent of total billed charges,,498.75,514.5,
Translocation analysis (BCR/ABL1) minor breakpoint,PX-30010002,CDM,81207,CPT,310,RC,,inpatient,,,688,619.2,,0.95,,653.6,Percent of total billed charges,,,0.98,,674.24,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,0.97,,667.36,Percent of total billed charges,,,0.97,,667.36,Percent of total billed charges,,,0.96,,660.48,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,653.6,Percent of total billed charges,,653.6,674.24,
Translocation analysis (BCR/ABL1) minor breakpoint,PX-30010002,CDM,81207,CPT,310,RC,,outpatient,,,688,619.2,,0.95,,653.6,Percent of total billed charges,,,0.98,,674.24,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,0.97,,667.36,Percent of total billed charges,,,0.96,,660.48,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,653.6,Percent of total billed charges,,653.6,674.24,
"Measure antibody to allergic, recombinant or purified, each",PX-30010003,CDM,86008,CPT,302,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
"Measure antibody to allergic, recombinant or purified, each",PX-30010003,CDM,86008,CPT,302,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Analysis for antibody to Zika virus,PX-30010014,CDM,86794,CPT,302,RC,,inpatient,,,14,12.6,,0.95,,13.3,Percent of total billed charges,,,0.98,,13.72,Percent of total billed charges,,,0.95,,13.3,Percent of total billed charges,,,0.97,,13.58,Percent of total billed charges,,,0.97,,13.58,Percent of total billed charges,,,0.96,,13.44,Percent of total billed charges,,,0.95,,13.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,13.3,Percent of total billed charges,,13.3,13.72,
Analysis for antibody to Zika virus,PX-30010014,CDM,86794,CPT,302,RC,,outpatient,,,14,12.6,,0.95,,13.3,Percent of total billed charges,,,0.98,,13.72,Percent of total billed charges,,,0.95,,13.3,Percent of total billed charges,,,0.95,,13.3,Percent of total billed charges,,,0.97,,13.58,Percent of total billed charges,,,0.96,,13.44,Percent of total billed charges,,,0.95,,13.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,13.3,Percent of total billed charges,,13.3,13.72,
"Test by nucleic acid for respiratory syncytial, amplified",PX-30010015,CDM,87634,CPT,306,RC,,inpatient,,,296,266.4,,0.95,,281.2,Percent of total billed charges,,,0.98,,290.08,Percent of total billed charges,,,0.95,,281.2,Percent of total billed charges,,,0.97,,287.12,Percent of total billed charges,,,0.97,,287.12,Percent of total billed charges,,,0.96,,284.16,Percent of total billed charges,,,0.95,,281.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,281.2,Percent of total billed charges,,281.2,290.08,
"Test by nucleic acid for respiratory syncytial, amplified",PX-30010015,CDM,87634,CPT,306,RC,,outpatient,,,296,266.4,,0.95,,281.2,Percent of total billed charges,,,0.98,,290.08,Percent of total billed charges,,,0.95,,281.2,Percent of total billed charges,,,0.95,,281.2,Percent of total billed charges,,,0.97,,287.12,Percent of total billed charges,,,0.96,,284.16,Percent of total billed charges,,,0.95,,281.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,281.2,Percent of total billed charges,,281.2,290.08,
"Test bynucleic acid for Zika virus, amplified",PX-30010080,CDM,87662,CPT,306,RC,,inpatient,,,63,56.7,,0.95,,59.85,Percent of total billed charges,,,0.98,,61.74,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.96,,60.48,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,,,,,,,0.95,,59.85,Percent of total billed charges,,59.85,61.74,
"Test bynucleic acid for Zika virus, amplified",PX-30010080,CDM,87662,CPT,306,RC,,outpatient,,,63,56.7,,0.95,,59.85,Percent of total billed charges,,,0.98,,61.74,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.96,,60.48,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,,,,,,,0.95,,59.85,Percent of total billed charges,,59.85,61.74,
Gene analysis full sequence analysis,PX-31010170,CDM,81364,CPT,310,RC,,inpatient,,,1004,903.6,,0.95,,953.8,Percent of total billed charges,,,0.98,,983.92,Percent of total billed charges,,,0.95,,953.8,Percent of total billed charges,,,0.97,,973.88,Percent of total billed charges,,,0.97,,973.88,Percent of total billed charges,,,0.96,,963.84,Percent of total billed charges,,,0.95,,953.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,953.8,Percent of total billed charges,,953.8,983.92,
Gene analysis full sequence analysis,PX-31010170,CDM,81364,CPT,310,RC,,outpatient,,,1004,903.6,,0.95,,953.8,Percent of total billed charges,,,0.98,,983.92,Percent of total billed charges,,,0.95,,953.8,Percent of total billed charges,,,0.95,,953.8,Percent of total billed charges,,,0.97,,973.88,Percent of total billed charges,,,0.96,,963.84,Percent of total billed charges,,,0.95,,953.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,953.8,Percent of total billed charges,,953.8,983.92,
"X-ray of abdomen, 1 view",PX-32010029,CDM,74018,CPT,320,RC,,inpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,286.9,Percent of total billed charges,,286.9,295.96,
"X-ray of abdomen, 1 view",PX-32010029,CDM,74018,CPT,320,RC,,outpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,286.9,Percent of total billed charges,,286.9,295.96,
"X-ray of abdomen, 2 views",PX-32010107,CDM,74019,CPT,320,RC,,inpatient,,,402,361.8,,0.95,,381.9,Percent of total billed charges,,,0.98,,393.96,Percent of total billed charges,,,0.95,,381.9,Percent of total billed charges,,,0.97,,389.94,Percent of total billed charges,,,0.97,,389.94,Percent of total billed charges,,,0.96,,385.92,Percent of total billed charges,,,0.95,,381.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,381.9,Percent of total billed charges,,381.9,393.96,
"X-ray of abdomen, 2 views",PX-32010107,CDM,74019,CPT,320,RC,,outpatient,,,402,361.8,,0.95,,381.9,Percent of total billed charges,,,0.98,,393.96,Percent of total billed charges,,,0.95,,381.9,Percent of total billed charges,,,0.95,,381.9,Percent of total billed charges,,,0.97,,389.94,Percent of total billed charges,,,0.96,,385.92,Percent of total billed charges,,,0.95,,381.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,381.9,Percent of total billed charges,,381.9,393.96,
HC Xr Abdomen 3+ Views,PX-32010135,CDM,74021,CPT,320,RC,,inpatient,,,449,404.1,,0.95,,426.55,Percent of total billed charges,,,0.98,,440.02,Percent of total billed charges,,,0.95,,426.55,Percent of total billed charges,,,0.97,,435.53,Percent of total billed charges,,,0.97,,435.53,Percent of total billed charges,,,0.96,,431.04,Percent of total billed charges,,,0.95,,426.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,426.55,Percent of total billed charges,,426.55,440.02,
HC Xr Abdomen 3+ Views,PX-32010135,CDM,74021,CPT,320,RC,,outpatient,,,449,404.1,,0.95,,426.55,Percent of total billed charges,,,0.98,,440.02,Percent of total billed charges,,,0.95,,426.55,Percent of total billed charges,,,0.95,,426.55,Percent of total billed charges,,,0.97,,435.53,Percent of total billed charges,,,0.96,,431.04,Percent of total billed charges,,,0.95,,426.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,426.55,Percent of total billed charges,,426.55,440.02,
"X-ray of chest, 1 view",PX-32410014,CDM,71045,CPT,324,RC,,inpatient,,,320,288,,0.95,,304,Percent of total billed charges,,,0.98,,313.6,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,0.97,,310.4,Percent of total billed charges,,,0.97,,310.4,Percent of total billed charges,,,0.96,,307.2,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,304,Percent of total billed charges,,304,313.6,
"X-ray of chest, 1 view",PX-32410014,CDM,71045,CPT,324,RC,,outpatient,,,320,288,,0.95,,304,Percent of total billed charges,,,0.98,,313.6,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,0.97,,310.4,Percent of total billed charges,,,0.96,,307.2,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,304,Percent of total billed charges,,304,313.6,
"X-ray of chest, 2 views",PX-32410015,CDM,71046,CPT,324,RC,,inpatient,,,371,333.9,,0.95,,352.45,Percent of total billed charges,,,0.98,,363.58,Percent of total billed charges,,,0.95,,352.45,Percent of total billed charges,,,0.97,,359.87,Percent of total billed charges,,,0.97,,359.87,Percent of total billed charges,,,0.96,,356.16,Percent of total billed charges,,,0.95,,352.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,352.45,Percent of total billed charges,,352.45,363.58,
"X-ray of chest, 2 views",PX-32410015,CDM,71046,CPT,324,RC,,outpatient,,,371,333.9,,0.95,,352.45,Percent of total billed charges,,,0.98,,363.58,Percent of total billed charges,,,0.95,,352.45,Percent of total billed charges,,,0.95,,352.45,Percent of total billed charges,,,0.97,,359.87,Percent of total billed charges,,,0.96,,356.16,Percent of total billed charges,,,0.95,,352.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,352.45,Percent of total billed charges,,352.45,363.58,
"X-ray of chest, 3 views",PX-32410016,CDM,71047,CPT,324,RC,,inpatient,,,371,333.9,,0.95,,352.45,Percent of total billed charges,,,0.98,,363.58,Percent of total billed charges,,,0.95,,352.45,Percent of total billed charges,,,0.97,,359.87,Percent of total billed charges,,,0.97,,359.87,Percent of total billed charges,,,0.96,,356.16,Percent of total billed charges,,,0.95,,352.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,352.45,Percent of total billed charges,,352.45,363.58,
"X-ray of chest, 3 views",PX-32410016,CDM,71047,CPT,324,RC,,outpatient,,,371,333.9,,0.95,,352.45,Percent of total billed charges,,,0.98,,363.58,Percent of total billed charges,,,0.95,,352.45,Percent of total billed charges,,,0.95,,352.45,Percent of total billed charges,,,0.97,,359.87,Percent of total billed charges,,,0.96,,356.16,Percent of total billed charges,,,0.95,,352.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,352.45,Percent of total billed charges,,352.45,363.58,
"X-ray of chest, minimum of 4 views",PX-32410017,CDM,71048,CPT,324,RC,,inpatient,,,380,342,,0.95,,361,Percent of total billed charges,,,0.98,,372.4,Percent of total billed charges,,,0.95,,361,Percent of total billed charges,,,0.97,,368.6,Percent of total billed charges,,,0.97,,368.6,Percent of total billed charges,,,0.96,,364.8,Percent of total billed charges,,,0.95,,361,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,361,Percent of total billed charges,,361,372.4,
"X-ray of chest, minimum of 4 views",PX-32410017,CDM,71048,CPT,324,RC,,outpatient,,,380,342,,0.95,,361,Percent of total billed charges,,,0.98,,372.4,Percent of total billed charges,,,0.95,,361,Percent of total billed charges,,,0.95,,361,Percent of total billed charges,,,0.97,,368.6,Percent of total billed charges,,,0.96,,364.8,Percent of total billed charges,,,0.95,,361,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,361,Percent of total billed charges,,361,372.4,
Test for exercise-induced spasm of lung airways,PX-46010011,CDM,94617,CPT,460,RC,,inpatient,,,244,219.6,,0.95,,231.8,Percent of total billed charges,,,0.98,,239.12,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,0.97,,236.68,Percent of total billed charges,,,0.97,,236.68,Percent of total billed charges,,,0.96,,234.24,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,231.8,Percent of total billed charges,,231.8,239.12,
Test for exercise-induced spasm of lung airways,PX-46010011,CDM,94617,CPT,460,RC,,outpatient,,,244,219.6,,0.95,,231.8,Percent of total billed charges,,,0.98,,239.12,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,0.97,,236.68,Percent of total billed charges,,,0.96,,234.24,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,231.8,Percent of total billed charges,,231.8,239.12,
Test for exercise-induced lung stress,PX-46010048,CDM,94618,CPT,460,RC,,inpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
Test for exercise-induced lung stress,PX-46010048,CDM,94618,CPT,460,RC,,outpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
Patient/caregiver training to monitor anticoagulant therapy,PX-51010004,CDM,93792,CPT,510,RC,,inpatient,,,173,155.7,,0.95,,164.35,Percent of total billed charges,,,0.98,,169.54,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.96,,166.08,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,164.35,Percent of total billed charges,,164.35,169.54,
Patient/caregiver training to monitor anticoagulant therapy,PX-51010004,CDM,93792,CPT,510,RC,,outpatient,,,173,155.7,,0.95,,164.35,Percent of total billed charges,,,0.98,,169.54,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.96,,166.08,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,164.35,Percent of total billed charges,,164.35,169.54,
Anticoagulant management of patient taking warfarin,PX-51010005,CDM,93793,CPT,510,RC,,inpatient,,,30,27,,0.95,,28.5,Percent of total billed charges,,,0.98,,29.4,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,0.97,,29.1,Percent of total billed charges,,,0.97,,29.1,Percent of total billed charges,,,0.96,,28.8,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,28.5,Percent of total billed charges,,28.5,29.4,
Anticoagulant management of patient taking warfarin,PX-51010005,CDM,93793,CPT,510,RC,,outpatient,,,30,27,,0.95,,28.5,Percent of total billed charges,,,0.98,,29.4,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,0.97,,29.1,Percent of total billed charges,,,0.96,,28.8,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,28.5,Percent of total billed charges,,28.5,29.4,
Continuous monitoring of blood sugar level in tissue fluid,PX-51010006,CDM,95249,CPT,510,RC,,inpatient,,,161,144.9,,0.95,,152.95,Percent of total billed charges,,,0.98,,157.78,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.96,,154.56,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,152.95,Percent of total billed charges,,152.95,157.78,
Continuous monitoring of blood sugar level in tissue fluid,PX-51010006,CDM,95249,CPT,510,RC,,outpatient,,,161,144.9,,0.95,,152.95,Percent of total billed charges,,,0.98,,157.78,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.96,,154.56,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,152.95,Percent of total billed charges,,152.95,157.78,
HC PR 00731 Anes Uppr GI Ndsc Px Nos,PX-96310282,CDM,731,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00731 Anes Uppr GI Ndsc Px Nos,PX-96310282,CDM,731,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00732 Anes Upr GI Ndsc Px Ercp,PX-96310283,CDM,732,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00732 Anes Upr GI Ndsc Px Ercp,PX-96310283,CDM,732,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00811 Anes Lwr Intst Ndsc Nos,PX-96310284,CDM,811,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00811 Anes Lwr Intst Ndsc Nos,PX-96310284,CDM,811,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00812 Anes Lwr Intst Scr Colsc,PX-96310285,CDM,812,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00812 Anes Lwr Intst Scr Colsc,PX-96310285,CDM,812,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00813 Anes Uppr Lwr GI Ndsc Px,PX-96310286,CDM,813,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 00813 Anes Uppr Lwr GI Ndsc Px,PX-96310286,CDM,813,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 19294 Prep Tum Cav Iort Prtl Mast,PX-96910009,CDM,19294,CPT,983,RC,,inpatient,,,406,365.4,,0.95,,385.7,Percent of total billed charges,,,0.98,,397.88,Percent of total billed charges,,,0.95,,385.7,Percent of total billed charges,,,0.97,,393.82,Percent of total billed charges,,,0.97,,393.82,Percent of total billed charges,,,0.96,,389.76,Percent of total billed charges,,,0.95,,385.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,385.7,Percent of total billed charges,,385.7,397.88,
HC PR 19294 Prep Tum Cav Iort Prtl Mast,PX-96910009,CDM,19294,CPT,983,RC,,outpatient,,,406,365.4,,0.95,,385.7,Percent of total billed charges,,,0.98,,397.88,Percent of total billed charges,,,0.95,,385.7,Percent of total billed charges,,,0.95,,385.7,Percent of total billed charges,,,0.97,,393.82,Percent of total billed charges,,,0.96,,389.76,Percent of total billed charges,,,0.95,,385.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,385.7,Percent of total billed charges,,385.7,397.88,
HC PR 99483 Assmt & Care Planning Pt W/Cognitive Impairment Cdm,PX-96910018,CDM,99483,CPT,983,RC,,inpatient,,,671,603.9,,0.95,,637.45,Percent of total billed charges,,,0.98,,657.58,Percent of total billed charges,,,0.95,,637.45,Percent of total billed charges,,,0.97,,650.87,Percent of total billed charges,,,0.97,,650.87,Percent of total billed charges,,,0.96,,644.16,Percent of total billed charges,,,0.95,,637.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,637.45,Percent of total billed charges,,637.45,657.58,
HC PR 99483 Assmt & Care Planning Pt W/Cognitive Impairment Cdm,PX-96910018,CDM,99483,CPT,983,RC,,outpatient,,,671,603.9,,0.95,,637.45,Percent of total billed charges,,,0.98,,657.58,Percent of total billed charges,,,0.95,,637.45,Percent of total billed charges,,,0.95,,637.45,Percent of total billed charges,,,0.97,,650.87,Percent of total billed charges,,,0.96,,644.16,Percent of total billed charges,,,0.95,,637.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,637.45,Percent of total billed charges,,637.45,657.58,
HC PR 15730 Mdfc Flap W/Prsrv Vasc Pedcl,PX-97510033,CDM,15730,CPT,975,RC,,inpatient,,,3794,3414.6,,0.95,,3604.3,Percent of total billed charges,,,0.98,,3718.12,Percent of total billed charges,,,0.95,,3604.3,Percent of total billed charges,,,0.97,,3680.18,Percent of total billed charges,,,0.97,,3680.18,Percent of total billed charges,,,0.96,,3642.24,Percent of total billed charges,,,0.95,,3604.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3604.3,Percent of total billed charges,,3604.3,3718.12,
HC PR 15730 Mdfc Flap W/Prsrv Vasc Pedcl,PX-97510033,CDM,15730,CPT,975,RC,,outpatient,,,3794,3414.6,,0.95,,3604.3,Percent of total billed charges,,,0.98,,3718.12,Percent of total billed charges,,,0.95,,3604.3,Percent of total billed charges,,,0.95,,3604.3,Percent of total billed charges,,,0.97,,3680.18,Percent of total billed charges,,,0.96,,3642.24,Percent of total billed charges,,,0.95,,3604.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3604.3,Percent of total billed charges,,3604.3,3718.12,
HC PR 15733 Musc Myoq/Fscq Flp H&N Pedcl,PX-97510035,CDM,15733,CPT,975,RC,,inpatient,,,2588,2329.2,,0.95,,2458.6,Percent of total billed charges,,,0.98,,2536.24,Percent of total billed charges,,,0.95,,2458.6,Percent of total billed charges,,,0.97,,2510.36,Percent of total billed charges,,,0.97,,2510.36,Percent of total billed charges,,,0.96,,2484.48,Percent of total billed charges,,,0.95,,2458.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2458.6,Percent of total billed charges,,2458.6,2536.24,
HC PR 15733 Musc Myoq/Fscq Flp H&N Pedcl,PX-97510035,CDM,15733,CPT,975,RC,,outpatient,,,2588,2329.2,,0.95,,2458.6,Percent of total billed charges,,,0.98,,2536.24,Percent of total billed charges,,,0.95,,2458.6,Percent of total billed charges,,,0.95,,2458.6,Percent of total billed charges,,,0.97,,2510.36,Percent of total billed charges,,,0.96,,2484.48,Percent of total billed charges,,,0.95,,2458.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2458.6,Percent of total billed charges,,2458.6,2536.24,
HC PR 20939 Bone Marrow Aspir Bone Grfg,PX-97510040,CDM,20939,CPT,975,RC,,inpatient,,,171,153.9,,0.95,,162.45,Percent of total billed charges,,,0.98,,167.58,Percent of total billed charges,,,0.95,,162.45,Percent of total billed charges,,,0.97,,165.87,Percent of total billed charges,,,0.97,,165.87,Percent of total billed charges,,,0.96,,164.16,Percent of total billed charges,,,0.95,,162.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,162.45,Percent of total billed charges,,162.45,167.58,
HC PR 20939 Bone Marrow Aspir Bone Grfg,PX-97510040,CDM,20939,CPT,975,RC,,outpatient,,,171,153.9,,0.95,,162.45,Percent of total billed charges,,,0.98,,167.58,Percent of total billed charges,,,0.95,,162.45,Percent of total billed charges,,,0.95,,162.45,Percent of total billed charges,,,0.97,,165.87,Percent of total billed charges,,,0.96,,164.16,Percent of total billed charges,,,0.95,,162.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,162.45,Percent of total billed charges,,162.45,167.58,
HC PR 31241 Nasal/Sinus Ndsc W/Artery Ligation,PX-97510042,CDM,31241,CPT,975,RC,,inpatient,,,1101,990.9,,0.95,,1045.95,Percent of total billed charges,,,0.98,,1078.98,Percent of total billed charges,,,0.95,,1045.95,Percent of total billed charges,,,0.97,,1067.97,Percent of total billed charges,,,0.97,,1067.97,Percent of total billed charges,,,0.96,,1056.96,Percent of total billed charges,,,0.95,,1045.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1045.95,Percent of total billed charges,,1045.95,1078.98,
HC PR 31241 Nasal/Sinus Ndsc W/Artery Ligation,PX-97510042,CDM,31241,CPT,975,RC,,outpatient,,,1101,990.9,,0.95,,1045.95,Percent of total billed charges,,,0.98,,1078.98,Percent of total billed charges,,,0.95,,1045.95,Percent of total billed charges,,,0.95,,1045.95,Percent of total billed charges,,,0.97,,1067.97,Percent of total billed charges,,,0.96,,1056.96,Percent of total billed charges,,,0.95,,1045.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1045.95,Percent of total billed charges,,1045.95,1078.98,
HC PR 31253 Nasal/Sinus Ndsc Total,PX-97510043,CDM,31253,CPT,975,RC,,inpatient,,,1233,1109.7,,0.95,,1171.35,Percent of total billed charges,,,0.98,,1208.34,Percent of total billed charges,,,0.95,,1171.35,Percent of total billed charges,,,0.97,,1196.01,Percent of total billed charges,,,0.97,,1196.01,Percent of total billed charges,,,0.96,,1183.68,Percent of total billed charges,,,0.95,,1171.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1171.35,Percent of total billed charges,,1171.35,1208.34,
HC PR 31253 Nasal/Sinus Ndsc Total,PX-97510043,CDM,31253,CPT,975,RC,,outpatient,,,1233,1109.7,,0.95,,1171.35,Percent of total billed charges,,,0.98,,1208.34,Percent of total billed charges,,,0.95,,1171.35,Percent of total billed charges,,,0.95,,1171.35,Percent of total billed charges,,,0.97,,1196.01,Percent of total billed charges,,,0.96,,1183.68,Percent of total billed charges,,,0.95,,1171.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1171.35,Percent of total billed charges,,1171.35,1208.34,
HC PR 31257 Nasal/Sinus Ndsc Tot W/Sphendt,PX-97510047,CDM,31257,CPT,975,RC,,inpatient,,,1098,988.2,,0.95,,1043.1,Percent of total billed charges,,,0.98,,1076.04,Percent of total billed charges,,,0.95,,1043.1,Percent of total billed charges,,,0.97,,1065.06,Percent of total billed charges,,,0.97,,1065.06,Percent of total billed charges,,,0.96,,1054.08,Percent of total billed charges,,,0.95,,1043.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1043.1,Percent of total billed charges,,1043.1,1076.04,
HC PR 31257 Nasal/Sinus Ndsc Tot W/Sphendt,PX-97510047,CDM,31257,CPT,975,RC,,outpatient,,,1098,988.2,,0.95,,1043.1,Percent of total billed charges,,,0.98,,1076.04,Percent of total billed charges,,,0.95,,1043.1,Percent of total billed charges,,,0.95,,1043.1,Percent of total billed charges,,,0.97,,1065.06,Percent of total billed charges,,,0.96,,1054.08,Percent of total billed charges,,,0.95,,1043.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1043.1,Percent of total billed charges,,1043.1,1076.04,
HC PR 31259 Nasal/Sinus Ndsc Sphn Tiss Rmvl,PX-97510049,CDM,31259,CPT,975,RC,,inpatient,,,1164,1047.6,,0.95,,1105.8,Percent of total billed charges,,,0.98,,1140.72,Percent of total billed charges,,,0.95,,1105.8,Percent of total billed charges,,,0.97,,1129.08,Percent of total billed charges,,,0.97,,1129.08,Percent of total billed charges,,,0.96,,1117.44,Percent of total billed charges,,,0.95,,1105.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1105.8,Percent of total billed charges,,1105.8,1140.72,
HC PR 31259 Nasal/Sinus Ndsc Sphn Tiss Rmvl,PX-97510049,CDM,31259,CPT,975,RC,,outpatient,,,1164,1047.6,,0.95,,1105.8,Percent of total billed charges,,,0.98,,1140.72,Percent of total billed charges,,,0.95,,1105.8,Percent of total billed charges,,,0.95,,1105.8,Percent of total billed charges,,,0.97,,1129.08,Percent of total billed charges,,,0.96,,1117.44,Percent of total billed charges,,,0.95,,1105.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1105.8,Percent of total billed charges,,1105.8,1140.72,
HC PR 31298 Nasal/Sinus Ndsc W/Sins Dilat,PX-97510051,CDM,31298,CPT,975,RC,,inpatient,,,9421,8478.9,,0.95,,8949.95,Percent of total billed charges,,,0.98,,9232.58,Percent of total billed charges,,,0.95,,8949.95,Percent of total billed charges,,,0.97,,9138.37,Percent of total billed charges,,,0.97,,9138.37,Percent of total billed charges,,,0.96,,9044.16,Percent of total billed charges,,,0.95,,8949.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,8949.95,Percent of total billed charges,,8949.95,9232.58,
HC PR 31298 Nasal/Sinus Ndsc W/Sins Dilat,PX-97510051,CDM,31298,CPT,975,RC,,outpatient,,,9421,8478.9,,0.95,,8949.95,Percent of total billed charges,,,0.98,,9232.58,Percent of total billed charges,,,0.95,,8949.95,Percent of total billed charges,,,0.95,,8949.95,Percent of total billed charges,,,0.97,,9138.37,Percent of total billed charges,,,0.96,,9044.16,Percent of total billed charges,,,0.95,,8949.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,8949.95,Percent of total billed charges,,8949.95,9232.58,
HC PR 32994 Ablate Pulm Tumor Perq Crybl,PX-97510052,CDM,32994,CPT,975,RC,,inpatient,,,15025,13522.5,,0.95,,14273.75,Percent of total billed charges,,,0.98,,14724.5,Percent of total billed charges,,,0.95,,14273.75,Percent of total billed charges,,,0.97,,14574.25,Percent of total billed charges,,,0.97,,14574.25,Percent of total billed charges,,,0.96,,14424,Percent of total billed charges,,,0.95,,14273.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,14273.75,Percent of total billed charges,,14273.75,14724.5,
HC PR 32994 Ablate Pulm Tumor Perq Crybl,PX-97510052,CDM,32994,CPT,975,RC,,outpatient,,,15025,13522.5,,0.95,,14273.75,Percent of total billed charges,,,0.98,,14724.5,Percent of total billed charges,,,0.95,,14273.75,Percent of total billed charges,,,0.95,,14273.75,Percent of total billed charges,,,0.97,,14574.25,Percent of total billed charges,,,0.96,,14424,Percent of total billed charges,,,0.95,,14273.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,14273.75,Percent of total billed charges,,14273.75,14724.5,
HC PR 33927 Impltj Tot Rplcmt Hrt Sys,PX-97510054,CDM,33927,CPT,975,RC,,inpatient,,,6333,5699.7,,0.95,,6016.35,Percent of total billed charges,,,0.98,,6206.34,Percent of total billed charges,,,0.95,,6016.35,Percent of total billed charges,,,0.97,,6143.01,Percent of total billed charges,,,0.97,,6143.01,Percent of total billed charges,,,0.96,,6079.68,Percent of total billed charges,,,0.95,,6016.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,6016.35,Percent of total billed charges,,6016.35,6206.34,
HC PR 33927 Impltj Tot Rplcmt Hrt Sys,PX-97510054,CDM,33927,CPT,975,RC,,outpatient,,,6333,5699.7,,0.95,,6016.35,Percent of total billed charges,,,0.98,,6206.34,Percent of total billed charges,,,0.95,,6016.35,Percent of total billed charges,,,0.95,,6016.35,Percent of total billed charges,,,0.97,,6143.01,Percent of total billed charges,,,0.96,,6079.68,Percent of total billed charges,,,0.95,,6016.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,6016.35,Percent of total billed charges,,6016.35,6206.34,
HC PR Dx Bone Marrow Bx & Aspir,PX-97510300,CDM,38222,CPT,975,RC,,inpatient,,,431,387.9,,0.95,,409.45,Percent of total billed charges,,,0.98,,422.38,Percent of total billed charges,,,0.95,,409.45,Percent of total billed charges,,,0.97,,418.07,Percent of total billed charges,,,0.97,,418.07,Percent of total billed charges,,,0.96,,413.76,Percent of total billed charges,,,0.95,,409.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,409.45,Percent of total billed charges,,409.45,422.38,
HC PR Dx Bone Marrow Bx & Aspir,PX-97510300,CDM,38222,CPT,975,RC,,outpatient,,,431,387.9,,0.95,,409.45,Percent of total billed charges,,,0.98,,422.38,Percent of total billed charges,,,0.95,,409.45,Percent of total billed charges,,,0.95,,409.45,Percent of total billed charges,,,0.97,,418.07,Percent of total billed charges,,,0.96,,413.76,Percent of total billed charges,,,0.95,,409.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,409.45,Percent of total billed charges,,409.45,422.38,
HC PR 38573 Laps Pelvic Lymphadec,PX-97510351,CDM,38573,CPT,975,RC,,inpatient,,,4071,3663.9,,0.95,,3867.45,Percent of total billed charges,,,0.98,,3989.58,Percent of total billed charges,,,0.95,,3867.45,Percent of total billed charges,,,0.97,,3948.87,Percent of total billed charges,,,0.97,,3948.87,Percent of total billed charges,,,0.96,,3908.16,Percent of total billed charges,,,0.95,,3867.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3867.45,Percent of total billed charges,,3867.45,3989.58,
HC PR 38573 Laps Pelvic Lymphadec,PX-97510351,CDM,38573,CPT,975,RC,,outpatient,,,4071,3663.9,,0.95,,3867.45,Percent of total billed charges,,,0.98,,3989.58,Percent of total billed charges,,,0.95,,3867.45,Percent of total billed charges,,,0.95,,3867.45,Percent of total billed charges,,,0.97,,3948.87,Percent of total billed charges,,,0.96,,3908.16,Percent of total billed charges,,,0.95,,3867.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3867.45,Percent of total billed charges,,3867.45,3989.58,
HC PR 43286 Esphg Tot W/Laps Moblj,PX-97510359,CDM,43286,CPT,975,RC,,inpatient,,,7810,7029,,0.95,,7419.5,Percent of total billed charges,,,0.98,,7653.8,Percent of total billed charges,,,0.95,,7419.5,Percent of total billed charges,,,0.97,,7575.7,Percent of total billed charges,,,0.97,,7575.7,Percent of total billed charges,,,0.96,,7497.6,Percent of total billed charges,,,0.95,,7419.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,7419.5,Percent of total billed charges,,7419.5,7653.8,
HC PR 43286 Esphg Tot W/Laps Moblj,PX-97510359,CDM,43286,CPT,975,RC,,outpatient,,,7810,7029,,0.95,,7419.5,Percent of total billed charges,,,0.98,,7653.8,Percent of total billed charges,,,0.95,,7419.5,Percent of total billed charges,,,0.95,,7419.5,Percent of total billed charges,,,0.97,,7575.7,Percent of total billed charges,,,0.96,,7497.6,Percent of total billed charges,,,0.95,,7419.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,7419.5,Percent of total billed charges,,7419.5,7653.8,
HC PR 43287 Esphg Dstl 2/3 W/Laps Moblj,PX-97510364,CDM,43287,CPT,975,RC,,inpatient,,,8920,8028,,0.95,,8474,Percent of total billed charges,,,0.98,,8741.6,Percent of total billed charges,,,0.95,,8474,Percent of total billed charges,,,0.97,,8652.4,Percent of total billed charges,,,0.97,,8652.4,Percent of total billed charges,,,0.96,,8563.2,Percent of total billed charges,,,0.95,,8474,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,8474,Percent of total billed charges,,8474,8741.6,
HC PR 43287 Esphg Dstl 2/3 W/Laps Moblj,PX-97510364,CDM,43287,CPT,975,RC,,outpatient,,,8920,8028,,0.95,,8474,Percent of total billed charges,,,0.98,,8741.6,Percent of total billed charges,,,0.95,,8474,Percent of total billed charges,,,0.95,,8474,Percent of total billed charges,,,0.97,,8652.4,Percent of total billed charges,,,0.96,,8563.2,Percent of total billed charges,,,0.95,,8474,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,8474,Percent of total billed charges,,8474,8741.6,
HC PR 43288 Esphg Thrsc Moblj,PX-97510366,CDM,43288,CPT,975,RC,,inpatient,,,9308,8377.2,,0.95,,8842.6,Percent of total billed charges,,,0.98,,9121.84,Percent of total billed charges,,,0.95,,8842.6,Percent of total billed charges,,,0.97,,9028.76,Percent of total billed charges,,,0.97,,9028.76,Percent of total billed charges,,,0.96,,8935.68,Percent of total billed charges,,,0.95,,8842.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,8842.6,Percent of total billed charges,,8842.6,9121.84,
HC PR 43288 Esphg Thrsc Moblj,PX-97510366,CDM,43288,CPT,975,RC,,outpatient,,,9308,8377.2,,0.95,,8842.6,Percent of total billed charges,,,0.98,,9121.84,Percent of total billed charges,,,0.95,,8842.6,Percent of total billed charges,,,0.95,,8842.6,Percent of total billed charges,,,0.97,,9028.76,Percent of total billed charges,,,0.96,,8935.68,Percent of total billed charges,,,0.95,,8842.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,8842.6,Percent of total billed charges,,8842.6,9121.84,
HC PR 55874 Tprnl Plmt Biodegrdabl Matrl W/Img Guidance,PX-97510371,CDM,55874,CPT,975,RC,,inpatient,,,9047,8142.3,,0.95,,8594.65,Percent of total billed charges,,,0.98,,8866.06,Percent of total billed charges,,,0.95,,8594.65,Percent of total billed charges,,,0.97,,8775.59,Percent of total billed charges,,,0.97,,8775.59,Percent of total billed charges,,,0.96,,8685.12,Percent of total billed charges,,,0.95,,8594.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,8594.65,Percent of total billed charges,,8594.65,8866.06,
HC PR 55874 Tprnl Plmt Biodegrdabl Matrl W/Img Guidance,PX-97510371,CDM,55874,CPT,975,RC,,outpatient,,,9047,8142.3,,0.95,,8594.65,Percent of total billed charges,,,0.98,,8866.06,Percent of total billed charges,,,0.95,,8594.65,Percent of total billed charges,,,0.95,,8594.65,Percent of total billed charges,,,0.97,,8775.59,Percent of total billed charges,,,0.96,,8685.12,Percent of total billed charges,,,0.95,,8594.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,8594.65,Percent of total billed charges,,8594.65,8866.06,
HC PR 58575 Laps Tot Hyst Resj Mal,PX-97510375,CDM,58575,CPT,975,RC,,inpatient,,,4766,4289.4,,0.95,,4527.7,Percent of total billed charges,,,0.98,,4670.68,Percent of total billed charges,,,0.95,,4527.7,Percent of total billed charges,,,0.97,,4623.02,Percent of total billed charges,,,0.97,,4623.02,Percent of total billed charges,,,0.96,,4575.36,Percent of total billed charges,,,0.95,,4527.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4527.7,Percent of total billed charges,,4527.7,4670.68,
HC PR 58575 Laps Tot Hyst Resj Mal,PX-97510375,CDM,58575,CPT,975,RC,,outpatient,,,4766,4289.4,,0.95,,4527.7,Percent of total billed charges,,,0.98,,4670.68,Percent of total billed charges,,,0.95,,4527.7,Percent of total billed charges,,,0.95,,4527.7,Percent of total billed charges,,,0.97,,4623.02,Percent of total billed charges,,,0.96,,4575.36,Percent of total billed charges,,,0.95,,4527.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4527.7,Percent of total billed charges,,4527.7,4670.68,
HC PR 64912 Nerve Repair W/Nrv Algrft 1st,PX-97510386,CDM,64912,CPT,975,RC,,inpatient,,,2207,1986.3,,0.95,,2096.65,Percent of total billed charges,,,0.98,,2162.86,Percent of total billed charges,,,0.95,,2096.65,Percent of total billed charges,,,0.97,,2140.79,Percent of total billed charges,,,0.97,,2140.79,Percent of total billed charges,,,0.96,,2118.72,Percent of total billed charges,,,0.95,,2096.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2096.65,Percent of total billed charges,,2096.65,2162.86,
HC PR 64912 Nerve Repair W/Nrv Algrft 1st,PX-97510386,CDM,64912,CPT,975,RC,,outpatient,,,2207,1986.3,,0.95,,2096.65,Percent of total billed charges,,,0.98,,2162.86,Percent of total billed charges,,,0.95,,2096.65,Percent of total billed charges,,,0.95,,2096.65,Percent of total billed charges,,,0.97,,2140.79,Percent of total billed charges,,,0.96,,2118.72,Percent of total billed charges,,,0.95,,2096.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2096.65,Percent of total billed charges,,2096.65,2162.86,
HC PR 64913 Nervev Repair W/Nrv Algrft Ea Addl,PX-97510398,CDM,64913,CPT,975,RC,,inpatient,,,420,378,,0.95,,399,Percent of total billed charges,,,0.98,,411.6,Percent of total billed charges,,,0.95,,399,Percent of total billed charges,,,0.97,,407.4,Percent of total billed charges,,,0.97,,407.4,Percent of total billed charges,,,0.96,,403.2,Percent of total billed charges,,,0.95,,399,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,399,Percent of total billed charges,,399,411.6,
HC PR 64913 Nervev Repair W/Nrv Algrft Ea Addl,PX-97510398,CDM,64913,CPT,975,RC,,outpatient,,,420,378,,0.95,,399,Percent of total billed charges,,,0.98,,411.6,Percent of total billed charges,,,0.95,,399,Percent of total billed charges,,,0.95,,399,Percent of total billed charges,,,0.97,,407.4,Percent of total billed charges,,,0.96,,403.2,Percent of total billed charges,,,0.95,,399,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,399,Percent of total billed charges,,399,411.6,
HC PR 93792 Pt/Caregiver Trainj Home Inr,PX-98310037,CDM,93792,CPT,983,RC,,inpatient,,,131,117.9,,0.95,,124.45,Percent of total billed charges,,,0.98,,128.38,Percent of total billed charges,,,0.95,,124.45,Percent of total billed charges,,,0.97,,127.07,Percent of total billed charges,,,0.97,,127.07,Percent of total billed charges,,,0.96,,125.76,Percent of total billed charges,,,0.95,,124.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,124.45,Percent of total billed charges,,124.45,128.38,
HC PR 93792 Pt/Caregiver Trainj Home Inr,PX-98310037,CDM,93792,CPT,983,RC,,outpatient,,,131,117.9,,0.95,,124.45,Percent of total billed charges,,,0.98,,128.38,Percent of total billed charges,,,0.95,,124.45,Percent of total billed charges,,,0.95,,124.45,Percent of total billed charges,,,0.97,,127.07,Percent of total billed charges,,,0.96,,125.76,Percent of total billed charges,,,0.95,,124.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,124.45,Percent of total billed charges,,124.45,128.38,
HC PR 93793 Anticoag Mgmt Pt Warfarin,PX-98310038,CDM,93793,CPT,983,RC,,inpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,0.01,Percent of total billed charges,,0.01,0.01,
HC PR 93793 Anticoag Mgmt Pt Warfarin,PX-98310038,CDM,93793,CPT,983,RC,,outpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,0.01,Percent of total billed charges,,0.01,0.01,
"X-ray of chest, 1 view",PX-32410018,CDM,71045,CPT,324,RC,,inpatient,,,320,288,,0.95,,304,Percent of total billed charges,,,0.98,,313.6,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,0.97,,310.4,Percent of total billed charges,,,0.97,,310.4,Percent of total billed charges,,,0.96,,307.2,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,304,Percent of total billed charges,,304,313.6,
"X-ray of chest, 1 view",PX-32410018,CDM,71045,CPT,324,RC,,outpatient,,,320,288,,0.95,,304,Percent of total billed charges,,,0.98,,313.6,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,0.97,,310.4,Percent of total billed charges,,,0.96,,307.2,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,304,Percent of total billed charges,,304,313.6,
"X-ray of abdomen, 1 view",PX-32010190,CDM,74018,CPT,320,RC,,inpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,286.9,Percent of total billed charges,,286.9,295.96,
"X-ray of abdomen, 1 view",PX-32010190,CDM,74018,CPT,320,RC,,outpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,286.9,Percent of total billed charges,,286.9,295.96,
HC Oral Med Direct Observation (per Day),PX-90010082,CDM,H0033,HCPCS,900,RC,,inpatient,,,82,73.8,,0.95,,77.9,Percent of total billed charges,,,0.98,,80.36,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,0.97,,79.54,Percent of total billed charges,,,0.97,,79.54,Percent of total billed charges,,,0.96,,78.72,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,77.9,Percent of total billed charges,,77.9,80.36,
HC Oral Med Direct Observation (per Day),PX-90010082,CDM,H0033,HCPCS,900,RC,,outpatient,,,82,73.8,,0.95,,77.9,Percent of total billed charges,,,0.98,,80.36,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,0.97,,79.54,Percent of total billed charges,,,0.96,,78.72,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,77.9,Percent of total billed charges,,77.9,80.36,
HC PR G0511 Ccm/Bhi by Rhc/FQHC 20min Mo,PX-98310045,CDM,G0511,HCPCS,983,RC,,inpatient,,,180,162,,0.95,,171,Percent of total billed charges,,,0.98,,176.4,Percent of total billed charges,,,0.95,,171,Percent of total billed charges,,,0.97,,174.6,Percent of total billed charges,,,0.97,,174.6,Percent of total billed charges,,,0.96,,172.8,Percent of total billed charges,,,0.95,,171,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,171,Percent of total billed charges,,171,176.4,
HC PR G0511 Ccm/Bhi by Rhc/FQHC 20min Mo,PX-98310045,CDM,G0511,HCPCS,983,RC,,outpatient,,,180,162,,0.95,,171,Percent of total billed charges,,,0.98,,176.4,Percent of total billed charges,,,0.95,,171,Percent of total billed charges,,,0.95,,171,Percent of total billed charges,,,0.97,,174.6,Percent of total billed charges,,,0.96,,172.8,Percent of total billed charges,,,0.95,,171,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,171,Percent of total billed charges,,171,176.4,
HC PR G0512 Cocm by Rhc/FQHC 60 Min Mo,PX-98310050,CDM,G0512,HCPCS,983,RC,,inpatient,,,361,324.9,,0.95,,342.95,Percent of total billed charges,,,0.98,,353.78,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,0.97,,350.17,Percent of total billed charges,,,0.97,,350.17,Percent of total billed charges,,,0.96,,346.56,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,342.95,Percent of total billed charges,,342.95,353.78,
HC PR G0512 Cocm by Rhc/FQHC 60 Min Mo,PX-98310050,CDM,G0512,HCPCS,983,RC,,outpatient,,,361,324.9,,0.95,,342.95,Percent of total billed charges,,,0.98,,353.78,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,0.97,,350.17,Percent of total billed charges,,,0.96,,346.56,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,342.95,Percent of total billed charges,,342.95,353.78,
"HC PR G0514 Prolong Prev Svcs, Addl 30m",PX-98310070,CDM,G0514,HCPCS,983,RC,,inpatient,,,156,140.4,,0.95,,148.2,Percent of total billed charges,,,0.98,,152.88,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,0.97,,151.32,Percent of total billed charges,,,0.97,,151.32,Percent of total billed charges,,,0.96,,149.76,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,148.2,Percent of total billed charges,,148.2,152.88,
"HC PR G0514 Prolong Prev Svcs, Addl 30m",PX-98310070,CDM,G0514,HCPCS,983,RC,,outpatient,,,156,140.4,,0.95,,148.2,Percent of total billed charges,,,0.98,,152.88,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,0.97,,151.32,Percent of total billed charges,,,0.96,,149.76,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,148.2,Percent of total billed charges,,148.2,152.88,
"HC PR G0513 Prolong Prev Svcs, First 30m",PX-98310085,CDM,G0513,HCPCS,983,RC,,inpatient,,,155,139.5,,0.95,,147.25,Percent of total billed charges,,,0.98,,151.9,Percent of total billed charges,,,0.95,,147.25,Percent of total billed charges,,,0.97,,150.35,Percent of total billed charges,,,0.97,,150.35,Percent of total billed charges,,,0.96,,148.8,Percent of total billed charges,,,0.95,,147.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,147.25,Percent of total billed charges,,147.25,151.9,
"HC PR G0513 Prolong Prev Svcs, First 30m",PX-98310085,CDM,G0513,HCPCS,983,RC,,outpatient,,,155,139.5,,0.95,,147.25,Percent of total billed charges,,,0.98,,151.9,Percent of total billed charges,,,0.95,,147.25,Percent of total billed charges,,,0.95,,147.25,Percent of total billed charges,,,0.97,,150.35,Percent of total billed charges,,,0.96,,148.8,Percent of total billed charges,,,0.95,,147.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,147.25,Percent of total billed charges,,147.25,151.9,
"HC PR G0516 Insert Drug Del Implant, >4",PX-97510689,CDM,G0516,HCPCS,975,RC,,inpatient,,,570,513,,0.95,,541.5,Percent of total billed charges,,,0.98,,558.6,Percent of total billed charges,,,0.95,,541.5,Percent of total billed charges,,,0.97,,552.9,Percent of total billed charges,,,0.97,,552.9,Percent of total billed charges,,,0.96,,547.2,Percent of total billed charges,,,0.95,,541.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,541.5,Percent of total billed charges,,541.5,558.6,
"HC PR G0516 Insert Drug Del Implant, >4",PX-97510689,CDM,G0516,HCPCS,975,RC,,outpatient,,,570,513,,0.95,,541.5,Percent of total billed charges,,,0.98,,558.6,Percent of total billed charges,,,0.95,,541.5,Percent of total billed charges,,,0.95,,541.5,Percent of total billed charges,,,0.97,,552.9,Percent of total billed charges,,,0.96,,547.2,Percent of total billed charges,,,0.95,,541.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,541.5,Percent of total billed charges,,541.5,558.6,
HC PR G0517 Remove Drug Implant,PX-97510690,CDM,G0517,HCPCS,975,RC,,inpatient,,,628,565.2,,0.95,,596.6,Percent of total billed charges,,,0.98,,615.44,Percent of total billed charges,,,0.95,,596.6,Percent of total billed charges,,,0.97,,609.16,Percent of total billed charges,,,0.97,,609.16,Percent of total billed charges,,,0.96,,602.88,Percent of total billed charges,,,0.95,,596.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,596.6,Percent of total billed charges,,596.6,615.44,
HC PR G0517 Remove Drug Implant,PX-97510690,CDM,G0517,HCPCS,975,RC,,outpatient,,,628,565.2,,0.95,,596.6,Percent of total billed charges,,,0.98,,615.44,Percent of total billed charges,,,0.95,,596.6,Percent of total billed charges,,,0.95,,596.6,Percent of total billed charges,,,0.97,,609.16,Percent of total billed charges,,,0.96,,602.88,Percent of total billed charges,,,0.95,,596.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,596.6,Percent of total billed charges,,596.6,615.44,
HC PR G0518 Remove W Insert Drug Implant,PX-97510691,CDM,G0518,HCPCS,975,RC,,inpatient,,,1084,975.6,,0.95,,1029.8,Percent of total billed charges,,,0.98,,1062.32,Percent of total billed charges,,,0.95,,1029.8,Percent of total billed charges,,,0.97,,1051.48,Percent of total billed charges,,,0.97,,1051.48,Percent of total billed charges,,,0.96,,1040.64,Percent of total billed charges,,,0.95,,1029.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1029.8,Percent of total billed charges,,1029.8,1062.32,
HC PR G0518 Remove W Insert Drug Implant,PX-97510691,CDM,G0518,HCPCS,975,RC,,outpatient,,,1084,975.6,,0.95,,1029.8,Percent of total billed charges,,,0.98,,1062.32,Percent of total billed charges,,,0.95,,1029.8,Percent of total billed charges,,,0.95,,1029.8,Percent of total billed charges,,,0.97,,1051.48,Percent of total billed charges,,,0.96,,1040.64,Percent of total billed charges,,,0.95,,1029.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1029.8,Percent of total billed charges,,1029.8,1062.32,
HC PR Rx Iiv Vaccine Pf Increased Ag Content Im 1 Ea,PX-63610111,CDM,90662,HCPCS,636,RC,,inpatient,,,49,44.1,,0.95,,46.55,Percent of total billed charges,,,0.98,,48.02,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.96,,47.04,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,46.55,Percent of total billed charges,,46.55,48.02,
HC PR Rx Iiv Vaccine Pf Increased Ag Content Im 1 Ea,PX-63610111,CDM,90662,HCPCS,636,RC,,outpatient,,,49,44.1,,0.95,,46.55,Percent of total billed charges,,,0.98,,48.02,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.96,,47.04,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,46.55,Percent of total billed charges,,46.55,48.02,
HC PR Rx Influenza Quadrivalent (Iiv4) Im 0.5 Ml,PX-63610113,CDM,90688,HCPCS,636,RC,,inpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
HC PR Rx Influenza Quadrivalent (Iiv4) Im 0.5 Ml,PX-63610113,CDM,90688,HCPCS,636,RC,,outpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
"Genetic sequencing localization, each additional procedure",PX-31010180,CDM,88364,CPT,310,RC,,inpatient,,,181,162.9,,0.95,,171.95,Percent of total billed charges,,,0.98,,177.38,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,0.97,,175.57,Percent of total billed charges,,,0.97,,175.57,Percent of total billed charges,,,0.96,,173.76,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,171.95,Percent of total billed charges,,171.95,177.38,
"Genetic sequencing localization, each additional procedure",PX-31010180,CDM,88364,CPT,310,RC,,outpatient,,,181,162.9,,0.95,,171.95,Percent of total billed charges,,,0.98,,177.38,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,0.97,,175.57,Percent of total billed charges,,,0.96,,173.76,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,171.95,Percent of total billed charges,,171.95,177.38,
HC PR Rx Levonorgestrel (Kyleena) Iud 19.5 Mg,PX-63610108,CDM,J7296,HCPCS,636,RC,,inpatient,,,1362,1225.8,,0.95,,1293.9,Percent of total billed charges,,,0.98,,1334.76,Percent of total billed charges,,,0.95,,1293.9,Percent of total billed charges,,,0.97,,1321.14,Percent of total billed charges,,,0.97,,1321.14,Percent of total billed charges,,,0.96,,1307.52,Percent of total billed charges,,,0.95,,1293.9,Percent of total billed charges,,,,,,,,,0.95,,1293.9,Percent of total billed charges,,1293.9,1334.76,
HC PR Rx Levonorgestrel (Kyleena) Iud 19.5 Mg,PX-63610108,CDM,J7296,HCPCS,636,RC,,outpatient,,,1362,1225.8,,0.95,,1293.9,Percent of total billed charges,,,0.98,,1334.76,Percent of total billed charges,,,0.95,,1293.9,Percent of total billed charges,,,0.95,,1293.9,Percent of total billed charges,,,0.97,,1321.14,Percent of total billed charges,,,0.96,,1307.52,Percent of total billed charges,,,0.95,,1293.9,Percent of total billed charges,,,,,,,,,0.95,,1293.9,Percent of total billed charges,,1293.9,1334.76,
"T cell count and ratio, including ratio",PX-31900000,CDM,86360,CPT,300,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
"T cell count and ratio, including ratio",PX-31900000,CDM,86360,CPT,300,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
HC T Cells Total Count,PX-31900003,CDM,86359,CPT,300,RC,,inpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
HC T Cells Total Count,PX-31900003,CDM,86359,CPT,300,RC,,outpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
Urine volume measurement,PX-31900004,CDM,81050,CPT,300,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
Urine volume measurement,PX-31900004,CDM,81050,CPT,300,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
Urine volume measurement,PX-31900005,CDM,81050,CPT,300,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
Urine volume measurement,PX-31900005,CDM,81050,CPT,300,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
Urine volume measurement,PX-31900006,CDM,81050,CPT,300,RC,,inpatient,,,41,36.9,,0.95,,38.95,Percent of total billed charges,,,0.98,,40.18,Percent of total billed charges,,,0.95,,38.95,Percent of total billed charges,,,0.97,,39.77,Percent of total billed charges,,,0.97,,39.77,Percent of total billed charges,,,0.96,,39.36,Percent of total billed charges,,,0.95,,38.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38.95,Percent of total billed charges,,38.95,40.18,
Urine volume measurement,PX-31900006,CDM,81050,CPT,300,RC,,outpatient,,,41,36.9,,0.95,,38.95,Percent of total billed charges,,,0.98,,40.18,Percent of total billed charges,,,0.95,,38.95,Percent of total billed charges,,,0.95,,38.95,Percent of total billed charges,,,0.97,,39.77,Percent of total billed charges,,,0.96,,39.36,Percent of total billed charges,,,0.95,,38.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38.95,Percent of total billed charges,,38.95,40.18,
Urine volume measurement,PX-31900007,CDM,81050,CPT,300,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
Urine volume measurement,PX-31900007,CDM,81050,CPT,300,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
Urine volume measurement,PX-31900008,CDM,81050,CPT,300,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
Urine volume measurement,PX-31900008,CDM,81050,CPT,300,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
IgE (immune system protein) level,PX-31900011,CDM,82785,CPT,300,RC,,inpatient,,,63,56.7,,0.95,,59.85,Percent of total billed charges,,,0.98,,61.74,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.96,,60.48,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,59.85,Percent of total billed charges,,59.85,61.74,
IgE (immune system protein) level,PX-31900011,CDM,82785,CPT,300,RC,,outpatient,,,63,56.7,,0.95,,59.85,Percent of total billed charges,,,0.98,,61.74,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.96,,60.48,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,59.85,Percent of total billed charges,,59.85,61.74,
Sex hormone binding globulin (protein) level,PX-31900012,CDM,84270,CPT,300,RC,,inpatient,,,81,72.9,,0.95,,76.95,Percent of total billed charges,,,0.98,,79.38,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.96,,77.76,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76.95,Percent of total billed charges,,76.95,79.38,
Sex hormone binding globulin (protein) level,PX-31900012,CDM,84270,CPT,300,RC,,outpatient,,,81,72.9,,0.95,,76.95,Percent of total billed charges,,,0.98,,79.38,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.96,,77.76,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76.95,Percent of total billed charges,,76.95,79.38,
Creatinine level to test for kidney function/muscle injury,PX-31900013,CDM,82570,CPT,300,RC,,inpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
Creatinine level to test for kidney function/muscle injury,PX-31900013,CDM,82570,CPT,300,RC,,outpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
Creatinine level to test for kidney function/muscle injury,PX-31900014,CDM,82570,CPT,300,RC,,inpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
Creatinine level to test for kidney function/muscle injury,PX-31900014,CDM,82570,CPT,300,RC,,outpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
Creatinine level to test for kidney function/muscle injury,PX-31900015,CDM,82570,CPT,300,RC,,inpatient,,,94,84.6,,0.95,,89.3,Percent of total billed charges,,,0.98,,92.12,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.96,,90.24,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,89.3,Percent of total billed charges,,89.3,92.12,
Creatinine level to test for kidney function/muscle injury,PX-31900015,CDM,82570,CPT,300,RC,,outpatient,,,94,84.6,,0.95,,89.3,Percent of total billed charges,,,0.98,,92.12,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.96,,90.24,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,89.3,Percent of total billed charges,,89.3,92.12,
Analysis for antibody to Coccidioides (bacteria),PX-31900018,CDM,86635,CPT,300,RC,,inpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
Analysis for antibody to Coccidioides (bacteria),PX-31900018,CDM,86635,CPT,300,RC,,outpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
Analysis for antibody (IgM) to West Nile virus,PX-31900019,CDM,86788,CPT,300,RC,,inpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Analysis for antibody (IgM) to West Nile virus,PX-31900019,CDM,86788,CPT,300,RC,,outpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Closed treatment of broken bone separating nose airways,PX-45010328,CDM,21337,CPT,450,RC,,inpatient,,,1273,1145.7,,0.95,,1209.35,Percent of total billed charges,,,0.98,,1247.54,Percent of total billed charges,,,0.95,,1209.35,Percent of total billed charges,,,0.97,,1234.81,Percent of total billed charges,,,0.97,,1234.81,Percent of total billed charges,,,0.96,,1222.08,Percent of total billed charges,,,0.95,,1209.35,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1209.35,Percent of total billed charges,,1209.35,3950,
Closed treatment of broken bone separating nose airways,PX-45010328,CDM,21337,CPT,450,RC,,outpatient,,,1273,1145.7,,0.95,,1209.35,Percent of total billed charges,,,0.98,,1247.54,Percent of total billed charges,,,0.95,,1209.35,Percent of total billed charges,,,0.95,,1209.35,Percent of total billed charges,,,0.97,,1234.81,Percent of total billed charges,,,0.96,,1222.08,Percent of total billed charges,,,0.95,,1209.35,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1209.35,Percent of total billed charges,,1209.35,3950,
HC Cath Emergency Airway #G09413,PX-3254144WWM,CDM,3254144WWM,LOCAL,270,RC,,inpatient,,,254,228.6,,0.95,,241.3,Percent of total billed charges,,,0.98,,248.92,Percent of total billed charges,,,0.95,,241.3,Percent of total billed charges,,,0.97,,246.38,Percent of total billed charges,,,0.97,,246.38,Percent of total billed charges,,,0.96,,243.84,Percent of total billed charges,,,0.95,,241.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,241.3,Percent of total billed charges,,241.3,248.92,
HC Cath Emergency Airway #G09413,PX-3254144WWM,CDM,3254144WWM,LOCAL,270,RC,,outpatient,,,254,228.6,,0.95,,241.3,Percent of total billed charges,,,0.98,,248.92,Percent of total billed charges,,,0.95,,241.3,Percent of total billed charges,,,0.95,,241.3,Percent of total billed charges,,,0.97,,246.38,Percent of total billed charges,,,0.96,,243.84,Percent of total billed charges,,,0.95,,241.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,241.3,Percent of total billed charges,,241.3,248.92,
"Gene analysis (breast cancer 1, 2) full sequence",PX-31900054,CDM,81162,CPT,301,RC,,inpatient,,,4612,4150.8,,0.95,,4381.4,Percent of total billed charges,,,0.98,,4519.76,Percent of total billed charges,,,0.95,,4381.4,Percent of total billed charges,,,0.97,,4473.64,Percent of total billed charges,,,0.97,,4473.64,Percent of total billed charges,,,0.96,,4427.52,Percent of total billed charges,,,0.95,,4381.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4381.4,Percent of total billed charges,,4381.4,4519.76,
"Gene analysis (breast cancer 1, 2) full sequence",PX-31900054,CDM,81162,CPT,301,RC,,outpatient,,,4612,4150.8,,0.95,,4381.4,Percent of total billed charges,,,0.98,,4519.76,Percent of total billed charges,,,0.95,,4381.4,Percent of total billed charges,,,0.95,,4381.4,Percent of total billed charges,,,0.97,,4473.64,Percent of total billed charges,,,0.96,,4427.52,Percent of total billed charges,,,0.95,,4381.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4381.4,Percent of total billed charges,,4381.4,4519.76,
Zinc level,PX-31900057,CDM,84630,CPT,301,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Zinc level,PX-31900057,CDM,84630,CPT,301,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Aspiration of fluid from chest cavity,PX-45010068,CDM,32554,CPT,450,RC,,inpatient,,,1432,1288.8,,0.95,,1360.4,Percent of total billed charges,,,0.98,,1403.36,Percent of total billed charges,,,0.95,,1360.4,Percent of total billed charges,,,0.97,,1389.04,Percent of total billed charges,,,0.97,,1389.04,Percent of total billed charges,,,0.96,,1374.72,Percent of total billed charges,,,0.95,,1360.4,Percent of total billed charges,,,,,,,,,0.95,,1360.4,Percent of total billed charges,,1360.4,1403.36,
Aspiration of fluid from chest cavity,PX-45010068,CDM,32554,CPT,450,RC,,outpatient,,,1432,1288.8,,0.95,,1360.4,Percent of total billed charges,,,0.98,,1403.36,Percent of total billed charges,,,0.95,,1360.4,Percent of total billed charges,,,0.95,,1360.4,Percent of total billed charges,,,0.97,,1389.04,Percent of total billed charges,,,0.96,,1374.72,Percent of total billed charges,,,0.95,,1360.4,Percent of total billed charges,,,,,,,,,0.95,,1360.4,Percent of total billed charges,,1360.4,1403.36,
Reposition oral or nasal feeding tube in small bowel,PX-45010092,CDM,43761,CPT,450,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
Reposition oral or nasal feeding tube in small bowel,PX-45010092,CDM,43761,CPT,450,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Critical care, first 30-74 minutes",PX-45010094,CDM,99291,CPT,450,RC,,inpatient,,,2899,2609.1,,0.95,,2754.05,Percent of total billed charges,,,0.98,,2841.02,Percent of total billed charges,,,0.95,,2754.05,Percent of total billed charges,,,0.97,,2812.03,Percent of total billed charges,,,0.97,,2812.03,Percent of total billed charges,,,0.96,,2783.04,Percent of total billed charges,,,0.95,,2754.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2754.05,Percent of total billed charges,,2754.05,3950,
"Critical care, first 30-74 minutes",PX-45010094,CDM,99291,CPT,450,RC,,outpatient,,,2899,2609.1,,0.95,,2754.05,Percent of total billed charges,,,0.98,,2841.02,Percent of total billed charges,,,0.95,,2754.05,Percent of total billed charges,,,0.95,,2754.05,Percent of total billed charges,,,0.97,,2812.03,Percent of total billed charges,,,0.96,,2783.04,Percent of total billed charges,,,0.95,,2754.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2754.05,Percent of total billed charges,,2754.05,3950,
Emergency department visit level 4,PX-45010130,CDM,99284,CPT,450,RC,,inpatient,,,785,706.5,,0.95,,745.75,Percent of total billed charges,,,0.98,,769.3,Percent of total billed charges,,,0.95,,745.75,Percent of total billed charges,,,0.97,,761.45,Percent of total billed charges,,,0.97,,761.45,Percent of total billed charges,,,0.96,,753.6,Percent of total billed charges,,,0.95,,745.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,745.75,Percent of total billed charges,,745.75,3950,
Emergency department visit level 4,PX-45010130,CDM,99284,CPT,450,RC,,outpatient,,,785,706.5,,0.95,,745.75,Percent of total billed charges,,,0.98,,769.3,Percent of total billed charges,,,0.95,,745.75,Percent of total billed charges,,,0.95,,745.75,Percent of total billed charges,,,0.97,,761.45,Percent of total billed charges,,,0.96,,753.6,Percent of total billed charges,,,0.95,,745.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,745.75,Percent of total billed charges,,745.75,3950,
Emergency department visit Level 1,PX-45010204,CDM,99281,CPT,450,RC,,inpatient,,,303,272.7,,0.95,,287.85,Percent of total billed charges,,,0.98,,296.94,Percent of total billed charges,,,0.95,,287.85,Percent of total billed charges,,,0.97,,293.91,Percent of total billed charges,,,0.97,,293.91,Percent of total billed charges,,,0.96,,290.88,Percent of total billed charges,,,0.95,,287.85,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,287.85,Percent of total billed charges,,287.85,3950,
Emergency department visit Level 1,PX-45010204,CDM,99281,CPT,450,RC,,outpatient,,,303,272.7,,0.95,,287.85,Percent of total billed charges,,,0.98,,296.94,Percent of total billed charges,,,0.95,,287.85,Percent of total billed charges,,,0.95,,287.85,Percent of total billed charges,,,0.97,,293.91,Percent of total billed charges,,,0.96,,290.88,Percent of total billed charges,,,0.95,,287.85,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,287.85,Percent of total billed charges,,287.85,3950,
Emergency department visit level 2,PX-45010207,CDM,99282,CPT,450,RC,,inpatient,,,341,306.9,,0.95,,323.95,Percent of total billed charges,,,0.98,,334.18,Percent of total billed charges,,,0.95,,323.95,Percent of total billed charges,,,0.97,,330.77,Percent of total billed charges,,,0.97,,330.77,Percent of total billed charges,,,0.96,,327.36,Percent of total billed charges,,,0.95,,323.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,323.95,Percent of total billed charges,,323.95,3950,
Emergency department visit level 2,PX-45010207,CDM,99282,CPT,450,RC,,outpatient,,,341,306.9,,0.95,,323.95,Percent of total billed charges,,,0.98,,334.18,Percent of total billed charges,,,0.95,,323.95,Percent of total billed charges,,,0.95,,323.95,Percent of total billed charges,,,0.97,,330.77,Percent of total billed charges,,,0.96,,327.36,Percent of total billed charges,,,0.95,,323.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,323.95,Percent of total billed charges,,323.95,3950,
Emergency department visit level 3,PX-45010210,CDM,99283,CPT,450,RC,,inpatient,,,920,828,,0.95,,874,Percent of total billed charges,,,0.98,,901.6,Percent of total billed charges,,,0.95,,874,Percent of total billed charges,,,0.97,,892.4,Percent of total billed charges,,,0.97,,892.4,Percent of total billed charges,,,0.96,,883.2,Percent of total billed charges,,,0.95,,874,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,874,Percent of total billed charges,,874,3950,
Emergency department visit level 3,PX-45010210,CDM,99283,CPT,450,RC,,outpatient,,,920,828,,0.95,,874,Percent of total billed charges,,,0.98,,901.6,Percent of total billed charges,,,0.95,,874,Percent of total billed charges,,,0.95,,874,Percent of total billed charges,,,0.97,,892.4,Percent of total billed charges,,,0.96,,883.2,Percent of total billed charges,,,0.95,,874,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,874,Percent of total billed charges,,874,3950,
Emergency department visit level 4,PX-45010213,CDM,99284,CPT,450,RC,,inpatient,,,1337,1203.3,,0.95,,1270.15,Percent of total billed charges,,,0.98,,1310.26,Percent of total billed charges,,,0.95,,1270.15,Percent of total billed charges,,,0.97,,1296.89,Percent of total billed charges,,,0.97,,1296.89,Percent of total billed charges,,,0.96,,1283.52,Percent of total billed charges,,,0.95,,1270.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1270.15,Percent of total billed charges,,1270.15,3950,
Emergency department visit level 4,PX-45010213,CDM,99284,CPT,450,RC,,outpatient,,,1337,1203.3,,0.95,,1270.15,Percent of total billed charges,,,0.98,,1310.26,Percent of total billed charges,,,0.95,,1270.15,Percent of total billed charges,,,0.95,,1270.15,Percent of total billed charges,,,0.97,,1296.89,Percent of total billed charges,,,0.96,,1283.52,Percent of total billed charges,,,0.95,,1270.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1270.15,Percent of total billed charges,,1270.15,3950,
Emergency department visit level 5,PX-45010216,CDM,99285,CPT,450,RC,,inpatient,,,1673,1505.7,,0.95,,1589.35,Percent of total billed charges,,,0.98,,1639.54,Percent of total billed charges,,,0.95,,1589.35,Percent of total billed charges,,,0.97,,1622.81,Percent of total billed charges,,,0.97,,1622.81,Percent of total billed charges,,,0.96,,1606.08,Percent of total billed charges,,,0.95,,1589.35,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1589.35,Percent of total billed charges,,1589.35,3950,
Emergency department visit level 5,PX-45010216,CDM,99285,CPT,450,RC,,outpatient,,,1673,1505.7,,0.95,,1589.35,Percent of total billed charges,,,0.98,,1639.54,Percent of total billed charges,,,0.95,,1589.35,Percent of total billed charges,,,0.95,,1589.35,Percent of total billed charges,,,0.97,,1622.81,Percent of total billed charges,,,0.96,,1606.08,Percent of total billed charges,,,0.95,,1589.35,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1589.35,Percent of total billed charges,,1589.35,3950,
"Critical care, each additional 30 minutes",PX-45010221,CDM,99292,CPT,450,RC,,inpatient,,,815,733.5,,0.95,,774.25,Percent of total billed charges,,,0.98,,798.7,Percent of total billed charges,,,0.95,,774.25,Percent of total billed charges,,,0.97,,790.55,Percent of total billed charges,,,0.97,,790.55,Percent of total billed charges,,,0.96,,782.4,Percent of total billed charges,,,0.95,,774.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,774.25,Percent of total billed charges,,774.25,3950,
"Critical care, each additional 30 minutes",PX-45010221,CDM,99292,CPT,450,RC,,outpatient,,,815,733.5,,0.95,,774.25,Percent of total billed charges,,,0.98,,798.7,Percent of total billed charges,,,0.95,,774.25,Percent of total billed charges,,,0.95,,774.25,Percent of total billed charges,,,0.97,,790.55,Percent of total billed charges,,,0.96,,782.4,Percent of total billed charges,,,0.95,,774.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,774.25,Percent of total billed charges,,774.25,3950,
Ultrasound measurement of bladder capacity after voiding,PX-45010229,CDM,51798,CPT,450,RC,,inpatient,,,188,169.2,,0.95,,178.6,Percent of total billed charges,,,0.98,,184.24,Percent of total billed charges,,,0.95,,178.6,Percent of total billed charges,,,0.97,,182.36,Percent of total billed charges,,,0.97,,182.36,Percent of total billed charges,,,0.96,,180.48,Percent of total billed charges,,,0.95,,178.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,178.6,Percent of total billed charges,,178.6,184.24,
Ultrasound measurement of bladder capacity after voiding,PX-45010229,CDM,51798,CPT,450,RC,,outpatient,,,188,169.2,,0.95,,178.6,Percent of total billed charges,,,0.98,,184.24,Percent of total billed charges,,,0.95,,178.6,Percent of total billed charges,,,0.95,,178.6,Percent of total billed charges,,,0.97,,182.36,Percent of total billed charges,,,0.96,,180.48,Percent of total billed charges,,,0.95,,178.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,178.6,Percent of total billed charges,,178.6,184.24,
HC ED Trauma Activation Full With Critical Care G0390 Cdm,PX-68310001,CDM,G0390,CPT,682,RC,,inpatient,,,2308,2077.2,,0.95,,2192.6,Percent of total billed charges,,,0.98,,2261.84,Percent of total billed charges,,,0.95,,2192.6,Percent of total billed charges,,,0.97,,2238.76,Percent of total billed charges,,,0.97,,2238.76,Percent of total billed charges,,,0.96,,2215.68,Percent of total billed charges,,,0.95,,2192.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2192.6,Percent of total billed charges,,2192.6,2261.84,
HC ED Trauma Activation Full With Critical Care G0390 Cdm,PX-68310001,CDM,G0390,CPT,682,RC,,outpatient,,,2308,2077.2,,0.95,,2192.6,Percent of total billed charges,,,0.98,,2261.84,Percent of total billed charges,,,0.95,,2192.6,Percent of total billed charges,,,0.95,,2192.6,Percent of total billed charges,,,0.97,,2238.76,Percent of total billed charges,,,0.96,,2215.68,Percent of total billed charges,,,0.95,,2192.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2192.6,Percent of total billed charges,,2192.6,2261.84,
HC PR ED 99283 Visit Low Mdm Cdm,PX-98110009,CDM,99283,CPT,981,RC,,inpatient,,,296,266.4,,0.95,,281.2,Percent of total billed charges,,,0.98,,290.08,Percent of total billed charges,,,0.95,,281.2,Percent of total billed charges,,,0.97,,287.12,Percent of total billed charges,,,0.97,,287.12,Percent of total billed charges,,,0.96,,284.16,Percent of total billed charges,,,0.95,,281.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,281.2,Percent of total billed charges,,281.2,290.08,
HC PR ED 99283 Visit Low Mdm Cdm,PX-98110009,CDM,99283,CPT,981,RC,,outpatient,,,296,266.4,,0.95,,281.2,Percent of total billed charges,,,0.98,,290.08,Percent of total billed charges,,,0.95,,281.2,Percent of total billed charges,,,0.95,,281.2,Percent of total billed charges,,,0.97,,287.12,Percent of total billed charges,,,0.96,,284.16,Percent of total billed charges,,,0.95,,281.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,281.2,Percent of total billed charges,,281.2,290.08,
HC PR ED 99284 Visit Moderate Mdm Cdm,PX-98110012,CDM,99284,CPT,981,RC,,inpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,440.8,Percent of total billed charges,,440.8,454.72,
HC PR ED 99284 Visit Moderate Mdm Cdm,PX-98110012,CDM,99284,CPT,981,RC,,outpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,440.8,Percent of total billed charges,,440.8,454.72,
HC PR ED 99285 Visit High Mdm Cdm,PX-98110016,CDM,99285,CPT,981,RC,,inpatient,,,478,430.2,,0.95,,454.1,Percent of total billed charges,,,0.98,,468.44,Percent of total billed charges,,,0.95,,454.1,Percent of total billed charges,,,0.97,,463.66,Percent of total billed charges,,,0.97,,463.66,Percent of total billed charges,,,0.96,,458.88,Percent of total billed charges,,,0.95,,454.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,454.1,Percent of total billed charges,,454.1,468.44,
HC PR ED 99285 Visit High Mdm Cdm,PX-98110016,CDM,99285,CPT,981,RC,,outpatient,,,478,430.2,,0.95,,454.1,Percent of total billed charges,,,0.98,,468.44,Percent of total billed charges,,,0.95,,454.1,Percent of total billed charges,,,0.95,,454.1,Percent of total billed charges,,,0.97,,463.66,Percent of total billed charges,,,0.96,,458.88,Percent of total billed charges,,,0.95,,454.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,454.1,Percent of total billed charges,,454.1,468.44,
HC PR ED 99291 Critical Care First Hour Cdm,PX-98110021,CDM,99291,CPT,981,RC,,inpatient,,,829,746.1,,0.95,,787.55,Percent of total billed charges,,,0.98,,812.42,Percent of total billed charges,,,0.95,,787.55,Percent of total billed charges,,,0.97,,804.13,Percent of total billed charges,,,0.97,,804.13,Percent of total billed charges,,,0.96,,795.84,Percent of total billed charges,,,0.95,,787.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,787.55,Percent of total billed charges,,787.55,812.42,
HC PR ED 99291 Critical Care First Hour Cdm,PX-98110021,CDM,99291,CPT,981,RC,,outpatient,,,829,746.1,,0.95,,787.55,Percent of total billed charges,,,0.98,,812.42,Percent of total billed charges,,,0.95,,787.55,Percent of total billed charges,,,0.95,,787.55,Percent of total billed charges,,,0.97,,804.13,Percent of total billed charges,,,0.96,,795.84,Percent of total billed charges,,,0.95,,787.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,787.55,Percent of total billed charges,,787.55,812.42,
HC PR ED 99292 Critical Care Addl 30 Min Cdm,PX-98110023,CDM,99292,CPT,981,RC,,inpatient,,,815,733.5,,0.95,,774.25,Percent of total billed charges,,,0.98,,798.7,Percent of total billed charges,,,0.95,,774.25,Percent of total billed charges,,,0.97,,790.55,Percent of total billed charges,,,0.97,,790.55,Percent of total billed charges,,,0.96,,782.4,Percent of total billed charges,,,0.95,,774.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,774.25,Percent of total billed charges,,774.25,798.7,
HC PR ED 99292 Critical Care Addl 30 Min Cdm,PX-98110023,CDM,99292,CPT,981,RC,,outpatient,,,815,733.5,,0.95,,774.25,Percent of total billed charges,,,0.98,,798.7,Percent of total billed charges,,,0.95,,774.25,Percent of total billed charges,,,0.95,,774.25,Percent of total billed charges,,,0.97,,790.55,Percent of total billed charges,,,0.96,,782.4,Percent of total billed charges,,,0.95,,774.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,774.25,Percent of total billed charges,,774.25,798.7,
HC PR ED 99282 Emergency Department Visit Straightforward Mdm Cdm,PX-98110489,CDM,99282,CPT,981,RC,,inpatient,,,251,225.9,,0.95,,238.45,Percent of total billed charges,,,0.98,,245.98,Percent of total billed charges,,,0.95,,238.45,Percent of total billed charges,,,0.97,,243.47,Percent of total billed charges,,,0.97,,243.47,Percent of total billed charges,,,0.96,,240.96,Percent of total billed charges,,,0.95,,238.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,238.45,Percent of total billed charges,,238.45,245.98,
HC PR ED 99282 Emergency Department Visit Straightforward Mdm Cdm,PX-98110489,CDM,99282,CPT,981,RC,,outpatient,,,251,225.9,,0.95,,238.45,Percent of total billed charges,,,0.98,,245.98,Percent of total billed charges,,,0.95,,238.45,Percent of total billed charges,,,0.95,,238.45,Percent of total billed charges,,,0.97,,243.47,Percent of total billed charges,,,0.96,,240.96,Percent of total billed charges,,,0.95,,238.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,238.45,Percent of total billed charges,,238.45,245.98,
HC PR ED 99281 Visit Minor Problem May Not Req Phys/Qhp Cdm,PX-98110604,CDM,99281,CPT,981,RC,,inpatient,,,177,159.3,,0.95,,168.15,Percent of total billed charges,,,0.98,,173.46,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.96,,169.92,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,168.15,Percent of total billed charges,,168.15,173.46,
HC PR ED 99281 Visit Minor Problem May Not Req Phys/Qhp Cdm,PX-98110604,CDM,99281,CPT,981,RC,,outpatient,,,177,159.3,,0.95,,168.15,Percent of total billed charges,,,0.98,,173.46,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.96,,169.92,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,168.15,Percent of total billed charges,,168.15,173.46,
Insert non-tunneled central venous tube for IV=>5 yrs,PX-36110418,CDM,36556,CPT,361,RC,,inpatient,,,704,633.6,,0.95,,668.8,Percent of total billed charges,,,0.98,,689.92,Percent of total billed charges,,,0.95,,668.8,Percent of total billed charges,,,0.97,,682.88,Percent of total billed charges,,,0.97,,682.88,Percent of total billed charges,,,0.96,,675.84,Percent of total billed charges,,,0.95,,668.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,668.8,Percent of total billed charges,,668.8,689.92,
Insert non-tunneled central venous tube for IV=>5 yrs,PX-36110418,CDM,36556,CPT,361,RC,,outpatient,,,704,633.6,,0.95,,668.8,Percent of total billed charges,,,0.98,,689.92,Percent of total billed charges,,,0.95,,668.8,Percent of total billed charges,,,0.95,,668.8,Percent of total billed charges,,,0.97,,682.88,Percent of total billed charges,,,0.96,,675.84,Percent of total billed charges,,,0.95,,668.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,668.8,Percent of total billed charges,,668.8,689.92,
Insert tube for IV=>5yrs,PX-36110432,CDM,36569,CPT,361,RC,,inpatient,,,2753,2477.7,,0.95,,2615.35,Percent of total billed charges,,,0.98,,2697.94,Percent of total billed charges,,,0.95,,2615.35,Percent of total billed charges,,,0.97,,2670.41,Percent of total billed charges,,,0.97,,2670.41,Percent of total billed charges,,,0.96,,2642.88,Percent of total billed charges,,,0.95,,2615.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2615.35,Percent of total billed charges,,2615.35,2697.94,
Insert tube for IV=>5yrs,PX-36110432,CDM,36569,CPT,361,RC,,outpatient,,,2753,2477.7,,0.95,,2615.35,Percent of total billed charges,,,0.98,,2697.94,Percent of total billed charges,,,0.95,,2615.35,Percent of total billed charges,,,0.95,,2615.35,Percent of total billed charges,,,0.97,,2670.41,Percent of total billed charges,,,0.96,,2642.88,Percent of total billed charges,,,0.95,,2615.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2615.35,Percent of total billed charges,,2615.35,2697.94,
"Aspiration of abscess, blood, or cyst",PX-36110602,CDM,10160,CPT,361,RC,,inpatient,,,272,244.8,,0.95,,258.4,Percent of total billed charges,,,0.98,,266.56,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,0.97,,263.84,Percent of total billed charges,,,0.97,,263.84,Percent of total billed charges,,,0.96,,261.12,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,258.4,Percent of total billed charges,,258.4,266.56,
"Aspiration of abscess, blood, or cyst",PX-36110602,CDM,10160,CPT,361,RC,,outpatient,,,272,244.8,,0.95,,258.4,Percent of total billed charges,,,0.98,,266.56,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,0.97,,263.84,Percent of total billed charges,,,0.96,,261.12,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,258.4,Percent of total billed charges,,258.4,266.56,
Emergent Insert breathing tube into windpipe w/endoscope,PX-36110619,CDM,31500,CPT,361,RC,,inpatient,,,686,617.4,,0.95,,651.7,Percent of total billed charges,,,0.98,,672.28,Percent of total billed charges,,,0.95,,651.7,Percent of total billed charges,,,0.97,,665.42,Percent of total billed charges,,,0.97,,665.42,Percent of total billed charges,,,0.96,,658.56,Percent of total billed charges,,,0.95,,651.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,651.7,Percent of total billed charges,,651.7,672.28,
Emergent Insert breathing tube into windpipe w/endoscope,PX-36110619,CDM,31500,CPT,361,RC,,outpatient,,,686,617.4,,0.95,,651.7,Percent of total billed charges,,,0.98,,672.28,Percent of total billed charges,,,0.95,,651.7,Percent of total billed charges,,,0.95,,651.7,Percent of total billed charges,,,0.97,,665.42,Percent of total billed charges,,,0.96,,658.56,Percent of total billed charges,,,0.95,,651.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,651.7,Percent of total billed charges,,651.7,672.28,
Removal of fluid from between lung and chest cavity,PX-36110622,CDM,32551,CPT,361,RC,,inpatient,,,1404,1263.6,,0.95,,1333.8,Percent of total billed charges,,,0.98,,1375.92,Percent of total billed charges,,,0.95,,1333.8,Percent of total billed charges,,,0.97,,1361.88,Percent of total billed charges,,,0.97,,1361.88,Percent of total billed charges,,,0.96,,1347.84,Percent of total billed charges,,,0.95,,1333.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1333.8,Percent of total billed charges,,1333.8,1375.92,
Removal of fluid from between lung and chest cavity,PX-36110622,CDM,32551,CPT,361,RC,,outpatient,,,1404,1263.6,,0.95,,1333.8,Percent of total billed charges,,,0.98,,1375.92,Percent of total billed charges,,,0.95,,1333.8,Percent of total billed charges,,,0.95,,1333.8,Percent of total billed charges,,,0.97,,1361.88,Percent of total billed charges,,,0.96,,1347.84,Percent of total billed charges,,,0.95,,1333.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1333.8,Percent of total billed charges,,1333.8,1375.92,
Drainage of fluid from abdominal cavity w/ imaging guidance,PX-36110662,CDM,49083,CPT,361,RC,,inpatient,,,1056,950.4,,0.95,,1003.2,Percent of total billed charges,,,0.98,,1034.88,Percent of total billed charges,,,0.95,,1003.2,Percent of total billed charges,,,0.97,,1024.32,Percent of total billed charges,,,0.97,,1024.32,Percent of total billed charges,,,0.96,,1013.76,Percent of total billed charges,,,0.95,,1003.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1003.2,Percent of total billed charges,,1003.2,1034.88,
Drainage of fluid from abdominal cavity w/ imaging guidance,PX-36110662,CDM,49083,CPT,361,RC,,outpatient,,,1056,950.4,,0.95,,1003.2,Percent of total billed charges,,,0.98,,1034.88,Percent of total billed charges,,,0.95,,1003.2,Percent of total billed charges,,,0.95,,1003.2,Percent of total billed charges,,,0.97,,1024.32,Percent of total billed charges,,,0.96,,1013.76,Percent of total billed charges,,,0.95,,1003.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1003.2,Percent of total billed charges,,1003.2,1034.88,
Simple change of bladder tube,PX-36110687,CDM,51705,CPT,361,RC,,inpatient,,,340,306,,0.95,,323,Percent of total billed charges,,,0.98,,333.2,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.96,,326.4,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,323,Percent of total billed charges,,323,333.2,
Simple change of bladder tube,PX-36110687,CDM,51705,CPT,361,RC,,outpatient,,,340,306,,0.95,,323,Percent of total billed charges,,,0.98,,333.2,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.96,,326.4,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,323,Percent of total billed charges,,323,333.2,
HC Ephys Eval Pacg Cvdfb Lds W/Tstg of Pulse Gen,PX-48010117,CDM,93641,CPT,480,RC,,inpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
HC Ephys Eval Pacg Cvdfb Lds W/Tstg of Pulse Gen,PX-48010117,CDM,93641,CPT,480,RC,,outpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
HC Ephys Eval Pacg Cvdfb Prgrmg/Reprgrmg Parameters,PX-48010118,CDM,93642,CPT,480,RC,,inpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
HC Ephys Eval Pacg Cvdfb Prgrmg/Reprgrmg Parameters,PX-48010118,CDM,93642,CPT,480,RC,,outpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
HC PR 36561 Insert Tunneled Cv Cath W/Port > 5,PX-97510986,CDM,36561,CPT,975,RC,,inpatient,,,3409,3068.1,,0.95,,3238.55,Percent of total billed charges,,,0.98,,3340.82,Percent of total billed charges,,,0.95,,3238.55,Percent of total billed charges,,,0.97,,3306.73,Percent of total billed charges,,,0.97,,3306.73,Percent of total billed charges,,,0.96,,3272.64,Percent of total billed charges,,,0.95,,3238.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3238.55,Percent of total billed charges,,3238.55,3340.82,
HC PR 36561 Insert Tunneled Cv Cath W/Port > 5,PX-97510986,CDM,36561,CPT,975,RC,,outpatient,,,3409,3068.1,,0.95,,3238.55,Percent of total billed charges,,,0.98,,3340.82,Percent of total billed charges,,,0.95,,3238.55,Percent of total billed charges,,,0.95,,3238.55,Percent of total billed charges,,,0.97,,3306.73,Percent of total billed charges,,,0.96,,3272.64,Percent of total billed charges,,,0.95,,3238.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3238.55,Percent of total billed charges,,3238.55,3340.82,
HC PR 36590 Removal Tunneled Cv Cath W/Port or Pump,PX-97510989,CDM,36590,CPT,975,RC,,inpatient,,,544,489.6,,0.95,,516.8,Percent of total billed charges,,,0.98,,533.12,Percent of total billed charges,,,0.95,,516.8,Percent of total billed charges,,,0.97,,527.68,Percent of total billed charges,,,0.97,,527.68,Percent of total billed charges,,,0.96,,522.24,Percent of total billed charges,,,0.95,,516.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,516.8,Percent of total billed charges,,516.8,533.12,
HC PR 36590 Removal Tunneled Cv Cath W/Port or Pump,PX-97510989,CDM,36590,CPT,975,RC,,outpatient,,,544,489.6,,0.95,,516.8,Percent of total billed charges,,,0.98,,533.12,Percent of total billed charges,,,0.95,,516.8,Percent of total billed charges,,,0.95,,516.8,Percent of total billed charges,,,0.97,,527.68,Percent of total billed charges,,,0.96,,522.24,Percent of total billed charges,,,0.95,,516.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,516.8,Percent of total billed charges,,516.8,533.12,
HC PR ED 37609 Temporal Artery Procedure Cdm,PX-98110609,CDM,37609,CPT,981,RC,,inpatient,,,866,779.4,,0.95,,822.7,Percent of total billed charges,,,0.98,,848.68,Percent of total billed charges,,,0.95,,822.7,Percent of total billed charges,,,0.97,,840.02,Percent of total billed charges,,,0.97,,840.02,Percent of total billed charges,,,0.96,,831.36,Percent of total billed charges,,,0.95,,822.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,822.7,Percent of total billed charges,,822.7,848.68,
HC PR ED 37609 Temporal Artery Procedure Cdm,PX-98110609,CDM,37609,CPT,981,RC,,outpatient,,,866,779.4,,0.95,,822.7,Percent of total billed charges,,,0.98,,848.68,Percent of total billed charges,,,0.95,,822.7,Percent of total billed charges,,,0.95,,822.7,Percent of total billed charges,,,0.97,,840.02,Percent of total billed charges,,,0.96,,831.36,Percent of total billed charges,,,0.95,,822.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,822.7,Percent of total billed charges,,822.7,848.68,
HC PR Rx Ceftriaxone Sodium Inj 250 Mg,PX-63610278,CDM,J0696,HCPCS,636,RC,,inpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
HC PR Rx Ceftriaxone Sodium Inj 250 Mg,PX-63610278,CDM,J0696,HCPCS,636,RC,,outpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
HC PR Rx Clonidine Hcl Inj 1 Mg,PX-63610279,CDM,J0735,HCPCS,636,RC,,inpatient,,,2,1.8,,0.95,,1.9,Percent of total billed charges,,,0.98,,1.96,Percent of total billed charges,,,0.95,,1.9,Percent of total billed charges,,,0.97,,1.94,Percent of total billed charges,,,0.97,,1.94,Percent of total billed charges,,,0.96,,1.92,Percent of total billed charges,,,0.95,,1.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1.9,Percent of total billed charges,,1.9,1.96,
HC PR Rx Clonidine Hcl Inj 1 Mg,PX-63610279,CDM,J0735,HCPCS,636,RC,,outpatient,,,2,1.8,,0.95,,1.9,Percent of total billed charges,,,0.98,,1.96,Percent of total billed charges,,,0.95,,1.9,Percent of total billed charges,,,0.95,,1.9,Percent of total billed charges,,,0.97,,1.94,Percent of total billed charges,,,0.96,,1.92,Percent of total billed charges,,,0.95,,1.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1.9,Percent of total billed charges,,1.9,1.96,
HC PR Rx Ketorolac Tromethamine Inj 15 Mg,PX-63610289,CDM,J1885,HCPCS,636,RC,,inpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
HC PR Rx Ketorolac Tromethamine Inj 15 Mg,PX-63610289,CDM,J1885,HCPCS,636,RC,,outpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
HC PR G0101 Screen;Pelvic/Breast Exam,PX-96910436,CDM,G0101,HCPCS,983,RC,,inpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
HC PR G0101 Screen;Pelvic/Breast Exam,PX-96910436,CDM,G0101,HCPCS,983,RC,,outpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
HC PR Q0091 Obtaining Screen Pap Smear,PX-96910439,CDM,Q0091,HCPCS,983,RC,,inpatient,,,120,108,,0.95,,114,Percent of total billed charges,,,0.98,,117.6,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.96,,115.2,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114,Percent of total billed charges,,114,117.6,
HC PR Q0091 Obtaining Screen Pap Smear,PX-96910439,CDM,Q0091,HCPCS,983,RC,,outpatient,,,120,108,,0.95,,114,Percent of total billed charges,,,0.98,,117.6,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.96,,115.2,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114,Percent of total billed charges,,114,117.6,
HC PR G0105 Colorectal Scrn; Hi Risk Ind,PX-97510012,CDM,G0105,HCPCS,975,RC,,inpatient,,,835,751.5,,0.95,,793.25,Percent of total billed charges,,,0.98,,818.3,Percent of total billed charges,,,0.95,,793.25,Percent of total billed charges,,,0.97,,809.95,Percent of total billed charges,,,0.97,,809.95,Percent of total billed charges,,,0.96,,801.6,Percent of total billed charges,,,0.95,,793.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,793.25,Percent of total billed charges,,793.25,818.3,
HC PR G0105 Colorectal Scrn; Hi Risk Ind,PX-97510012,CDM,G0105,HCPCS,975,RC,,outpatient,,,835,751.5,,0.95,,793.25,Percent of total billed charges,,,0.98,,818.3,Percent of total billed charges,,,0.95,,793.25,Percent of total billed charges,,,0.95,,793.25,Percent of total billed charges,,,0.97,,809.95,Percent of total billed charges,,,0.96,,801.6,Percent of total billed charges,,,0.95,,793.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,793.25,Percent of total billed charges,,793.25,818.3,
HC PR G0121 Colorectal Scrn; Not Hi Risk Ind,PX-97510013,CDM,G0121,HCPCS,975,RC,,inpatient,,,878,790.2,,0.95,,834.1,Percent of total billed charges,,,0.98,,860.44,Percent of total billed charges,,,0.95,,834.1,Percent of total billed charges,,,0.97,,851.66,Percent of total billed charges,,,0.97,,851.66,Percent of total billed charges,,,0.96,,842.88,Percent of total billed charges,,,0.95,,834.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,834.1,Percent of total billed charges,,834.1,860.44,
HC PR G0121 Colorectal Scrn; Not Hi Risk Ind,PX-97510013,CDM,G0121,HCPCS,975,RC,,outpatient,,,878,790.2,,0.95,,834.1,Percent of total billed charges,,,0.98,,860.44,Percent of total billed charges,,,0.95,,834.1,Percent of total billed charges,,,0.95,,834.1,Percent of total billed charges,,,0.97,,851.66,Percent of total billed charges,,,0.96,,842.88,Percent of total billed charges,,,0.95,,834.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,834.1,Percent of total billed charges,,834.1,860.44,
HC Blood Draw Venipuncture,PX-30010004,CDM,36415,CPT,300,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC Blood Draw Venipuncture,PX-30010004,CDM,36415,CPT,300,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
Insert needle into vein for collection of blood sample,PX-30010009,CDM,36415,CPT,300,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
Insert needle into vein for collection of blood sample,PX-30010009,CDM,36415,CPT,300,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
Puncture of skin for collection of blood sample,PX-30010011,CDM,36416,CPT,300,RC,,inpatient,,,32,28.8,,0.95,,30.4,Percent of total billed charges,,,0.98,,31.36,Percent of total billed charges,,,0.95,,30.4,Percent of total billed charges,,,0.97,,31.04,Percent of total billed charges,,,0.97,,31.04,Percent of total billed charges,,,0.96,,30.72,Percent of total billed charges,,,0.95,,30.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,30.4,Percent of total billed charges,,30.4,31.36,
Puncture of skin for collection of blood sample,PX-30010011,CDM,36416,CPT,300,RC,,outpatient,,,32,28.8,,0.95,,30.4,Percent of total billed charges,,,0.98,,31.36,Percent of total billed charges,,,0.95,,30.4,Percent of total billed charges,,,0.95,,30.4,Percent of total billed charges,,,0.97,,31.04,Percent of total billed charges,,,0.96,,30.72,Percent of total billed charges,,,0.95,,30.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,30.4,Percent of total billed charges,,30.4,31.36,
Artery puncture collection of blood sample,PX-30010013,CDM,36600,CPT,300,RC,,inpatient,,,152,136.8,,0.95,,144.4,Percent of total billed charges,,,0.98,,148.96,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,0.97,,147.44,Percent of total billed charges,,,0.97,,147.44,Percent of total billed charges,,,0.96,,145.92,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,144.4,Percent of total billed charges,,144.4,148.96,
Artery puncture collection of blood sample,PX-30010013,CDM,36600,CPT,300,RC,,outpatient,,,152,136.8,,0.95,,144.4,Percent of total billed charges,,,0.98,,148.96,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,0.97,,147.44,Percent of total billed charges,,,0.96,,145.92,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,144.4,Percent of total billed charges,,144.4,148.96,
Drawing of blood for a medical problem,PX-94010204,CDM,99195,CPT,940,RC,,inpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
Drawing of blood for a medical problem,PX-94010204,CDM,99195,CPT,940,RC,,outpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
HC PR Routine Venipuncture,PX-96910173,CDM,36415,CPT,983,RC,,inpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
HC PR Routine Venipuncture,PX-96910173,CDM,36415,CPT,983,RC,,outpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
HC PR ED 36600 Withdrawal of Arterial Blood Cdm,PX-98110587,CDM,36600,CPT,981,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR ED 36600 Withdrawal of Arterial Blood Cdm,PX-98110587,CDM,36600,CPT,981,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
X-ray eye for detection of foreign body,PX-32010003,CDM,70030,CPT,320,RC,,inpatient,,,204,183.6,,0.95,,193.8,Percent of total billed charges,,,0.98,,199.92,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.96,,195.84,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,193.8,Percent of total billed charges,,193.8,199.92,
X-ray eye for detection of foreign body,PX-32010003,CDM,70030,CPT,320,RC,,outpatient,,,204,183.6,,0.95,,193.8,Percent of total billed charges,,,0.98,,199.92,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.96,,195.84,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,193.8,Percent of total billed charges,,193.8,199.92,
"X-ray of toe, minimum of 2 views",PX-32010004,CDM,73660,CPT,320,RC,,inpatient,,,237,213.3,,0.95,,225.15,Percent of total billed charges,,,0.98,,232.26,Percent of total billed charges,,,0.95,,225.15,Percent of total billed charges,,,0.97,,229.89,Percent of total billed charges,,,0.97,,229.89,Percent of total billed charges,,,0.96,,227.52,Percent of total billed charges,,,0.95,,225.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,225.15,Percent of total billed charges,,225.15,232.26,
"X-ray of toe, minimum of 2 views",PX-32010004,CDM,73660,CPT,320,RC,,outpatient,,,237,213.3,,0.95,,225.15,Percent of total billed charges,,,0.98,,232.26,Percent of total billed charges,,,0.95,,225.15,Percent of total billed charges,,,0.95,,225.15,Percent of total billed charges,,,0.97,,229.89,Percent of total billed charges,,,0.96,,227.52,Percent of total billed charges,,,0.95,,225.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,225.15,Percent of total billed charges,,225.15,232.26,
"X-ray of part of lower jaw, 1-4 views",PX-32010006,CDM,70100,CPT,320,RC,,inpatient,,,261,234.9,,0.95,,247.95,Percent of total billed charges,,,0.98,,255.78,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,0.97,,253.17,Percent of total billed charges,,,0.97,,253.17,Percent of total billed charges,,,0.96,,250.56,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,247.95,Percent of total billed charges,,247.95,255.78,
"X-ray of part of lower jaw, 1-4 views",PX-32010006,CDM,70100,CPT,320,RC,,outpatient,,,261,234.9,,0.95,,247.95,Percent of total billed charges,,,0.98,,255.78,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,0.97,,253.17,Percent of total billed charges,,,0.96,,250.56,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,247.95,Percent of total billed charges,,247.95,255.78,
"X-ray of lower jaw, minimum of 4 views",PX-32010007,CDM,70110,CPT,320,RC,,inpatient,,,412,370.8,,0.95,,391.4,Percent of total billed charges,,,0.98,,403.76,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.96,,395.52,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,391.4,Percent of total billed charges,,391.4,403.76,
"X-ray of lower jaw, minimum of 4 views",PX-32010007,CDM,70110,CPT,320,RC,,outpatient,,,412,370.8,,0.95,,391.4,Percent of total billed charges,,,0.98,,403.76,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.96,,395.52,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,391.4,Percent of total billed charges,,391.4,403.76,
"X-ray of face bones, 1-2 views",PX-32010011,CDM,70140,CPT,320,RC,,inpatient,,,347,312.3,,0.95,,329.65,Percent of total billed charges,,,0.98,,340.06,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,0.97,,336.59,Percent of total billed charges,,,0.97,,336.59,Percent of total billed charges,,,0.96,,333.12,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,329.65,Percent of total billed charges,,329.65,340.06,
"X-ray of face bones, 1-2 views",PX-32010011,CDM,70140,CPT,320,RC,,outpatient,,,347,312.3,,0.95,,329.65,Percent of total billed charges,,,0.98,,340.06,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,0.97,,336.59,Percent of total billed charges,,,0.96,,333.12,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,329.65,Percent of total billed charges,,329.65,340.06,
"X-ray of face bones, minimum of 3 views",PX-32010012,CDM,70150,CPT,320,RC,,inpatient,,,515,463.5,,0.95,,489.25,Percent of total billed charges,,,0.98,,504.7,Percent of total billed charges,,,0.95,,489.25,Percent of total billed charges,,,0.97,,499.55,Percent of total billed charges,,,0.97,,499.55,Percent of total billed charges,,,0.96,,494.4,Percent of total billed charges,,,0.95,,489.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,489.25,Percent of total billed charges,,489.25,504.7,
"X-ray of face bones, minimum of 3 views",PX-32010012,CDM,70150,CPT,320,RC,,outpatient,,,515,463.5,,0.95,,489.25,Percent of total billed charges,,,0.98,,504.7,Percent of total billed charges,,,0.95,,489.25,Percent of total billed charges,,,0.95,,489.25,Percent of total billed charges,,,0.97,,499.55,Percent of total billed charges,,,0.96,,494.4,Percent of total billed charges,,,0.95,,489.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,489.25,Percent of total billed charges,,489.25,504.7,
"X-ray of nose bones, minimum of 3 views",PX-32010014,CDM,70160,CPT,320,RC,,inpatient,,,335,301.5,,0.95,,318.25,Percent of total billed charges,,,0.98,,328.3,Percent of total billed charges,,,0.95,,318.25,Percent of total billed charges,,,0.97,,324.95,Percent of total billed charges,,,0.97,,324.95,Percent of total billed charges,,,0.96,,321.6,Percent of total billed charges,,,0.95,,318.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,318.25,Percent of total billed charges,,318.25,328.3,
"X-ray of nose bones, minimum of 3 views",PX-32010014,CDM,70160,CPT,320,RC,,outpatient,,,335,301.5,,0.95,,318.25,Percent of total billed charges,,,0.98,,328.3,Percent of total billed charges,,,0.95,,318.25,Percent of total billed charges,,,0.95,,318.25,Percent of total billed charges,,,0.97,,324.95,Percent of total billed charges,,,0.96,,321.6,Percent of total billed charges,,,0.95,,318.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,318.25,Percent of total billed charges,,318.25,328.3,
X-ray of eye canal,PX-32010016,CDM,70190,CPT,320,RC,,inpatient,,,240,216,,0.95,,228,Percent of total billed charges,,,0.98,,235.2,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,0.97,,232.8,Percent of total billed charges,,,0.97,,232.8,Percent of total billed charges,,,0.96,,230.4,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,228,Percent of total billed charges,,228,235.2,
X-ray of eye canal,PX-32010016,CDM,70190,CPT,320,RC,,outpatient,,,240,216,,0.95,,228,Percent of total billed charges,,,0.98,,235.2,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,0.97,,232.8,Percent of total billed charges,,,0.96,,230.4,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,228,Percent of total billed charges,,228,235.2,
"X-ray of paranasal sinus, 1-2 views",PX-32010018,CDM,70210,CPT,320,RC,,inpatient,,,240,216,,0.95,,228,Percent of total billed charges,,,0.98,,235.2,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,0.97,,232.8,Percent of total billed charges,,,0.97,,232.8,Percent of total billed charges,,,0.96,,230.4,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,228,Percent of total billed charges,,228,235.2,
"X-ray of paranasal sinus, 1-2 views",PX-32010018,CDM,70210,CPT,320,RC,,outpatient,,,240,216,,0.95,,228,Percent of total billed charges,,,0.98,,235.2,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,0.97,,232.8,Percent of total billed charges,,,0.96,,230.4,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,228,Percent of total billed charges,,228,235.2,
"X-ray of paranasal sinus, minimum of 3 views",PX-32010020,CDM,70220,CPT,320,RC,,inpatient,,,515,463.5,,0.95,,489.25,Percent of total billed charges,,,0.98,,504.7,Percent of total billed charges,,,0.95,,489.25,Percent of total billed charges,,,0.97,,499.55,Percent of total billed charges,,,0.97,,499.55,Percent of total billed charges,,,0.96,,494.4,Percent of total billed charges,,,0.95,,489.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,489.25,Percent of total billed charges,,489.25,504.7,
"X-ray of paranasal sinus, minimum of 3 views",PX-32010020,CDM,70220,CPT,320,RC,,outpatient,,,515,463.5,,0.95,,489.25,Percent of total billed charges,,,0.98,,504.7,Percent of total billed charges,,,0.95,,489.25,Percent of total billed charges,,,0.95,,489.25,Percent of total billed charges,,,0.97,,499.55,Percent of total billed charges,,,0.96,,494.4,Percent of total billed charges,,,0.95,,489.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,489.25,Percent of total billed charges,,489.25,504.7,
X-ray of bone at base of skull,PX-32010021,CDM,70240,CPT,320,RC,,inpatient,,,164,147.6,,0.95,,155.8,Percent of total billed charges,,,0.98,,160.72,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.96,,157.44,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,155.8,Percent of total billed charges,,155.8,160.72,
X-ray of bone at base of skull,PX-32010021,CDM,70240,CPT,320,RC,,outpatient,,,164,147.6,,0.95,,155.8,Percent of total billed charges,,,0.98,,160.72,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.96,,157.44,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,155.8,Percent of total billed charges,,155.8,160.72,
"X-ray of skull, 1-3 views",PX-32010022,CDM,70250,CPT,320,RC,,inpatient,,,363,326.7,,0.95,,344.85,Percent of total billed charges,,,0.98,,355.74,Percent of total billed charges,,,0.95,,344.85,Percent of total billed charges,,,0.97,,352.11,Percent of total billed charges,,,0.97,,352.11,Percent of total billed charges,,,0.96,,348.48,Percent of total billed charges,,,0.95,,344.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,344.85,Percent of total billed charges,,344.85,355.74,
"X-ray of skull, 1-3 views",PX-32010022,CDM,70250,CPT,320,RC,,outpatient,,,363,326.7,,0.95,,344.85,Percent of total billed charges,,,0.98,,355.74,Percent of total billed charges,,,0.95,,344.85,Percent of total billed charges,,,0.95,,344.85,Percent of total billed charges,,,0.97,,352.11,Percent of total billed charges,,,0.96,,348.48,Percent of total billed charges,,,0.95,,344.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,344.85,Percent of total billed charges,,344.85,355.74,
"X-ray of skull, minimum of 4 views",PX-32010023,CDM,70260,CPT,320,RC,,inpatient,,,412,370.8,,0.95,,391.4,Percent of total billed charges,,,0.98,,403.76,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.96,,395.52,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,391.4,Percent of total billed charges,,391.4,403.76,
"X-ray of skull, minimum of 4 views",PX-32010023,CDM,70260,CPT,320,RC,,outpatient,,,412,370.8,,0.95,,391.4,Percent of total billed charges,,,0.98,,403.76,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.96,,395.52,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,391.4,Percent of total billed charges,,391.4,403.76,
X-ray jaw joint on 1 side of mouth,PX-32010027,CDM,70328,CPT,320,RC,,inpatient,,,216,194.4,,0.95,,205.2,Percent of total billed charges,,,0.98,,211.68,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,0.97,,209.52,Percent of total billed charges,,,0.97,,209.52,Percent of total billed charges,,,0.96,,207.36,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,205.2,Percent of total billed charges,,205.2,211.68,
X-ray jaw joint on 1 side of mouth,PX-32010027,CDM,70328,CPT,320,RC,,outpatient,,,216,194.4,,0.95,,205.2,Percent of total billed charges,,,0.98,,211.68,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,0.97,,209.52,Percent of total billed charges,,,0.96,,207.36,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,205.2,Percent of total billed charges,,205.2,211.68,
X-ray of soft tissue of neck,PX-32010031,CDM,70360,CPT,320,RC,,inpatient,,,284,255.6,,0.95,,269.8,Percent of total billed charges,,,0.98,,278.32,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,0.97,,275.48,Percent of total billed charges,,,0.97,,275.48,Percent of total billed charges,,,0.96,,272.64,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,269.8,Percent of total billed charges,,269.8,278.32,
X-ray of soft tissue of neck,PX-32010031,CDM,70360,CPT,320,RC,,outpatient,,,284,255.6,,0.95,,269.8,Percent of total billed charges,,,0.98,,278.32,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,0.97,,275.48,Percent of total billed charges,,,0.96,,272.64,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,269.8,Percent of total billed charges,,269.8,278.32,
X-ray for bone length assessment,PX-32010039,CDM,77073,CPT,320,RC,,inpatient,,,347,312.3,,0.95,,329.65,Percent of total billed charges,,,0.98,,340.06,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,0.97,,336.59,Percent of total billed charges,,,0.97,,336.59,Percent of total billed charges,,,0.96,,333.12,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,329.65,Percent of total billed charges,,329.65,340.06,
X-ray for bone length assessment,PX-32010039,CDM,77073,CPT,320,RC,,outpatient,,,347,312.3,,0.95,,329.65,Percent of total billed charges,,,0.98,,340.06,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,0.97,,336.59,Percent of total billed charges,,,0.96,,333.12,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,329.65,Percent of total billed charges,,329.65,340.06,
Single contrast X-ray of esophagus,PX-32010041,CDM,74220,CPT,320,RC,,inpatient,,,485,436.5,,0.95,,460.75,Percent of total billed charges,,,0.98,,475.3,Percent of total billed charges,,,0.95,,460.75,Percent of total billed charges,,,0.97,,470.45,Percent of total billed charges,,,0.97,,470.45,Percent of total billed charges,,,0.96,,465.6,Percent of total billed charges,,,0.95,,460.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,460.75,Percent of total billed charges,,460.75,475.3,
Single contrast X-ray of esophagus,PX-32010041,CDM,74220,CPT,320,RC,,outpatient,,,485,436.5,,0.95,,460.75,Percent of total billed charges,,,0.98,,475.3,Percent of total billed charges,,,0.95,,460.75,Percent of total billed charges,,,0.95,,460.75,Percent of total billed charges,,,0.97,,470.45,Percent of total billed charges,,,0.96,,465.6,Percent of total billed charges,,,0.95,,460.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,460.75,Percent of total billed charges,,460.75,475.3,
"X-ray of ribs on side of body, 2 views",PX-32010045,CDM,71100,CPT,320,RC,,inpatient,,,340,306,,0.95,,323,Percent of total billed charges,,,0.98,,333.2,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.96,,326.4,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,323,Percent of total billed charges,,323,333.2,
"X-ray of ribs on side of body, 2 views",PX-32010045,CDM,71100,CPT,320,RC,,outpatient,,,340,306,,0.95,,323,Percent of total billed charges,,,0.98,,333.2,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.96,,326.4,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,323,Percent of total billed charges,,323,333.2,
"X-ray of ribs on side of body, minimum of 3 views",PX-32010046,CDM,71101,CPT,320,RC,,inpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,440.8,Percent of total billed charges,,440.8,454.72,
"X-ray of ribs on side of body, minimum of 3 views",PX-32010046,CDM,71101,CPT,320,RC,,outpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,440.8,Percent of total billed charges,,440.8,454.72,
"X-ray of ribs on both sides of body, minimum of 4 views",PX-32010049,CDM,71111,CPT,320,RC,,inpatient,,,618,556.2,,0.95,,587.1,Percent of total billed charges,,,0.98,,605.64,Percent of total billed charges,,,0.95,,587.1,Percent of total billed charges,,,0.97,,599.46,Percent of total billed charges,,,0.97,,599.46,Percent of total billed charges,,,0.96,,593.28,Percent of total billed charges,,,0.95,,587.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,587.1,Percent of total billed charges,,587.1,605.64,
"X-ray of ribs on both sides of body, minimum of 4 views",PX-32010049,CDM,71111,CPT,320,RC,,outpatient,,,618,556.2,,0.95,,587.1,Percent of total billed charges,,,0.98,,605.64,Percent of total billed charges,,,0.95,,587.1,Percent of total billed charges,,,0.95,,587.1,Percent of total billed charges,,,0.97,,599.46,Percent of total billed charges,,,0.96,,593.28,Percent of total billed charges,,,0.95,,587.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,587.1,Percent of total billed charges,,587.1,605.64,
"X-ray of chest bone, minimum of 2 views",PX-32010050,CDM,71120,CPT,320,RC,,inpatient,,,335,301.5,,0.95,,318.25,Percent of total billed charges,,,0.98,,328.3,Percent of total billed charges,,,0.95,,318.25,Percent of total billed charges,,,0.97,,324.95,Percent of total billed charges,,,0.97,,324.95,Percent of total billed charges,,,0.96,,321.6,Percent of total billed charges,,,0.95,,318.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,318.25,Percent of total billed charges,,318.25,328.3,
"X-ray of chest bone, minimum of 2 views",PX-32010050,CDM,71120,CPT,320,RC,,outpatient,,,335,301.5,,0.95,,318.25,Percent of total billed charges,,,0.98,,328.3,Percent of total billed charges,,,0.95,,318.25,Percent of total billed charges,,,0.95,,318.25,Percent of total billed charges,,,0.97,,324.95,Percent of total billed charges,,,0.96,,321.6,Percent of total billed charges,,,0.95,,318.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,318.25,Percent of total billed charges,,318.25,328.3,
"X-ray joint b/w breast and collar bones, minimum of 2 views",PX-32010051,CDM,71130,CPT,320,RC,,inpatient,,,276,248.4,,0.95,,262.2,Percent of total billed charges,,,0.98,,270.48,Percent of total billed charges,,,0.95,,262.2,Percent of total billed charges,,,0.97,,267.72,Percent of total billed charges,,,0.97,,267.72,Percent of total billed charges,,,0.96,,264.96,Percent of total billed charges,,,0.95,,262.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,262.2,Percent of total billed charges,,262.2,270.48,
"X-ray joint b/w breast and collar bones, minimum of 2 views",PX-32010051,CDM,71130,CPT,320,RC,,outpatient,,,276,248.4,,0.95,,262.2,Percent of total billed charges,,,0.98,,270.48,Percent of total billed charges,,,0.95,,262.2,Percent of total billed charges,,,0.95,,262.2,Percent of total billed charges,,,0.97,,267.72,Percent of total billed charges,,,0.96,,264.96,Percent of total billed charges,,,0.95,,262.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,262.2,Percent of total billed charges,,262.2,270.48,
"X-ray of spine, 1 view",PX-32010053,CDM,72020,CPT,320,RC,,inpatient,,,230,207,,0.95,,218.5,Percent of total billed charges,,,0.98,,225.4,Percent of total billed charges,,,0.95,,218.5,Percent of total billed charges,,,0.97,,223.1,Percent of total billed charges,,,0.97,,223.1,Percent of total billed charges,,,0.96,,220.8,Percent of total billed charges,,,0.95,,218.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,218.5,Percent of total billed charges,,218.5,225.4,
"X-ray of spine, 1 view",PX-32010053,CDM,72020,CPT,320,RC,,outpatient,,,230,207,,0.95,,218.5,Percent of total billed charges,,,0.98,,225.4,Percent of total billed charges,,,0.95,,218.5,Percent of total billed charges,,,0.95,,218.5,Percent of total billed charges,,,0.97,,223.1,Percent of total billed charges,,,0.96,,220.8,Percent of total billed charges,,,0.95,,218.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,218.5,Percent of total billed charges,,218.5,225.4,
"X-ray of upper spine, 2-3 views",PX-32010055,CDM,72040,CPT,320,RC,,inpatient,,,348,313.2,,0.95,,330.6,Percent of total billed charges,,,0.98,,341.04,Percent of total billed charges,,,0.95,,330.6,Percent of total billed charges,,,0.97,,337.56,Percent of total billed charges,,,0.97,,337.56,Percent of total billed charges,,,0.96,,334.08,Percent of total billed charges,,,0.95,,330.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,330.6,Percent of total billed charges,,330.6,341.04,
"X-ray of upper spine, 2-3 views",PX-32010055,CDM,72040,CPT,320,RC,,outpatient,,,348,313.2,,0.95,,330.6,Percent of total billed charges,,,0.98,,341.04,Percent of total billed charges,,,0.95,,330.6,Percent of total billed charges,,,0.95,,330.6,Percent of total billed charges,,,0.97,,337.56,Percent of total billed charges,,,0.96,,334.08,Percent of total billed charges,,,0.95,,330.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,330.6,Percent of total billed charges,,330.6,341.04,
"X-ray of upper spine, 4-5 views",PX-32010056,CDM,72050,CPT,320,RC,,inpatient,,,503,452.7,,0.95,,477.85,Percent of total billed charges,,,0.98,,492.94,Percent of total billed charges,,,0.95,,477.85,Percent of total billed charges,,,0.97,,487.91,Percent of total billed charges,,,0.97,,487.91,Percent of total billed charges,,,0.96,,482.88,Percent of total billed charges,,,0.95,,477.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,477.85,Percent of total billed charges,,477.85,492.94,
"X-ray of upper spine, 4-5 views",PX-32010056,CDM,72050,CPT,320,RC,,outpatient,,,503,452.7,,0.95,,477.85,Percent of total billed charges,,,0.98,,492.94,Percent of total billed charges,,,0.95,,477.85,Percent of total billed charges,,,0.95,,477.85,Percent of total billed charges,,,0.97,,487.91,Percent of total billed charges,,,0.96,,482.88,Percent of total billed charges,,,0.95,,477.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,477.85,Percent of total billed charges,,477.85,492.94,
"X-ray of upper spine, 6 or more views",PX-32010057,CDM,72052,CPT,320,RC,,inpatient,,,507,456.3,,0.95,,481.65,Percent of total billed charges,,,0.98,,496.86,Percent of total billed charges,,,0.95,,481.65,Percent of total billed charges,,,0.97,,491.79,Percent of total billed charges,,,0.97,,491.79,Percent of total billed charges,,,0.96,,486.72,Percent of total billed charges,,,0.95,,481.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,481.65,Percent of total billed charges,,481.65,496.86,
"X-ray of upper spine, 6 or more views",PX-32010057,CDM,72052,CPT,320,RC,,outpatient,,,507,456.3,,0.95,,481.65,Percent of total billed charges,,,0.98,,496.86,Percent of total billed charges,,,0.95,,481.65,Percent of total billed charges,,,0.95,,481.65,Percent of total billed charges,,,0.97,,491.79,Percent of total billed charges,,,0.96,,486.72,Percent of total billed charges,,,0.95,,481.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,481.65,Percent of total billed charges,,481.65,496.86,
"X-ray of middle spine, 2 views",PX-32010059,CDM,72070,CPT,320,RC,,inpatient,,,412,370.8,,0.95,,391.4,Percent of total billed charges,,,0.98,,403.76,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.96,,395.52,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,391.4,Percent of total billed charges,,391.4,403.76,
"X-ray of middle spine, 2 views",PX-32010059,CDM,72070,CPT,320,RC,,outpatient,,,412,370.8,,0.95,,391.4,Percent of total billed charges,,,0.98,,403.76,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.96,,395.52,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,391.4,Percent of total billed charges,,391.4,403.76,
"X-ray of middle spine, 3 views",PX-32010060,CDM,72072,CPT,320,RC,,inpatient,,,454,408.6,,0.95,,431.3,Percent of total billed charges,,,0.98,,444.92,Percent of total billed charges,,,0.95,,431.3,Percent of total billed charges,,,0.97,,440.38,Percent of total billed charges,,,0.97,,440.38,Percent of total billed charges,,,0.96,,435.84,Percent of total billed charges,,,0.95,,431.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,431.3,Percent of total billed charges,,431.3,444.92,
"X-ray of middle spine, 3 views",PX-32010060,CDM,72072,CPT,320,RC,,outpatient,,,454,408.6,,0.95,,431.3,Percent of total billed charges,,,0.98,,444.92,Percent of total billed charges,,,0.95,,431.3,Percent of total billed charges,,,0.95,,431.3,Percent of total billed charges,,,0.97,,440.38,Percent of total billed charges,,,0.96,,435.84,Percent of total billed charges,,,0.95,,431.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,431.3,Percent of total billed charges,,431.3,444.92,
"X-ray of middle and lower spine, 2 views",PX-32010062,CDM,72080,CPT,320,RC,,inpatient,,,361,324.9,,0.95,,342.95,Percent of total billed charges,,,0.98,,353.78,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,0.97,,350.17,Percent of total billed charges,,,0.97,,350.17,Percent of total billed charges,,,0.96,,346.56,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,342.95,Percent of total billed charges,,342.95,353.78,
"X-ray of middle and lower spine, 2 views",PX-32010062,CDM,72080,CPT,320,RC,,outpatient,,,361,324.9,,0.95,,342.95,Percent of total billed charges,,,0.98,,353.78,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,0.97,,350.17,Percent of total billed charges,,,0.96,,346.56,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,342.95,Percent of total billed charges,,342.95,353.78,
"X-ray of lower and sacral spine, 2-3 views",PX-32010065,CDM,72100,CPT,320,RC,,inpatient,,,367,330.3,,0.95,,348.65,Percent of total billed charges,,,0.98,,359.66,Percent of total billed charges,,,0.95,,348.65,Percent of total billed charges,,,0.97,,355.99,Percent of total billed charges,,,0.97,,355.99,Percent of total billed charges,,,0.96,,352.32,Percent of total billed charges,,,0.95,,348.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,348.65,Percent of total billed charges,,348.65,359.66,
"X-ray of lower and sacral spine, 2-3 views",PX-32010065,CDM,72100,CPT,320,RC,,outpatient,,,367,330.3,,0.95,,348.65,Percent of total billed charges,,,0.98,,359.66,Percent of total billed charges,,,0.95,,348.65,Percent of total billed charges,,,0.95,,348.65,Percent of total billed charges,,,0.97,,355.99,Percent of total billed charges,,,0.96,,352.32,Percent of total billed charges,,,0.95,,348.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,348.65,Percent of total billed charges,,348.65,359.66,
"X-ray of lower and sacral spine, minimum of 4 views",PX-32010066,CDM,72110,CPT,320,RC,,inpatient,,,593,533.7,,0.95,,563.35,Percent of total billed charges,,,0.98,,581.14,Percent of total billed charges,,,0.95,,563.35,Percent of total billed charges,,,0.97,,575.21,Percent of total billed charges,,,0.97,,575.21,Percent of total billed charges,,,0.96,,569.28,Percent of total billed charges,,,0.95,,563.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,563.35,Percent of total billed charges,,563.35,581.14,
"X-ray of lower and sacral spine, minimum of 4 views",PX-32010066,CDM,72110,CPT,320,RC,,outpatient,,,593,533.7,,0.95,,563.35,Percent of total billed charges,,,0.98,,581.14,Percent of total billed charges,,,0.95,,563.35,Percent of total billed charges,,,0.95,,563.35,Percent of total billed charges,,,0.97,,575.21,Percent of total billed charges,,,0.96,,569.28,Percent of total billed charges,,,0.95,,563.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,563.35,Percent of total billed charges,,563.35,581.14,
"X-ray lower and sacral spine, minimum of 6 views",PX-32010067,CDM,72114,CPT,320,RC,,inpatient,,,400,360,,0.95,,380,Percent of total billed charges,,,0.98,,392,Percent of total billed charges,,,0.95,,380,Percent of total billed charges,,,0.97,,388,Percent of total billed charges,,,0.97,,388,Percent of total billed charges,,,0.96,,384,Percent of total billed charges,,,0.95,,380,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,380,Percent of total billed charges,,380,392,
"X-ray lower and sacral spine, minimum of 6 views",PX-32010067,CDM,72114,CPT,320,RC,,outpatient,,,400,360,,0.95,,380,Percent of total billed charges,,,0.98,,392,Percent of total billed charges,,,0.95,,380,Percent of total billed charges,,,0.95,,380,Percent of total billed charges,,,0.97,,388,Percent of total billed charges,,,0.96,,384,Percent of total billed charges,,,0.95,,380,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,380,Percent of total billed charges,,380,392,
"X-ray lower and sacral spine, 2-3 views bending views",PX-32010068,CDM,72120,CPT,320,RC,,inpatient,,,637,573.3,,0.95,,605.15,Percent of total billed charges,,,0.98,,624.26,Percent of total billed charges,,,0.95,,605.15,Percent of total billed charges,,,0.97,,617.89,Percent of total billed charges,,,0.97,,617.89,Percent of total billed charges,,,0.96,,611.52,Percent of total billed charges,,,0.95,,605.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,605.15,Percent of total billed charges,,605.15,624.26,
"X-ray lower and sacral spine, 2-3 views bending views",PX-32010068,CDM,72120,CPT,320,RC,,outpatient,,,637,573.3,,0.95,,605.15,Percent of total billed charges,,,0.98,,624.26,Percent of total billed charges,,,0.95,,605.15,Percent of total billed charges,,,0.95,,605.15,Percent of total billed charges,,,0.97,,617.89,Percent of total billed charges,,,0.96,,611.52,Percent of total billed charges,,,0.95,,605.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,605.15,Percent of total billed charges,,605.15,624.26,
"X-ray of pelvis, 1-2 views",PX-32010069,CDM,72170,CPT,320,RC,,inpatient,,,315,283.5,,0.95,,299.25,Percent of total billed charges,,,0.98,,308.7,Percent of total billed charges,,,0.95,,299.25,Percent of total billed charges,,,0.97,,305.55,Percent of total billed charges,,,0.97,,305.55,Percent of total billed charges,,,0.96,,302.4,Percent of total billed charges,,,0.95,,299.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,299.25,Percent of total billed charges,,299.25,308.7,
"X-ray of pelvis, 1-2 views",PX-32010069,CDM,72170,CPT,320,RC,,outpatient,,,315,283.5,,0.95,,299.25,Percent of total billed charges,,,0.98,,308.7,Percent of total billed charges,,,0.95,,299.25,Percent of total billed charges,,,0.95,,299.25,Percent of total billed charges,,,0.97,,305.55,Percent of total billed charges,,,0.96,,302.4,Percent of total billed charges,,,0.95,,299.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,299.25,Percent of total billed charges,,299.25,308.7,
"X-ray of pelvis, minimum of 3 views",PX-32010072,CDM,72190,CPT,320,RC,,inpatient,,,506,455.4,,0.95,,480.7,Percent of total billed charges,,,0.98,,495.88,Percent of total billed charges,,,0.95,,480.7,Percent of total billed charges,,,0.97,,490.82,Percent of total billed charges,,,0.97,,490.82,Percent of total billed charges,,,0.96,,485.76,Percent of total billed charges,,,0.95,,480.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,480.7,Percent of total billed charges,,480.7,495.88,
"X-ray of pelvis, minimum of 3 views",PX-32010072,CDM,72190,CPT,320,RC,,outpatient,,,506,455.4,,0.95,,480.7,Percent of total billed charges,,,0.98,,495.88,Percent of total billed charges,,,0.95,,480.7,Percent of total billed charges,,,0.95,,480.7,Percent of total billed charges,,,0.97,,490.82,Percent of total billed charges,,,0.96,,485.76,Percent of total billed charges,,,0.95,,480.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,480.7,Percent of total billed charges,,480.7,495.88,
"X-ray of joint between lower spine and hip bone, 1-2 views",PX-32010073,CDM,72200,CPT,320,RC,,inpatient,,,330,297,,0.95,,313.5,Percent of total billed charges,,,0.98,,323.4,Percent of total billed charges,,,0.95,,313.5,Percent of total billed charges,,,0.97,,320.1,Percent of total billed charges,,,0.97,,320.1,Percent of total billed charges,,,0.96,,316.8,Percent of total billed charges,,,0.95,,313.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,313.5,Percent of total billed charges,,313.5,323.4,
"X-ray of joint between lower spine and hip bone, 1-2 views",PX-32010073,CDM,72200,CPT,320,RC,,outpatient,,,330,297,,0.95,,313.5,Percent of total billed charges,,,0.98,,323.4,Percent of total billed charges,,,0.95,,313.5,Percent of total billed charges,,,0.95,,313.5,Percent of total billed charges,,,0.97,,320.1,Percent of total billed charges,,,0.96,,316.8,Percent of total billed charges,,,0.95,,313.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,313.5,Percent of total billed charges,,313.5,323.4,
"X-ray joint b/w lower spine and hip bone, 3 or more views",PX-32010074,CDM,72202,CPT,320,RC,,inpatient,,,412,370.8,,0.95,,391.4,Percent of total billed charges,,,0.98,,403.76,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.96,,395.52,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,391.4,Percent of total billed charges,,391.4,403.76,
"X-ray joint b/w lower spine and hip bone, 3 or more views",PX-32010074,CDM,72202,CPT,320,RC,,outpatient,,,412,370.8,,0.95,,391.4,Percent of total billed charges,,,0.98,,403.76,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.96,,395.52,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,391.4,Percent of total billed charges,,391.4,403.76,
"X-ray of sacrum and tailbone, minimum of 2 views",PX-32010075,CDM,72220,CPT,320,RC,,inpatient,,,300,270,,0.95,,285,Percent of total billed charges,,,0.98,,294,Percent of total billed charges,,,0.95,,285,Percent of total billed charges,,,0.97,,291,Percent of total billed charges,,,0.97,,291,Percent of total billed charges,,,0.96,,288,Percent of total billed charges,,,0.95,,285,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,285,Percent of total billed charges,,285,294,
"X-ray of sacrum and tailbone, minimum of 2 views",PX-32010075,CDM,72220,CPT,320,RC,,outpatient,,,300,270,,0.95,,285,Percent of total billed charges,,,0.98,,294,Percent of total billed charges,,,0.95,,285,Percent of total billed charges,,,0.95,,285,Percent of total billed charges,,,0.97,,291,Percent of total billed charges,,,0.96,,288,Percent of total billed charges,,,0.95,,285,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,285,Percent of total billed charges,,285,294,
X-ray of collar bone,PX-32010085,CDM,73000,CPT,320,RC,,inpatient,,,299,269.1,,0.95,,284.05,Percent of total billed charges,,,0.98,,293.02,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,0.97,,290.03,Percent of total billed charges,,,0.97,,290.03,Percent of total billed charges,,,0.96,,287.04,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,284.05,Percent of total billed charges,,284.05,293.02,
X-ray of collar bone,PX-32010085,CDM,73000,CPT,320,RC,,outpatient,,,299,269.1,,0.95,,284.05,Percent of total billed charges,,,0.98,,293.02,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,0.97,,290.03,Percent of total billed charges,,,0.96,,287.04,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,284.05,Percent of total billed charges,,284.05,293.02,
"X-ray of heel, minimum of 2 views",PX-32010088,CDM,73650,CPT,320,RC,,inpatient,,,256,230.4,,0.95,,243.2,Percent of total billed charges,,,0.98,,250.88,Percent of total billed charges,,,0.95,,243.2,Percent of total billed charges,,,0.97,,248.32,Percent of total billed charges,,,0.97,,248.32,Percent of total billed charges,,,0.96,,245.76,Percent of total billed charges,,,0.95,,243.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,243.2,Percent of total billed charges,,243.2,250.88,
"X-ray of heel, minimum of 2 views",PX-32010088,CDM,73650,CPT,320,RC,,outpatient,,,256,230.4,,0.95,,243.2,Percent of total billed charges,,,0.98,,250.88,Percent of total billed charges,,,0.95,,243.2,Percent of total billed charges,,,0.95,,243.2,Percent of total billed charges,,,0.97,,248.32,Percent of total billed charges,,,0.96,,245.76,Percent of total billed charges,,,0.95,,243.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,243.2,Percent of total billed charges,,243.2,250.88,
X-ray of shoulder blade,PX-32010089,CDM,73010,CPT,320,RC,,inpatient,,,347,312.3,,0.95,,329.65,Percent of total billed charges,,,0.98,,340.06,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,0.97,,336.59,Percent of total billed charges,,,0.97,,336.59,Percent of total billed charges,,,0.96,,333.12,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,329.65,Percent of total billed charges,,329.65,340.06,
X-ray of shoulder blade,PX-32010089,CDM,73010,CPT,320,RC,,outpatient,,,347,312.3,,0.95,,329.65,Percent of total billed charges,,,0.98,,340.06,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,0.97,,336.59,Percent of total billed charges,,,0.96,,333.12,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,329.65,Percent of total billed charges,,329.65,340.06,
"X-ray of foot, minimum of 3 views",PX-32010091,CDM,73630,CPT,320,RC,,inpatient,,,347,312.3,,0.95,,329.65,Percent of total billed charges,,,0.98,,340.06,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,0.97,,336.59,Percent of total billed charges,,,0.97,,336.59,Percent of total billed charges,,,0.96,,333.12,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,329.65,Percent of total billed charges,,329.65,340.06,
"X-ray of foot, minimum of 3 views",PX-32010091,CDM,73630,CPT,320,RC,,outpatient,,,347,312.3,,0.95,,329.65,Percent of total billed charges,,,0.98,,340.06,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,0.97,,336.59,Percent of total billed charges,,,0.96,,333.12,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,329.65,Percent of total billed charges,,329.65,340.06,
"X-ray of shoulder, 1 view",PX-32010092,CDM,73020,CPT,320,RC,,inpatient,,,250,225,,0.95,,237.5,Percent of total billed charges,,,0.98,,245,Percent of total billed charges,,,0.95,,237.5,Percent of total billed charges,,,0.97,,242.5,Percent of total billed charges,,,0.97,,242.5,Percent of total billed charges,,,0.96,,240,Percent of total billed charges,,,0.95,,237.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,237.5,Percent of total billed charges,,237.5,245,
"X-ray of shoulder, 1 view",PX-32010092,CDM,73020,CPT,320,RC,,outpatient,,,250,225,,0.95,,237.5,Percent of total billed charges,,,0.98,,245,Percent of total billed charges,,,0.95,,237.5,Percent of total billed charges,,,0.95,,237.5,Percent of total billed charges,,,0.97,,242.5,Percent of total billed charges,,,0.96,,240,Percent of total billed charges,,,0.95,,237.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,237.5,Percent of total billed charges,,237.5,245,
Review by radiologist of shoulder joint image,PX-32010097,CDM,73040,CPT,320,RC,,inpatient,,,745,670.5,,0.95,,707.75,Percent of total billed charges,,,0.98,,730.1,Percent of total billed charges,,,0.95,,707.75,Percent of total billed charges,,,0.97,,722.65,Percent of total billed charges,,,0.97,,722.65,Percent of total billed charges,,,0.96,,715.2,Percent of total billed charges,,,0.95,,707.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,707.75,Percent of total billed charges,,707.75,730.1,
Review by radiologist of shoulder joint image,PX-32010097,CDM,73040,CPT,320,RC,,outpatient,,,745,670.5,,0.95,,707.75,Percent of total billed charges,,,0.98,,730.1,Percent of total billed charges,,,0.95,,707.75,Percent of total billed charges,,,0.95,,707.75,Percent of total billed charges,,,0.97,,722.65,Percent of total billed charges,,,0.96,,715.2,Percent of total billed charges,,,0.95,,707.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,707.75,Percent of total billed charges,,707.75,730.1,
X-ray of both collar bones joints,PX-32010099,CDM,73050,CPT,320,RC,,inpatient,,,392,352.8,,0.95,,372.4,Percent of total billed charges,,,0.98,,384.16,Percent of total billed charges,,,0.95,,372.4,Percent of total billed charges,,,0.97,,380.24,Percent of total billed charges,,,0.97,,380.24,Percent of total billed charges,,,0.96,,376.32,Percent of total billed charges,,,0.95,,372.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,372.4,Percent of total billed charges,,372.4,384.16,
X-ray of both collar bones joints,PX-32010099,CDM,73050,CPT,320,RC,,outpatient,,,392,352.8,,0.95,,372.4,Percent of total billed charges,,,0.98,,384.16,Percent of total billed charges,,,0.95,,372.4,Percent of total billed charges,,,0.95,,372.4,Percent of total billed charges,,,0.97,,380.24,Percent of total billed charges,,,0.96,,376.32,Percent of total billed charges,,,0.95,,372.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,372.4,Percent of total billed charges,,372.4,384.16,
"X-ray of upper arm, minimum of 2 views",PX-32010102,CDM,73060,CPT,320,RC,,inpatient,,,325,292.5,,0.95,,308.75,Percent of total billed charges,,,0.98,,318.5,Percent of total billed charges,,,0.95,,308.75,Percent of total billed charges,,,0.97,,315.25,Percent of total billed charges,,,0.97,,315.25,Percent of total billed charges,,,0.96,,312,Percent of total billed charges,,,0.95,,308.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,308.75,Percent of total billed charges,,308.75,318.5,
"X-ray of upper arm, minimum of 2 views",PX-32010102,CDM,73060,CPT,320,RC,,outpatient,,,325,292.5,,0.95,,308.75,Percent of total billed charges,,,0.98,,318.5,Percent of total billed charges,,,0.95,,308.75,Percent of total billed charges,,,0.95,,308.75,Percent of total billed charges,,,0.97,,315.25,Percent of total billed charges,,,0.96,,312,Percent of total billed charges,,,0.95,,308.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,308.75,Percent of total billed charges,,308.75,318.5,
"X-ray of elbow, 2 views",PX-32010105,CDM,73070,CPT,320,RC,,inpatient,,,351,315.9,,0.95,,333.45,Percent of total billed charges,,,0.98,,343.98,Percent of total billed charges,,,0.95,,333.45,Percent of total billed charges,,,0.97,,340.47,Percent of total billed charges,,,0.97,,340.47,Percent of total billed charges,,,0.96,,336.96,Percent of total billed charges,,,0.95,,333.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,333.45,Percent of total billed charges,,333.45,343.98,
"X-ray of elbow, 2 views",PX-32010105,CDM,73070,CPT,320,RC,,outpatient,,,351,315.9,,0.95,,333.45,Percent of total billed charges,,,0.98,,343.98,Percent of total billed charges,,,0.95,,333.45,Percent of total billed charges,,,0.95,,333.45,Percent of total billed charges,,,0.97,,340.47,Percent of total billed charges,,,0.96,,336.96,Percent of total billed charges,,,0.95,,333.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,333.45,Percent of total billed charges,,333.45,343.98,
"X-ray of elbow, minimum of 3 views",PX-32010106,CDM,73080,CPT,320,RC,,inpatient,,,447,402.3,,0.95,,424.65,Percent of total billed charges,,,0.98,,438.06,Percent of total billed charges,,,0.95,,424.65,Percent of total billed charges,,,0.97,,433.59,Percent of total billed charges,,,0.97,,433.59,Percent of total billed charges,,,0.96,,429.12,Percent of total billed charges,,,0.95,,424.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,424.65,Percent of total billed charges,,424.65,438.06,
"X-ray of elbow, minimum of 3 views",PX-32010106,CDM,73080,CPT,320,RC,,outpatient,,,447,402.3,,0.95,,424.65,Percent of total billed charges,,,0.98,,438.06,Percent of total billed charges,,,0.95,,424.65,Percent of total billed charges,,,0.95,,424.65,Percent of total billed charges,,,0.97,,433.59,Percent of total billed charges,,,0.96,,429.12,Percent of total billed charges,,,0.95,,424.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,424.65,Percent of total billed charges,,424.65,438.06,
"X-ray of foot, 2 views",PX-32010110,CDM,73620,CPT,320,RC,,inpatient,,,274,246.6,,0.95,,260.3,Percent of total billed charges,,,0.98,,268.52,Percent of total billed charges,,,0.95,,260.3,Percent of total billed charges,,,0.97,,265.78,Percent of total billed charges,,,0.97,,265.78,Percent of total billed charges,,,0.96,,263.04,Percent of total billed charges,,,0.95,,260.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,260.3,Percent of total billed charges,,260.3,268.52,
"X-ray of foot, 2 views",PX-32010110,CDM,73620,CPT,320,RC,,outpatient,,,274,246.6,,0.95,,260.3,Percent of total billed charges,,,0.98,,268.52,Percent of total billed charges,,,0.95,,260.3,Percent of total billed charges,,,0.95,,260.3,Percent of total billed charges,,,0.97,,265.78,Percent of total billed charges,,,0.96,,263.04,Percent of total billed charges,,,0.95,,260.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,260.3,Percent of total billed charges,,260.3,268.52,
X-ray elbow,PX-32010111,CDM,73085,CPT,320,RC,,inpatient,,,1231,1107.9,,0.95,,1169.45,Percent of total billed charges,,,0.98,,1206.38,Percent of total billed charges,,,0.95,,1169.45,Percent of total billed charges,,,0.97,,1194.07,Percent of total billed charges,,,0.97,,1194.07,Percent of total billed charges,,,0.96,,1181.76,Percent of total billed charges,,,0.95,,1169.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1169.45,Percent of total billed charges,,1169.45,1206.38,
X-ray elbow,PX-32010111,CDM,73085,CPT,320,RC,,outpatient,,,1231,1107.9,,0.95,,1169.45,Percent of total billed charges,,,0.98,,1206.38,Percent of total billed charges,,,0.95,,1169.45,Percent of total billed charges,,,0.95,,1169.45,Percent of total billed charges,,,0.97,,1194.07,Percent of total billed charges,,,0.96,,1181.76,Percent of total billed charges,,,0.95,,1169.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1169.45,Percent of total billed charges,,1169.45,1206.38,
"X-ray of forearm, 2 views",PX-32010112,CDM,73090,CPT,320,RC,,inpatient,,,304,273.6,,0.95,,288.8,Percent of total billed charges,,,0.98,,297.92,Percent of total billed charges,,,0.95,,288.8,Percent of total billed charges,,,0.97,,294.88,Percent of total billed charges,,,0.97,,294.88,Percent of total billed charges,,,0.96,,291.84,Percent of total billed charges,,,0.95,,288.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,288.8,Percent of total billed charges,,288.8,297.92,
"X-ray of forearm, 2 views",PX-32010112,CDM,73090,CPT,320,RC,,outpatient,,,304,273.6,,0.95,,288.8,Percent of total billed charges,,,0.98,,297.92,Percent of total billed charges,,,0.95,,288.8,Percent of total billed charges,,,0.95,,288.8,Percent of total billed charges,,,0.97,,294.88,Percent of total billed charges,,,0.96,,291.84,Percent of total billed charges,,,0.95,,288.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,288.8,Percent of total billed charges,,288.8,297.92,
"X-ray of infant arm, minimum of 2 views",PX-32010115,CDM,73092,CPT,320,RC,,inpatient,,,211,189.9,,0.95,,200.45,Percent of total billed charges,,,0.98,,206.78,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,0.97,,204.67,Percent of total billed charges,,,0.97,,204.67,Percent of total billed charges,,,0.96,,202.56,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,200.45,Percent of total billed charges,,200.45,206.78,
"X-ray of infant arm, minimum of 2 views",PX-32010115,CDM,73092,CPT,320,RC,,outpatient,,,211,189.9,,0.95,,200.45,Percent of total billed charges,,,0.98,,206.78,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,0.97,,204.67,Percent of total billed charges,,,0.96,,202.56,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,200.45,Percent of total billed charges,,200.45,206.78,
"X-ray of wrist, 2 views",PX-32010117,CDM,73100,CPT,320,RC,,inpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
"X-ray of wrist, 2 views",PX-32010117,CDM,73100,CPT,320,RC,,outpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
"X-ray of wrist, 2 views",PX-32010118,CDM,73100,CPT,320,RC,,inpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
"X-ray of wrist, 2 views",PX-32010118,CDM,73100,CPT,320,RC,,outpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
"X-ray of wrist, minimum of 3 views",PX-32010119,CDM,73110,CPT,320,RC,,inpatient,,,441,396.9,,0.95,,418.95,Percent of total billed charges,,,0.98,,432.18,Percent of total billed charges,,,0.95,,418.95,Percent of total billed charges,,,0.97,,427.77,Percent of total billed charges,,,0.97,,427.77,Percent of total billed charges,,,0.96,,423.36,Percent of total billed charges,,,0.95,,418.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,418.95,Percent of total billed charges,,418.95,432.18,
"X-ray of wrist, minimum of 3 views",PX-32010119,CDM,73110,CPT,320,RC,,outpatient,,,441,396.9,,0.95,,418.95,Percent of total billed charges,,,0.98,,432.18,Percent of total billed charges,,,0.95,,418.95,Percent of total billed charges,,,0.95,,418.95,Percent of total billed charges,,,0.97,,427.77,Percent of total billed charges,,,0.96,,423.36,Percent of total billed charges,,,0.95,,418.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,418.95,Percent of total billed charges,,418.95,432.18,
X-ray wrist joint,PX-32010122,CDM,73115,CPT,320,RC,,inpatient,,,1174,1056.6,,0.95,,1115.3,Percent of total billed charges,,,0.98,,1150.52,Percent of total billed charges,,,0.95,,1115.3,Percent of total billed charges,,,0.97,,1138.78,Percent of total billed charges,,,0.97,,1138.78,Percent of total billed charges,,,0.96,,1127.04,Percent of total billed charges,,,0.95,,1115.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1115.3,Percent of total billed charges,,1115.3,1150.52,
X-ray wrist joint,PX-32010122,CDM,73115,CPT,320,RC,,outpatient,,,1174,1056.6,,0.95,,1115.3,Percent of total billed charges,,,0.98,,1150.52,Percent of total billed charges,,,0.95,,1115.3,Percent of total billed charges,,,0.95,,1115.3,Percent of total billed charges,,,0.97,,1138.78,Percent of total billed charges,,,0.96,,1127.04,Percent of total billed charges,,,0.95,,1115.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1115.3,Percent of total billed charges,,1115.3,1150.52,
"X-ray of hand, 2 views",PX-32010127,CDM,73120,CPT,320,RC,,inpatient,,,309,278.1,,0.95,,293.55,Percent of total billed charges,,,0.98,,302.82,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,0.97,,299.73,Percent of total billed charges,,,0.97,,299.73,Percent of total billed charges,,,0.96,,296.64,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,293.55,Percent of total billed charges,,293.55,302.82,
"X-ray of hand, 2 views",PX-32010127,CDM,73120,CPT,320,RC,,outpatient,,,309,278.1,,0.95,,293.55,Percent of total billed charges,,,0.98,,302.82,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,0.97,,299.73,Percent of total billed charges,,,0.96,,296.64,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,293.55,Percent of total billed charges,,293.55,302.82,
"X-ray of hand, minimum of 3 views",PX-32010129,CDM,73130,CPT,320,RC,,inpatient,,,361,324.9,,0.95,,342.95,Percent of total billed charges,,,0.98,,353.78,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,0.97,,350.17,Percent of total billed charges,,,0.97,,350.17,Percent of total billed charges,,,0.96,,346.56,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,342.95,Percent of total billed charges,,342.95,353.78,
"X-ray of hand, minimum of 3 views",PX-32010129,CDM,73130,CPT,320,RC,,outpatient,,,361,324.9,,0.95,,342.95,Percent of total billed charges,,,0.98,,353.78,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,0.97,,350.17,Percent of total billed charges,,,0.96,,346.56,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,342.95,Percent of total billed charges,,342.95,353.78,
"X-ray of finger, minimum of 2 views",PX-32010131,CDM,73140,CPT,320,RC,,inpatient,,,264,237.6,,0.95,,250.8,Percent of total billed charges,,,0.98,,258.72,Percent of total billed charges,,,0.95,,250.8,Percent of total billed charges,,,0.97,,256.08,Percent of total billed charges,,,0.97,,256.08,Percent of total billed charges,,,0.96,,253.44,Percent of total billed charges,,,0.95,,250.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,250.8,Percent of total billed charges,,250.8,258.72,
"X-ray of finger, minimum of 2 views",PX-32010131,CDM,73140,CPT,320,RC,,outpatient,,,264,237.6,,0.95,,250.8,Percent of total billed charges,,,0.98,,258.72,Percent of total billed charges,,,0.95,,250.8,Percent of total billed charges,,,0.95,,250.8,Percent of total billed charges,,,0.97,,256.08,Percent of total billed charges,,,0.96,,253.44,Percent of total billed charges,,,0.95,,250.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,250.8,Percent of total billed charges,,250.8,258.72,
"X-ray of knee, 1-2 views",PX-32010149,CDM,73560,CPT,320,RC,,inpatient,,,356,320.4,,0.95,,338.2,Percent of total billed charges,,,0.98,,348.88,Percent of total billed charges,,,0.95,,338.2,Percent of total billed charges,,,0.97,,345.32,Percent of total billed charges,,,0.97,,345.32,Percent of total billed charges,,,0.96,,341.76,Percent of total billed charges,,,0.95,,338.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,338.2,Percent of total billed charges,,338.2,348.88,
"X-ray of knee, 1-2 views",PX-32010149,CDM,73560,CPT,320,RC,,outpatient,,,356,320.4,,0.95,,338.2,Percent of total billed charges,,,0.98,,348.88,Percent of total billed charges,,,0.95,,338.2,Percent of total billed charges,,,0.95,,338.2,Percent of total billed charges,,,0.97,,345.32,Percent of total billed charges,,,0.96,,341.76,Percent of total billed charges,,,0.95,,338.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,338.2,Percent of total billed charges,,338.2,348.88,
"X-ray of knee, 3 views",PX-32010152,CDM,73562,CPT,320,RC,,inpatient,,,412,370.8,,0.95,,391.4,Percent of total billed charges,,,0.98,,403.76,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.96,,395.52,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,391.4,Percent of total billed charges,,391.4,403.76,
"X-ray of knee, 3 views",PX-32010152,CDM,73562,CPT,320,RC,,outpatient,,,412,370.8,,0.95,,391.4,Percent of total billed charges,,,0.98,,403.76,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.96,,395.52,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,391.4,Percent of total billed charges,,391.4,403.76,
"X-ray knee, 4 or more views",PX-32010154,CDM,73564,CPT,320,RC,,inpatient,,,577,519.3,,0.95,,548.15,Percent of total billed charges,,,0.98,,565.46,Percent of total billed charges,,,0.95,,548.15,Percent of total billed charges,,,0.97,,559.69,Percent of total billed charges,,,0.97,,559.69,Percent of total billed charges,,,0.96,,553.92,Percent of total billed charges,,,0.95,,548.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,548.15,Percent of total billed charges,,548.15,565.46,
"X-ray knee, 4 or more views",PX-32010154,CDM,73564,CPT,320,RC,,outpatient,,,577,519.3,,0.95,,548.15,Percent of total billed charges,,,0.98,,565.46,Percent of total billed charges,,,0.95,,548.15,Percent of total billed charges,,,0.95,,548.15,Percent of total billed charges,,,0.97,,559.69,Percent of total billed charges,,,0.96,,553.92,Percent of total billed charges,,,0.95,,548.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,548.15,Percent of total billed charges,,548.15,565.46,
X-ray both knees while standing,PX-32010156,CDM,73565,CPT,320,RC,,inpatient,,,344,309.6,,0.95,,326.8,Percent of total billed charges,,,0.98,,337.12,Percent of total billed charges,,,0.95,,326.8,Percent of total billed charges,,,0.97,,333.68,Percent of total billed charges,,,0.97,,333.68,Percent of total billed charges,,,0.96,,330.24,Percent of total billed charges,,,0.95,,326.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,326.8,Percent of total billed charges,,326.8,337.12,
X-ray both knees while standing,PX-32010156,CDM,73565,CPT,320,RC,,outpatient,,,344,309.6,,0.95,,326.8,Percent of total billed charges,,,0.98,,337.12,Percent of total billed charges,,,0.95,,326.8,Percent of total billed charges,,,0.95,,326.8,Percent of total billed charges,,,0.97,,333.68,Percent of total billed charges,,,0.96,,330.24,Percent of total billed charges,,,0.95,,326.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,326.8,Percent of total billed charges,,326.8,337.12,
"X-ray of lower leg, 2 views",PX-32010159,CDM,73590,CPT,320,RC,,inpatient,,,309,278.1,,0.95,,293.55,Percent of total billed charges,,,0.98,,302.82,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,0.97,,299.73,Percent of total billed charges,,,0.97,,299.73,Percent of total billed charges,,,0.96,,296.64,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,293.55,Percent of total billed charges,,293.55,302.82,
"X-ray of lower leg, 2 views",PX-32010159,CDM,73590,CPT,320,RC,,outpatient,,,309,278.1,,0.95,,293.55,Percent of total billed charges,,,0.98,,302.82,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,0.97,,299.73,Percent of total billed charges,,,0.96,,296.64,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,293.55,Percent of total billed charges,,293.55,302.82,
"X-ray of infant leg, minimum of 2 views",PX-32010161,CDM,73592,CPT,320,RC,,inpatient,,,300,270,,0.95,,285,Percent of total billed charges,,,0.98,,294,Percent of total billed charges,,,0.95,,285,Percent of total billed charges,,,0.97,,291,Percent of total billed charges,,,0.97,,291,Percent of total billed charges,,,0.96,,288,Percent of total billed charges,,,0.95,,285,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,285,Percent of total billed charges,,285,294,
"X-ray of infant leg, minimum of 2 views",PX-32010161,CDM,73592,CPT,320,RC,,outpatient,,,300,270,,0.95,,285,Percent of total billed charges,,,0.98,,294,Percent of total billed charges,,,0.95,,285,Percent of total billed charges,,,0.95,,285,Percent of total billed charges,,,0.97,,291,Percent of total billed charges,,,0.96,,288,Percent of total billed charges,,,0.95,,285,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,285,Percent of total billed charges,,285,294,
"X-ray of ankle, 2 views",PX-32010163,CDM,73600,CPT,320,RC,,inpatient,,,264,237.6,,0.95,,250.8,Percent of total billed charges,,,0.98,,258.72,Percent of total billed charges,,,0.95,,250.8,Percent of total billed charges,,,0.97,,256.08,Percent of total billed charges,,,0.97,,256.08,Percent of total billed charges,,,0.96,,253.44,Percent of total billed charges,,,0.95,,250.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,250.8,Percent of total billed charges,,250.8,258.72,
"X-ray of ankle, 2 views",PX-32010163,CDM,73600,CPT,320,RC,,outpatient,,,264,237.6,,0.95,,250.8,Percent of total billed charges,,,0.98,,258.72,Percent of total billed charges,,,0.95,,250.8,Percent of total billed charges,,,0.95,,250.8,Percent of total billed charges,,,0.97,,256.08,Percent of total billed charges,,,0.96,,253.44,Percent of total billed charges,,,0.95,,250.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,250.8,Percent of total billed charges,,250.8,258.72,
"X-ray of ankle, minimum of 3 views",PX-32010165,CDM,73610,CPT,320,RC,,inpatient,,,347,312.3,,0.95,,329.65,Percent of total billed charges,,,0.98,,340.06,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,0.97,,336.59,Percent of total billed charges,,,0.97,,336.59,Percent of total billed charges,,,0.96,,333.12,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,329.65,Percent of total billed charges,,329.65,340.06,
"X-ray of ankle, minimum of 3 views",PX-32010165,CDM,73610,CPT,320,RC,,outpatient,,,347,312.3,,0.95,,329.65,Percent of total billed charges,,,0.98,,340.06,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,0.97,,336.59,Percent of total billed charges,,,0.96,,333.12,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,329.65,Percent of total billed charges,,329.65,340.06,
X-ray series of abdomen with single X-ray of chest,PX-32010175,CDM,74022,CPT,320,RC,,inpatient,,,613,551.7,,0.95,,582.35,Percent of total billed charges,,,0.98,,600.74,Percent of total billed charges,,,0.95,,582.35,Percent of total billed charges,,,0.97,,594.61,Percent of total billed charges,,,0.97,,594.61,Percent of total billed charges,,,0.96,,588.48,Percent of total billed charges,,,0.95,,582.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,582.35,Percent of total billed charges,,582.35,600.74,
X-ray series of abdomen with single X-ray of chest,PX-32010175,CDM,74022,CPT,320,RC,,outpatient,,,613,551.7,,0.95,,582.35,Percent of total billed charges,,,0.98,,600.74,Percent of total billed charges,,,0.95,,582.35,Percent of total billed charges,,,0.95,,582.35,Percent of total billed charges,,,0.97,,594.61,Percent of total billed charges,,,0.96,,588.48,Percent of total billed charges,,,0.95,,582.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,582.35,Percent of total billed charges,,582.35,600.74,
Single contrast X-ray of small intestine,PX-32010187,CDM,74250,CPT,320,RC,,inpatient,,,474,426.6,,0.95,,450.3,Percent of total billed charges,,,0.98,,464.52,Percent of total billed charges,,,0.95,,450.3,Percent of total billed charges,,,0.97,,459.78,Percent of total billed charges,,,0.97,,459.78,Percent of total billed charges,,,0.96,,455.04,Percent of total billed charges,,,0.95,,450.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,450.3,Percent of total billed charges,,450.3,464.52,
Single contrast X-ray of small intestine,PX-32010187,CDM,74250,CPT,320,RC,,outpatient,,,474,426.6,,0.95,,450.3,Percent of total billed charges,,,0.98,,464.52,Percent of total billed charges,,,0.95,,450.3,Percent of total billed charges,,,0.95,,450.3,Percent of total billed charges,,,0.97,,459.78,Percent of total billed charges,,,0.96,,455.04,Percent of total billed charges,,,0.95,,450.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,450.3,Percent of total billed charges,,450.3,464.52,
X-ray Bile ducts/pancreas intraop w/contrast,PX-32010196,CDM,74300,CPT,320,RC,,inpatient,,,484,435.6,,0.95,,459.8,Percent of total billed charges,,,0.98,,474.32,Percent of total billed charges,,,0.95,,459.8,Percent of total billed charges,,,0.97,,469.48,Percent of total billed charges,,,0.97,,469.48,Percent of total billed charges,,,0.96,,464.64,Percent of total billed charges,,,0.95,,459.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,459.8,Percent of total billed charges,,459.8,474.32,
X-ray Bile ducts/pancreas intraop w/contrast,PX-32010196,CDM,74300,CPT,320,RC,,outpatient,,,484,435.6,,0.95,,459.8,Percent of total billed charges,,,0.98,,474.32,Percent of total billed charges,,,0.95,,459.8,Percent of total billed charges,,,0.95,,459.8,Percent of total billed charges,,,0.97,,469.48,Percent of total billed charges,,,0.96,,464.64,Percent of total billed charges,,,0.95,,459.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,459.8,Percent of total billed charges,,459.8,474.32,
X-ray urinary tract following injection of a contrast agent,PX-32010211,CDM,74420,CPT,320,RC,,inpatient,,,775,697.5,,0.95,,736.25,Percent of total billed charges,,,0.98,,759.5,Percent of total billed charges,,,0.95,,736.25,Percent of total billed charges,,,0.97,,751.75,Percent of total billed charges,,,0.97,,751.75,Percent of total billed charges,,,0.96,,744,Percent of total billed charges,,,0.95,,736.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,736.25,Percent of total billed charges,,736.25,759.5,
X-ray urinary tract following injection of a contrast agent,PX-32010211,CDM,74420,CPT,320,RC,,outpatient,,,775,697.5,,0.95,,736.25,Percent of total billed charges,,,0.98,,759.5,Percent of total billed charges,,,0.95,,736.25,Percent of total billed charges,,,0.95,,736.25,Percent of total billed charges,,,0.97,,751.75,Percent of total billed charges,,,0.96,,744,Percent of total billed charges,,,0.95,,736.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,736.25,Percent of total billed charges,,736.25,759.5,
Review by radiologist of urinary bladder image,PX-32010213,CDM,74430,CPT,320,RC,,inpatient,,,437,393.3,,0.95,,415.15,Percent of total billed charges,,,0.98,,428.26,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,0.97,,423.89,Percent of total billed charges,,,0.97,,423.89,Percent of total billed charges,,,0.96,,419.52,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,415.15,Percent of total billed charges,,415.15,428.26,
Review by radiologist of urinary bladder image,PX-32010213,CDM,74430,CPT,320,RC,,outpatient,,,437,393.3,,0.95,,415.15,Percent of total billed charges,,,0.98,,428.26,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,0.97,,423.89,Percent of total billed charges,,,0.96,,419.52,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,415.15,Percent of total billed charges,,415.15,428.26,
X-ray urinary bladder and urethra w/contrast after voiding,PX-32010217,CDM,74455,CPT,320,RC,,inpatient,,,475,427.5,,0.95,,451.25,Percent of total billed charges,,,0.98,,465.5,Percent of total billed charges,,,0.95,,451.25,Percent of total billed charges,,,0.97,,460.75,Percent of total billed charges,,,0.97,,460.75,Percent of total billed charges,,,0.96,,456,Percent of total billed charges,,,0.95,,451.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,451.25,Percent of total billed charges,,451.25,465.5,
X-ray urinary bladder and urethra w/contrast after voiding,PX-32010217,CDM,74455,CPT,320,RC,,outpatient,,,475,427.5,,0.95,,451.25,Percent of total billed charges,,,0.98,,465.5,Percent of total billed charges,,,0.95,,451.25,Percent of total billed charges,,,0.95,,451.25,Percent of total billed charges,,,0.97,,460.75,Percent of total billed charges,,,0.96,,456,Percent of total billed charges,,,0.95,,451.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,451.25,Percent of total billed charges,,451.25,465.5,
X-ray for drainage of fluid,PX-32010312,CDM,75989,CPT,320,RC,,inpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,440.8,Percent of total billed charges,,440.8,454.72,
X-ray for drainage of fluid,PX-32010312,CDM,75989,CPT,320,RC,,outpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,440.8,Percent of total billed charges,,440.8,454.72,
"Imaging guidance for procedure, 60 minutes or less",PX-32010318,CDM,76000,CPT,320,RC,,inpatient,,,467,420.3,,0.95,,443.65,Percent of total billed charges,,,0.98,,457.66,Percent of total billed charges,,,0.95,,443.65,Percent of total billed charges,,,0.97,,452.99,Percent of total billed charges,,,0.97,,452.99,Percent of total billed charges,,,0.96,,448.32,Percent of total billed charges,,,0.95,,443.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,443.65,Percent of total billed charges,,443.65,457.66,
"Imaging guidance for procedure, 60 minutes or less",PX-32010318,CDM,76000,CPT,320,RC,,outpatient,,,467,420.3,,0.95,,443.65,Percent of total billed charges,,,0.98,,457.66,Percent of total billed charges,,,0.95,,443.65,Percent of total billed charges,,,0.95,,443.65,Percent of total billed charges,,,0.97,,452.99,Percent of total billed charges,,,0.96,,448.32,Percent of total billed charges,,,0.95,,443.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,443.65,Percent of total billed charges,,443.65,457.66,
X-ray of surgical specimen,PX-32010322,CDM,76098,CPT,320,RC,,inpatient,,,309,278.1,,0.95,,293.55,Percent of total billed charges,,,0.98,,302.82,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,0.97,,299.73,Percent of total billed charges,,,0.97,,299.73,Percent of total billed charges,,,0.96,,296.64,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,293.55,Percent of total billed charges,,293.55,302.82,
X-ray of surgical specimen,PX-32010322,CDM,76098,CPT,320,RC,,outpatient,,,309,278.1,,0.95,,293.55,Percent of total billed charges,,,0.98,,302.82,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,0.97,,299.73,Percent of total billed charges,,,0.96,,296.64,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,293.55,Percent of total billed charges,,293.55,302.82,
Fluoroscopic guidance to insert/remove central vein device,PX-32010330,CDM,77001,CPT,320,RC,,inpatient,,,412,370.8,,0.95,,391.4,Percent of total billed charges,,,0.98,,403.76,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.96,,395.52,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,391.4,Percent of total billed charges,,391.4,403.76,
Fluoroscopic guidance to insert/remove central vein device,PX-32010330,CDM,77001,CPT,320,RC,,outpatient,,,412,370.8,,0.95,,391.4,Percent of total billed charges,,,0.98,,403.76,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.96,,395.52,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,391.4,Percent of total billed charges,,391.4,403.76,
Fluoroscopic guidance for needle placement,PX-32010331,CDM,77002,CPT,320,RC,,inpatient,,,421,378.9,,0.95,,399.95,Percent of total billed charges,,,0.98,,412.58,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,0.97,,408.37,Percent of total billed charges,,,0.97,,408.37,Percent of total billed charges,,,0.96,,404.16,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,399.95,Percent of total billed charges,,399.95,412.58,
Fluoroscopic guidance for needle placement,PX-32010331,CDM,77002,CPT,320,RC,,outpatient,,,421,378.9,,0.95,,399.95,Percent of total billed charges,,,0.98,,412.58,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,0.97,,408.37,Percent of total billed charges,,,0.96,,404.16,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,399.95,Percent of total billed charges,,399.95,412.58,
"X-ray breast duct, single duct",PX-32010335,CDM,77053,CPT,320,RC,,inpatient,,,677,609.3,,0.95,,643.15,Percent of total billed charges,,,0.98,,663.46,Percent of total billed charges,,,0.95,,643.15,Percent of total billed charges,,,0.97,,656.69,Percent of total billed charges,,,0.97,,656.69,Percent of total billed charges,,,0.96,,649.92,Percent of total billed charges,,,0.95,,643.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,643.15,Percent of total billed charges,,643.15,663.46,
"X-ray breast duct, single duct",PX-32010335,CDM,77053,CPT,320,RC,,outpatient,,,677,609.3,,0.95,,643.15,Percent of total billed charges,,,0.98,,663.46,Percent of total billed charges,,,0.95,,643.15,Percent of total billed charges,,,0.95,,643.15,Percent of total billed charges,,,0.97,,656.69,Percent of total billed charges,,,0.96,,649.92,Percent of total billed charges,,,0.95,,643.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,643.15,Percent of total billed charges,,643.15,663.46,
"X-ray breast duct, multiple ducts",PX-32010336,CDM,77054,CPT,320,RC,,inpatient,,,885,796.5,,0.95,,840.75,Percent of total billed charges,,,0.98,,867.3,Percent of total billed charges,,,0.95,,840.75,Percent of total billed charges,,,0.97,,858.45,Percent of total billed charges,,,0.97,,858.45,Percent of total billed charges,,,0.96,,849.6,Percent of total billed charges,,,0.95,,840.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,840.75,Percent of total billed charges,,840.75,867.3,
"X-ray breast duct, multiple ducts",PX-32010336,CDM,77054,CPT,320,RC,,outpatient,,,885,796.5,,0.95,,840.75,Percent of total billed charges,,,0.98,,867.3,Percent of total billed charges,,,0.95,,840.75,Percent of total billed charges,,,0.95,,840.75,Percent of total billed charges,,,0.97,,858.45,Percent of total billed charges,,,0.96,,849.6,Percent of total billed charges,,,0.95,,840.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,840.75,Percent of total billed charges,,840.75,867.3,
X-ray for estimating bone age,PX-32010338,CDM,77072,CPT,320,RC,,inpatient,,,347,312.3,,0.95,,329.65,Percent of total billed charges,,,0.98,,340.06,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,0.97,,336.59,Percent of total billed charges,,,0.97,,336.59,Percent of total billed charges,,,0.96,,333.12,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,329.65,Percent of total billed charges,,329.65,340.06,
X-ray for estimating bone age,PX-32010338,CDM,77072,CPT,320,RC,,outpatient,,,347,312.3,,0.95,,329.65,Percent of total billed charges,,,0.98,,340.06,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,0.97,,336.59,Percent of total billed charges,,,0.96,,333.12,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,329.65,Percent of total billed charges,,329.65,340.06,
Complete X-ray of body bones,PX-32010341,CDM,77075,CPT,320,RC,,inpatient,,,766,689.4,,0.95,,727.7,Percent of total billed charges,,,0.98,,750.68,Percent of total billed charges,,,0.95,,727.7,Percent of total billed charges,,,0.97,,743.02,Percent of total billed charges,,,0.97,,743.02,Percent of total billed charges,,,0.96,,735.36,Percent of total billed charges,,,0.95,,727.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,727.7,Percent of total billed charges,,727.7,750.68,
Complete X-ray of body bones,PX-32010341,CDM,77075,CPT,320,RC,,outpatient,,,766,689.4,,0.95,,727.7,Percent of total billed charges,,,0.98,,750.68,Percent of total billed charges,,,0.95,,727.7,Percent of total billed charges,,,0.95,,727.7,Percent of total billed charges,,,0.97,,743.02,Percent of total billed charges,,,0.96,,735.36,Percent of total billed charges,,,0.95,,727.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,727.7,Percent of total billed charges,,727.7,750.68,
"X-ray joints, multiple",PX-32010343,CDM,77077,CPT,320,RC,,inpatient,,,416,374.4,,0.95,,395.2,Percent of total billed charges,,,0.98,,407.68,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,0.97,,403.52,Percent of total billed charges,,,0.97,,403.52,Percent of total billed charges,,,0.96,,399.36,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,395.2,Percent of total billed charges,,395.2,407.68,
"X-ray joints, multiple",PX-32010343,CDM,77077,CPT,320,RC,,outpatient,,,416,374.4,,0.95,,395.2,Percent of total billed charges,,,0.98,,407.68,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,0.97,,403.52,Percent of total billed charges,,,0.96,,399.36,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,395.2,Percent of total billed charges,,395.2,407.68,
HC Xr DXA Bone Density Study Axial,PX-32010344,CDM,77080,CPT,320,RC,,inpatient,,,490,441,,0.95,,465.5,Percent of total billed charges,,,0.98,,480.2,Percent of total billed charges,,,0.95,,465.5,Percent of total billed charges,,,0.97,,475.3,Percent of total billed charges,,,0.97,,475.3,Percent of total billed charges,,,0.96,,470.4,Percent of total billed charges,,,0.95,,465.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,465.5,Percent of total billed charges,,465.5,480.2,
HC Xr DXA Bone Density Study Axial,PX-32010344,CDM,77080,CPT,320,RC,,outpatient,,,490,441,,0.95,,465.5,Percent of total billed charges,,,0.98,,480.2,Percent of total billed charges,,,0.95,,465.5,Percent of total billed charges,,,0.95,,465.5,Percent of total billed charges,,,0.97,,475.3,Percent of total billed charges,,,0.96,,470.4,Percent of total billed charges,,,0.95,,465.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,465.5,Percent of total billed charges,,465.5,480.2,
"DXA bone density measurement of forearm, finger, hand, foot",PX-32010345,CDM,77081,CPT,320,RC,,inpatient,,,336,302.4,,0.95,,319.2,Percent of total billed charges,,,0.98,,329.28,Percent of total billed charges,,,0.95,,319.2,Percent of total billed charges,,,0.97,,325.92,Percent of total billed charges,,,0.97,,325.92,Percent of total billed charges,,,0.96,,322.56,Percent of total billed charges,,,0.95,,319.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,319.2,Percent of total billed charges,,319.2,329.28,
"DXA bone density measurement of forearm, finger, hand, foot",PX-32010345,CDM,77081,CPT,320,RC,,outpatient,,,336,302.4,,0.95,,319.2,Percent of total billed charges,,,0.98,,329.28,Percent of total billed charges,,,0.95,,319.2,Percent of total billed charges,,,0.95,,319.2,Percent of total billed charges,,,0.97,,325.92,Percent of total billed charges,,,0.96,,322.56,Percent of total billed charges,,,0.95,,319.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,319.2,Percent of total billed charges,,319.2,329.28,
Other diagnostic Imaging procedure,PX-32010465,CDM,76499,CPT,320,RC,,inpatient,,,921,828.9,,0.95,,874.95,Percent of total billed charges,,,0.98,,902.58,Percent of total billed charges,,,0.95,,874.95,Percent of total billed charges,,,0.97,,893.37,Percent of total billed charges,,,0.97,,893.37,Percent of total billed charges,,,0.96,,884.16,Percent of total billed charges,,,0.95,,874.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,874.95,Percent of total billed charges,,874.95,902.58,
Other diagnostic Imaging procedure,PX-32010465,CDM,76499,CPT,320,RC,,outpatient,,,921,828.9,,0.95,,874.95,Percent of total billed charges,,,0.98,,902.58,Percent of total billed charges,,,0.95,,874.95,Percent of total billed charges,,,0.95,,874.95,Percent of total billed charges,,,0.97,,893.37,Percent of total billed charges,,,0.96,,884.16,Percent of total billed charges,,,0.95,,874.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,874.95,Percent of total billed charges,,874.95,902.58,
"X-ray of shoulder, minimum of 2 views",PX-32010481,CDM,73030,CPT,320,RC,,inpatient,,,387,348.3,,0.95,,367.65,Percent of total billed charges,,,0.98,,379.26,Percent of total billed charges,,,0.95,,367.65,Percent of total billed charges,,,0.97,,375.39,Percent of total billed charges,,,0.97,,375.39,Percent of total billed charges,,,0.96,,371.52,Percent of total billed charges,,,0.95,,367.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,367.65,Percent of total billed charges,,367.65,379.26,
"X-ray of shoulder, minimum of 2 views",PX-32010481,CDM,73030,CPT,320,RC,,outpatient,,,387,348.3,,0.95,,367.65,Percent of total billed charges,,,0.98,,379.26,Percent of total billed charges,,,0.95,,367.65,Percent of total billed charges,,,0.95,,367.65,Percent of total billed charges,,,0.97,,375.39,Percent of total billed charges,,,0.96,,371.52,Percent of total billed charges,,,0.95,,367.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,367.65,Percent of total billed charges,,367.65,379.26,
CT scan of face before and after contrast,PX-35010006,CDM,70488,CPT,350,RC,,inpatient,,,2192,1972.8,,0.95,,2082.4,Percent of total billed charges,,,0.98,,2148.16,Percent of total billed charges,,,0.95,,2082.4,Percent of total billed charges,,,0.97,,2126.24,Percent of total billed charges,,,0.97,,2126.24,Percent of total billed charges,,,0.96,,2104.32,Percent of total billed charges,,,0.95,,2082.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2082.4,Percent of total billed charges,,2082.4,2148.16,
CT scan of face before and after contrast,PX-35010006,CDM,70488,CPT,350,RC,,outpatient,,,2192,1972.8,,0.95,,2082.4,Percent of total billed charges,,,0.98,,2148.16,Percent of total billed charges,,,0.95,,2082.4,Percent of total billed charges,,,0.95,,2082.4,Percent of total billed charges,,,0.97,,2126.24,Percent of total billed charges,,,0.96,,2104.32,Percent of total billed charges,,,0.95,,2082.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2082.4,Percent of total billed charges,,2082.4,2148.16,
CT scan of soft tissue of neck without contrast,PX-35010007,CDM,70490,CPT,350,RC,,inpatient,,,1640,1476,,0.95,,1558,Percent of total billed charges,,,0.98,,1607.2,Percent of total billed charges,,,0.95,,1558,Percent of total billed charges,,,0.97,,1590.8,Percent of total billed charges,,,0.97,,1590.8,Percent of total billed charges,,,0.96,,1574.4,Percent of total billed charges,,,0.95,,1558,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1558,Percent of total billed charges,,1558,1607.2,
CT scan of soft tissue of neck without contrast,PX-35010007,CDM,70490,CPT,350,RC,,outpatient,,,1640,1476,,0.95,,1558,Percent of total billed charges,,,0.98,,1607.2,Percent of total billed charges,,,0.95,,1558,Percent of total billed charges,,,0.95,,1558,Percent of total billed charges,,,0.97,,1590.8,Percent of total billed charges,,,0.96,,1574.4,Percent of total billed charges,,,0.95,,1558,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1558,Percent of total billed charges,,1558,1607.2,
CT scan of soft tissue of neck with contrast,PX-35010008,CDM,70491,CPT,350,RC,,inpatient,,,1957,1761.3,,0.95,,1859.15,Percent of total billed charges,,,0.98,,1917.86,Percent of total billed charges,,,0.95,,1859.15,Percent of total billed charges,,,0.97,,1898.29,Percent of total billed charges,,,0.97,,1898.29,Percent of total billed charges,,,0.96,,1878.72,Percent of total billed charges,,,0.95,,1859.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1859.15,Percent of total billed charges,,1859.15,1917.86,
CT scan of soft tissue of neck with contrast,PX-35010008,CDM,70491,CPT,350,RC,,outpatient,,,1957,1761.3,,0.95,,1859.15,Percent of total billed charges,,,0.98,,1917.86,Percent of total billed charges,,,0.95,,1859.15,Percent of total billed charges,,,0.95,,1859.15,Percent of total billed charges,,,0.97,,1898.29,Percent of total billed charges,,,0.96,,1878.72,Percent of total billed charges,,,0.95,,1859.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1859.15,Percent of total billed charges,,1859.15,1917.86,
CT scan of soft tissue of neck before and after contrast,PX-35010009,CDM,70492,CPT,350,RC,,inpatient,,,2379,2141.1,,0.95,,2260.05,Percent of total billed charges,,,0.98,,2331.42,Percent of total billed charges,,,0.95,,2260.05,Percent of total billed charges,,,0.97,,2307.63,Percent of total billed charges,,,0.97,,2307.63,Percent of total billed charges,,,0.96,,2283.84,Percent of total billed charges,,,0.95,,2260.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2260.05,Percent of total billed charges,,2260.05,2331.42,
CT scan of soft tissue of neck before and after contrast,PX-35010009,CDM,70492,CPT,350,RC,,outpatient,,,2379,2141.1,,0.95,,2260.05,Percent of total billed charges,,,0.98,,2331.42,Percent of total billed charges,,,0.95,,2260.05,Percent of total billed charges,,,0.95,,2260.05,Percent of total billed charges,,,0.97,,2307.63,Percent of total billed charges,,,0.96,,2283.84,Percent of total billed charges,,,0.95,,2260.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2260.05,Percent of total billed charges,,2260.05,2331.42,
CT scan of blood vessels of neck with contrast,PX-35010010,CDM,70498,CPT,350,RC,,inpatient,,,2835,2551.5,,0.95,,2693.25,Percent of total billed charges,,,0.98,,2778.3,Percent of total billed charges,,,0.95,,2693.25,Percent of total billed charges,,,0.97,,2749.95,Percent of total billed charges,,,0.97,,2749.95,Percent of total billed charges,,,0.96,,2721.6,Percent of total billed charges,,,0.95,,2693.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2693.25,Percent of total billed charges,,2693.25,2778.3,
CT scan of blood vessels of neck with contrast,PX-35010010,CDM,70498,CPT,350,RC,,outpatient,,,2835,2551.5,,0.95,,2693.25,Percent of total billed charges,,,0.98,,2778.3,Percent of total billed charges,,,0.95,,2693.25,Percent of total billed charges,,,0.95,,2693.25,Percent of total billed charges,,,0.97,,2749.95,Percent of total billed charges,,,0.96,,2721.6,Percent of total billed charges,,,0.95,,2693.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2693.25,Percent of total billed charges,,2693.25,2778.3,
CT scan of chest without contrast,PX-35010011,CDM,71250,CPT,350,RC,,inpatient,,,1854,1668.6,,0.95,,1761.3,Percent of total billed charges,,,0.98,,1816.92,Percent of total billed charges,,,0.95,,1761.3,Percent of total billed charges,,,0.97,,1798.38,Percent of total billed charges,,,0.97,,1798.38,Percent of total billed charges,,,0.96,,1779.84,Percent of total billed charges,,,0.95,,1761.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1761.3,Percent of total billed charges,,1761.3,1816.92,
CT scan of chest without contrast,PX-35010011,CDM,71250,CPT,350,RC,,outpatient,,,1854,1668.6,,0.95,,1761.3,Percent of total billed charges,,,0.98,,1816.92,Percent of total billed charges,,,0.95,,1761.3,Percent of total billed charges,,,0.95,,1761.3,Percent of total billed charges,,,0.97,,1798.38,Percent of total billed charges,,,0.96,,1779.84,Percent of total billed charges,,,0.95,,1761.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1761.3,Percent of total billed charges,,1761.3,1816.92,
CT blood vessels chest with contrast,PX-35010013,CDM,71275,CPT,350,RC,,inpatient,,,2805,2524.5,,0.95,,2664.75,Percent of total billed charges,,,0.98,,2748.9,Percent of total billed charges,,,0.95,,2664.75,Percent of total billed charges,,,0.97,,2720.85,Percent of total billed charges,,,0.97,,2720.85,Percent of total billed charges,,,0.96,,2692.8,Percent of total billed charges,,,0.95,,2664.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2664.75,Percent of total billed charges,,2664.75,2748.9,
CT blood vessels chest with contrast,PX-35010013,CDM,71275,CPT,350,RC,,outpatient,,,2805,2524.5,,0.95,,2664.75,Percent of total billed charges,,,0.98,,2748.9,Percent of total billed charges,,,0.95,,2664.75,Percent of total billed charges,,,0.95,,2664.75,Percent of total billed charges,,,0.97,,2720.85,Percent of total billed charges,,,0.96,,2692.8,Percent of total billed charges,,,0.95,,2664.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2664.75,Percent of total billed charges,,2664.75,2748.9,
CT scan of leg before and after contrast,PX-35010018,CDM,73702,CPT,350,RC,,inpatient,,,2100,1890,,0.95,,1995,Percent of total billed charges,,,0.98,,2058,Percent of total billed charges,,,0.95,,1995,Percent of total billed charges,,,0.97,,2037,Percent of total billed charges,,,0.97,,2037,Percent of total billed charges,,,0.96,,2016,Percent of total billed charges,,,0.95,,1995,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1995,Percent of total billed charges,,1995,2058,
CT scan of leg before and after contrast,PX-35010018,CDM,73702,CPT,350,RC,,outpatient,,,2100,1890,,0.95,,1995,Percent of total billed charges,,,0.98,,2058,Percent of total billed charges,,,0.95,,1995,Percent of total billed charges,,,0.95,,1995,Percent of total billed charges,,,0.97,,2037,Percent of total billed charges,,,0.96,,2016,Percent of total billed charges,,,0.95,,1995,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1995,Percent of total billed charges,,1995,2058,
CT scan of blood vessels of neck with contrast,PX-35010020,CDM,73706,CPT,350,RC,,inpatient,,,2653,2387.7,,0.95,,2520.35,Percent of total billed charges,,,0.98,,2599.94,Percent of total billed charges,,,0.95,,2520.35,Percent of total billed charges,,,0.97,,2573.41,Percent of total billed charges,,,0.97,,2573.41,Percent of total billed charges,,,0.96,,2546.88,Percent of total billed charges,,,0.95,,2520.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2520.35,Percent of total billed charges,,2520.35,2599.94,
CT scan of blood vessels of neck with contrast,PX-35010020,CDM,73706,CPT,350,RC,,outpatient,,,2653,2387.7,,0.95,,2520.35,Percent of total billed charges,,,0.98,,2599.94,Percent of total billed charges,,,0.95,,2520.35,Percent of total billed charges,,,0.95,,2520.35,Percent of total billed charges,,,0.97,,2573.41,Percent of total billed charges,,,0.96,,2546.88,Percent of total billed charges,,,0.95,,2520.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2520.35,Percent of total billed charges,,2520.35,2599.94,
CT scan of blood vessels of arm with contrast,PX-35010023,CDM,74175,CPT,350,RC,,inpatient,,,2859,2573.1,,0.95,,2716.05,Percent of total billed charges,,,0.98,,2801.82,Percent of total billed charges,,,0.95,,2716.05,Percent of total billed charges,,,0.97,,2773.23,Percent of total billed charges,,,0.97,,2773.23,Percent of total billed charges,,,0.96,,2744.64,Percent of total billed charges,,,0.95,,2716.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2716.05,Percent of total billed charges,,2716.05,2801.82,
CT scan of blood vessels of arm with contrast,PX-35010023,CDM,74175,CPT,350,RC,,outpatient,,,2859,2573.1,,0.95,,2716.05,Percent of total billed charges,,,0.98,,2801.82,Percent of total billed charges,,,0.95,,2716.05,Percent of total billed charges,,,0.95,,2716.05,Percent of total billed charges,,,0.97,,2773.23,Percent of total billed charges,,,0.96,,2744.64,Percent of total billed charges,,,0.95,,2716.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2716.05,Percent of total billed charges,,2716.05,2801.82,
CT scan of abdomen and pelvis without contrast,PX-35010024,CDM,74176,CPT,350,RC,,inpatient,,,3502,3151.8,,0.95,,3326.9,Percent of total billed charges,,,0.98,,3431.96,Percent of total billed charges,,,0.95,,3326.9,Percent of total billed charges,,,0.97,,3396.94,Percent of total billed charges,,,0.97,,3396.94,Percent of total billed charges,,,0.96,,3361.92,Percent of total billed charges,,,0.95,,3326.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3326.9,Percent of total billed charges,,3326.9,3431.96,
CT scan of abdomen and pelvis without contrast,PX-35010024,CDM,74176,CPT,350,RC,,outpatient,,,3502,3151.8,,0.95,,3326.9,Percent of total billed charges,,,0.98,,3431.96,Percent of total billed charges,,,0.95,,3326.9,Percent of total billed charges,,,0.95,,3326.9,Percent of total billed charges,,,0.97,,3396.94,Percent of total billed charges,,,0.96,,3361.92,Percent of total billed charges,,,0.95,,3326.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3326.9,Percent of total billed charges,,3326.9,3431.96,
CT scan of abdomen and pelvis with contrast,PX-35010025,CDM,74177,CPT,350,RC,,inpatient,,,4120,3708,,0.95,,3914,Percent of total billed charges,,,0.98,,4037.6,Percent of total billed charges,,,0.95,,3914,Percent of total billed charges,,,0.97,,3996.4,Percent of total billed charges,,,0.97,,3996.4,Percent of total billed charges,,,0.96,,3955.2,Percent of total billed charges,,,0.95,,3914,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3914,Percent of total billed charges,,3914,4037.6,
CT scan of abdomen and pelvis with contrast,PX-35010025,CDM,74177,CPT,350,RC,,outpatient,,,4120,3708,,0.95,,3914,Percent of total billed charges,,,0.98,,4037.6,Percent of total billed charges,,,0.95,,3914,Percent of total billed charges,,,0.95,,3914,Percent of total billed charges,,,0.97,,3996.4,Percent of total billed charges,,,0.96,,3955.2,Percent of total billed charges,,,0.95,,3914,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3914,Percent of total billed charges,,3914,4037.6,
CT scan of abdominal aorta and both leg arteries w/contrast,PX-35010031,CDM,75635,CPT,350,RC,,inpatient,,,2678,2410.2,,0.95,,2544.1,Percent of total billed charges,,,0.98,,2624.44,Percent of total billed charges,,,0.95,,2544.1,Percent of total billed charges,,,0.97,,2597.66,Percent of total billed charges,,,0.97,,2597.66,Percent of total billed charges,,,0.96,,2570.88,Percent of total billed charges,,,0.95,,2544.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2544.1,Percent of total billed charges,,2544.1,2624.44,
CT scan of abdominal aorta and both leg arteries w/contrast,PX-35010031,CDM,75635,CPT,350,RC,,outpatient,,,2678,2410.2,,0.95,,2544.1,Percent of total billed charges,,,0.98,,2624.44,Percent of total billed charges,,,0.95,,2544.1,Percent of total billed charges,,,0.95,,2544.1,Percent of total billed charges,,,0.97,,2597.66,Percent of total billed charges,,,0.96,,2570.88,Percent of total billed charges,,,0.95,,2544.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2544.1,Percent of total billed charges,,2544.1,2624.44,
3D radiographic procedure,PX-35010032,CDM,76376,CPT,350,RC,,inpatient,,,48,43.2,,0.95,,45.6,Percent of total billed charges,,,0.98,,47.04,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.96,,46.08,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,45.6,Percent of total billed charges,,45.6,47.04,
3D radiographic procedure,PX-35010032,CDM,76376,CPT,350,RC,,outpatient,,,48,43.2,,0.95,,45.6,Percent of total billed charges,,,0.98,,47.04,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.96,,46.08,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,45.6,Percent of total billed charges,,45.6,47.04,
3D radiographic procedure w/image postprocessing,PX-35010033,CDM,76377,CPT,350,RC,,inpatient,,,814,732.6,,0.95,,773.3,Percent of total billed charges,,,0.98,,797.72,Percent of total billed charges,,,0.95,,773.3,Percent of total billed charges,,,0.97,,789.58,Percent of total billed charges,,,0.97,,789.58,Percent of total billed charges,,,0.96,,781.44,Percent of total billed charges,,,0.95,,773.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,773.3,Percent of total billed charges,,773.3,797.72,
3D radiographic procedure w/image postprocessing,PX-35010033,CDM,76377,CPT,350,RC,,outpatient,,,814,732.6,,0.95,,773.3,Percent of total billed charges,,,0.98,,797.72,Percent of total billed charges,,,0.95,,773.3,Percent of total billed charges,,,0.95,,773.3,Percent of total billed charges,,,0.97,,789.58,Percent of total billed charges,,,0.96,,781.44,Percent of total billed charges,,,0.95,,773.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,773.3,Percent of total billed charges,,773.3,797.72,
CT Guide placement of needle,PX-35010037,CDM,77012,CPT,350,RC,,inpatient,,,1854,1668.6,,0.95,,1761.3,Percent of total billed charges,,,0.98,,1816.92,Percent of total billed charges,,,0.95,,1761.3,Percent of total billed charges,,,0.97,,1798.38,Percent of total billed charges,,,0.97,,1798.38,Percent of total billed charges,,,0.96,,1779.84,Percent of total billed charges,,,0.95,,1761.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1761.3,Percent of total billed charges,,1761.3,1816.92,
CT Guide placement of needle,PX-35010037,CDM,77012,CPT,350,RC,,outpatient,,,1854,1668.6,,0.95,,1761.3,Percent of total billed charges,,,0.98,,1816.92,Percent of total billed charges,,,0.95,,1761.3,Percent of total billed charges,,,0.95,,1761.3,Percent of total billed charges,,,0.97,,1798.38,Percent of total billed charges,,,0.96,,1779.84,Percent of total billed charges,,,0.95,,1761.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1761.3,Percent of total billed charges,,1761.3,1816.92,
CT scan of blood vessels of abdomen and pelvis w/contrast,PX-35010072,CDM,74174,CPT,350,RC,,inpatient,,,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
CT scan of blood vessels of abdomen and pelvis w/contrast,PX-35010072,CDM,74174,CPT,350,RC,,outpatient,,,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
CT scan head or brain without contrast,PX-35110002,CDM,70450,CPT,351,RC,,inpatient,,,1803,1622.7,,0.95,,1712.85,Percent of total billed charges,,,0.98,,1766.94,Percent of total billed charges,,,0.95,,1712.85,Percent of total billed charges,,,0.97,,1748.91,Percent of total billed charges,,,0.97,,1748.91,Percent of total billed charges,,,0.96,,1730.88,Percent of total billed charges,,,0.95,,1712.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1712.85,Percent of total billed charges,,1712.85,1766.94,
CT scan head or brain without contrast,PX-35110002,CDM,70450,CPT,351,RC,,outpatient,,,1803,1622.7,,0.95,,1712.85,Percent of total billed charges,,,0.98,,1766.94,Percent of total billed charges,,,0.95,,1712.85,Percent of total billed charges,,,0.95,,1712.85,Percent of total billed charges,,,0.97,,1748.91,Percent of total billed charges,,,0.96,,1730.88,Percent of total billed charges,,,0.95,,1712.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1712.85,Percent of total billed charges,,1712.85,1766.94,
CT scan head or brain with contrast,PX-35110007,CDM,70460,CPT,351,RC,,inpatient,,,1798,1618.2,,0.95,,1708.1,Percent of total billed charges,,,0.98,,1762.04,Percent of total billed charges,,,0.95,,1708.1,Percent of total billed charges,,,0.97,,1744.06,Percent of total billed charges,,,0.97,,1744.06,Percent of total billed charges,,,0.96,,1726.08,Percent of total billed charges,,,0.95,,1708.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1708.1,Percent of total billed charges,,1708.1,1762.04,
CT scan head or brain with contrast,PX-35110007,CDM,70460,CPT,351,RC,,outpatient,,,1798,1618.2,,0.95,,1708.1,Percent of total billed charges,,,0.98,,1762.04,Percent of total billed charges,,,0.95,,1708.1,Percent of total billed charges,,,0.95,,1708.1,Percent of total billed charges,,,0.97,,1744.06,Percent of total billed charges,,,0.96,,1726.08,Percent of total billed charges,,,0.95,,1708.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1708.1,Percent of total billed charges,,1708.1,1762.04,
CT scan of head or brain before and after contrast,PX-35110012,CDM,70470,CPT,351,RC,,inpatient,,,2403,2162.7,,0.95,,2282.85,Percent of total billed charges,,,0.98,,2354.94,Percent of total billed charges,,,0.95,,2282.85,Percent of total billed charges,,,0.97,,2330.91,Percent of total billed charges,,,0.97,,2330.91,Percent of total billed charges,,,0.96,,2306.88,Percent of total billed charges,,,0.95,,2282.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2282.85,Percent of total billed charges,,2282.85,2354.94,
CT scan of head or brain before and after contrast,PX-35110012,CDM,70470,CPT,351,RC,,outpatient,,,2403,2162.7,,0.95,,2282.85,Percent of total billed charges,,,0.98,,2354.94,Percent of total billed charges,,,0.95,,2282.85,Percent of total billed charges,,,0.95,,2282.85,Percent of total billed charges,,,0.97,,2330.91,Percent of total billed charges,,,0.96,,2306.88,Percent of total billed charges,,,0.95,,2282.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2282.85,Percent of total billed charges,,2282.85,2354.94,
CT scan of cranial cavity without contrast,PX-35110014,CDM,70480,CPT,351,RC,,inpatient,,,1620,1458,,0.95,,1539,Percent of total billed charges,,,0.98,,1587.6,Percent of total billed charges,,,0.95,,1539,Percent of total billed charges,,,0.97,,1571.4,Percent of total billed charges,,,0.97,,1571.4,Percent of total billed charges,,,0.96,,1555.2,Percent of total billed charges,,,0.95,,1539,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1539,Percent of total billed charges,,1539,1587.6,
CT scan of cranial cavity without contrast,PX-35110014,CDM,70480,CPT,351,RC,,outpatient,,,1620,1458,,0.95,,1539,Percent of total billed charges,,,0.98,,1587.6,Percent of total billed charges,,,0.95,,1539,Percent of total billed charges,,,0.95,,1539,Percent of total billed charges,,,0.97,,1571.4,Percent of total billed charges,,,0.96,,1555.2,Percent of total billed charges,,,0.95,,1539,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1539,Percent of total billed charges,,1539,1587.6,
CT scan of cranial cavity with contrast,PX-35110017,CDM,70481,CPT,351,RC,,inpatient,,,1726,1553.4,,0.95,,1639.7,Percent of total billed charges,,,0.98,,1691.48,Percent of total billed charges,,,0.95,,1639.7,Percent of total billed charges,,,0.97,,1674.22,Percent of total billed charges,,,0.97,,1674.22,Percent of total billed charges,,,0.96,,1656.96,Percent of total billed charges,,,0.95,,1639.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1639.7,Percent of total billed charges,,1639.7,1691.48,
CT scan of cranial cavity with contrast,PX-35110017,CDM,70481,CPT,351,RC,,outpatient,,,1726,1553.4,,0.95,,1639.7,Percent of total billed charges,,,0.98,,1691.48,Percent of total billed charges,,,0.95,,1639.7,Percent of total billed charges,,,0.95,,1639.7,Percent of total billed charges,,,0.97,,1674.22,Percent of total billed charges,,,0.96,,1656.96,Percent of total billed charges,,,0.95,,1639.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1639.7,Percent of total billed charges,,1639.7,1691.48,
CT scan of cranial cavity before and after contrast,PX-35110019,CDM,70482,CPT,351,RC,,inpatient,,,2105,1894.5,,0.95,,1999.75,Percent of total billed charges,,,0.98,,2062.9,Percent of total billed charges,,,0.95,,1999.75,Percent of total billed charges,,,0.97,,2041.85,Percent of total billed charges,,,0.97,,2041.85,Percent of total billed charges,,,0.96,,2020.8,Percent of total billed charges,,,0.95,,1999.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1999.75,Percent of total billed charges,,1999.75,2062.9,
CT scan of cranial cavity before and after contrast,PX-35110019,CDM,70482,CPT,351,RC,,outpatient,,,2105,1894.5,,0.95,,1999.75,Percent of total billed charges,,,0.98,,2062.9,Percent of total billed charges,,,0.95,,1999.75,Percent of total billed charges,,,0.95,,1999.75,Percent of total billed charges,,,0.97,,2041.85,Percent of total billed charges,,,0.96,,2020.8,Percent of total billed charges,,,0.95,,1999.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1999.75,Percent of total billed charges,,1999.75,2062.9,
CT scan of face without contrast,PX-35110022,CDM,70486,CPT,350,RC,,inpatient,,,1365,1228.5,,0.95,,1296.75,Percent of total billed charges,,,0.98,,1337.7,Percent of total billed charges,,,0.95,,1296.75,Percent of total billed charges,,,0.97,,1324.05,Percent of total billed charges,,,0.97,,1324.05,Percent of total billed charges,,,0.96,,1310.4,Percent of total billed charges,,,0.95,,1296.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1296.75,Percent of total billed charges,,1296.75,1337.7,
CT scan of face without contrast,PX-35110022,CDM,70486,CPT,350,RC,,outpatient,,,1365,1228.5,,0.95,,1296.75,Percent of total billed charges,,,0.98,,1337.7,Percent of total billed charges,,,0.95,,1296.75,Percent of total billed charges,,,0.95,,1296.75,Percent of total billed charges,,,0.97,,1324.05,Percent of total billed charges,,,0.96,,1310.4,Percent of total billed charges,,,0.95,,1296.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1296.75,Percent of total billed charges,,1296.75,1337.7,
CT scan of face with contrast,PX-35110030,CDM,70487,CPT,351,RC,,inpatient,,,1803,1622.7,,0.95,,1712.85,Percent of total billed charges,,,0.98,,1766.94,Percent of total billed charges,,,0.95,,1712.85,Percent of total billed charges,,,0.97,,1748.91,Percent of total billed charges,,,0.97,,1748.91,Percent of total billed charges,,,0.96,,1730.88,Percent of total billed charges,,,0.95,,1712.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1712.85,Percent of total billed charges,,1712.85,1766.94,
CT scan of face with contrast,PX-35110030,CDM,70487,CPT,351,RC,,outpatient,,,1803,1622.7,,0.95,,1712.85,Percent of total billed charges,,,0.98,,1766.94,Percent of total billed charges,,,0.95,,1712.85,Percent of total billed charges,,,0.95,,1712.85,Percent of total billed charges,,,0.97,,1748.91,Percent of total billed charges,,,0.96,,1730.88,Percent of total billed charges,,,0.95,,1712.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1712.85,Percent of total billed charges,,1712.85,1766.94,
CT scan of blood vessels of head with contrast,PX-35110032,CDM,70496,CPT,351,RC,,inpatient,,,2835,2551.5,,0.95,,2693.25,Percent of total billed charges,,,0.98,,2778.3,Percent of total billed charges,,,0.95,,2693.25,Percent of total billed charges,,,0.97,,2749.95,Percent of total billed charges,,,0.97,,2749.95,Percent of total billed charges,,,0.96,,2721.6,Percent of total billed charges,,,0.95,,2693.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2693.25,Percent of total billed charges,,2693.25,2778.3,
CT scan of blood vessels of head with contrast,PX-35110032,CDM,70496,CPT,351,RC,,outpatient,,,2835,2551.5,,0.95,,2693.25,Percent of total billed charges,,,0.98,,2778.3,Percent of total billed charges,,,0.95,,2693.25,Percent of total billed charges,,,0.95,,2693.25,Percent of total billed charges,,,0.97,,2749.95,Percent of total billed charges,,,0.96,,2721.6,Percent of total billed charges,,,0.95,,2693.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2693.25,Percent of total billed charges,,2693.25,2778.3,
CT scan of chest with contrast,PX-35210003,CDM,71260,CPT,352,RC,,inpatient,,,2292,2062.8,,0.95,,2177.4,Percent of total billed charges,,,0.98,,2246.16,Percent of total billed charges,,,0.95,,2177.4,Percent of total billed charges,,,0.97,,2223.24,Percent of total billed charges,,,0.97,,2223.24,Percent of total billed charges,,,0.96,,2200.32,Percent of total billed charges,,,0.95,,2177.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2177.4,Percent of total billed charges,,2177.4,2246.16,
CT scan of chest with contrast,PX-35210003,CDM,71260,CPT,352,RC,,outpatient,,,2292,2062.8,,0.95,,2177.4,Percent of total billed charges,,,0.98,,2246.16,Percent of total billed charges,,,0.95,,2177.4,Percent of total billed charges,,,0.95,,2177.4,Percent of total billed charges,,,0.97,,2223.24,Percent of total billed charges,,,0.96,,2200.32,Percent of total billed charges,,,0.95,,2177.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2177.4,Percent of total billed charges,,2177.4,2246.16,
CT scan of chest before and after contrast,PX-35210006,CDM,71270,CPT,352,RC,,inpatient,,,2862,2575.8,,0.95,,2718.9,Percent of total billed charges,,,0.98,,2804.76,Percent of total billed charges,,,0.95,,2718.9,Percent of total billed charges,,,0.97,,2776.14,Percent of total billed charges,,,0.97,,2776.14,Percent of total billed charges,,,0.96,,2747.52,Percent of total billed charges,,,0.95,,2718.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2718.9,Percent of total billed charges,,2718.9,2804.76,
CT scan of chest before and after contrast,PX-35210006,CDM,71270,CPT,352,RC,,outpatient,,,2862,2575.8,,0.95,,2718.9,Percent of total billed charges,,,0.98,,2804.76,Percent of total billed charges,,,0.95,,2718.9,Percent of total billed charges,,,0.95,,2718.9,Percent of total billed charges,,,0.97,,2776.14,Percent of total billed charges,,,0.96,,2747.52,Percent of total billed charges,,,0.95,,2718.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2718.9,Percent of total billed charges,,2718.9,2804.76,
CT scan of upper spine without contrast,PX-35210008,CDM,72125,CPT,352,RC,,inpatient,,,1880,1692,,0.95,,1786,Percent of total billed charges,,,0.98,,1842.4,Percent of total billed charges,,,0.95,,1786,Percent of total billed charges,,,0.97,,1823.6,Percent of total billed charges,,,0.97,,1823.6,Percent of total billed charges,,,0.96,,1804.8,Percent of total billed charges,,,0.95,,1786,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1786,Percent of total billed charges,,1786,1842.4,
CT scan of upper spine without contrast,PX-35210008,CDM,72125,CPT,352,RC,,outpatient,,,1880,1692,,0.95,,1786,Percent of total billed charges,,,0.98,,1842.4,Percent of total billed charges,,,0.95,,1786,Percent of total billed charges,,,0.95,,1786,Percent of total billed charges,,,0.97,,1823.6,Percent of total billed charges,,,0.96,,1804.8,Percent of total billed charges,,,0.95,,1786,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1786,Percent of total billed charges,,1786,1842.4,
CT scan of upper spine with contrast,PX-35210009,CDM,72126,CPT,352,RC,,inpatient,,,2229,2006.1,,0.95,,2117.55,Percent of total billed charges,,,0.98,,2184.42,Percent of total billed charges,,,0.95,,2117.55,Percent of total billed charges,,,0.97,,2162.13,Percent of total billed charges,,,0.97,,2162.13,Percent of total billed charges,,,0.96,,2139.84,Percent of total billed charges,,,0.95,,2117.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2117.55,Percent of total billed charges,,2117.55,2184.42,
CT scan of upper spine with contrast,PX-35210009,CDM,72126,CPT,352,RC,,outpatient,,,2229,2006.1,,0.95,,2117.55,Percent of total billed charges,,,0.98,,2184.42,Percent of total billed charges,,,0.95,,2117.55,Percent of total billed charges,,,0.95,,2117.55,Percent of total billed charges,,,0.97,,2162.13,Percent of total billed charges,,,0.96,,2139.84,Percent of total billed charges,,,0.95,,2117.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2117.55,Percent of total billed charges,,2117.55,2184.42,
CT scan of upper spine before and after contrast,PX-35210010,CDM,72127,CPT,352,RC,,inpatient,,,2331,2097.9,,0.95,,2214.45,Percent of total billed charges,,,0.98,,2284.38,Percent of total billed charges,,,0.95,,2214.45,Percent of total billed charges,,,0.97,,2261.07,Percent of total billed charges,,,0.97,,2261.07,Percent of total billed charges,,,0.96,,2237.76,Percent of total billed charges,,,0.95,,2214.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2214.45,Percent of total billed charges,,2214.45,2284.38,
CT scan of upper spine before and after contrast,PX-35210010,CDM,72127,CPT,352,RC,,outpatient,,,2331,2097.9,,0.95,,2214.45,Percent of total billed charges,,,0.98,,2284.38,Percent of total billed charges,,,0.95,,2214.45,Percent of total billed charges,,,0.95,,2214.45,Percent of total billed charges,,,0.97,,2261.07,Percent of total billed charges,,,0.96,,2237.76,Percent of total billed charges,,,0.95,,2214.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2214.45,Percent of total billed charges,,2214.45,2284.38,
CT scan of middle spine without contrast,PX-35210011,CDM,72128,CPT,352,RC,,inpatient,,,1885,1696.5,,0.95,,1790.75,Percent of total billed charges,,,0.98,,1847.3,Percent of total billed charges,,,0.95,,1790.75,Percent of total billed charges,,,0.97,,1828.45,Percent of total billed charges,,,0.97,,1828.45,Percent of total billed charges,,,0.96,,1809.6,Percent of total billed charges,,,0.95,,1790.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1790.75,Percent of total billed charges,,1790.75,1847.3,
CT scan of middle spine without contrast,PX-35210011,CDM,72128,CPT,352,RC,,outpatient,,,1885,1696.5,,0.95,,1790.75,Percent of total billed charges,,,0.98,,1847.3,Percent of total billed charges,,,0.95,,1790.75,Percent of total billed charges,,,0.95,,1790.75,Percent of total billed charges,,,0.97,,1828.45,Percent of total billed charges,,,0.96,,1809.6,Percent of total billed charges,,,0.95,,1790.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1790.75,Percent of total billed charges,,1790.75,1847.3,
CT scan of middle spine with contrast,PX-35210012,CDM,72129,CPT,352,RC,,inpatient,,,2060,1854,,0.95,,1957,Percent of total billed charges,,,0.98,,2018.8,Percent of total billed charges,,,0.95,,1957,Percent of total billed charges,,,0.97,,1998.2,Percent of total billed charges,,,0.97,,1998.2,Percent of total billed charges,,,0.96,,1977.6,Percent of total billed charges,,,0.95,,1957,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1957,Percent of total billed charges,,1957,2018.8,
CT scan of middle spine with contrast,PX-35210012,CDM,72129,CPT,352,RC,,outpatient,,,2060,1854,,0.95,,1957,Percent of total billed charges,,,0.98,,2018.8,Percent of total billed charges,,,0.95,,1957,Percent of total billed charges,,,0.95,,1957,Percent of total billed charges,,,0.97,,1998.2,Percent of total billed charges,,,0.96,,1977.6,Percent of total billed charges,,,0.95,,1957,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1957,Percent of total billed charges,,1957,2018.8,
CT scan of middle spine before and after contrast,PX-35210013,CDM,72130,CPT,352,RC,,inpatient,,,2597,2337.3,,0.95,,2467.15,Percent of total billed charges,,,0.98,,2545.06,Percent of total billed charges,,,0.95,,2467.15,Percent of total billed charges,,,0.97,,2519.09,Percent of total billed charges,,,0.97,,2519.09,Percent of total billed charges,,,0.96,,2493.12,Percent of total billed charges,,,0.95,,2467.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2467.15,Percent of total billed charges,,2467.15,2545.06,
CT scan of middle spine before and after contrast,PX-35210013,CDM,72130,CPT,352,RC,,outpatient,,,2597,2337.3,,0.95,,2467.15,Percent of total billed charges,,,0.98,,2545.06,Percent of total billed charges,,,0.95,,2467.15,Percent of total billed charges,,,0.95,,2467.15,Percent of total billed charges,,,0.97,,2519.09,Percent of total billed charges,,,0.96,,2493.12,Percent of total billed charges,,,0.95,,2467.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2467.15,Percent of total billed charges,,2467.15,2545.06,
CT scan of lower spine without contrast,PX-35210014,CDM,72131,CPT,352,RC,,inpatient,,,1751,1575.9,,0.95,,1663.45,Percent of total billed charges,,,0.98,,1715.98,Percent of total billed charges,,,0.95,,1663.45,Percent of total billed charges,,,0.97,,1698.47,Percent of total billed charges,,,0.97,,1698.47,Percent of total billed charges,,,0.96,,1680.96,Percent of total billed charges,,,0.95,,1663.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1663.45,Percent of total billed charges,,1663.45,1715.98,
CT scan of lower spine without contrast,PX-35210014,CDM,72131,CPT,352,RC,,outpatient,,,1751,1575.9,,0.95,,1663.45,Percent of total billed charges,,,0.98,,1715.98,Percent of total billed charges,,,0.95,,1663.45,Percent of total billed charges,,,0.95,,1663.45,Percent of total billed charges,,,0.97,,1698.47,Percent of total billed charges,,,0.96,,1680.96,Percent of total billed charges,,,0.95,,1663.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1663.45,Percent of total billed charges,,1663.45,1715.98,
CT scan of lower spine with contrast,PX-35210015,CDM,72132,CPT,352,RC,,inpatient,,,2122,1909.8,,0.95,,2015.9,Percent of total billed charges,,,0.98,,2079.56,Percent of total billed charges,,,0.95,,2015.9,Percent of total billed charges,,,0.97,,2058.34,Percent of total billed charges,,,0.97,,2058.34,Percent of total billed charges,,,0.96,,2037.12,Percent of total billed charges,,,0.95,,2015.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2015.9,Percent of total billed charges,,2015.9,2079.56,
CT scan of lower spine with contrast,PX-35210015,CDM,72132,CPT,352,RC,,outpatient,,,2122,1909.8,,0.95,,2015.9,Percent of total billed charges,,,0.98,,2079.56,Percent of total billed charges,,,0.95,,2015.9,Percent of total billed charges,,,0.95,,2015.9,Percent of total billed charges,,,0.97,,2058.34,Percent of total billed charges,,,0.96,,2037.12,Percent of total billed charges,,,0.95,,2015.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2015.9,Percent of total billed charges,,2015.9,2079.56,
CT scan of lower spine before and after contrast,PX-35210016,CDM,72133,CPT,352,RC,,inpatient,,,2553,2297.7,,0.95,,2425.35,Percent of total billed charges,,,0.98,,2501.94,Percent of total billed charges,,,0.95,,2425.35,Percent of total billed charges,,,0.97,,2476.41,Percent of total billed charges,,,0.97,,2476.41,Percent of total billed charges,,,0.96,,2450.88,Percent of total billed charges,,,0.95,,2425.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2425.35,Percent of total billed charges,,2425.35,2501.94,
CT scan of lower spine before and after contrast,PX-35210016,CDM,72133,CPT,352,RC,,outpatient,,,2553,2297.7,,0.95,,2425.35,Percent of total billed charges,,,0.98,,2501.94,Percent of total billed charges,,,0.95,,2425.35,Percent of total billed charges,,,0.95,,2425.35,Percent of total billed charges,,,0.97,,2476.41,Percent of total billed charges,,,0.96,,2450.88,Percent of total billed charges,,,0.95,,2425.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2425.35,Percent of total billed charges,,2425.35,2501.94,
CT blood vessels pelvis with/without contrast,PX-35210017,CDM,72191,CPT,352,RC,,inpatient,,,2277,2049.3,,0.95,,2163.15,Percent of total billed charges,,,0.98,,2231.46,Percent of total billed charges,,,0.95,,2163.15,Percent of total billed charges,,,0.97,,2208.69,Percent of total billed charges,,,0.97,,2208.69,Percent of total billed charges,,,0.96,,2185.92,Percent of total billed charges,,,0.95,,2163.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2163.15,Percent of total billed charges,,2163.15,2231.46,
CT blood vessels pelvis with/without contrast,PX-35210017,CDM,72191,CPT,352,RC,,outpatient,,,2277,2049.3,,0.95,,2163.15,Percent of total billed charges,,,0.98,,2231.46,Percent of total billed charges,,,0.95,,2163.15,Percent of total billed charges,,,0.95,,2163.15,Percent of total billed charges,,,0.97,,2208.69,Percent of total billed charges,,,0.96,,2185.92,Percent of total billed charges,,,0.95,,2163.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2163.15,Percent of total billed charges,,2163.15,2231.46,
CT scan of pelvis without contrast,PX-35210018,CDM,72192,CPT,352,RC,,inpatient,,,1813,1631.7,,0.95,,1722.35,Percent of total billed charges,,,0.98,,1776.74,Percent of total billed charges,,,0.95,,1722.35,Percent of total billed charges,,,0.97,,1758.61,Percent of total billed charges,,,0.97,,1758.61,Percent of total billed charges,,,0.96,,1740.48,Percent of total billed charges,,,0.95,,1722.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1722.35,Percent of total billed charges,,1722.35,1776.74,
CT scan of pelvis without contrast,PX-35210018,CDM,72192,CPT,352,RC,,outpatient,,,1813,1631.7,,0.95,,1722.35,Percent of total billed charges,,,0.98,,1776.74,Percent of total billed charges,,,0.95,,1722.35,Percent of total billed charges,,,0.95,,1722.35,Percent of total billed charges,,,0.97,,1758.61,Percent of total billed charges,,,0.96,,1740.48,Percent of total billed charges,,,0.95,,1722.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1722.35,Percent of total billed charges,,1722.35,1776.74,
CT scan of pelvis with contrast,PX-35210020,CDM,72193,CPT,352,RC,,inpatient,,,2098,1888.2,,0.95,,1993.1,Percent of total billed charges,,,0.98,,2056.04,Percent of total billed charges,,,0.95,,1993.1,Percent of total billed charges,,,0.97,,2035.06,Percent of total billed charges,,,0.97,,2035.06,Percent of total billed charges,,,0.96,,2014.08,Percent of total billed charges,,,0.95,,1993.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1993.1,Percent of total billed charges,,1993.1,2056.04,
CT scan of pelvis with contrast,PX-35210020,CDM,72193,CPT,352,RC,,outpatient,,,2098,1888.2,,0.95,,1993.1,Percent of total billed charges,,,0.98,,2056.04,Percent of total billed charges,,,0.95,,1993.1,Percent of total billed charges,,,0.95,,1993.1,Percent of total billed charges,,,0.97,,2035.06,Percent of total billed charges,,,0.96,,2014.08,Percent of total billed charges,,,0.95,,1993.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1993.1,Percent of total billed charges,,1993.1,2056.04,
CT scan of pelvis before and after contrast,PX-35210024,CDM,72194,CPT,352,RC,,inpatient,,,2480,2232,,0.95,,2356,Percent of total billed charges,,,0.98,,2430.4,Percent of total billed charges,,,0.95,,2356,Percent of total billed charges,,,0.97,,2405.6,Percent of total billed charges,,,0.97,,2405.6,Percent of total billed charges,,,0.96,,2380.8,Percent of total billed charges,,,0.95,,2356,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2356,Percent of total billed charges,,2356,2430.4,
CT scan of pelvis before and after contrast,PX-35210024,CDM,72194,CPT,352,RC,,outpatient,,,2480,2232,,0.95,,2356,Percent of total billed charges,,,0.98,,2430.4,Percent of total billed charges,,,0.95,,2356,Percent of total billed charges,,,0.95,,2356,Percent of total billed charges,,,0.97,,2405.6,Percent of total billed charges,,,0.96,,2380.8,Percent of total billed charges,,,0.95,,2356,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2356,Percent of total billed charges,,2356,2430.4,
CT scan of arm without contrast,PX-35210029,CDM,73200,CPT,350,RC,,inpatient,,,1659,1493.1,,0.95,,1576.05,Percent of total billed charges,,,0.98,,1625.82,Percent of total billed charges,,,0.95,,1576.05,Percent of total billed charges,,,0.97,,1609.23,Percent of total billed charges,,,0.97,,1609.23,Percent of total billed charges,,,0.96,,1592.64,Percent of total billed charges,,,0.95,,1576.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1576.05,Percent of total billed charges,,1576.05,1625.82,
CT scan of arm without contrast,PX-35210029,CDM,73200,CPT,350,RC,,outpatient,,,1659,1493.1,,0.95,,1576.05,Percent of total billed charges,,,0.98,,1625.82,Percent of total billed charges,,,0.95,,1576.05,Percent of total billed charges,,,0.95,,1576.05,Percent of total billed charges,,,0.97,,1609.23,Percent of total billed charges,,,0.96,,1592.64,Percent of total billed charges,,,0.95,,1576.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1576.05,Percent of total billed charges,,1576.05,1625.82,
CT scan of leg without contrast,PX-35210030,CDM,73700,CPT,350,RC,,inpatient,,,1751,1575.9,,0.95,,1663.45,Percent of total billed charges,,,0.98,,1715.98,Percent of total billed charges,,,0.95,,1663.45,Percent of total billed charges,,,0.97,,1698.47,Percent of total billed charges,,,0.97,,1698.47,Percent of total billed charges,,,0.96,,1680.96,Percent of total billed charges,,,0.95,,1663.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1663.45,Percent of total billed charges,,1663.45,1715.98,
CT scan of leg without contrast,PX-35210030,CDM,73700,CPT,350,RC,,outpatient,,,1751,1575.9,,0.95,,1663.45,Percent of total billed charges,,,0.98,,1715.98,Percent of total billed charges,,,0.95,,1663.45,Percent of total billed charges,,,0.95,,1663.45,Percent of total billed charges,,,0.97,,1698.47,Percent of total billed charges,,,0.96,,1680.96,Percent of total billed charges,,,0.95,,1663.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1663.45,Percent of total billed charges,,1663.45,1715.98,
CT scan of arm with contrast,PX-35210031,CDM,73201,CPT,352,RC,,inpatient,,,1854,1668.6,,0.95,,1761.3,Percent of total billed charges,,,0.98,,1816.92,Percent of total billed charges,,,0.95,,1761.3,Percent of total billed charges,,,0.97,,1798.38,Percent of total billed charges,,,0.97,,1798.38,Percent of total billed charges,,,0.96,,1779.84,Percent of total billed charges,,,0.95,,1761.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1761.3,Percent of total billed charges,,1761.3,1816.92,
CT scan of arm with contrast,PX-35210031,CDM,73201,CPT,352,RC,,outpatient,,,1854,1668.6,,0.95,,1761.3,Percent of total billed charges,,,0.98,,1816.92,Percent of total billed charges,,,0.95,,1761.3,Percent of total billed charges,,,0.95,,1761.3,Percent of total billed charges,,,0.97,,1798.38,Percent of total billed charges,,,0.96,,1779.84,Percent of total billed charges,,,0.95,,1761.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1761.3,Percent of total billed charges,,1761.3,1816.92,
CT scan of blood vessels of arm with contrast,PX-35210037,CDM,73206,CPT,352,RC,,inpatient,,,2678,2410.2,,0.95,,2544.1,Percent of total billed charges,,,0.98,,2624.44,Percent of total billed charges,,,0.95,,2544.1,Percent of total billed charges,,,0.97,,2597.66,Percent of total billed charges,,,0.97,,2597.66,Percent of total billed charges,,,0.96,,2570.88,Percent of total billed charges,,,0.95,,2544.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2544.1,Percent of total billed charges,,2544.1,2624.44,
CT scan of blood vessels of arm with contrast,PX-35210037,CDM,73206,CPT,352,RC,,outpatient,,,2678,2410.2,,0.95,,2544.1,Percent of total billed charges,,,0.98,,2624.44,Percent of total billed charges,,,0.95,,2544.1,Percent of total billed charges,,,0.95,,2544.1,Percent of total billed charges,,,0.97,,2597.66,Percent of total billed charges,,,0.96,,2570.88,Percent of total billed charges,,,0.95,,2544.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2544.1,Percent of total billed charges,,2544.1,2624.44,
CT scan of abdomen without contrast,PX-35210038,CDM,74150,CPT,352,RC,,inpatient,,,1906,1715.4,,0.95,,1810.7,Percent of total billed charges,,,0.98,,1867.88,Percent of total billed charges,,,0.95,,1810.7,Percent of total billed charges,,,0.97,,1848.82,Percent of total billed charges,,,0.97,,1848.82,Percent of total billed charges,,,0.96,,1829.76,Percent of total billed charges,,,0.95,,1810.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1810.7,Percent of total billed charges,,1810.7,1867.88,
CT scan of abdomen without contrast,PX-35210038,CDM,74150,CPT,352,RC,,outpatient,,,1906,1715.4,,0.95,,1810.7,Percent of total billed charges,,,0.98,,1867.88,Percent of total billed charges,,,0.95,,1810.7,Percent of total billed charges,,,0.95,,1810.7,Percent of total billed charges,,,0.97,,1848.82,Percent of total billed charges,,,0.96,,1829.76,Percent of total billed charges,,,0.95,,1810.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1810.7,Percent of total billed charges,,1810.7,1867.88,
CT scan of leg with contrast material,PX-35210040,CDM,73701,CPT,352,RC,,inpatient,,,2060,1854,,0.95,,1957,Percent of total billed charges,,,0.98,,2018.8,Percent of total billed charges,,,0.95,,1957,Percent of total billed charges,,,0.97,,1998.2,Percent of total billed charges,,,0.97,,1998.2,Percent of total billed charges,,,0.96,,1977.6,Percent of total billed charges,,,0.95,,1957,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1957,Percent of total billed charges,,1957,2018.8,
CT scan of leg with contrast material,PX-35210040,CDM,73701,CPT,352,RC,,outpatient,,,2060,1854,,0.95,,1957,Percent of total billed charges,,,0.98,,2018.8,Percent of total billed charges,,,0.95,,1957,Percent of total billed charges,,,0.95,,1957,Percent of total billed charges,,,0.97,,1998.2,Percent of total billed charges,,,0.96,,1977.6,Percent of total billed charges,,,0.95,,1957,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1957,Percent of total billed charges,,1957,2018.8,
CT scan of abdomen with contrast,PX-35210046,CDM,74160,CPT,352,RC,,inpatient,,,2266,2039.4,,0.95,,2152.7,Percent of total billed charges,,,0.98,,2220.68,Percent of total billed charges,,,0.95,,2152.7,Percent of total billed charges,,,0.97,,2198.02,Percent of total billed charges,,,0.97,,2198.02,Percent of total billed charges,,,0.96,,2175.36,Percent of total billed charges,,,0.95,,2152.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2152.7,Percent of total billed charges,,2152.7,2220.68,
CT scan of abdomen with contrast,PX-35210046,CDM,74160,CPT,352,RC,,outpatient,,,2266,2039.4,,0.95,,2152.7,Percent of total billed charges,,,0.98,,2220.68,Percent of total billed charges,,,0.95,,2152.7,Percent of total billed charges,,,0.95,,2152.7,Percent of total billed charges,,,0.97,,2198.02,Percent of total billed charges,,,0.96,,2175.36,Percent of total billed charges,,,0.95,,2152.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2152.7,Percent of total billed charges,,2152.7,2220.68,
CT scan of abdomen before and after contrast,PX-35210047,CDM,74170,CPT,352,RC,,inpatient,,,2472,2224.8,,0.95,,2348.4,Percent of total billed charges,,,0.98,,2422.56,Percent of total billed charges,,,0.95,,2348.4,Percent of total billed charges,,,0.97,,2397.84,Percent of total billed charges,,,0.97,,2397.84,Percent of total billed charges,,,0.96,,2373.12,Percent of total billed charges,,,0.95,,2348.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2348.4,Percent of total billed charges,,2348.4,2422.56,
CT scan of abdomen before and after contrast,PX-35210047,CDM,74170,CPT,352,RC,,outpatient,,,2472,2224.8,,0.95,,2348.4,Percent of total billed charges,,,0.98,,2422.56,Percent of total billed charges,,,0.95,,2348.4,Percent of total billed charges,,,0.95,,2348.4,Percent of total billed charges,,,0.97,,2397.84,Percent of total billed charges,,,0.96,,2373.12,Percent of total billed charges,,,0.95,,2348.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2348.4,Percent of total billed charges,,2348.4,2422.56,
CT scan of abdomen and pelvis before and after contrast,PX-35210054,CDM,74178,CPT,352,RC,,inpatient,,,4326,3893.4,,0.95,,4109.7,Percent of total billed charges,,,0.98,,4239.48,Percent of total billed charges,,,0.95,,4109.7,Percent of total billed charges,,,0.97,,4196.22,Percent of total billed charges,,,0.97,,4196.22,Percent of total billed charges,,,0.96,,4152.96,Percent of total billed charges,,,0.95,,4109.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4109.7,Percent of total billed charges,,4109.7,4239.48,
CT scan of abdomen and pelvis before and after contrast,PX-35210054,CDM,74178,CPT,352,RC,,outpatient,,,4326,3893.4,,0.95,,4109.7,Percent of total billed charges,,,0.98,,4239.48,Percent of total billed charges,,,0.95,,4109.7,Percent of total billed charges,,,0.95,,4109.7,Percent of total billed charges,,,0.97,,4196.22,Percent of total billed charges,,,0.96,,4152.96,Percent of total billed charges,,,0.95,,4109.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4109.7,Percent of total billed charges,,4109.7,4239.48,
Aspiration of bone marrow sample for diagnosis,PX-36110101,CDM,38220,CPT,361,RC,,inpatient,,,644,579.6,,0.95,,611.8,Percent of total billed charges,,,0.98,,631.12,Percent of total billed charges,,,0.95,,611.8,Percent of total billed charges,,,0.97,,624.68,Percent of total billed charges,,,0.97,,624.68,Percent of total billed charges,,,0.96,,618.24,Percent of total billed charges,,,0.95,,611.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,611.8,Percent of total billed charges,,611.8,631.12,
Aspiration of bone marrow sample for diagnosis,PX-36110101,CDM,38220,CPT,361,RC,,outpatient,,,644,579.6,,0.95,,611.8,Percent of total billed charges,,,0.98,,631.12,Percent of total billed charges,,,0.95,,611.8,Percent of total billed charges,,,0.95,,611.8,Percent of total billed charges,,,0.97,,624.68,Percent of total billed charges,,,0.96,,618.24,Percent of total billed charges,,,0.95,,611.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,611.8,Percent of total billed charges,,611.8,631.12,
Diagnostic mammography of both breasts,PX-40110004,CDM,77066,CPT,401,RC,,inpatient,,,490,441,,0.95,,465.5,Percent of total billed charges,,,0.98,,480.2,Percent of total billed charges,,,0.95,,465.5,Percent of total billed charges,,,0.97,,475.3,Percent of total billed charges,,,0.97,,475.3,Percent of total billed charges,,,0.96,,470.4,Percent of total billed charges,,,0.95,,465.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,465.5,Percent of total billed charges,,465.5,480.2,
Diagnostic mammography of both breasts,PX-40110004,CDM,77066,CPT,401,RC,,outpatient,,,490,441,,0.95,,465.5,Percent of total billed charges,,,0.98,,480.2,Percent of total billed charges,,,0.95,,465.5,Percent of total billed charges,,,0.95,,465.5,Percent of total billed charges,,,0.97,,475.3,Percent of total billed charges,,,0.96,,470.4,Percent of total billed charges,,,0.95,,465.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,465.5,Percent of total billed charges,,465.5,480.2,
Diagnostic mammography of 1 breast,PX-40110005,CDM,77065,CPT,401,RC,,inpatient,,,412,370.8,,0.95,,391.4,Percent of total billed charges,,,0.98,,403.76,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.96,,395.52,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,391.4,Percent of total billed charges,,391.4,403.76,
Diagnostic mammography of 1 breast,PX-40110005,CDM,77065,CPT,401,RC,,outpatient,,,412,370.8,,0.95,,391.4,Percent of total billed charges,,,0.98,,403.76,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.96,,395.52,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,391.4,Percent of total billed charges,,391.4,403.76,
Ultrasound scan of brain,PX-40210001,CDM,76506,CPT,402,RC,,inpatient,,,770,693,,0.95,,731.5,Percent of total billed charges,,,0.98,,754.6,Percent of total billed charges,,,0.95,,731.5,Percent of total billed charges,,,0.97,,746.9,Percent of total billed charges,,,0.97,,746.9,Percent of total billed charges,,,0.96,,739.2,Percent of total billed charges,,,0.95,,731.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,731.5,Percent of total billed charges,,731.5,754.6,
Ultrasound scan of brain,PX-40210001,CDM,76506,CPT,402,RC,,outpatient,,,770,693,,0.95,,731.5,Percent of total billed charges,,,0.98,,754.6,Percent of total billed charges,,,0.95,,731.5,Percent of total billed charges,,,0.95,,731.5,Percent of total billed charges,,,0.97,,746.9,Percent of total billed charges,,,0.96,,739.2,Percent of total billed charges,,,0.95,,731.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,731.5,Percent of total billed charges,,731.5,754.6,
Ultrasound scan of head and neck soft tissue,PX-40210004,CDM,76536,CPT,402,RC,,inpatient,,,573,515.7,,0.95,,544.35,Percent of total billed charges,,,0.98,,561.54,Percent of total billed charges,,,0.95,,544.35,Percent of total billed charges,,,0.97,,555.81,Percent of total billed charges,,,0.97,,555.81,Percent of total billed charges,,,0.96,,550.08,Percent of total billed charges,,,0.95,,544.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,544.35,Percent of total billed charges,,544.35,561.54,
Ultrasound scan of head and neck soft tissue,PX-40210004,CDM,76536,CPT,402,RC,,outpatient,,,573,515.7,,0.95,,544.35,Percent of total billed charges,,,0.98,,561.54,Percent of total billed charges,,,0.95,,544.35,Percent of total billed charges,,,0.95,,544.35,Percent of total billed charges,,,0.97,,555.81,Percent of total billed charges,,,0.96,,550.08,Percent of total billed charges,,,0.95,,544.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,544.35,Percent of total billed charges,,544.35,561.54,
Ultrasound scan of chest,PX-40210005,CDM,76604,CPT,402,RC,,inpatient,,,567,510.3,,0.95,,538.65,Percent of total billed charges,,,0.98,,555.66,Percent of total billed charges,,,0.95,,538.65,Percent of total billed charges,,,0.97,,549.99,Percent of total billed charges,,,0.97,,549.99,Percent of total billed charges,,,0.96,,544.32,Percent of total billed charges,,,0.95,,538.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,538.65,Percent of total billed charges,,538.65,555.66,
Ultrasound scan of chest,PX-40210005,CDM,76604,CPT,402,RC,,outpatient,,,567,510.3,,0.95,,538.65,Percent of total billed charges,,,0.98,,555.66,Percent of total billed charges,,,0.95,,538.65,Percent of total billed charges,,,0.95,,538.65,Percent of total billed charges,,,0.97,,549.99,Percent of total billed charges,,,0.96,,544.32,Percent of total billed charges,,,0.95,,538.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,538.65,Percent of total billed charges,,538.65,555.66,
Complete ultrasound scan of abdomen,PX-40210008,CDM,76700,CPT,402,RC,,inpatient,,,824,741.6,,0.95,,782.8,Percent of total billed charges,,,0.98,,807.52,Percent of total billed charges,,,0.95,,782.8,Percent of total billed charges,,,0.97,,799.28,Percent of total billed charges,,,0.97,,799.28,Percent of total billed charges,,,0.96,,791.04,Percent of total billed charges,,,0.95,,782.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,782.8,Percent of total billed charges,,782.8,807.52,
Complete ultrasound scan of abdomen,PX-40210008,CDM,76700,CPT,402,RC,,outpatient,,,824,741.6,,0.95,,782.8,Percent of total billed charges,,,0.98,,807.52,Percent of total billed charges,,,0.95,,782.8,Percent of total billed charges,,,0.95,,782.8,Percent of total billed charges,,,0.97,,799.28,Percent of total billed charges,,,0.96,,791.04,Percent of total billed charges,,,0.95,,782.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,782.8,Percent of total billed charges,,782.8,807.52,
Limited ultrasound scan of pelvis,PX-40210009,CDM,76857,CPT,402,RC,,inpatient,,,474,426.6,,0.95,,450.3,Percent of total billed charges,,,0.98,,464.52,Percent of total billed charges,,,0.95,,450.3,Percent of total billed charges,,,0.97,,459.78,Percent of total billed charges,,,0.97,,459.78,Percent of total billed charges,,,0.96,,455.04,Percent of total billed charges,,,0.95,,450.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,450.3,Percent of total billed charges,,450.3,464.52,
Limited ultrasound scan of pelvis,PX-40210009,CDM,76857,CPT,402,RC,,outpatient,,,474,426.6,,0.95,,450.3,Percent of total billed charges,,,0.98,,464.52,Percent of total billed charges,,,0.95,,450.3,Percent of total billed charges,,,0.95,,450.3,Percent of total billed charges,,,0.97,,459.78,Percent of total billed charges,,,0.96,,455.04,Percent of total billed charges,,,0.95,,450.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,450.3,Percent of total billed charges,,450.3,464.52,
Complete ultrasound scan behind abdominal cavity,PX-40210010,CDM,76770,CPT,402,RC,,inpatient,,,747,672.3,,0.95,,709.65,Percent of total billed charges,,,0.98,,732.06,Percent of total billed charges,,,0.95,,709.65,Percent of total billed charges,,,0.97,,724.59,Percent of total billed charges,,,0.97,,724.59,Percent of total billed charges,,,0.96,,717.12,Percent of total billed charges,,,0.95,,709.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,709.65,Percent of total billed charges,,709.65,732.06,
Complete ultrasound scan behind abdominal cavity,PX-40210010,CDM,76770,CPT,402,RC,,outpatient,,,747,672.3,,0.95,,709.65,Percent of total billed charges,,,0.98,,732.06,Percent of total billed charges,,,0.95,,709.65,Percent of total billed charges,,,0.95,,709.65,Percent of total billed charges,,,0.97,,724.59,Percent of total billed charges,,,0.96,,717.12,Percent of total billed charges,,,0.95,,709.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,709.65,Percent of total billed charges,,709.65,732.06,
Limited ultrasound scan behind abdominal cavity,PX-40210011,CDM,76775,CPT,402,RC,,inpatient,,,526,473.4,,0.95,,499.7,Percent of total billed charges,,,0.98,,515.48,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,,0.97,,510.22,Percent of total billed charges,,,0.97,,510.22,Percent of total billed charges,,,0.96,,504.96,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,499.7,Percent of total billed charges,,499.7,515.48,
Limited ultrasound scan behind abdominal cavity,PX-40210011,CDM,76775,CPT,402,RC,,outpatient,,,526,473.4,,0.95,,499.7,Percent of total billed charges,,,0.98,,515.48,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,,0.97,,510.22,Percent of total billed charges,,,0.96,,504.96,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,499.7,Percent of total billed charges,,499.7,515.48,
Ultrasound scan of transplanted kidney,PX-40210012,CDM,76776,CPT,402,RC,,inpatient,,,459,413.1,,0.95,,436.05,Percent of total billed charges,,,0.98,,449.82,Percent of total billed charges,,,0.95,,436.05,Percent of total billed charges,,,0.97,,445.23,Percent of total billed charges,,,0.97,,445.23,Percent of total billed charges,,,0.96,,440.64,Percent of total billed charges,,,0.95,,436.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,436.05,Percent of total billed charges,,436.05,449.82,
Ultrasound scan of transplanted kidney,PX-40210012,CDM,76776,CPT,402,RC,,outpatient,,,459,413.1,,0.95,,436.05,Percent of total billed charges,,,0.98,,449.82,Percent of total billed charges,,,0.95,,436.05,Percent of total billed charges,,,0.95,,436.05,Percent of total billed charges,,,0.97,,445.23,Percent of total billed charges,,,0.96,,440.64,Percent of total billed charges,,,0.95,,436.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,436.05,Percent of total billed charges,,436.05,449.82,
Ultrasound scan of spinal canal,PX-40210013,CDM,76800,CPT,402,RC,,inpatient,,,593,533.7,,0.95,,563.35,Percent of total billed charges,,,0.98,,581.14,Percent of total billed charges,,,0.95,,563.35,Percent of total billed charges,,,0.97,,575.21,Percent of total billed charges,,,0.97,,575.21,Percent of total billed charges,,,0.96,,569.28,Percent of total billed charges,,,0.95,,563.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,563.35,Percent of total billed charges,,563.35,581.14,
Ultrasound scan of spinal canal,PX-40210013,CDM,76800,CPT,402,RC,,outpatient,,,593,533.7,,0.95,,563.35,Percent of total billed charges,,,0.98,,581.14,Percent of total billed charges,,,0.95,,563.35,Percent of total billed charges,,,0.95,,563.35,Percent of total billed charges,,,0.97,,575.21,Percent of total billed charges,,,0.96,,569.28,Percent of total billed charges,,,0.95,,563.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,563.35,Percent of total billed charges,,563.35,581.14,
Ultrasound OB < 14 wks single fetus,PX-40210014,CDM,76801,CPT,402,RC,,inpatient,,,655,589.5,,0.95,,622.25,Percent of total billed charges,,,0.98,,641.9,Percent of total billed charges,,,0.95,,622.25,Percent of total billed charges,,,0.97,,635.35,Percent of total billed charges,,,0.97,,635.35,Percent of total billed charges,,,0.96,,628.8,Percent of total billed charges,,,0.95,,622.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,622.25,Percent of total billed charges,,622.25,641.9,
Ultrasound OB < 14 wks single fetus,PX-40210014,CDM,76801,CPT,402,RC,,outpatient,,,655,589.5,,0.95,,622.25,Percent of total billed charges,,,0.98,,641.9,Percent of total billed charges,,,0.95,,622.25,Percent of total billed charges,,,0.95,,622.25,Percent of total billed charges,,,0.97,,635.35,Percent of total billed charges,,,0.96,,628.8,Percent of total billed charges,,,0.95,,622.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,622.25,Percent of total billed charges,,622.25,641.9,
"Ultrasound OB < 14 wks, additional fetus",PX-40210015,CDM,76802,CPT,402,RC,,inpatient,,,568,511.2,,0.95,,539.6,Percent of total billed charges,,,0.98,,556.64,Percent of total billed charges,,,0.95,,539.6,Percent of total billed charges,,,0.97,,550.96,Percent of total billed charges,,,0.97,,550.96,Percent of total billed charges,,,0.96,,545.28,Percent of total billed charges,,,0.95,,539.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,539.6,Percent of total billed charges,,539.6,556.64,
"Ultrasound OB < 14 wks, additional fetus",PX-40210015,CDM,76802,CPT,402,RC,,outpatient,,,568,511.2,,0.95,,539.6,Percent of total billed charges,,,0.98,,556.64,Percent of total billed charges,,,0.95,,539.6,Percent of total billed charges,,,0.95,,539.6,Percent of total billed charges,,,0.97,,550.96,Percent of total billed charges,,,0.96,,545.28,Percent of total billed charges,,,0.95,,539.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,539.6,Percent of total billed charges,,539.6,556.64,
Ultrasound OB >= 14 wks single fetus,PX-40210016,CDM,76805,CPT,402,RC,,inpatient,,,582,523.8,,0.95,,552.9,Percent of total billed charges,,,0.98,,570.36,Percent of total billed charges,,,0.95,,552.9,Percent of total billed charges,,,0.97,,564.54,Percent of total billed charges,,,0.97,,564.54,Percent of total billed charges,,,0.96,,558.72,Percent of total billed charges,,,0.95,,552.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,552.9,Percent of total billed charges,,552.9,570.36,
Ultrasound OB >= 14 wks single fetus,PX-40210016,CDM,76805,CPT,402,RC,,outpatient,,,582,523.8,,0.95,,552.9,Percent of total billed charges,,,0.98,,570.36,Percent of total billed charges,,,0.95,,552.9,Percent of total billed charges,,,0.95,,552.9,Percent of total billed charges,,,0.97,,564.54,Percent of total billed charges,,,0.96,,558.72,Percent of total billed charges,,,0.95,,552.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,552.9,Percent of total billed charges,,552.9,570.36,
Ultrasound OB>= 14 wks additional fetus,PX-40210017,CDM,76810,CPT,402,RC,,inpatient,,,502,451.8,,0.95,,476.9,Percent of total billed charges,,,0.98,,491.96,Percent of total billed charges,,,0.95,,476.9,Percent of total billed charges,,,0.97,,486.94,Percent of total billed charges,,,0.97,,486.94,Percent of total billed charges,,,0.96,,481.92,Percent of total billed charges,,,0.95,,476.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,476.9,Percent of total billed charges,,476.9,491.96,
Ultrasound OB>= 14 wks additional fetus,PX-40210017,CDM,76810,CPT,402,RC,,outpatient,,,502,451.8,,0.95,,476.9,Percent of total billed charges,,,0.98,,491.96,Percent of total billed charges,,,0.95,,476.9,Percent of total billed charges,,,0.95,,476.9,Percent of total billed charges,,,0.97,,486.94,Percent of total billed charges,,,0.96,,481.92,Percent of total billed charges,,,0.95,,476.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,476.9,Percent of total billed charges,,476.9,491.96,
Ultrasound OB detailed single fetus,PX-40210018,CDM,76811,CPT,402,RC,,inpatient,,,824,741.6,,0.95,,782.8,Percent of total billed charges,,,0.98,,807.52,Percent of total billed charges,,,0.95,,782.8,Percent of total billed charges,,,0.97,,799.28,Percent of total billed charges,,,0.97,,799.28,Percent of total billed charges,,,0.96,,791.04,Percent of total billed charges,,,0.95,,782.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,782.8,Percent of total billed charges,,782.8,807.52,
Ultrasound OB detailed single fetus,PX-40210018,CDM,76811,CPT,402,RC,,outpatient,,,824,741.6,,0.95,,782.8,Percent of total billed charges,,,0.98,,807.52,Percent of total billed charges,,,0.95,,782.8,Percent of total billed charges,,,0.95,,782.8,Percent of total billed charges,,,0.97,,799.28,Percent of total billed charges,,,0.96,,791.04,Percent of total billed charges,,,0.95,,782.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,782.8,Percent of total billed charges,,782.8,807.52,
Ultrasound OB detailed single fetus,PX-40210019,CDM,76812,CPT,402,RC,,inpatient,,,579,521.1,,0.95,,550.05,Percent of total billed charges,,,0.98,,567.42,Percent of total billed charges,,,0.95,,550.05,Percent of total billed charges,,,0.97,,561.63,Percent of total billed charges,,,0.97,,561.63,Percent of total billed charges,,,0.96,,555.84,Percent of total billed charges,,,0.95,,550.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,550.05,Percent of total billed charges,,550.05,567.42,
Ultrasound OB detailed single fetus,PX-40210019,CDM,76812,CPT,402,RC,,outpatient,,,579,521.1,,0.95,,550.05,Percent of total billed charges,,,0.98,,567.42,Percent of total billed charges,,,0.95,,550.05,Percent of total billed charges,,,0.95,,550.05,Percent of total billed charges,,,0.97,,561.63,Percent of total billed charges,,,0.96,,555.84,Percent of total billed charges,,,0.95,,550.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,550.05,Percent of total billed charges,,550.05,567.42,
Ultrasound OB detailed additional fetus,PX-40210020,CDM,76813,CPT,402,RC,,inpatient,,,507,456.3,,0.95,,481.65,Percent of total billed charges,,,0.98,,496.86,Percent of total billed charges,,,0.95,,481.65,Percent of total billed charges,,,0.97,,491.79,Percent of total billed charges,,,0.97,,491.79,Percent of total billed charges,,,0.96,,486.72,Percent of total billed charges,,,0.95,,481.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,481.65,Percent of total billed charges,,481.65,496.86,
Ultrasound OB detailed additional fetus,PX-40210020,CDM,76813,CPT,402,RC,,outpatient,,,507,456.3,,0.95,,481.65,Percent of total billed charges,,,0.98,,496.86,Percent of total billed charges,,,0.95,,481.65,Percent of total billed charges,,,0.95,,481.65,Percent of total billed charges,,,0.97,,491.79,Percent of total billed charges,,,0.96,,486.72,Percent of total billed charges,,,0.95,,481.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,481.65,Percent of total billed charges,,481.65,496.86,
Ultrasound OB detailed additional fetus,PX-40210021,CDM,76814,CPT,402,RC,,inpatient,,,562,505.8,,0.95,,533.9,Percent of total billed charges,,,0.98,,550.76,Percent of total billed charges,,,0.95,,533.9,Percent of total billed charges,,,0.97,,545.14,Percent of total billed charges,,,0.97,,545.14,Percent of total billed charges,,,0.96,,539.52,Percent of total billed charges,,,0.95,,533.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,533.9,Percent of total billed charges,,533.9,550.76,
Ultrasound OB detailed additional fetus,PX-40210021,CDM,76814,CPT,402,RC,,outpatient,,,562,505.8,,0.95,,533.9,Percent of total billed charges,,,0.98,,550.76,Percent of total billed charges,,,0.95,,533.9,Percent of total billed charges,,,0.95,,533.9,Percent of total billed charges,,,0.97,,545.14,Percent of total billed charges,,,0.96,,539.52,Percent of total billed charges,,,0.95,,533.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,533.9,Percent of total billed charges,,533.9,550.76,
Ultrasound OB limited 1 or more fetuses,PX-40210022,CDM,76815,CPT,402,RC,,inpatient,,,526,473.4,,0.95,,499.7,Percent of total billed charges,,,0.98,,515.48,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,,0.97,,510.22,Percent of total billed charges,,,0.97,,510.22,Percent of total billed charges,,,0.96,,504.96,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,499.7,Percent of total billed charges,,499.7,515.48,
Ultrasound OB limited 1 or more fetuses,PX-40210022,CDM,76815,CPT,402,RC,,outpatient,,,526,473.4,,0.95,,499.7,Percent of total billed charges,,,0.98,,515.48,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,,0.97,,510.22,Percent of total billed charges,,,0.96,,504.96,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,499.7,Percent of total billed charges,,499.7,515.48,
Ultrasound OB follow up per fetus,PX-40210023,CDM,76816,CPT,402,RC,,inpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,440.8,Percent of total billed charges,,440.8,454.72,
Ultrasound OB follow up per fetus,PX-40210023,CDM,76816,CPT,402,RC,,outpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,440.8,Percent of total billed charges,,440.8,454.72,
Ultrasound of pregnant uterus,PX-40210024,CDM,76817,CPT,402,RC,,inpatient,,,335,301.5,,0.95,,318.25,Percent of total billed charges,,,0.98,,328.3,Percent of total billed charges,,,0.95,,318.25,Percent of total billed charges,,,0.97,,324.95,Percent of total billed charges,,,0.97,,324.95,Percent of total billed charges,,,0.96,,321.6,Percent of total billed charges,,,0.95,,318.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,318.25,Percent of total billed charges,,318.25,328.3,
Ultrasound of pregnant uterus,PX-40210024,CDM,76817,CPT,402,RC,,outpatient,,,335,301.5,,0.95,,318.25,Percent of total billed charges,,,0.98,,328.3,Percent of total billed charges,,,0.95,,318.25,Percent of total billed charges,,,0.95,,318.25,Percent of total billed charges,,,0.97,,324.95,Percent of total billed charges,,,0.96,,321.6,Percent of total billed charges,,,0.95,,318.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,318.25,Percent of total billed charges,,318.25,328.3,
Ultrasound and monitoring of heart of fetus,PX-40210025,CDM,76818,CPT,402,RC,,inpatient,,,490,441,,0.95,,465.5,Percent of total billed charges,,,0.98,,480.2,Percent of total billed charges,,,0.95,,465.5,Percent of total billed charges,,,0.97,,475.3,Percent of total billed charges,,,0.97,,475.3,Percent of total billed charges,,,0.96,,470.4,Percent of total billed charges,,,0.95,,465.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,465.5,Percent of total billed charges,,465.5,480.2,
Ultrasound and monitoring of heart of fetus,PX-40210025,CDM,76818,CPT,402,RC,,outpatient,,,490,441,,0.95,,465.5,Percent of total billed charges,,,0.98,,480.2,Percent of total billed charges,,,0.95,,465.5,Percent of total billed charges,,,0.95,,465.5,Percent of total billed charges,,,0.97,,475.3,Percent of total billed charges,,,0.96,,470.4,Percent of total billed charges,,,0.95,,465.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,465.5,Percent of total billed charges,,465.5,480.2,
Ultrasound scan of fetus,PX-40210026,CDM,76819,CPT,402,RC,,inpatient,,,655,589.5,,0.95,,622.25,Percent of total billed charges,,,0.98,,641.9,Percent of total billed charges,,,0.95,,622.25,Percent of total billed charges,,,0.97,,635.35,Percent of total billed charges,,,0.97,,635.35,Percent of total billed charges,,,0.96,,628.8,Percent of total billed charges,,,0.95,,622.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,622.25,Percent of total billed charges,,622.25,641.9,
Ultrasound scan of fetus,PX-40210026,CDM,76819,CPT,402,RC,,outpatient,,,655,589.5,,0.95,,622.25,Percent of total billed charges,,,0.98,,641.9,Percent of total billed charges,,,0.95,,622.25,Percent of total billed charges,,,0.95,,622.25,Percent of total billed charges,,,0.97,,635.35,Percent of total billed charges,,,0.96,,628.8,Percent of total billed charges,,,0.95,,622.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,622.25,Percent of total billed charges,,622.25,641.9,
Ultrasound scan of fetal brain artery blood flow rate,PX-40210028,CDM,76821,CPT,402,RC,,inpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,0.01,Percent of total billed charges,,0.01,0.01,
Ultrasound scan of fetal brain artery blood flow rate,PX-40210028,CDM,76821,CPT,402,RC,,outpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,0.01,Percent of total billed charges,,0.01,0.01,
"Ultrasound uterus, ovaries, tubes, cervix and pelvic area",PX-40210033,CDM,76830,CPT,402,RC,,inpatient,,,768,691.2,,0.95,,729.6,Percent of total billed charges,,,0.98,,752.64,Percent of total billed charges,,,0.95,,729.6,Percent of total billed charges,,,0.97,,744.96,Percent of total billed charges,,,0.97,,744.96,Percent of total billed charges,,,0.96,,737.28,Percent of total billed charges,,,0.95,,729.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,729.6,Percent of total billed charges,,729.6,752.64,
"Ultrasound uterus, ovaries, tubes, cervix and pelvic area",PX-40210033,CDM,76830,CPT,402,RC,,outpatient,,,768,691.2,,0.95,,729.6,Percent of total billed charges,,,0.98,,752.64,Percent of total billed charges,,,0.95,,729.6,Percent of total billed charges,,,0.95,,729.6,Percent of total billed charges,,,0.97,,744.96,Percent of total billed charges,,,0.96,,737.28,Percent of total billed charges,,,0.95,,729.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,729.6,Percent of total billed charges,,729.6,752.64,
Limited ultrasound scan of pelvis,PX-40210035,CDM,76857,CPT,402,RC,,inpatient,,,474,426.6,,0.95,,450.3,Percent of total billed charges,,,0.98,,464.52,Percent of total billed charges,,,0.95,,450.3,Percent of total billed charges,,,0.97,,459.78,Percent of total billed charges,,,0.97,,459.78,Percent of total billed charges,,,0.96,,455.04,Percent of total billed charges,,,0.95,,450.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,450.3,Percent of total billed charges,,450.3,464.52,
Limited ultrasound scan of pelvis,PX-40210035,CDM,76857,CPT,402,RC,,outpatient,,,474,426.6,,0.95,,450.3,Percent of total billed charges,,,0.98,,464.52,Percent of total billed charges,,,0.95,,450.3,Percent of total billed charges,,,0.95,,450.3,Percent of total billed charges,,,0.97,,459.78,Percent of total billed charges,,,0.96,,455.04,Percent of total billed charges,,,0.95,,450.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,450.3,Percent of total billed charges,,450.3,464.52,
Ultrasound scan of scrotum,PX-40210036,CDM,76870,CPT,402,RC,,inpatient,,,721,648.9,,0.95,,684.95,Percent of total billed charges,,,0.98,,706.58,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,0.97,,699.37,Percent of total billed charges,,,0.97,,699.37,Percent of total billed charges,,,0.96,,692.16,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,684.95,Percent of total billed charges,,684.95,706.58,
Ultrasound scan of scrotum,PX-40210036,CDM,76870,CPT,402,RC,,outpatient,,,721,648.9,,0.95,,684.95,Percent of total billed charges,,,0.98,,706.58,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,0.97,,699.37,Percent of total billed charges,,,0.96,,692.16,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,684.95,Percent of total billed charges,,684.95,706.58,
Complete ultrasound scan of joint,PX-40210041,CDM,76881,CPT,402,RC,,inpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,440.8,Percent of total billed charges,,440.8,454.72,
Complete ultrasound scan of joint,PX-40210041,CDM,76881,CPT,402,RC,,outpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,440.8,Percent of total billed charges,,440.8,454.72,
"Ultrasound joint or extremity, limited",PX-40210043,CDM,76882,CPT,402,RC,,inpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,440.8,Percent of total billed charges,,440.8,454.72,
"Ultrasound joint or extremity, limited",PX-40210043,CDM,76882,CPT,402,RC,,outpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,440.8,Percent of total billed charges,,440.8,454.72,
Ultrasonic guidance for blood vessel access,PX-40210049,CDM,76937,CPT,402,RC,,inpatient,,,361,324.9,,0.95,,342.95,Percent of total billed charges,,,0.98,,353.78,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,0.97,,350.17,Percent of total billed charges,,,0.97,,350.17,Percent of total billed charges,,,0.96,,346.56,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,342.95,Percent of total billed charges,,342.95,353.78,
Ultrasonic guidance for blood vessel access,PX-40210049,CDM,76937,CPT,402,RC,,outpatient,,,361,324.9,,0.95,,342.95,Percent of total billed charges,,,0.98,,353.78,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,0.97,,350.17,Percent of total billed charges,,,0.96,,346.56,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,342.95,Percent of total billed charges,,342.95,353.78,
Ultrasonic guidance for needle placement,PX-40210052,CDM,76942,CPT,402,RC,,inpatient,,,567,510.3,,0.95,,538.65,Percent of total billed charges,,,0.98,,555.66,Percent of total billed charges,,,0.95,,538.65,Percent of total billed charges,,,0.97,,549.99,Percent of total billed charges,,,0.97,,549.99,Percent of total billed charges,,,0.96,,544.32,Percent of total billed charges,,,0.95,,538.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,538.65,Percent of total billed charges,,538.65,555.66,
Ultrasonic guidance for needle placement,PX-40210052,CDM,76942,CPT,402,RC,,outpatient,,,567,510.3,,0.95,,538.65,Percent of total billed charges,,,0.98,,555.66,Percent of total billed charges,,,0.95,,538.65,Percent of total billed charges,,,0.95,,538.65,Percent of total billed charges,,,0.97,,549.99,Percent of total billed charges,,,0.96,,544.32,Percent of total billed charges,,,0.95,,538.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,538.65,Percent of total billed charges,,538.65,555.66,
Ultrasonic guidance for removal of amniotic fluid,PX-40210053,CDM,76946,CPT,402,RC,,inpatient,,,557,501.3,,0.95,,529.15,Percent of total billed charges,,,0.98,,545.86,Percent of total billed charges,,,0.95,,529.15,Percent of total billed charges,,,0.97,,540.29,Percent of total billed charges,,,0.97,,540.29,Percent of total billed charges,,,0.96,,534.72,Percent of total billed charges,,,0.95,,529.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,529.15,Percent of total billed charges,,529.15,545.86,
Ultrasonic guidance for removal of amniotic fluid,PX-40210053,CDM,76946,CPT,402,RC,,outpatient,,,557,501.3,,0.95,,529.15,Percent of total billed charges,,,0.98,,545.86,Percent of total billed charges,,,0.95,,529.15,Percent of total billed charges,,,0.95,,529.15,Percent of total billed charges,,,0.97,,540.29,Percent of total billed charges,,,0.96,,534.72,Percent of total billed charges,,,0.95,,529.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,529.15,Percent of total billed charges,,529.15,545.86,
Ultrasonic guidance during surgery,PX-40210059,CDM,76998,CPT,402,RC,,inpatient,,,716,644.4,,0.95,,680.2,Percent of total billed charges,,,0.98,,701.68,Percent of total billed charges,,,0.95,,680.2,Percent of total billed charges,,,0.97,,694.52,Percent of total billed charges,,,0.97,,694.52,Percent of total billed charges,,,0.96,,687.36,Percent of total billed charges,,,0.95,,680.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,680.2,Percent of total billed charges,,680.2,701.68,
Ultrasonic guidance during surgery,PX-40210059,CDM,76998,CPT,402,RC,,outpatient,,,716,644.4,,0.95,,680.2,Percent of total billed charges,,,0.98,,701.68,Percent of total billed charges,,,0.95,,680.2,Percent of total billed charges,,,0.95,,680.2,Percent of total billed charges,,,0.97,,694.52,Percent of total billed charges,,,0.96,,687.36,Percent of total billed charges,,,0.95,,680.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,680.2,Percent of total billed charges,,680.2,701.68,
Ultrasound scan of fetal umbilical artery blood flow rate,PX-40210076,CDM,76820,CPT,402,RC,,inpatient,,,480,432,,0.95,,456,Percent of total billed charges,,,0.98,,470.4,Percent of total billed charges,,,0.95,,456,Percent of total billed charges,,,0.97,,465.6,Percent of total billed charges,,,0.97,,465.6,Percent of total billed charges,,,0.96,,460.8,Percent of total billed charges,,,0.95,,456,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,456,Percent of total billed charges,,456,470.4,
Ultrasound scan of fetal umbilical artery blood flow rate,PX-40210076,CDM,76820,CPT,402,RC,,outpatient,,,480,432,,0.95,,456,Percent of total billed charges,,,0.98,,470.4,Percent of total billed charges,,,0.95,,456,Percent of total billed charges,,,0.95,,456,Percent of total billed charges,,,0.97,,465.6,Percent of total billed charges,,,0.96,,460.8,Percent of total billed charges,,,0.95,,456,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,456,Percent of total billed charges,,456,470.4,
Complete ultrasound scan of pelvis,PX-40210093,CDM,76856,CPT,402,RC,,inpatient,,,747,672.3,,0.95,,709.65,Percent of total billed charges,,,0.98,,732.06,Percent of total billed charges,,,0.95,,709.65,Percent of total billed charges,,,0.97,,724.59,Percent of total billed charges,,,0.97,,724.59,Percent of total billed charges,,,0.96,,717.12,Percent of total billed charges,,,0.95,,709.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,709.65,Percent of total billed charges,,709.65,732.06,
Complete ultrasound scan of pelvis,PX-40210093,CDM,76856,CPT,402,RC,,outpatient,,,747,672.3,,0.95,,709.65,Percent of total billed charges,,,0.98,,732.06,Percent of total billed charges,,,0.95,,709.65,Percent of total billed charges,,,0.95,,709.65,Percent of total billed charges,,,0.97,,724.59,Percent of total billed charges,,,0.96,,717.12,Percent of total billed charges,,,0.95,,709.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,709.65,Percent of total billed charges,,709.65,732.06,
Limited ultrasound scan of abdomen,PX-40210104,CDM,76705,CPT,402,RC,,inpatient,,,539,485.1,,0.95,,512.05,Percent of total billed charges,,,0.98,,528.22,Percent of total billed charges,,,0.95,,512.05,Percent of total billed charges,,,0.97,,522.83,Percent of total billed charges,,,0.97,,522.83,Percent of total billed charges,,,0.96,,517.44,Percent of total billed charges,,,0.95,,512.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,512.05,Percent of total billed charges,,512.05,528.22,
Limited ultrasound scan of abdomen,PX-40210104,CDM,76705,CPT,402,RC,,outpatient,,,539,485.1,,0.95,,512.05,Percent of total billed charges,,,0.98,,528.22,Percent of total billed charges,,,0.95,,512.05,Percent of total billed charges,,,0.95,,512.05,Percent of total billed charges,,,0.97,,522.83,Percent of total billed charges,,,0.96,,517.44,Percent of total billed charges,,,0.95,,512.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,512.05,Percent of total billed charges,,512.05,528.22,
"Ultrasound joint or extremity, limited",PX-40210112,CDM,76882,CPT,402,RC,,inpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,440.8,Percent of total billed charges,,440.8,454.72,
"Ultrasound joint or extremity, limited",PX-40210112,CDM,76882,CPT,402,RC,,outpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,440.8,Percent of total billed charges,,440.8,454.72,
Screening mammography,PX-40310004,CDM,77067,CPT,403,RC,,inpatient,,,397,357.3,,0.95,,377.15,Percent of total billed charges,,,0.98,,389.06,Percent of total billed charges,,,0.95,,377.15,Percent of total billed charges,,,0.97,,385.09,Percent of total billed charges,,,0.97,,385.09,Percent of total billed charges,,,0.96,,381.12,Percent of total billed charges,,,0.95,,377.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,377.15,Percent of total billed charges,,377.15,389.06,
Screening mammography,PX-40310004,CDM,77067,CPT,403,RC,,outpatient,,,397,357.3,,0.95,,377.15,Percent of total billed charges,,,0.98,,389.06,Percent of total billed charges,,,0.95,,377.15,Percent of total billed charges,,,0.95,,377.15,Percent of total billed charges,,,0.97,,385.09,Percent of total billed charges,,,0.96,,381.12,Percent of total billed charges,,,0.95,,377.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,377.15,Percent of total billed charges,,377.15,389.06,
Screening mammography,PX-40310005,CDM,77067,CPT,403,RC,,inpatient,,,361,324.9,,0.95,,342.95,Percent of total billed charges,,,0.98,,353.78,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,0.97,,350.17,Percent of total billed charges,,,0.97,,350.17,Percent of total billed charges,,,0.96,,346.56,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,342.95,Percent of total billed charges,,342.95,353.78,
Screening mammography,PX-40310005,CDM,77067,CPT,403,RC,,outpatient,,,361,324.9,,0.95,,342.95,Percent of total billed charges,,,0.98,,353.78,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,0.97,,350.17,Percent of total billed charges,,,0.96,,346.56,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,342.95,Percent of total billed charges,,342.95,353.78,
"Coagulation blood test, substitution, plasma fractions",PX-30510003,CDM,85732,CPT,305,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
"Coagulation blood test, substitution, plasma fractions",PX-30510003,CDM,85732,CPT,305,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
MRI scan of jaw joint,PX-61010002,CDM,70336,CPT,610,RC,,inpatient,,,2519,2267.1,,0.95,,2393.05,Percent of total billed charges,,,0.98,,2468.62,Percent of total billed charges,,,0.95,,2393.05,Percent of total billed charges,,,0.97,,2443.43,Percent of total billed charges,,,0.97,,2443.43,Percent of total billed charges,,,0.96,,2418.24,Percent of total billed charges,,,0.95,,2393.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2393.05,Percent of total billed charges,,2393.05,2468.62,
MRI scan of jaw joint,PX-61010002,CDM,70336,CPT,610,RC,,outpatient,,,2519,2267.1,,0.95,,2393.05,Percent of total billed charges,,,0.98,,2468.62,Percent of total billed charges,,,0.95,,2393.05,Percent of total billed charges,,,0.95,,2393.05,Percent of total billed charges,,,0.97,,2443.43,Percent of total billed charges,,,0.96,,2418.24,Percent of total billed charges,,,0.95,,2393.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2393.05,Percent of total billed charges,,2393.05,2468.62,
"MRI scan of bone of eye socket, face, and/or neck",PX-61010007,CDM,70543,CPT,610,RC,,inpatient,,,3348,3013.2,,0.95,,3180.6,Percent of total billed charges,,,0.98,,3281.04,Percent of total billed charges,,,0.95,,3180.6,Percent of total billed charges,,,0.97,,3247.56,Percent of total billed charges,,,0.97,,3247.56,Percent of total billed charges,,,0.96,,3214.08,Percent of total billed charges,,,0.95,,3180.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3180.6,Percent of total billed charges,,3180.6,3281.04,
"MRI scan of bone of eye socket, face, and/or neck",PX-61010007,CDM,70543,CPT,610,RC,,outpatient,,,3348,3013.2,,0.95,,3180.6,Percent of total billed charges,,,0.98,,3281.04,Percent of total billed charges,,,0.95,,3180.6,Percent of total billed charges,,,0.95,,3180.6,Percent of total billed charges,,,0.97,,3247.56,Percent of total billed charges,,,0.96,,3214.08,Percent of total billed charges,,,0.95,,3180.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3180.6,Percent of total billed charges,,3180.6,3281.04,
MRI scan of blood vessels of head without contrast,PX-61010009,CDM,70544,CPT,615,RC,,inpatient,,,3245,2920.5,,0.95,,3082.75,Percent of total billed charges,,,0.98,,3180.1,Percent of total billed charges,,,0.95,,3082.75,Percent of total billed charges,,,0.97,,3147.65,Percent of total billed charges,,,0.97,,3147.65,Percent of total billed charges,,,0.96,,3115.2,Percent of total billed charges,,,0.95,,3082.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3082.75,Percent of total billed charges,,3082.75,3180.1,
MRI scan of blood vessels of head without contrast,PX-61010009,CDM,70544,CPT,615,RC,,outpatient,,,3245,2920.5,,0.95,,3082.75,Percent of total billed charges,,,0.98,,3180.1,Percent of total billed charges,,,0.95,,3082.75,Percent of total billed charges,,,0.95,,3082.75,Percent of total billed charges,,,0.97,,3147.65,Percent of total billed charges,,,0.96,,3115.2,Percent of total billed charges,,,0.95,,3082.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3082.75,Percent of total billed charges,,3082.75,3180.1,
MRI scan of blood vessels of head with contrast,PX-61010010,CDM,70545,CPT,615,RC,,inpatient,,,2474,2226.6,,0.95,,2350.3,Percent of total billed charges,,,0.98,,2424.52,Percent of total billed charges,,,0.95,,2350.3,Percent of total billed charges,,,0.97,,2399.78,Percent of total billed charges,,,0.97,,2399.78,Percent of total billed charges,,,0.96,,2375.04,Percent of total billed charges,,,0.95,,2350.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2350.3,Percent of total billed charges,,2350.3,2424.52,
MRI scan of blood vessels of head with contrast,PX-61010010,CDM,70545,CPT,615,RC,,outpatient,,,2474,2226.6,,0.95,,2350.3,Percent of total billed charges,,,0.98,,2424.52,Percent of total billed charges,,,0.95,,2350.3,Percent of total billed charges,,,0.95,,2350.3,Percent of total billed charges,,,0.97,,2399.78,Percent of total billed charges,,,0.96,,2375.04,Percent of total billed charges,,,0.95,,2350.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2350.3,Percent of total billed charges,,2350.3,2424.52,
MRI scan of blood vessels of head before and after contrast,PX-61010012,CDM,70546,CPT,615,RC,,inpatient,,,3076,2768.4,,0.95,,2922.2,Percent of total billed charges,,,0.98,,3014.48,Percent of total billed charges,,,0.95,,2922.2,Percent of total billed charges,,,0.97,,2983.72,Percent of total billed charges,,,0.97,,2983.72,Percent of total billed charges,,,0.96,,2952.96,Percent of total billed charges,,,0.95,,2922.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2922.2,Percent of total billed charges,,2922.2,3014.48,
MRI scan of blood vessels of head before and after contrast,PX-61010012,CDM,70546,CPT,615,RC,,outpatient,,,3076,2768.4,,0.95,,2922.2,Percent of total billed charges,,,0.98,,3014.48,Percent of total billed charges,,,0.95,,2922.2,Percent of total billed charges,,,0.95,,2922.2,Percent of total billed charges,,,0.97,,2983.72,Percent of total billed charges,,,0.96,,2952.96,Percent of total billed charges,,,0.95,,2922.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2922.2,Percent of total billed charges,,2922.2,3014.48,
MRI scan of blood vessels of neck without contrast,PX-61010013,CDM,70547,CPT,615,RC,,inpatient,,,3271,2943.9,,0.95,,3107.45,Percent of total billed charges,,,0.98,,3205.58,Percent of total billed charges,,,0.95,,3107.45,Percent of total billed charges,,,0.97,,3172.87,Percent of total billed charges,,,0.97,,3172.87,Percent of total billed charges,,,0.96,,3140.16,Percent of total billed charges,,,0.95,,3107.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3107.45,Percent of total billed charges,,3107.45,3205.58,
MRI scan of blood vessels of neck without contrast,PX-61010013,CDM,70547,CPT,615,RC,,outpatient,,,3271,2943.9,,0.95,,3107.45,Percent of total billed charges,,,0.98,,3205.58,Percent of total billed charges,,,0.95,,3107.45,Percent of total billed charges,,,0.95,,3107.45,Percent of total billed charges,,,0.97,,3172.87,Percent of total billed charges,,,0.96,,3140.16,Percent of total billed charges,,,0.95,,3107.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3107.45,Percent of total billed charges,,3107.45,3205.58,
MRI scan of blood vessels of neck with contrast,PX-61010014,CDM,70548,CPT,615,RC,,inpatient,,,2517,2265.3,,0.95,,2391.15,Percent of total billed charges,,,0.98,,2466.66,Percent of total billed charges,,,0.95,,2391.15,Percent of total billed charges,,,0.97,,2441.49,Percent of total billed charges,,,0.97,,2441.49,Percent of total billed charges,,,0.96,,2416.32,Percent of total billed charges,,,0.95,,2391.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2391.15,Percent of total billed charges,,2391.15,2466.66,
MRI scan of blood vessels of neck with contrast,PX-61010014,CDM,70548,CPT,615,RC,,outpatient,,,2517,2265.3,,0.95,,2391.15,Percent of total billed charges,,,0.98,,2466.66,Percent of total billed charges,,,0.95,,2391.15,Percent of total billed charges,,,0.95,,2391.15,Percent of total billed charges,,,0.97,,2441.49,Percent of total billed charges,,,0.96,,2416.32,Percent of total billed charges,,,0.95,,2391.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2391.15,Percent of total billed charges,,2391.15,2466.66,
MRI scan of blood vessels of neck before and after contrast,PX-61010015,CDM,70549,CPT,615,RC,,inpatient,,,4573,4115.7,,0.95,,4344.35,Percent of total billed charges,,,0.98,,4481.54,Percent of total billed charges,,,0.95,,4344.35,Percent of total billed charges,,,0.97,,4435.81,Percent of total billed charges,,,0.97,,4435.81,Percent of total billed charges,,,0.96,,4390.08,Percent of total billed charges,,,0.95,,4344.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4344.35,Percent of total billed charges,,4344.35,4481.54,
MRI scan of blood vessels of neck before and after contrast,PX-61010015,CDM,70549,CPT,615,RC,,outpatient,,,4573,4115.7,,0.95,,4344.35,Percent of total billed charges,,,0.98,,4481.54,Percent of total billed charges,,,0.95,,4344.35,Percent of total billed charges,,,0.95,,4344.35,Percent of total billed charges,,,0.97,,4435.81,Percent of total billed charges,,,0.96,,4390.08,Percent of total billed charges,,,0.95,,4344.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4344.35,Percent of total billed charges,,4344.35,4481.54,
MRI scan of chest without contrast,PX-61010019,CDM,71550,CPT,610,RC,,inpatient,,,2754,2478.6,,0.95,,2616.3,Percent of total billed charges,,,0.98,,2698.92,Percent of total billed charges,,,0.95,,2616.3,Percent of total billed charges,,,0.97,,2671.38,Percent of total billed charges,,,0.97,,2671.38,Percent of total billed charges,,,0.96,,2643.84,Percent of total billed charges,,,0.95,,2616.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2616.3,Percent of total billed charges,,2616.3,2698.92,
MRI scan of chest without contrast,PX-61010019,CDM,71550,CPT,610,RC,,outpatient,,,2754,2478.6,,0.95,,2616.3,Percent of total billed charges,,,0.98,,2698.92,Percent of total billed charges,,,0.95,,2616.3,Percent of total billed charges,,,0.95,,2616.3,Percent of total billed charges,,,0.97,,2671.38,Percent of total billed charges,,,0.96,,2643.84,Percent of total billed charges,,,0.95,,2616.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2616.3,Percent of total billed charges,,2616.3,2698.92,
MRI scan of chest with contrast,PX-61010022,CDM,71551,CPT,610,RC,,inpatient,,,2925,2632.5,,0.95,,2778.75,Percent of total billed charges,,,0.98,,2866.5,Percent of total billed charges,,,0.95,,2778.75,Percent of total billed charges,,,0.97,,2837.25,Percent of total billed charges,,,0.97,,2837.25,Percent of total billed charges,,,0.96,,2808,Percent of total billed charges,,,0.95,,2778.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2778.75,Percent of total billed charges,,2778.75,2866.5,
MRI scan of chest with contrast,PX-61010022,CDM,71551,CPT,610,RC,,outpatient,,,2925,2632.5,,0.95,,2778.75,Percent of total billed charges,,,0.98,,2866.5,Percent of total billed charges,,,0.95,,2778.75,Percent of total billed charges,,,0.95,,2778.75,Percent of total billed charges,,,0.97,,2837.25,Percent of total billed charges,,,0.96,,2808,Percent of total billed charges,,,0.95,,2778.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2778.75,Percent of total billed charges,,2778.75,2866.5,
MRI scan of chest before and after contrast,PX-61010025,CDM,71552,CPT,610,RC,,inpatient,,,3863,3476.7,,0.95,,3669.85,Percent of total billed charges,,,0.98,,3785.74,Percent of total billed charges,,,0.95,,3669.85,Percent of total billed charges,,,0.97,,3747.11,Percent of total billed charges,,,0.97,,3747.11,Percent of total billed charges,,,0.96,,3708.48,Percent of total billed charges,,,0.95,,3669.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3669.85,Percent of total billed charges,,3669.85,3785.74,
MRI scan of chest before and after contrast,PX-61010025,CDM,71552,CPT,610,RC,,outpatient,,,3863,3476.7,,0.95,,3669.85,Percent of total billed charges,,,0.98,,3785.74,Percent of total billed charges,,,0.95,,3669.85,Percent of total billed charges,,,0.95,,3669.85,Percent of total billed charges,,,0.97,,3747.11,Percent of total billed charges,,,0.96,,3708.48,Percent of total billed charges,,,0.95,,3669.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3669.85,Percent of total billed charges,,3669.85,3785.74,
MRI scan of pelvis without contrast,PX-61010029,CDM,72195,CPT,610,RC,,inpatient,,,2524,2271.6,,0.95,,2397.8,Percent of total billed charges,,,0.98,,2473.52,Percent of total billed charges,,,0.95,,2397.8,Percent of total billed charges,,,0.97,,2448.28,Percent of total billed charges,,,0.97,,2448.28,Percent of total billed charges,,,0.96,,2423.04,Percent of total billed charges,,,0.95,,2397.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2397.8,Percent of total billed charges,,2397.8,2473.52,
MRI scan of pelvis without contrast,PX-61010029,CDM,72195,CPT,610,RC,,outpatient,,,2524,2271.6,,0.95,,2397.8,Percent of total billed charges,,,0.98,,2473.52,Percent of total billed charges,,,0.95,,2397.8,Percent of total billed charges,,,0.95,,2397.8,Percent of total billed charges,,,0.97,,2448.28,Percent of total billed charges,,,0.96,,2423.04,Percent of total billed charges,,,0.95,,2397.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2397.8,Percent of total billed charges,,2397.8,2473.52,
MRI scan of pelvis with contrast,PX-61010038,CDM,72196,CPT,610,RC,,inpatient,,,3592,3232.8,,0.95,,3412.4,Percent of total billed charges,,,0.98,,3520.16,Percent of total billed charges,,,0.95,,3412.4,Percent of total billed charges,,,0.97,,3484.24,Percent of total billed charges,,,0.97,,3484.24,Percent of total billed charges,,,0.96,,3448.32,Percent of total billed charges,,,0.95,,3412.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3412.4,Percent of total billed charges,,3412.4,3520.16,
MRI scan of pelvis with contrast,PX-61010038,CDM,72196,CPT,610,RC,,outpatient,,,3592,3232.8,,0.95,,3412.4,Percent of total billed charges,,,0.98,,3520.16,Percent of total billed charges,,,0.95,,3412.4,Percent of total billed charges,,,0.95,,3412.4,Percent of total billed charges,,,0.97,,3484.24,Percent of total billed charges,,,0.96,,3448.32,Percent of total billed charges,,,0.95,,3412.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3412.4,Percent of total billed charges,,3412.4,3520.16,
MRI scan of pelvis before and after contrast,PX-61010044,CDM,72197,CPT,610,RC,,inpatient,,,3142,2827.8,,0.95,,2984.9,Percent of total billed charges,,,0.98,,3079.16,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,0.97,,3047.74,Percent of total billed charges,,,0.97,,3047.74,Percent of total billed charges,,,0.96,,3016.32,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2984.9,Percent of total billed charges,,2984.9,3079.16,
MRI scan of pelvis before and after contrast,PX-61010044,CDM,72197,CPT,610,RC,,outpatient,,,3142,2827.8,,0.95,,2984.9,Percent of total billed charges,,,0.98,,3079.16,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,0.97,,3047.74,Percent of total billed charges,,,0.96,,3016.32,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2984.9,Percent of total billed charges,,2984.9,3079.16,
MRI scan of leg before and after contrast,PX-61010053,CDM,73720,CPT,610,RC,,inpatient,,,3142,2827.8,,0.95,,2984.9,Percent of total billed charges,,,0.98,,3079.16,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,0.97,,3047.74,Percent of total billed charges,,,0.97,,3047.74,Percent of total billed charges,,,0.96,,3016.32,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2984.9,Percent of total billed charges,,2984.9,3079.16,
MRI scan of leg before and after contrast,PX-61010053,CDM,73720,CPT,610,RC,,outpatient,,,3142,2827.8,,0.95,,2984.9,Percent of total billed charges,,,0.98,,3079.16,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,0.97,,3047.74,Percent of total billed charges,,,0.96,,3016.32,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2984.9,Percent of total billed charges,,2984.9,3079.16,
MRI scan of arm without contrast,PX-61010054,CDM,73218,CPT,610,RC,,inpatient,,,2936,2642.4,,0.95,,2789.2,Percent of total billed charges,,,0.98,,2877.28,Percent of total billed charges,,,0.95,,2789.2,Percent of total billed charges,,,0.97,,2847.92,Percent of total billed charges,,,0.97,,2847.92,Percent of total billed charges,,,0.96,,2818.56,Percent of total billed charges,,,0.95,,2789.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2789.2,Percent of total billed charges,,2789.2,2877.28,
MRI scan of arm without contrast,PX-61010054,CDM,73218,CPT,610,RC,,outpatient,,,2936,2642.4,,0.95,,2789.2,Percent of total billed charges,,,0.98,,2877.28,Percent of total billed charges,,,0.95,,2789.2,Percent of total billed charges,,,0.95,,2789.2,Percent of total billed charges,,,0.97,,2847.92,Percent of total billed charges,,,0.96,,2818.56,Percent of total billed charges,,,0.95,,2789.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2789.2,Percent of total billed charges,,2789.2,2877.28,
MRI scan of leg with contrast,PX-61010057,CDM,73719,CPT,610,RC,,inpatient,,,3144,2829.6,,0.95,,2986.8,Percent of total billed charges,,,0.98,,3081.12,Percent of total billed charges,,,0.95,,2986.8,Percent of total billed charges,,,0.97,,3049.68,Percent of total billed charges,,,0.97,,3049.68,Percent of total billed charges,,,0.96,,3018.24,Percent of total billed charges,,,0.95,,2986.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2986.8,Percent of total billed charges,,2986.8,3081.12,
MRI scan of leg with contrast,PX-61010057,CDM,73719,CPT,610,RC,,outpatient,,,3144,2829.6,,0.95,,2986.8,Percent of total billed charges,,,0.98,,3081.12,Percent of total billed charges,,,0.95,,2986.8,Percent of total billed charges,,,0.95,,2986.8,Percent of total billed charges,,,0.97,,3049.68,Percent of total billed charges,,,0.96,,3018.24,Percent of total billed charges,,,0.95,,2986.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2986.8,Percent of total billed charges,,2986.8,3081.12,
MRI scan of arm before and after contrast,PX-61010059,CDM,73220,CPT,610,RC,,inpatient,,,2936,2642.4,,0.95,,2789.2,Percent of total billed charges,,,0.98,,2877.28,Percent of total billed charges,,,0.95,,2789.2,Percent of total billed charges,,,0.97,,2847.92,Percent of total billed charges,,,0.97,,2847.92,Percent of total billed charges,,,0.96,,2818.56,Percent of total billed charges,,,0.95,,2789.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2789.2,Percent of total billed charges,,2789.2,2877.28,
MRI scan of arm before and after contrast,PX-61010059,CDM,73220,CPT,610,RC,,outpatient,,,2936,2642.4,,0.95,,2789.2,Percent of total billed charges,,,0.98,,2877.28,Percent of total billed charges,,,0.95,,2789.2,Percent of total billed charges,,,0.95,,2789.2,Percent of total billed charges,,,0.97,,2847.92,Percent of total billed charges,,,0.96,,2818.56,Percent of total billed charges,,,0.95,,2789.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2789.2,Percent of total billed charges,,2789.2,2877.28,
MRI scan of arm joint without contrast,PX-61010063,CDM,73221,CPT,610,RC,,inpatient,,,2472,2224.8,,0.95,,2348.4,Percent of total billed charges,,,0.98,,2422.56,Percent of total billed charges,,,0.95,,2348.4,Percent of total billed charges,,,0.97,,2397.84,Percent of total billed charges,,,0.97,,2397.84,Percent of total billed charges,,,0.96,,2373.12,Percent of total billed charges,,,0.95,,2348.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2348.4,Percent of total billed charges,,2348.4,2422.56,
MRI scan of arm joint without contrast,PX-61010063,CDM,73221,CPT,610,RC,,outpatient,,,2472,2224.8,,0.95,,2348.4,Percent of total billed charges,,,0.98,,2422.56,Percent of total billed charges,,,0.95,,2348.4,Percent of total billed charges,,,0.95,,2348.4,Percent of total billed charges,,,0.97,,2397.84,Percent of total billed charges,,,0.96,,2373.12,Percent of total billed charges,,,0.95,,2348.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2348.4,Percent of total billed charges,,2348.4,2422.56,
MRI scan of leg without contrast,PX-61010065,CDM,73718,CPT,610,RC,,inpatient,,,2627,2364.3,,0.95,,2495.65,Percent of total billed charges,,,0.98,,2574.46,Percent of total billed charges,,,0.95,,2495.65,Percent of total billed charges,,,0.97,,2548.19,Percent of total billed charges,,,0.97,,2548.19,Percent of total billed charges,,,0.96,,2521.92,Percent of total billed charges,,,0.95,,2495.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2495.65,Percent of total billed charges,,2495.65,2574.46,
MRI scan of leg without contrast,PX-61010065,CDM,73718,CPT,610,RC,,outpatient,,,2627,2364.3,,0.95,,2495.65,Percent of total billed charges,,,0.98,,2574.46,Percent of total billed charges,,,0.95,,2495.65,Percent of total billed charges,,,0.95,,2495.65,Percent of total billed charges,,,0.97,,2548.19,Percent of total billed charges,,,0.96,,2521.92,Percent of total billed charges,,,0.95,,2495.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2495.65,Percent of total billed charges,,2495.65,2574.46,
MRI scan of arm joint with contrast,PX-61010066,CDM,73222,CPT,610,RC,,inpatient,,,3144,2829.6,,0.95,,2986.8,Percent of total billed charges,,,0.98,,3081.12,Percent of total billed charges,,,0.95,,2986.8,Percent of total billed charges,,,0.97,,3049.68,Percent of total billed charges,,,0.97,,3049.68,Percent of total billed charges,,,0.96,,3018.24,Percent of total billed charges,,,0.95,,2986.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2986.8,Percent of total billed charges,,2986.8,3081.12,
MRI scan of arm joint with contrast,PX-61010066,CDM,73222,CPT,610,RC,,outpatient,,,3144,2829.6,,0.95,,2986.8,Percent of total billed charges,,,0.98,,3081.12,Percent of total billed charges,,,0.95,,2986.8,Percent of total billed charges,,,0.95,,2986.8,Percent of total billed charges,,,0.97,,3049.68,Percent of total billed charges,,,0.96,,3018.24,Percent of total billed charges,,,0.95,,2986.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2986.8,Percent of total billed charges,,2986.8,3081.12,
MRI scan of arm joint before and after contrast,PX-61010068,CDM,73223,CPT,610,RC,,inpatient,,,3142,2827.8,,0.95,,2984.9,Percent of total billed charges,,,0.98,,3079.16,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,0.97,,3047.74,Percent of total billed charges,,,0.97,,3047.74,Percent of total billed charges,,,0.96,,3016.32,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2984.9,Percent of total billed charges,,2984.9,3079.16,
MRI scan of arm joint before and after contrast,PX-61010068,CDM,73223,CPT,610,RC,,outpatient,,,3142,2827.8,,0.95,,2984.9,Percent of total billed charges,,,0.98,,3079.16,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,0.97,,3047.74,Percent of total billed charges,,,0.96,,3016.32,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2984.9,Percent of total billed charges,,2984.9,3079.16,
MRI scan of leg joint without contrast,PX-61010075,CDM,73721,CPT,610,RC,,inpatient,,,2653,2387.7,,0.95,,2520.35,Percent of total billed charges,,,0.98,,2599.94,Percent of total billed charges,,,0.95,,2520.35,Percent of total billed charges,,,0.97,,2573.41,Percent of total billed charges,,,0.97,,2573.41,Percent of total billed charges,,,0.96,,2546.88,Percent of total billed charges,,,0.95,,2520.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2520.35,Percent of total billed charges,,2520.35,2599.94,
MRI scan of leg joint without contrast,PX-61010075,CDM,73721,CPT,610,RC,,outpatient,,,2653,2387.7,,0.95,,2520.35,Percent of total billed charges,,,0.98,,2599.94,Percent of total billed charges,,,0.95,,2520.35,Percent of total billed charges,,,0.95,,2520.35,Percent of total billed charges,,,0.97,,2573.41,Percent of total billed charges,,,0.96,,2546.88,Percent of total billed charges,,,0.95,,2520.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2520.35,Percent of total billed charges,,2520.35,2599.94,
MRI scan of leg joint with contrast,PX-61010077,CDM,73722,CPT,610,RC,,inpatient,,,3052,2746.8,,0.95,,2899.4,Percent of total billed charges,,,0.98,,2990.96,Percent of total billed charges,,,0.95,,2899.4,Percent of total billed charges,,,0.97,,2960.44,Percent of total billed charges,,,0.97,,2960.44,Percent of total billed charges,,,0.96,,2929.92,Percent of total billed charges,,,0.95,,2899.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2899.4,Percent of total billed charges,,2899.4,2990.96,
MRI scan of leg joint with contrast,PX-61010077,CDM,73722,CPT,610,RC,,outpatient,,,3052,2746.8,,0.95,,2899.4,Percent of total billed charges,,,0.98,,2990.96,Percent of total billed charges,,,0.95,,2899.4,Percent of total billed charges,,,0.95,,2899.4,Percent of total billed charges,,,0.97,,2960.44,Percent of total billed charges,,,0.96,,2929.92,Percent of total billed charges,,,0.95,,2899.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2899.4,Percent of total billed charges,,2899.4,2990.96,
MRI scan of leg joint before and after contrast,PX-61010079,CDM,73723,CPT,610,RC,,inpatient,,,3142,2827.8,,0.95,,2984.9,Percent of total billed charges,,,0.98,,3079.16,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,0.97,,3047.74,Percent of total billed charges,,,0.97,,3047.74,Percent of total billed charges,,,0.96,,3016.32,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2984.9,Percent of total billed charges,,2984.9,3079.16,
MRI scan of leg joint before and after contrast,PX-61010079,CDM,73723,CPT,610,RC,,outpatient,,,3142,2827.8,,0.95,,2984.9,Percent of total billed charges,,,0.98,,3079.16,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,0.97,,3047.74,Percent of total billed charges,,,0.96,,3016.32,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2984.9,Percent of total billed charges,,2984.9,3079.16,
MRI scan of abdomen without contrast,PX-61010083,CDM,74181,CPT,610,RC,,inpatient,,,3142,2827.8,,0.95,,2984.9,Percent of total billed charges,,,0.98,,3079.16,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,0.97,,3047.74,Percent of total billed charges,,,0.97,,3047.74,Percent of total billed charges,,,0.96,,3016.32,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2984.9,Percent of total billed charges,,2984.9,3079.16,
MRI scan of abdomen without contrast,PX-61010083,CDM,74181,CPT,610,RC,,outpatient,,,3142,2827.8,,0.95,,2984.9,Percent of total billed charges,,,0.98,,3079.16,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,0.97,,3047.74,Percent of total billed charges,,,0.96,,3016.32,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2984.9,Percent of total billed charges,,2984.9,3079.16,
MRI scan of abdomen with contrast,PX-61010085,CDM,74182,CPT,610,RC,,inpatient,,,3756,3380.4,,0.95,,3568.2,Percent of total billed charges,,,0.98,,3680.88,Percent of total billed charges,,,0.95,,3568.2,Percent of total billed charges,,,0.97,,3643.32,Percent of total billed charges,,,0.97,,3643.32,Percent of total billed charges,,,0.96,,3605.76,Percent of total billed charges,,,0.95,,3568.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3568.2,Percent of total billed charges,,3568.2,3680.88,
MRI scan of abdomen with contrast,PX-61010085,CDM,74182,CPT,610,RC,,outpatient,,,3756,3380.4,,0.95,,3568.2,Percent of total billed charges,,,0.98,,3680.88,Percent of total billed charges,,,0.95,,3568.2,Percent of total billed charges,,,0.95,,3568.2,Percent of total billed charges,,,0.97,,3643.32,Percent of total billed charges,,,0.96,,3605.76,Percent of total billed charges,,,0.95,,3568.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3568.2,Percent of total billed charges,,3568.2,3680.88,
MRI scan of abdomen before and after contrast,PX-61010087,CDM,74183,CPT,610,RC,,inpatient,,,3142,2827.8,,0.95,,2984.9,Percent of total billed charges,,,0.98,,3079.16,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,0.97,,3047.74,Percent of total billed charges,,,0.97,,3047.74,Percent of total billed charges,,,0.96,,3016.32,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2984.9,Percent of total billed charges,,2984.9,3079.16,
MRI scan of abdomen before and after contrast,PX-61010087,CDM,74183,CPT,610,RC,,outpatient,,,3142,2827.8,,0.95,,2984.9,Percent of total billed charges,,,0.98,,3079.16,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,0.97,,3047.74,Percent of total billed charges,,,0.96,,3016.32,Percent of total billed charges,,,0.95,,2984.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2984.9,Percent of total billed charges,,2984.9,3079.16,
MRI scan of blood vessels of leg,PX-61010116,CDM,73725,CPT,616,RC,,inpatient,,,3225,2902.5,,0.95,,3063.75,Percent of total billed charges,,,0.98,,3160.5,Percent of total billed charges,,,0.95,,3063.75,Percent of total billed charges,,,0.97,,3128.25,Percent of total billed charges,,,0.97,,3128.25,Percent of total billed charges,,,0.96,,3096,Percent of total billed charges,,,0.95,,3063.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3063.75,Percent of total billed charges,,3063.75,3160.5,
MRI scan of blood vessels of leg,PX-61010116,CDM,73725,CPT,616,RC,,outpatient,,,3225,2902.5,,0.95,,3063.75,Percent of total billed charges,,,0.98,,3160.5,Percent of total billed charges,,,0.95,,3063.75,Percent of total billed charges,,,0.95,,3063.75,Percent of total billed charges,,,0.97,,3128.25,Percent of total billed charges,,,0.96,,3096,Percent of total billed charges,,,0.95,,3063.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3063.75,Percent of total billed charges,,3063.75,3160.5,
MRI scan of blood vessels of spinal canal,PX-61010120,CDM,72159,CPT,618,RC,,inpatient,,,2929,2636.1,,0.95,,2782.55,Percent of total billed charges,,,0.98,,2870.42,Percent of total billed charges,,,0.95,,2782.55,Percent of total billed charges,,,0.97,,2841.13,Percent of total billed charges,,,0.97,,2841.13,Percent of total billed charges,,,0.96,,2811.84,Percent of total billed charges,,,0.95,,2782.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2782.55,Percent of total billed charges,,2782.55,2870.42,
MRI scan of blood vessels of spinal canal,PX-61010120,CDM,72159,CPT,618,RC,,outpatient,,,2929,2636.1,,0.95,,2782.55,Percent of total billed charges,,,0.98,,2870.42,Percent of total billed charges,,,0.95,,2782.55,Percent of total billed charges,,,0.95,,2782.55,Percent of total billed charges,,,0.97,,2841.13,Percent of total billed charges,,,0.96,,2811.84,Percent of total billed charges,,,0.95,,2782.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2782.55,Percent of total billed charges,,2782.55,2870.42,
MRI scan of arm with contrast,PX-61010137,CDM,73219,CPT,610,RC,,inpatient,,,2995,2695.5,,0.95,,2845.25,Percent of total billed charges,,,0.98,,2935.1,Percent of total billed charges,,,0.95,,2845.25,Percent of total billed charges,,,0.97,,2905.15,Percent of total billed charges,,,0.97,,2905.15,Percent of total billed charges,,,0.96,,2875.2,Percent of total billed charges,,,0.95,,2845.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2845.25,Percent of total billed charges,,2845.25,2935.1,
MRI scan of arm with contrast,PX-61010137,CDM,73219,CPT,610,RC,,outpatient,,,2995,2695.5,,0.95,,2845.25,Percent of total billed charges,,,0.98,,2935.1,Percent of total billed charges,,,0.95,,2845.25,Percent of total billed charges,,,0.95,,2845.25,Percent of total billed charges,,,0.97,,2905.15,Percent of total billed charges,,,0.96,,2875.2,Percent of total billed charges,,,0.95,,2845.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2845.25,Percent of total billed charges,,2845.25,2935.1,
"MRI scan of bone of eye socket, face, neck w/contrast",PX-61010142,CDM,70540,CPT,610,RC,,inpatient,,,2575,2317.5,,0.95,,2446.25,Percent of total billed charges,,,0.98,,2523.5,Percent of total billed charges,,,0.95,,2446.25,Percent of total billed charges,,,0.97,,2497.75,Percent of total billed charges,,,0.97,,2497.75,Percent of total billed charges,,,0.96,,2472,Percent of total billed charges,,,0.95,,2446.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2446.25,Percent of total billed charges,,2446.25,2523.5,
"MRI scan of bone of eye socket, face, neck w/contrast",PX-61010142,CDM,70540,CPT,610,RC,,outpatient,,,2575,2317.5,,0.95,,2446.25,Percent of total billed charges,,,0.98,,2523.5,Percent of total billed charges,,,0.95,,2446.25,Percent of total billed charges,,,0.95,,2446.25,Percent of total billed charges,,,0.97,,2497.75,Percent of total billed charges,,,0.96,,2472,Percent of total billed charges,,,0.95,,2446.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2446.25,Percent of total billed charges,,2446.25,2523.5,
MRI scan of blood vessels of chest,PX-61010145,CDM,71555,CPT,610,RC,,inpatient,,,3730,3357,,0.95,,3543.5,Percent of total billed charges,,,0.98,,3655.4,Percent of total billed charges,,,0.95,,3543.5,Percent of total billed charges,,,0.97,,3618.1,Percent of total billed charges,,,0.97,,3618.1,Percent of total billed charges,,,0.96,,3580.8,Percent of total billed charges,,,0.95,,3543.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3543.5,Percent of total billed charges,,3543.5,3655.4,
MRI scan of blood vessels of chest,PX-61010145,CDM,71555,CPT,610,RC,,outpatient,,,3730,3357,,0.95,,3543.5,Percent of total billed charges,,,0.98,,3655.4,Percent of total billed charges,,,0.95,,3543.5,Percent of total billed charges,,,0.95,,3543.5,Percent of total billed charges,,,0.97,,3618.1,Percent of total billed charges,,,0.96,,3580.8,Percent of total billed charges,,,0.95,,3543.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3543.5,Percent of total billed charges,,3543.5,3655.4,
MRI scan of blood vessels of abdomen,PX-61010237,CDM,74185,CPT,618,RC,,inpatient,,,3288,2959.2,,0.95,,3123.6,Percent of total billed charges,,,0.98,,3222.24,Percent of total billed charges,,,0.95,,3123.6,Percent of total billed charges,,,0.97,,3189.36,Percent of total billed charges,,,0.97,,3189.36,Percent of total billed charges,,,0.96,,3156.48,Percent of total billed charges,,,0.95,,3123.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3123.6,Percent of total billed charges,,3123.6,3222.24,
MRI scan of blood vessels of abdomen,PX-61010237,CDM,74185,CPT,618,RC,,outpatient,,,3288,2959.2,,0.95,,3123.6,Percent of total billed charges,,,0.98,,3222.24,Percent of total billed charges,,,0.95,,3123.6,Percent of total billed charges,,,0.95,,3123.6,Percent of total billed charges,,,0.97,,3189.36,Percent of total billed charges,,,0.96,,3156.48,Percent of total billed charges,,,0.95,,3123.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3123.6,Percent of total billed charges,,3123.6,3222.24,
MRI scan of brain without contrast,PX-61110001,CDM,70551,CPT,611,RC,,inpatient,,,2730,2457,,0.95,,2593.5,Percent of total billed charges,,,0.98,,2675.4,Percent of total billed charges,,,0.95,,2593.5,Percent of total billed charges,,,0.97,,2648.1,Percent of total billed charges,,,0.97,,2648.1,Percent of total billed charges,,,0.96,,2620.8,Percent of total billed charges,,,0.95,,2593.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2593.5,Percent of total billed charges,,2593.5,2675.4,
MRI scan of brain without contrast,PX-61110001,CDM,70551,CPT,611,RC,,outpatient,,,2730,2457,,0.95,,2593.5,Percent of total billed charges,,,0.98,,2675.4,Percent of total billed charges,,,0.95,,2593.5,Percent of total billed charges,,,0.95,,2593.5,Percent of total billed charges,,,0.97,,2648.1,Percent of total billed charges,,,0.96,,2620.8,Percent of total billed charges,,,0.95,,2593.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2593.5,Percent of total billed charges,,2593.5,2675.4,
MRI scan of brain with contrast,PX-61110007,CDM,70552,CPT,611,RC,,inpatient,,,3985,3586.5,,0.95,,3785.75,Percent of total billed charges,,,0.98,,3905.3,Percent of total billed charges,,,0.95,,3785.75,Percent of total billed charges,,,0.97,,3865.45,Percent of total billed charges,,,0.97,,3865.45,Percent of total billed charges,,,0.96,,3825.6,Percent of total billed charges,,,0.95,,3785.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3785.75,Percent of total billed charges,,3785.75,3905.3,
MRI scan of brain with contrast,PX-61110007,CDM,70552,CPT,611,RC,,outpatient,,,3985,3586.5,,0.95,,3785.75,Percent of total billed charges,,,0.98,,3905.3,Percent of total billed charges,,,0.95,,3785.75,Percent of total billed charges,,,0.95,,3785.75,Percent of total billed charges,,,0.97,,3865.45,Percent of total billed charges,,,0.96,,3825.6,Percent of total billed charges,,,0.95,,3785.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3785.75,Percent of total billed charges,,3785.75,3905.3,
MRI scan of brain before and after contrast,PX-61110015,CDM,70553,CPT,611,RC,,inpatient,,,3863,3476.7,,0.95,,3669.85,Percent of total billed charges,,,0.98,,3785.74,Percent of total billed charges,,,0.95,,3669.85,Percent of total billed charges,,,0.97,,3747.11,Percent of total billed charges,,,0.97,,3747.11,Percent of total billed charges,,,0.96,,3708.48,Percent of total billed charges,,,0.95,,3669.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3669.85,Percent of total billed charges,,3669.85,3785.74,
MRI scan of brain before and after contrast,PX-61110015,CDM,70553,CPT,611,RC,,outpatient,,,3863,3476.7,,0.95,,3669.85,Percent of total billed charges,,,0.98,,3785.74,Percent of total billed charges,,,0.95,,3669.85,Percent of total billed charges,,,0.95,,3669.85,Percent of total billed charges,,,0.97,,3747.11,Percent of total billed charges,,,0.96,,3708.48,Percent of total billed charges,,,0.95,,3669.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3669.85,Percent of total billed charges,,3669.85,3785.74,
MRI scan of upper spinal canal without contrast,PX-61210001,CDM,72141,CPT,612,RC,,inpatient,,,2678,2410.2,,0.95,,2544.1,Percent of total billed charges,,,0.98,,2624.44,Percent of total billed charges,,,0.95,,2544.1,Percent of total billed charges,,,0.97,,2597.66,Percent of total billed charges,,,0.97,,2597.66,Percent of total billed charges,,,0.96,,2570.88,Percent of total billed charges,,,0.95,,2544.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2544.1,Percent of total billed charges,,2544.1,2624.44,
MRI scan of upper spinal canal without contrast,PX-61210001,CDM,72141,CPT,612,RC,,outpatient,,,2678,2410.2,,0.95,,2544.1,Percent of total billed charges,,,0.98,,2624.44,Percent of total billed charges,,,0.95,,2544.1,Percent of total billed charges,,,0.95,,2544.1,Percent of total billed charges,,,0.97,,2597.66,Percent of total billed charges,,,0.96,,2570.88,Percent of total billed charges,,,0.95,,2544.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2544.1,Percent of total billed charges,,2544.1,2624.44,
MRI scan of upper spinal canal with contrast,PX-61210003,CDM,72142,CPT,612,RC,,inpatient,,,3628,3265.2,,0.95,,3446.6,Percent of total billed charges,,,0.98,,3555.44,Percent of total billed charges,,,0.95,,3446.6,Percent of total billed charges,,,0.97,,3519.16,Percent of total billed charges,,,0.97,,3519.16,Percent of total billed charges,,,0.96,,3482.88,Percent of total billed charges,,,0.95,,3446.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3446.6,Percent of total billed charges,,3446.6,3555.44,
MRI scan of upper spinal canal with contrast,PX-61210003,CDM,72142,CPT,612,RC,,outpatient,,,3628,3265.2,,0.95,,3446.6,Percent of total billed charges,,,0.98,,3555.44,Percent of total billed charges,,,0.95,,3446.6,Percent of total billed charges,,,0.95,,3446.6,Percent of total billed charges,,,0.97,,3519.16,Percent of total billed charges,,,0.96,,3482.88,Percent of total billed charges,,,0.95,,3446.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3446.6,Percent of total billed charges,,3446.6,3555.44,
MRI scan of middle spinal canal without contrast,PX-61210005,CDM,72146,CPT,612,RC,,inpatient,,,2884,2595.6,,0.95,,2739.8,Percent of total billed charges,,,0.98,,2826.32,Percent of total billed charges,,,0.95,,2739.8,Percent of total billed charges,,,0.97,,2797.48,Percent of total billed charges,,,0.97,,2797.48,Percent of total billed charges,,,0.96,,2768.64,Percent of total billed charges,,,0.95,,2739.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2739.8,Percent of total billed charges,,2739.8,2826.32,
MRI scan of middle spinal canal without contrast,PX-61210005,CDM,72146,CPT,612,RC,,outpatient,,,2884,2595.6,,0.95,,2739.8,Percent of total billed charges,,,0.98,,2826.32,Percent of total billed charges,,,0.95,,2739.8,Percent of total billed charges,,,0.95,,2739.8,Percent of total billed charges,,,0.97,,2797.48,Percent of total billed charges,,,0.96,,2768.64,Percent of total billed charges,,,0.95,,2739.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2739.8,Percent of total billed charges,,2739.8,2826.32,
MRI scan of middle spinal canal with contrast,PX-61210007,CDM,72147,CPT,612,RC,,inpatient,,,3610,3249,,0.95,,3429.5,Percent of total billed charges,,,0.98,,3537.8,Percent of total billed charges,,,0.95,,3429.5,Percent of total billed charges,,,0.97,,3501.7,Percent of total billed charges,,,0.97,,3501.7,Percent of total billed charges,,,0.96,,3465.6,Percent of total billed charges,,,0.95,,3429.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3429.5,Percent of total billed charges,,3429.5,3537.8,
MRI scan of middle spinal canal with contrast,PX-61210007,CDM,72147,CPT,612,RC,,outpatient,,,3610,3249,,0.95,,3429.5,Percent of total billed charges,,,0.98,,3537.8,Percent of total billed charges,,,0.95,,3429.5,Percent of total billed charges,,,0.95,,3429.5,Percent of total billed charges,,,0.97,,3501.7,Percent of total billed charges,,,0.96,,3465.6,Percent of total billed charges,,,0.95,,3429.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3429.5,Percent of total billed charges,,3429.5,3537.8,
MRI scan of lower spinal canal without contrast,PX-61210009,CDM,72148,CPT,612,RC,,inpatient,,,2987,2688.3,,0.95,,2837.65,Percent of total billed charges,,,0.98,,2927.26,Percent of total billed charges,,,0.95,,2837.65,Percent of total billed charges,,,0.97,,2897.39,Percent of total billed charges,,,0.97,,2897.39,Percent of total billed charges,,,0.96,,2867.52,Percent of total billed charges,,,0.95,,2837.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2837.65,Percent of total billed charges,,2837.65,2927.26,
MRI scan of lower spinal canal without contrast,PX-61210009,CDM,72148,CPT,612,RC,,outpatient,,,2987,2688.3,,0.95,,2837.65,Percent of total billed charges,,,0.98,,2927.26,Percent of total billed charges,,,0.95,,2837.65,Percent of total billed charges,,,0.95,,2837.65,Percent of total billed charges,,,0.97,,2897.39,Percent of total billed charges,,,0.96,,2867.52,Percent of total billed charges,,,0.95,,2837.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2837.65,Percent of total billed charges,,2837.65,2927.26,
MRI scan of lower spinal canal with contrast,PX-61210011,CDM,72149,CPT,612,RC,,inpatient,,,3961,3564.9,,0.95,,3762.95,Percent of total billed charges,,,0.98,,3881.78,Percent of total billed charges,,,0.95,,3762.95,Percent of total billed charges,,,0.97,,3842.17,Percent of total billed charges,,,0.97,,3842.17,Percent of total billed charges,,,0.96,,3802.56,Percent of total billed charges,,,0.95,,3762.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3762.95,Percent of total billed charges,,3762.95,3881.78,
MRI scan of lower spinal canal with contrast,PX-61210011,CDM,72149,CPT,612,RC,,outpatient,,,3961,3564.9,,0.95,,3762.95,Percent of total billed charges,,,0.98,,3881.78,Percent of total billed charges,,,0.95,,3762.95,Percent of total billed charges,,,0.95,,3762.95,Percent of total billed charges,,,0.97,,3842.17,Percent of total billed charges,,,0.96,,3802.56,Percent of total billed charges,,,0.95,,3762.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3762.95,Percent of total billed charges,,3762.95,3881.78,
MRI scan of upper spinal canal before and after contrast,PX-61210013,CDM,72156,CPT,612,RC,,inpatient,,,3245,2920.5,,0.95,,3082.75,Percent of total billed charges,,,0.98,,3180.1,Percent of total billed charges,,,0.95,,3082.75,Percent of total billed charges,,,0.97,,3147.65,Percent of total billed charges,,,0.97,,3147.65,Percent of total billed charges,,,0.96,,3115.2,Percent of total billed charges,,,0.95,,3082.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3082.75,Percent of total billed charges,,3082.75,3180.1,
MRI scan of upper spinal canal before and after contrast,PX-61210013,CDM,72156,CPT,612,RC,,outpatient,,,3245,2920.5,,0.95,,3082.75,Percent of total billed charges,,,0.98,,3180.1,Percent of total billed charges,,,0.95,,3082.75,Percent of total billed charges,,,0.95,,3082.75,Percent of total billed charges,,,0.97,,3147.65,Percent of total billed charges,,,0.96,,3115.2,Percent of total billed charges,,,0.95,,3082.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3082.75,Percent of total billed charges,,3082.75,3180.1,
MRI scan of middle spinal canal before and after contrast,PX-61210015,CDM,72157,CPT,612,RC,,inpatient,,,4275,3847.5,,0.95,,4061.25,Percent of total billed charges,,,0.98,,4189.5,Percent of total billed charges,,,0.95,,4061.25,Percent of total billed charges,,,0.97,,4146.75,Percent of total billed charges,,,0.97,,4146.75,Percent of total billed charges,,,0.96,,4104,Percent of total billed charges,,,0.95,,4061.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4061.25,Percent of total billed charges,,4061.25,4189.5,
MRI scan of middle spinal canal before and after contrast,PX-61210015,CDM,72157,CPT,612,RC,,outpatient,,,4275,3847.5,,0.95,,4061.25,Percent of total billed charges,,,0.98,,4189.5,Percent of total billed charges,,,0.95,,4061.25,Percent of total billed charges,,,0.95,,4061.25,Percent of total billed charges,,,0.97,,4146.75,Percent of total billed charges,,,0.96,,4104,Percent of total billed charges,,,0.95,,4061.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4061.25,Percent of total billed charges,,4061.25,4189.5,
MRI scan of lower spinal canal before and after contrast,PX-61210017,CDM,72158,CPT,612,RC,,inpatient,,,4275,3847.5,,0.95,,4061.25,Percent of total billed charges,,,0.98,,4189.5,Percent of total billed charges,,,0.95,,4061.25,Percent of total billed charges,,,0.97,,4146.75,Percent of total billed charges,,,0.97,,4146.75,Percent of total billed charges,,,0.96,,4104,Percent of total billed charges,,,0.95,,4061.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4061.25,Percent of total billed charges,,4061.25,4189.5,
MRI scan of lower spinal canal before and after contrast,PX-61210017,CDM,72158,CPT,612,RC,,outpatient,,,4275,3847.5,,0.95,,4061.25,Percent of total billed charges,,,0.98,,4189.5,Percent of total billed charges,,,0.95,,4061.25,Percent of total billed charges,,,0.95,,4061.25,Percent of total billed charges,,,0.97,,4146.75,Percent of total billed charges,,,0.96,,4104,Percent of total billed charges,,,0.95,,4061.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4061.25,Percent of total billed charges,,4061.25,4189.5,
MRI scan of blood vessels of pelvis,PX-61810001,CDM,72198,CPT,618,RC,,inpatient,,,2929,2636.1,,0.95,,2782.55,Percent of total billed charges,,,0.98,,2870.42,Percent of total billed charges,,,0.95,,2782.55,Percent of total billed charges,,,0.97,,2841.13,Percent of total billed charges,,,0.97,,2841.13,Percent of total billed charges,,,0.96,,2811.84,Percent of total billed charges,,,0.95,,2782.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2782.55,Percent of total billed charges,,2782.55,2870.42,
MRI scan of blood vessels of pelvis,PX-61810001,CDM,72198,CPT,618,RC,,outpatient,,,2929,2636.1,,0.95,,2782.55,Percent of total billed charges,,,0.98,,2870.42,Percent of total billed charges,,,0.95,,2782.55,Percent of total billed charges,,,0.95,,2782.55,Percent of total billed charges,,,0.97,,2841.13,Percent of total billed charges,,,0.96,,2811.84,Percent of total billed charges,,,0.95,,2782.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2782.55,Percent of total billed charges,,2782.55,2870.42,
Ultrasound of both sides of head and neck blood flow,PX-92110002,CDM,93880,CPT,921,RC,,inpatient,,,984,885.6,,0.95,,934.8,Percent of total billed charges,,,0.98,,964.32,Percent of total billed charges,,,0.95,,934.8,Percent of total billed charges,,,0.97,,954.48,Percent of total billed charges,,,0.97,,954.48,Percent of total billed charges,,,0.96,,944.64,Percent of total billed charges,,,0.95,,934.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,934.8,Percent of total billed charges,,934.8,964.32,
Ultrasound of both sides of head and neck blood flow,PX-92110002,CDM,93880,CPT,921,RC,,outpatient,,,984,885.6,,0.95,,934.8,Percent of total billed charges,,,0.98,,964.32,Percent of total billed charges,,,0.95,,934.8,Percent of total billed charges,,,0.95,,934.8,Percent of total billed charges,,,0.97,,954.48,Percent of total billed charges,,,0.96,,944.64,Percent of total billed charges,,,0.95,,934.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,934.8,Percent of total billed charges,,934.8,964.32,
Ultrasound of one side of head and neck blood flow,PX-92110003,CDM,93882,CPT,921,RC,,inpatient,,,623,560.7,,0.95,,591.85,Percent of total billed charges,,,0.98,,610.54,Percent of total billed charges,,,0.95,,591.85,Percent of total billed charges,,,0.97,,604.31,Percent of total billed charges,,,0.97,,604.31,Percent of total billed charges,,,0.96,,598.08,Percent of total billed charges,,,0.95,,591.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,591.85,Percent of total billed charges,,591.85,610.54,
Ultrasound of one side of head and neck blood flow,PX-92110003,CDM,93882,CPT,921,RC,,outpatient,,,623,560.7,,0.95,,591.85,Percent of total billed charges,,,0.98,,610.54,Percent of total billed charges,,,0.95,,591.85,Percent of total billed charges,,,0.95,,591.85,Percent of total billed charges,,,0.97,,604.31,Percent of total billed charges,,,0.96,,598.08,Percent of total billed charges,,,0.95,,591.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,591.85,Percent of total billed charges,,591.85,610.54,
Ultrasound of leg arteries at rest and after exercise,PX-92110009,CDM,93924,CPT,921,RC,,inpatient,,,696,626.4,,0.95,,661.2,Percent of total billed charges,,,0.98,,682.08,Percent of total billed charges,,,0.95,,661.2,Percent of total billed charges,,,0.97,,675.12,Percent of total billed charges,,,0.97,,675.12,Percent of total billed charges,,,0.96,,668.16,Percent of total billed charges,,,0.95,,661.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,661.2,Percent of total billed charges,,661.2,682.08,
Ultrasound of leg arteries at rest and after exercise,PX-92110009,CDM,93924,CPT,921,RC,,outpatient,,,696,626.4,,0.95,,661.2,Percent of total billed charges,,,0.98,,682.08,Percent of total billed charges,,,0.95,,661.2,Percent of total billed charges,,,0.95,,661.2,Percent of total billed charges,,,0.97,,675.12,Percent of total billed charges,,,0.96,,668.16,Percent of total billed charges,,,0.95,,661.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,661.2,Percent of total billed charges,,661.2,682.08,
Ultrasound of leg arteries or artery grafts,PX-92110010,CDM,93925,CPT,921,RC,,inpatient,,,1092,982.8,,0.95,,1037.4,Percent of total billed charges,,,0.98,,1070.16,Percent of total billed charges,,,0.95,,1037.4,Percent of total billed charges,,,0.97,,1059.24,Percent of total billed charges,,,0.97,,1059.24,Percent of total billed charges,,,0.96,,1048.32,Percent of total billed charges,,,0.95,,1037.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1037.4,Percent of total billed charges,,1037.4,1070.16,
Ultrasound of leg arteries or artery grafts,PX-92110010,CDM,93925,CPT,921,RC,,outpatient,,,1092,982.8,,0.95,,1037.4,Percent of total billed charges,,,0.98,,1070.16,Percent of total billed charges,,,0.95,,1037.4,Percent of total billed charges,,,0.95,,1037.4,Percent of total billed charges,,,0.97,,1059.24,Percent of total billed charges,,,0.96,,1048.32,Percent of total billed charges,,,0.95,,1037.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1037.4,Percent of total billed charges,,1037.4,1070.16,
Ultrasound of one leg arteries or artery grafts,PX-92110011,CDM,93926,CPT,921,RC,,inpatient,,,664,597.6,,0.95,,630.8,Percent of total billed charges,,,0.98,,650.72,Percent of total billed charges,,,0.95,,630.8,Percent of total billed charges,,,0.97,,644.08,Percent of total billed charges,,,0.97,,644.08,Percent of total billed charges,,,0.96,,637.44,Percent of total billed charges,,,0.95,,630.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,630.8,Percent of total billed charges,,630.8,650.72,
Ultrasound of one leg arteries or artery grafts,PX-92110011,CDM,93926,CPT,921,RC,,outpatient,,,664,597.6,,0.95,,630.8,Percent of total billed charges,,,0.98,,650.72,Percent of total billed charges,,,0.95,,630.8,Percent of total billed charges,,,0.95,,630.8,Percent of total billed charges,,,0.97,,644.08,Percent of total billed charges,,,0.96,,637.44,Percent of total billed charges,,,0.95,,630.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,630.8,Percent of total billed charges,,630.8,650.72,
Ultrasound of arm arteries or artery grafts,PX-92110012,CDM,93930,CPT,921,RC,,inpatient,,,720,648,,0.95,,684,Percent of total billed charges,,,0.98,,705.6,Percent of total billed charges,,,0.95,,684,Percent of total billed charges,,,0.97,,698.4,Percent of total billed charges,,,0.97,,698.4,Percent of total billed charges,,,0.96,,691.2,Percent of total billed charges,,,0.95,,684,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,684,Percent of total billed charges,,684,705.6,
Ultrasound of arm arteries or artery grafts,PX-92110012,CDM,93930,CPT,921,RC,,outpatient,,,720,648,,0.95,,684,Percent of total billed charges,,,0.98,,705.6,Percent of total billed charges,,,0.95,,684,Percent of total billed charges,,,0.95,,684,Percent of total billed charges,,,0.97,,698.4,Percent of total billed charges,,,0.96,,691.2,Percent of total billed charges,,,0.95,,684,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,684,Percent of total billed charges,,684,705.6,
Ultrasound of one arm arteries or artery grafts,PX-92110013,CDM,93931,CPT,921,RC,,inpatient,,,515,463.5,,0.95,,489.25,Percent of total billed charges,,,0.98,,504.7,Percent of total billed charges,,,0.95,,489.25,Percent of total billed charges,,,0.97,,499.55,Percent of total billed charges,,,0.97,,499.55,Percent of total billed charges,,,0.96,,494.4,Percent of total billed charges,,,0.95,,489.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,489.25,Percent of total billed charges,,489.25,504.7,
Ultrasound of one arm arteries or artery grafts,PX-92110013,CDM,93931,CPT,921,RC,,outpatient,,,515,463.5,,0.95,,489.25,Percent of total billed charges,,,0.98,,504.7,Percent of total billed charges,,,0.95,,489.25,Percent of total billed charges,,,0.95,,489.25,Percent of total billed charges,,,0.97,,499.55,Percent of total billed charges,,,0.96,,494.4,Percent of total billed charges,,,0.95,,489.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,489.25,Percent of total billed charges,,489.25,504.7,
Ultrasound arm or leg veins with compression and maneuvers,PX-92110015,CDM,93970,CPT,921,RC,,inpatient,,,949,854.1,,0.95,,901.55,Percent of total billed charges,,,0.98,,930.02,Percent of total billed charges,,,0.95,,901.55,Percent of total billed charges,,,0.97,,920.53,Percent of total billed charges,,,0.97,,920.53,Percent of total billed charges,,,0.96,,911.04,Percent of total billed charges,,,0.95,,901.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,901.55,Percent of total billed charges,,901.55,930.02,
Ultrasound arm or leg veins with compression and maneuvers,PX-92110015,CDM,93970,CPT,921,RC,,outpatient,,,949,854.1,,0.95,,901.55,Percent of total billed charges,,,0.98,,930.02,Percent of total billed charges,,,0.95,,901.55,Percent of total billed charges,,,0.95,,901.55,Percent of total billed charges,,,0.97,,920.53,Percent of total billed charges,,,0.96,,911.04,Percent of total billed charges,,,0.95,,901.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,901.55,Percent of total billed charges,,901.55,930.02,
Ultrasound one limb veins w/compression and maneuvers,PX-92110016,CDM,93971,CPT,921,RC,,inpatient,,,917,825.3,,0.95,,871.15,Percent of total billed charges,,,0.98,,898.66,Percent of total billed charges,,,0.95,,871.15,Percent of total billed charges,,,0.97,,889.49,Percent of total billed charges,,,0.97,,889.49,Percent of total billed charges,,,0.96,,880.32,Percent of total billed charges,,,0.95,,871.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,871.15,Percent of total billed charges,,871.15,898.66,
Ultrasound one limb veins w/compression and maneuvers,PX-92110016,CDM,93971,CPT,921,RC,,outpatient,,,917,825.3,,0.95,,871.15,Percent of total billed charges,,,0.98,,898.66,Percent of total billed charges,,,0.95,,871.15,Percent of total billed charges,,,0.95,,871.15,Percent of total billed charges,,,0.97,,889.49,Percent of total billed charges,,,0.96,,880.32,Percent of total billed charges,,,0.95,,871.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,871.15,Percent of total billed charges,,871.15,898.66,
Ultrasound abdomen and pelvis artery and vein blood flow,PX-92110017,CDM,93975,CPT,921,RC,,inpatient,,,824,741.6,,0.95,,782.8,Percent of total billed charges,,,0.98,,807.52,Percent of total billed charges,,,0.95,,782.8,Percent of total billed charges,,,0.97,,799.28,Percent of total billed charges,,,0.97,,799.28,Percent of total billed charges,,,0.96,,791.04,Percent of total billed charges,,,0.95,,782.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,782.8,Percent of total billed charges,,782.8,807.52,
Ultrasound abdomen and pelvis artery and vein blood flow,PX-92110017,CDM,93975,CPT,921,RC,,outpatient,,,824,741.6,,0.95,,782.8,Percent of total billed charges,,,0.98,,807.52,Percent of total billed charges,,,0.95,,782.8,Percent of total billed charges,,,0.95,,782.8,Percent of total billed charges,,,0.97,,799.28,Percent of total billed charges,,,0.96,,791.04,Percent of total billed charges,,,0.95,,782.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,782.8,Percent of total billed charges,,782.8,807.52,
Ultrasound of abdomen and pelvis artery and vein blood flow,PX-92110018,CDM,93976,CPT,921,RC,,inpatient,,,453,407.7,,0.95,,430.35,Percent of total billed charges,,,0.98,,443.94,Percent of total billed charges,,,0.95,,430.35,Percent of total billed charges,,,0.97,,439.41,Percent of total billed charges,,,0.97,,439.41,Percent of total billed charges,,,0.96,,434.88,Percent of total billed charges,,,0.95,,430.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,430.35,Percent of total billed charges,,430.35,443.94,
Ultrasound of abdomen and pelvis artery and vein blood flow,PX-92110018,CDM,93976,CPT,921,RC,,outpatient,,,453,407.7,,0.95,,430.35,Percent of total billed charges,,,0.98,,443.94,Percent of total billed charges,,,0.95,,430.35,Percent of total billed charges,,,0.95,,430.35,Percent of total billed charges,,,0.97,,439.41,Percent of total billed charges,,,0.96,,434.88,Percent of total billed charges,,,0.95,,430.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,430.35,Percent of total billed charges,,430.35,443.94,
"Ultrasound aorta, vena cava, groin vessels or bypass grafts",PX-92110019,CDM,93978,CPT,921,RC,,inpatient,,,773,695.7,,0.95,,734.35,Percent of total billed charges,,,0.98,,757.54,Percent of total billed charges,,,0.95,,734.35,Percent of total billed charges,,,0.97,,749.81,Percent of total billed charges,,,0.97,,749.81,Percent of total billed charges,,,0.96,,742.08,Percent of total billed charges,,,0.95,,734.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,734.35,Percent of total billed charges,,734.35,757.54,
"Ultrasound aorta, vena cava, groin vessels or bypass grafts",PX-92110019,CDM,93978,CPT,921,RC,,outpatient,,,773,695.7,,0.95,,734.35,Percent of total billed charges,,,0.98,,757.54,Percent of total billed charges,,,0.95,,734.35,Percent of total billed charges,,,0.95,,734.35,Percent of total billed charges,,,0.97,,749.81,Percent of total billed charges,,,0.96,,742.08,Percent of total billed charges,,,0.95,,734.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,734.35,Percent of total billed charges,,734.35,757.54,
"Ultrasound aorta, vena cava, groin vessels or bypass grafts",PX-92110020,CDM,93979,CPT,921,RC,,inpatient,,,716,644.4,,0.95,,680.2,Percent of total billed charges,,,0.98,,701.68,Percent of total billed charges,,,0.95,,680.2,Percent of total billed charges,,,0.97,,694.52,Percent of total billed charges,,,0.97,,694.52,Percent of total billed charges,,,0.96,,687.36,Percent of total billed charges,,,0.95,,680.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,680.2,Percent of total billed charges,,680.2,701.68,
"Ultrasound aorta, vena cava, groin vessels or bypass grafts",PX-92110020,CDM,93979,CPT,921,RC,,outpatient,,,716,644.4,,0.95,,680.2,Percent of total billed charges,,,0.98,,701.68,Percent of total billed charges,,,0.95,,680.2,Percent of total billed charges,,,0.95,,680.2,Percent of total billed charges,,,0.97,,694.52,Percent of total billed charges,,,0.96,,687.36,Percent of total billed charges,,,0.95,,680.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,680.2,Percent of total billed charges,,680.2,701.68,
Ultrasound of hemodialysis access,PX-92110024,CDM,93990,CPT,921,RC,,inpatient,,,460,414,,0.95,,437,Percent of total billed charges,,,0.98,,450.8,Percent of total billed charges,,,0.95,,437,Percent of total billed charges,,,0.97,,446.2,Percent of total billed charges,,,0.97,,446.2,Percent of total billed charges,,,0.96,,441.6,Percent of total billed charges,,,0.95,,437,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,437,Percent of total billed charges,,437,450.8,
Ultrasound of hemodialysis access,PX-92110024,CDM,93990,CPT,921,RC,,outpatient,,,460,414,,0.95,,437,Percent of total billed charges,,,0.98,,450.8,Percent of total billed charges,,,0.95,,437,Percent of total billed charges,,,0.95,,437,Percent of total billed charges,,,0.97,,446.2,Percent of total billed charges,,,0.96,,441.6,Percent of total billed charges,,,0.95,,437,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,437,Percent of total billed charges,,437,450.8,
Ultrasound study of arm and leg arteries,PX-92110028,CDM,93922,CPT,921,RC,,inpatient,,,503,452.7,,0.95,,477.85,Percent of total billed charges,,,0.98,,492.94,Percent of total billed charges,,,0.95,,477.85,Percent of total billed charges,,,0.97,,487.91,Percent of total billed charges,,,0.97,,487.91,Percent of total billed charges,,,0.96,,482.88,Percent of total billed charges,,,0.95,,477.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,477.85,Percent of total billed charges,,477.85,492.94,
Ultrasound study of arm and leg arteries,PX-92110028,CDM,93922,CPT,921,RC,,outpatient,,,503,452.7,,0.95,,477.85,Percent of total billed charges,,,0.98,,492.94,Percent of total billed charges,,,0.95,,477.85,Percent of total billed charges,,,0.95,,477.85,Percent of total billed charges,,,0.97,,487.91,Percent of total billed charges,,,0.96,,482.88,Percent of total billed charges,,,0.95,,477.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,477.85,Percent of total billed charges,,477.85,492.94,
"Testosterone (hormone) level, free",PX-30110193,CDM,84402,CPT,301,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
"Testosterone (hormone) level, free",PX-30110193,CDM,84402,CPT,301,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
HC PR 76815 US OB Limited Fetus(S),PX-96910319,CDM,76815,CPT,983,RC,,inpatient,,,199,179.1,,0.95,,189.05,Percent of total billed charges,,,0.98,,195.02,Percent of total billed charges,,,0.95,,189.05,Percent of total billed charges,,,0.97,,193.03,Percent of total billed charges,,,0.97,,193.03,Percent of total billed charges,,,0.96,,191.04,Percent of total billed charges,,,0.95,,189.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,189.05,Percent of total billed charges,,189.05,195.02,
HC PR 76815 US OB Limited Fetus(S),PX-96910319,CDM,76815,CPT,983,RC,,outpatient,,,199,179.1,,0.95,,189.05,Percent of total billed charges,,,0.98,,195.02,Percent of total billed charges,,,0.95,,189.05,Percent of total billed charges,,,0.95,,189.05,Percent of total billed charges,,,0.97,,193.03,Percent of total billed charges,,,0.96,,191.04,Percent of total billed charges,,,0.95,,189.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,189.05,Percent of total billed charges,,189.05,195.02,
HC PR 74300 Xr Bile Ducts/Pancreas Intraop,PX-97210002,CDM,74300,CPT,972,RC,,inpatient,,,418,376.2,,0.95,,397.1,Percent of total billed charges,,,0.98,,409.64,Percent of total billed charges,,,0.95,,397.1,Percent of total billed charges,,,0.97,,405.46,Percent of total billed charges,,,0.97,,405.46,Percent of total billed charges,,,0.96,,401.28,Percent of total billed charges,,,0.95,,397.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,397.1,Percent of total billed charges,,397.1,409.64,
HC PR 74300 Xr Bile Ducts/Pancreas Intraop,PX-97210002,CDM,74300,CPT,972,RC,,outpatient,,,418,376.2,,0.95,,397.1,Percent of total billed charges,,,0.98,,409.64,Percent of total billed charges,,,0.95,,397.1,Percent of total billed charges,,,0.95,,397.1,Percent of total billed charges,,,0.97,,405.46,Percent of total billed charges,,,0.96,,401.28,Percent of total billed charges,,,0.95,,397.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,397.1,Percent of total billed charges,,397.1,409.64,
Analysis for antibody to Cytomegalovirus (CMV),PX-30210253,CDM,86644,CPT,302,RC,,inpatient,,,157,141.3,,0.95,,149.15,Percent of total billed charges,,,0.98,,153.86,Percent of total billed charges,,,0.95,,149.15,Percent of total billed charges,,,0.97,,152.29,Percent of total billed charges,,,0.97,,152.29,Percent of total billed charges,,,0.96,,150.72,Percent of total billed charges,,,0.95,,149.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,149.15,Percent of total billed charges,,149.15,153.86,
Analysis for antibody to Cytomegalovirus (CMV),PX-30210253,CDM,86644,CPT,302,RC,,outpatient,,,157,141.3,,0.95,,149.15,Percent of total billed charges,,,0.98,,153.86,Percent of total billed charges,,,0.95,,149.15,Percent of total billed charges,,,0.95,,149.15,Percent of total billed charges,,,0.97,,152.29,Percent of total billed charges,,,0.96,,150.72,Percent of total billed charges,,,0.95,,149.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,149.15,Percent of total billed charges,,149.15,153.86,
HC PR 76872 US Transrectal,PX-97210013,CDM,76872,CPT,960,RC,,inpatient,,,297,267.3,,0.95,,282.15,Percent of total billed charges,,,0.98,,291.06,Percent of total billed charges,,,0.95,,282.15,Percent of total billed charges,,,0.97,,288.09,Percent of total billed charges,,,0.97,,288.09,Percent of total billed charges,,,0.96,,285.12,Percent of total billed charges,,,0.95,,282.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,282.15,Percent of total billed charges,,282.15,291.06,
HC PR 76872 US Transrectal,PX-97210013,CDM,76872,CPT,960,RC,,outpatient,,,297,267.3,,0.95,,282.15,Percent of total billed charges,,,0.98,,291.06,Percent of total billed charges,,,0.95,,282.15,Percent of total billed charges,,,0.95,,282.15,Percent of total billed charges,,,0.97,,288.09,Percent of total billed charges,,,0.96,,285.12,Percent of total billed charges,,,0.95,,282.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,282.15,Percent of total billed charges,,282.15,291.06,
HC PR 77001 Fluoroguide for Vein Device,PX-97210018,CDM,77001,CPT,972,RC,,inpatient,,,163,146.7,,0.95,,154.85,Percent of total billed charges,,,0.98,,159.74,Percent of total billed charges,,,0.95,,154.85,Percent of total billed charges,,,0.97,,158.11,Percent of total billed charges,,,0.97,,158.11,Percent of total billed charges,,,0.96,,156.48,Percent of total billed charges,,,0.95,,154.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,154.85,Percent of total billed charges,,154.85,159.74,
HC PR 77001 Fluoroguide for Vein Device,PX-97210018,CDM,77001,CPT,972,RC,,outpatient,,,163,146.7,,0.95,,154.85,Percent of total billed charges,,,0.98,,159.74,Percent of total billed charges,,,0.95,,154.85,Percent of total billed charges,,,0.95,,154.85,Percent of total billed charges,,,0.97,,158.11,Percent of total billed charges,,,0.96,,156.48,Percent of total billed charges,,,0.95,,154.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,154.85,Percent of total billed charges,,154.85,159.74,
"Test bynucleic acid for chlamydia trachomatis, amplified",PX-30610191,CDM,87491,CPT,306,RC,,inpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
"Test bynucleic acid for chlamydia trachomatis, amplified",PX-30610191,CDM,87491,CPT,306,RC,,outpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
"Test by nucleic acid for Neisseria gonorrhoeae, amplified",PX-30610194,CDM,87591,CPT,306,RC,,inpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
"Test by nucleic acid for Neisseria gonorrhoeae, amplified",PX-30610194,CDM,87591,CPT,306,RC,,outpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
HC PR 76942 US Guidance Needle Placement Img S&I Cdm,PX-97210029,CDM,76942,CPT,972,RC,,inpatient,,,149,134.1,,0.95,,141.55,Percent of total billed charges,,,0.98,,146.02,Percent of total billed charges,,,0.95,,141.55,Percent of total billed charges,,,0.97,,144.53,Percent of total billed charges,,,0.97,,144.53,Percent of total billed charges,,,0.96,,143.04,Percent of total billed charges,,,0.95,,141.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,141.55,Percent of total billed charges,,141.55,146.02,
HC PR 76942 US Guidance Needle Placement Img S&I Cdm,PX-97210029,CDM,76942,CPT,972,RC,,outpatient,,,149,134.1,,0.95,,141.55,Percent of total billed charges,,,0.98,,146.02,Percent of total billed charges,,,0.95,,141.55,Percent of total billed charges,,,0.95,,141.55,Percent of total billed charges,,,0.97,,144.53,Percent of total billed charges,,,0.96,,143.04,Percent of total billed charges,,,0.95,,141.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,141.55,Percent of total billed charges,,141.55,146.02,
HC PR Rx 4vhpv Vaccine 3 Dose Im 0.5 Ml,PX-63610293,CDM,90649,HCPCS,636,RC,,inpatient,,,463,416.7,,0.95,,439.85,Percent of total billed charges,,,0.98,,453.74,Percent of total billed charges,,,0.95,,439.85,Percent of total billed charges,,,0.97,,449.11,Percent of total billed charges,,,0.97,,449.11,Percent of total billed charges,,,0.96,,444.48,Percent of total billed charges,,,0.95,,439.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,439.85,Percent of total billed charges,,439.85,453.74,
HC PR Rx 4vhpv Vaccine 3 Dose Im 0.5 Ml,PX-63610293,CDM,90649,HCPCS,636,RC,,outpatient,,,463,416.7,,0.95,,439.85,Percent of total billed charges,,,0.98,,453.74,Percent of total billed charges,,,0.95,,439.85,Percent of total billed charges,,,0.95,,439.85,Percent of total billed charges,,,0.97,,449.11,Percent of total billed charges,,,0.96,,444.48,Percent of total billed charges,,,0.95,,439.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,439.85,Percent of total billed charges,,439.85,453.74,
HC PR Rx Diphth Tetanus Tox Acell Pertussis Vaccine < 7 Yr Im 0.5 Ml,PX-63610294,CDM,90700,HCPCS,636,RC,,inpatient,,,72,64.8,,0.95,,68.4,Percent of total billed charges,,,0.98,,70.56,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.96,,69.12,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,68.4,Percent of total billed charges,,68.4,70.56,
HC PR Rx Diphth Tetanus Tox Acell Pertussis Vaccine < 7 Yr Im 0.5 Ml,PX-63610294,CDM,90700,HCPCS,636,RC,,outpatient,,,72,64.8,,0.95,,68.4,Percent of total billed charges,,,0.98,,70.56,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.96,,69.12,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,68.4,Percent of total billed charges,,68.4,70.56,
HC PR Rx Dtap-Hepb-Ipv Vaccine Im 0.5 Ml,PX-63610295,CDM,90723,HCPCS,636,RC,,inpatient,,,245,220.5,,0.95,,232.75,Percent of total billed charges,,,0.98,,240.1,Percent of total billed charges,,,0.95,,232.75,Percent of total billed charges,,,0.97,,237.65,Percent of total billed charges,,,0.97,,237.65,Percent of total billed charges,,,0.96,,235.2,Percent of total billed charges,,,0.95,,232.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,232.75,Percent of total billed charges,,232.75,240.1,
HC PR Rx Dtap-Hepb-Ipv Vaccine Im 0.5 Ml,PX-63610295,CDM,90723,HCPCS,636,RC,,outpatient,,,245,220.5,,0.95,,232.75,Percent of total billed charges,,,0.98,,240.1,Percent of total billed charges,,,0.95,,232.75,Percent of total billed charges,,,0.95,,232.75,Percent of total billed charges,,,0.97,,237.65,Percent of total billed charges,,,0.96,,235.2,Percent of total billed charges,,,0.95,,232.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,232.75,Percent of total billed charges,,232.75,240.1,
HC PR Rx Dtap-Ipv Vaccine Child 4-6 Yrs Im 0.5 Ml,PX-63610296,CDM,90696,HCPCS,636,RC,,inpatient,,,166,149.4,,0.95,,157.7,Percent of total billed charges,,,0.98,,162.68,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.96,,159.36,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,157.7,Percent of total billed charges,,157.7,162.68,
HC PR Rx Dtap-Ipv Vaccine Child 4-6 Yrs Im 0.5 Ml,PX-63610296,CDM,90696,HCPCS,636,RC,,outpatient,,,166,149.4,,0.95,,157.7,Percent of total billed charges,,,0.98,,162.68,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.96,,159.36,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,157.7,Percent of total billed charges,,157.7,162.68,
HC PR Rx Dtap-Ipv/Hib Vaccine Im 0.5 Ml,PX-63610297,CDM,90698,HCPCS,636,RC,,inpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
HC PR Rx Dtap-Ipv/Hib Vaccine Im 0.5 Ml,PX-63610297,CDM,90698,HCPCS,636,RC,,outpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
HC PR Rx Hepb Vaccine Adolescent 2 Dose Im 1 Ml,PX-63610298,CDM,90743,HCPCS,636,RC,,inpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
HC PR Rx Hepb Vaccine Adolescent 2 Dose Im 1 Ml,PX-63610298,CDM,90743,HCPCS,636,RC,,outpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
HC PR Rx Hepb Vaccine Adult 3 Dose Im 1 Ml,PX-63610299,CDM,90746,HCPCS,636,RC,,inpatient,,,107,96.3,,0.95,,101.65,Percent of total billed charges,,,0.98,,104.86,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.96,,102.72,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,101.65,Percent of total billed charges,,101.65,104.86,
HC PR Rx Hepb Vaccine Adult 3 Dose Im 1 Ml,PX-63610299,CDM,90746,HCPCS,636,RC,,outpatient,,,107,96.3,,0.95,,101.65,Percent of total billed charges,,,0.98,,104.86,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.96,,102.72,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,101.65,Percent of total billed charges,,101.65,104.86,
HC PR Rx Hepb Vaccine Ped/Adolesc 3 Dose Im 0.5 Ml,PX-63610300,CDM,90744,HCPCS,636,RC,,inpatient,,,174,156.6,,0.95,,165.3,Percent of total billed charges,,,0.98,,170.52,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,0.97,,168.78,Percent of total billed charges,,,0.97,,168.78,Percent of total billed charges,,,0.96,,167.04,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,165.3,Percent of total billed charges,,165.3,170.52,
HC PR Rx Hepb Vaccine Ped/Adolesc 3 Dose Im 0.5 Ml,PX-63610300,CDM,90744,HCPCS,636,RC,,outpatient,,,174,156.6,,0.95,,165.3,Percent of total billed charges,,,0.98,,170.52,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,0.97,,168.78,Percent of total billed charges,,,0.96,,167.04,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,165.3,Percent of total billed charges,,165.3,170.52,
HC PR Rx Hib Prp-Omp Vaccine 3 Dose Im 0.5 Ml,PX-63610301,CDM,90647,HCPCS,636,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
HC PR Rx Hib Prp-Omp Vaccine 3 Dose Im 0.5 Ml,PX-63610301,CDM,90647,HCPCS,636,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
HC PR Rx Hib-Hepb Vaccine Im 1 Ea,PX-63610303,CDM,90748,HCPCS,636,RC,,inpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
HC PR Rx Hib-Hepb Vaccine Im 1 Ea,PX-63610303,CDM,90748,HCPCS,636,RC,,outpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
HC PR Rx Menacwyd/Menacwy-CRM Conj Vaccine Grps Acyw Im 0.5 Ml,PX-63610305,CDM,90734,HCPCS,636,RC,,inpatient,,,349,314.1,,0.95,,331.55,Percent of total billed charges,,,0.98,,342.02,Percent of total billed charges,,,0.95,,331.55,Percent of total billed charges,,,0.97,,338.53,Percent of total billed charges,,,0.97,,338.53,Percent of total billed charges,,,0.96,,335.04,Percent of total billed charges,,,0.95,,331.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,331.55,Percent of total billed charges,,331.55,342.02,
HC PR Rx Menacwyd/Menacwy-CRM Conj Vaccine Grps Acyw Im 0.5 Ml,PX-63610305,CDM,90734,HCPCS,636,RC,,outpatient,,,349,314.1,,0.95,,331.55,Percent of total billed charges,,,0.98,,342.02,Percent of total billed charges,,,0.95,,331.55,Percent of total billed charges,,,0.95,,331.55,Percent of total billed charges,,,0.97,,338.53,Percent of total billed charges,,,0.96,,335.04,Percent of total billed charges,,,0.95,,331.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,331.55,Percent of total billed charges,,331.55,342.02,
HC PR 47000 Needle Biopsy of Liver,PX-97510102,CDM,47000,CPT,975,RC,,inpatient,,,884,795.6,,0.95,,839.8,Percent of total billed charges,,,0.98,,866.32,Percent of total billed charges,,,0.95,,839.8,Percent of total billed charges,,,0.97,,857.48,Percent of total billed charges,,,0.97,,857.48,Percent of total billed charges,,,0.96,,848.64,Percent of total billed charges,,,0.95,,839.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,839.8,Percent of total billed charges,,839.8,866.32,
HC PR 47000 Needle Biopsy of Liver,PX-97510102,CDM,47000,CPT,975,RC,,outpatient,,,884,795.6,,0.95,,839.8,Percent of total billed charges,,,0.98,,866.32,Percent of total billed charges,,,0.95,,839.8,Percent of total billed charges,,,0.95,,839.8,Percent of total billed charges,,,0.97,,857.48,Percent of total billed charges,,,0.96,,848.64,Percent of total billed charges,,,0.95,,839.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,839.8,Percent of total billed charges,,839.8,866.32,
HC PR Rx Respiratory Syncytial Virus Ig Im 50 Mg,PX-63610308,CDM,90378,HCPCS,636,RC,,inpatient,,,560,504,,0.95,,532,Percent of total billed charges,,,0.98,,548.8,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,0.97,,543.2,Percent of total billed charges,,,0.97,,543.2,Percent of total billed charges,,,0.96,,537.6,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,,,,,,,0.95,,532,Percent of total billed charges,,532,548.8,
HC PR Rx Respiratory Syncytial Virus Ig Im 50 Mg,PX-63610308,CDM,90378,HCPCS,636,RC,,outpatient,,,560,504,,0.95,,532,Percent of total billed charges,,,0.98,,548.8,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,0.97,,543.2,Percent of total billed charges,,,0.96,,537.6,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,,,,,,,0.95,,532,Percent of total billed charges,,532,548.8,
HC PR Rx Rotovirus Vaccine (Rv5) 3 Dose Oral 2 Ml,PX-63610310,CDM,90680,HCPCS,636,RC,,inpatient,,,194,174.6,,0.95,,184.3,Percent of total billed charges,,,0.98,,190.12,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,0.97,,188.18,Percent of total billed charges,,,0.97,,188.18,Percent of total billed charges,,,0.96,,186.24,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,184.3,Percent of total billed charges,,184.3,190.12,
HC PR Rx Rotovirus Vaccine (Rv5) 3 Dose Oral 2 Ml,PX-63610310,CDM,90680,HCPCS,636,RC,,outpatient,,,194,174.6,,0.95,,184.3,Percent of total billed charges,,,0.98,,190.12,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,0.97,,188.18,Percent of total billed charges,,,0.96,,186.24,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,184.3,Percent of total billed charges,,184.3,190.12,
HC PR Rx Hepatitus a Vaccine Adult Im 1 Ml,PX-63610313,CDM,90632,HCPCS,636,RC,,inpatient,,,136,122.4,,0.95,,129.2,Percent of total billed charges,,,0.98,,133.28,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,0.97,,131.92,Percent of total billed charges,,,0.97,,131.92,Percent of total billed charges,,,0.96,,130.56,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,129.2,Percent of total billed charges,,129.2,133.28,
HC PR Rx Hepatitus a Vaccine Adult Im 1 Ml,PX-63610313,CDM,90632,HCPCS,636,RC,,outpatient,,,136,122.4,,0.95,,129.2,Percent of total billed charges,,,0.98,,133.28,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,0.97,,131.92,Percent of total billed charges,,,0.96,,130.56,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,129.2,Percent of total billed charges,,129.2,133.28,
"Antibody evaluation, each additional single antibody stain",PX-31010720,CDM,88350,CPT,310,RC,,inpatient,,,280,252,,0.95,,266,Percent of total billed charges,,,0.98,,274.4,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,0.97,,271.6,Percent of total billed charges,,,0.97,,271.6,Percent of total billed charges,,,0.96,,268.8,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,266,Percent of total billed charges,,266,274.4,
"Antibody evaluation, each additional single antibody stain",PX-31010720,CDM,88350,CPT,310,RC,,outpatient,,,280,252,,0.95,,266,Percent of total billed charges,,,0.98,,274.4,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,0.97,,271.6,Percent of total billed charges,,,0.96,,268.8,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,266,Percent of total billed charges,,266,274.4,
"Inhalation for acute airway obstruction, each additional hr",PX-41010237,CDM,94645,CPT,410,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
"Inhalation for acute airway obstruction, each additional hr",PX-41010237,CDM,94645,CPT,410,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Initial therapy service to facilitate lung function,PX-41010261,CDM,94667,CPT,410,RC,,inpatient,,,115,103.5,,0.95,,109.25,Percent of total billed charges,,,0.98,,112.7,Percent of total billed charges,,,0.95,,109.25,Percent of total billed charges,,,0.97,,111.55,Percent of total billed charges,,,0.97,,111.55,Percent of total billed charges,,,0.96,,110.4,Percent of total billed charges,,,0.95,,109.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,109.25,Percent of total billed charges,,109.25,112.7,
Initial therapy service to facilitate lung function,PX-41010261,CDM,94667,CPT,410,RC,,outpatient,,,115,103.5,,0.95,,109.25,Percent of total billed charges,,,0.98,,112.7,Percent of total billed charges,,,0.95,,109.25,Percent of total billed charges,,,0.95,,109.25,Percent of total billed charges,,,0.97,,111.55,Percent of total billed charges,,,0.96,,110.4,Percent of total billed charges,,,0.95,,109.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,109.25,Percent of total billed charges,,109.25,112.7,
Follow-up therapy service to facilitate lung function,PX-41010263,CDM,94668,CPT,410,RC,,inpatient,,,97,87.3,,0.95,,92.15,Percent of total billed charges,,,0.98,,95.06,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,0.97,,94.09,Percent of total billed charges,,,0.97,,94.09,Percent of total billed charges,,,0.96,,93.12,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,92.15,Percent of total billed charges,,92.15,95.06,
Follow-up therapy service to facilitate lung function,PX-41010263,CDM,94668,CPT,410,RC,,outpatient,,,97,87.3,,0.95,,92.15,Percent of total billed charges,,,0.98,,95.06,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,0.97,,94.09,Percent of total billed charges,,,0.96,,93.12,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,92.15,Percent of total billed charges,,92.15,95.06,
Inhalation for airway obstruction or sputum production,PX-41010275,CDM,94640,CPT,410,RC,,inpatient,,,107,96.3,,0.95,,101.65,Percent of total billed charges,,,0.98,,104.86,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.96,,102.72,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,101.65,Percent of total billed charges,,101.65,104.86,
Inhalation for airway obstruction or sputum production,PX-41010275,CDM,94640,CPT,410,RC,,outpatient,,,107,96.3,,0.95,,101.65,Percent of total billed charges,,,0.98,,104.86,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.96,,102.72,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,101.65,Percent of total billed charges,,101.65,104.86,
Initial hospital inpatient or observation vent management,PX-41010290,CDM,94002,CPT,410,RC,,inpatient,,,1494,1344.6,,0.95,,1419.3,Percent of total billed charges,,,0.98,,1464.12,Percent of total billed charges,,,0.95,,1419.3,Percent of total billed charges,,,0.97,,1449.18,Percent of total billed charges,,,0.97,,1449.18,Percent of total billed charges,,,0.96,,1434.24,Percent of total billed charges,,,0.95,,1419.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1419.3,Percent of total billed charges,,1419.3,1464.12,
Initial hospital inpatient or observation vent management,PX-41010290,CDM,94002,CPT,410,RC,,outpatient,,,1494,1344.6,,0.95,,1419.3,Percent of total billed charges,,,0.98,,1464.12,Percent of total billed charges,,,0.95,,1419.3,Percent of total billed charges,,,0.95,,1419.3,Percent of total billed charges,,,0.97,,1449.18,Percent of total billed charges,,,0.96,,1434.24,Percent of total billed charges,,,0.95,,1419.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1419.3,Percent of total billed charges,,1419.3,1464.12,
Follow-up inpatient or observation ventilation management,PX-41010296,CDM,94003,CPT,410,RC,,inpatient,,,732,658.8,,0.95,,695.4,Percent of total billed charges,,,0.98,,717.36,Percent of total billed charges,,,0.95,,695.4,Percent of total billed charges,,,0.97,,710.04,Percent of total billed charges,,,0.97,,710.04,Percent of total billed charges,,,0.96,,702.72,Percent of total billed charges,,,0.95,,695.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,695.4,Percent of total billed charges,,695.4,717.36,
Follow-up inpatient or observation ventilation management,PX-41010296,CDM,94003,CPT,410,RC,,outpatient,,,732,658.8,,0.95,,695.4,Percent of total billed charges,,,0.98,,717.36,Percent of total billed charges,,,0.95,,695.4,Percent of total billed charges,,,0.95,,695.4,Percent of total billed charges,,,0.97,,710.04,Percent of total billed charges,,,0.96,,702.72,Percent of total billed charges,,,0.95,,695.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,695.4,Percent of total billed charges,,695.4,717.36,
"Measure antibody to allergic, crude allergen extract, each",PX-30210267,CDM,86003,CPT,302,RC,,inpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
"Measure antibody to allergic, crude allergen extract, each",PX-30210267,CDM,86003,CPT,302,RC,,outpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
Test byimmunoassay for Histoplasma capsulatum (parasite),PX-30610199,CDM,87385,CPT,306,RC,,inpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
Test byimmunoassay for Histoplasma capsulatum (parasite),PX-30610199,CDM,87385,CPT,306,RC,,outpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
Therapy procedure using a positive pressure ventilator,PX-41010325,CDM,94660,CPT,410,RC,,inpatient,,,412,370.8,,0.95,,391.4,Percent of total billed charges,,,0.98,,403.76,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.96,,395.52,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,391.4,Percent of total billed charges,,391.4,403.76,
Therapy procedure using a positive pressure ventilator,PX-41010325,CDM,94660,CPT,410,RC,,outpatient,,,412,370.8,,0.95,,391.4,Percent of total billed charges,,,0.98,,403.76,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.96,,395.52,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,391.4,Percent of total billed charges,,391.4,403.76,
Therapy procedure using a positive pressure ventilator,PX-41010328,CDM,94660,CPT,410,RC,,inpatient,,,412,370.8,,0.95,,391.4,Percent of total billed charges,,,0.98,,403.76,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.96,,395.52,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,391.4,Percent of total billed charges,,391.4,403.76,
Therapy procedure using a positive pressure ventilator,PX-41010328,CDM,94660,CPT,410,RC,,outpatient,,,412,370.8,,0.95,,391.4,Percent of total billed charges,,,0.98,,403.76,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.96,,395.52,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,391.4,Percent of total billed charges,,391.4,403.76,
Inhalation for airway obstruction or sputum production,PX-41010353,CDM,94640,CPT,410,RC,,inpatient,,,120,108,,0.95,,114,Percent of total billed charges,,,0.98,,117.6,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.96,,115.2,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114,Percent of total billed charges,,114,117.6,
Inhalation for airway obstruction or sputum production,PX-41010353,CDM,94640,CPT,410,RC,,outpatient,,,120,108,,0.95,,114,Percent of total billed charges,,,0.98,,117.6,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.96,,115.2,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114,Percent of total billed charges,,114,117.6,
Therapy procedure using a positive pressure ventilator,PX-41010366,CDM,41010366,LOCAL,410,RC,,inpatient,,,412,370.8,,0.95,,391.4,Percent of total billed charges,,,0.98,,403.76,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.96,,395.52,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,391.4,Percent of total billed charges,,391.4,403.76,
Therapy procedure using a positive pressure ventilator,PX-41010366,CDM,41010366,LOCAL,410,RC,,outpatient,,,412,370.8,,0.95,,391.4,Percent of total billed charges,,,0.98,,403.76,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.96,,395.52,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,391.4,Percent of total billed charges,,391.4,403.76,
Change of breathing tube in windpipe,PX-41010406,CDM,31502,CPT,410,RC,,inpatient,,,279,251.1,,0.95,,265.05,Percent of total billed charges,,,0.98,,273.42,Percent of total billed charges,,,0.95,,265.05,Percent of total billed charges,,,0.97,,270.63,Percent of total billed charges,,,0.97,,270.63,Percent of total billed charges,,,0.96,,267.84,Percent of total billed charges,,,0.95,,265.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,265.05,Percent of total billed charges,,265.05,273.42,
Change of breathing tube in windpipe,PX-41010406,CDM,31502,CPT,410,RC,,outpatient,,,279,251.1,,0.95,,265.05,Percent of total billed charges,,,0.98,,273.42,Percent of total billed charges,,,0.95,,265.05,Percent of total billed charges,,,0.95,,265.05,Percent of total billed charges,,,0.97,,270.63,Percent of total billed charges,,,0.96,,267.84,Percent of total billed charges,,,0.95,,265.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,265.05,Percent of total billed charges,,265.05,273.42,
Test to examine how well the lungs exchange gases,PX-46010012,CDM,94729,CPT,460,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Test to examine how well the lungs exchange gases,PX-46010012,CDM,94729,CPT,460,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Test to measure expiratory airflow and volume,PX-46010055,CDM,94010,CPT,460,RC,,inpatient,,,222,199.8,,0.95,,210.9,Percent of total billed charges,,,0.98,,217.56,Percent of total billed charges,,,0.95,,210.9,Percent of total billed charges,,,0.97,,215.34,Percent of total billed charges,,,0.97,,215.34,Percent of total billed charges,,,0.96,,213.12,Percent of total billed charges,,,0.95,,210.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,210.9,Percent of total billed charges,,210.9,217.56,
Test to measure expiratory airflow and volume,PX-46010055,CDM,94010,CPT,460,RC,,outpatient,,,222,199.8,,0.95,,210.9,Percent of total billed charges,,,0.98,,217.56,Percent of total billed charges,,,0.95,,210.9,Percent of total billed charges,,,0.95,,210.9,Percent of total billed charges,,,0.97,,215.34,Percent of total billed charges,,,0.96,,213.12,Percent of total billed charges,,,0.95,,210.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,210.9,Percent of total billed charges,,210.9,217.56,
Measure total volume of air exhaled after inhaling,PX-46010063,CDM,94060,CPT,460,RC,,inpatient,,,461,414.9,,0.95,,437.95,Percent of total billed charges,,,0.98,,451.78,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,0.97,,447.17,Percent of total billed charges,,,0.97,,447.17,Percent of total billed charges,,,0.96,,442.56,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,437.95,Percent of total billed charges,,437.95,451.78,
Measure total volume of air exhaled after inhaling,PX-46010063,CDM,94060,CPT,460,RC,,outpatient,,,461,414.9,,0.95,,437.95,Percent of total billed charges,,,0.98,,451.78,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,0.97,,447.17,Percent of total billed charges,,,0.96,,442.56,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,437.95,Percent of total billed charges,,437.95,451.78,
HC PR 94060 Spirometry Pre Post Bronchodilator,PX-97610003,CDM,94060,CPT,976,RC,,inpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
HC PR 94060 Spirometry Pre Post Bronchodilator,PX-97610003,CDM,94060,CPT,976,RC,,outpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
HC PR Spirometry/Pft Vit Cap Test,PX-97610016,CDM,94010,CPT,976,RC,,inpatient,,,84,75.6,,0.95,,79.8,Percent of total billed charges,,,0.98,,82.32,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,0.97,,81.48,Percent of total billed charges,,,0.97,,81.48,Percent of total billed charges,,,0.96,,80.64,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,79.8,Percent of total billed charges,,79.8,82.32,
HC PR Spirometry/Pft Vit Cap Test,PX-97610016,CDM,94010,CPT,976,RC,,outpatient,,,84,75.6,,0.95,,79.8,Percent of total billed charges,,,0.98,,82.32,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,0.97,,81.48,Percent of total billed charges,,,0.96,,80.64,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,79.8,Percent of total billed charges,,79.8,82.32,
HC PR ED 92950 Cardiopulmonary Resuscitation Cdm,PX-98110596,CDM,92950,CPT,981,RC,,inpatient,,,1140,1026,,0.95,,1083,Percent of total billed charges,,,0.98,,1117.2,Percent of total billed charges,,,0.95,,1083,Percent of total billed charges,,,0.97,,1105.8,Percent of total billed charges,,,0.97,,1105.8,Percent of total billed charges,,,0.96,,1094.4,Percent of total billed charges,,,0.95,,1083,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1083,Percent of total billed charges,,1083,1117.2,
HC PR ED 92950 Cardiopulmonary Resuscitation Cdm,PX-98110596,CDM,92950,CPT,981,RC,,outpatient,,,1140,1026,,0.95,,1083,Percent of total billed charges,,,0.98,,1117.2,Percent of total billed charges,,,0.95,,1083,Percent of total billed charges,,,0.95,,1083,Percent of total billed charges,,,0.97,,1105.8,Percent of total billed charges,,,0.96,,1094.4,Percent of total billed charges,,,0.95,,1083,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1083,Percent of total billed charges,,1083,1117.2,
Collection blood specimen from completely implantable venous access device,PX-26010005,CDM,36591,CPT,761,RC,,inpatient,,,168,151.2,,0.95,,159.6,Percent of total billed charges,,,0.98,,164.64,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,0.97,,162.96,Percent of total billed charges,,,0.97,,162.96,Percent of total billed charges,,,0.96,,161.28,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,159.6,Percent of total billed charges,,159.6,164.64,
Collection blood specimen from completely implantable venous access device,PX-26010005,CDM,36591,CPT,761,RC,,outpatient,,,168,151.2,,0.95,,159.6,Percent of total billed charges,,,0.98,,164.64,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,0.97,,162.96,Percent of total billed charges,,,0.96,,161.28,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,159.6,Percent of total billed charges,,159.6,164.64,
HC Blood Draw Picc or Nonimplanted Central Line Cdm,PX-26010006,CDM,36592,CPT,761,RC,,inpatient,,,94,84.6,,0.95,,89.3,Percent of total billed charges,,,0.98,,92.12,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.96,,90.24,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,89.3,Percent of total billed charges,,89.3,92.12,
HC Blood Draw Picc or Nonimplanted Central Line Cdm,PX-26010006,CDM,36592,CPT,761,RC,,outpatient,,,94,84.6,,0.95,,89.3,Percent of total billed charges,,,0.98,,92.12,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.96,,90.24,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,89.3,Percent of total billed charges,,89.3,92.12,
HC IV Hydration Initial Hr,PX-26010007,CDM,96360,CPT,260,RC,,inpatient,,,340,306,,0.95,,323,Percent of total billed charges,,,0.98,,333.2,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.96,,326.4,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,323,Percent of total billed charges,,323,333.2,
HC IV Hydration Initial Hr,PX-26010007,CDM,96360,CPT,260,RC,,outpatient,,,340,306,,0.95,,323,Percent of total billed charges,,,0.98,,333.2,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.96,,326.4,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,323,Percent of total billed charges,,323,333.2,
HC IV Hydration Each Addl Hr,PX-26010008,CDM,96361,CPT,260,RC,,inpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
HC IV Hydration Each Addl Hr,PX-26010008,CDM,96361,CPT,260,RC,,outpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
HC IV Infusion Initial Hr,PX-26010009,CDM,96365,CPT,260,RC,,inpatient,,,343,308.7,,0.95,,325.85,Percent of total billed charges,,,0.98,,336.14,Percent of total billed charges,,,0.95,,325.85,Percent of total billed charges,,,0.97,,332.71,Percent of total billed charges,,,0.97,,332.71,Percent of total billed charges,,,0.96,,329.28,Percent of total billed charges,,,0.95,,325.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,325.85,Percent of total billed charges,,325.85,336.14,
HC IV Infusion Initial Hr,PX-26010009,CDM,96365,CPT,260,RC,,outpatient,,,343,308.7,,0.95,,325.85,Percent of total billed charges,,,0.98,,336.14,Percent of total billed charges,,,0.95,,325.85,Percent of total billed charges,,,0.95,,325.85,Percent of total billed charges,,,0.97,,332.71,Percent of total billed charges,,,0.96,,329.28,Percent of total billed charges,,,0.95,,325.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,325.85,Percent of total billed charges,,325.85,336.14,
IV IV each additional hr,PX-26010010,CDM,96366,CPT,260,RC,,inpatient,,,128,115.2,,0.95,,121.6,Percent of total billed charges,,,0.98,,125.44,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.96,,122.88,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,121.6,Percent of total billed charges,,121.6,125.44,
IV IV each additional hr,PX-26010010,CDM,96366,CPT,260,RC,,outpatient,,,128,115.2,,0.95,,121.6,Percent of total billed charges,,,0.98,,125.44,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.96,,122.88,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,121.6,Percent of total billed charges,,121.6,125.44,
HC IV Infusion Sequential Hr,PX-26010011,CDM,96367,CPT,260,RC,,inpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
HC IV Infusion Sequential Hr,PX-26010011,CDM,96367,CPT,260,RC,,outpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
HC IV Infusion Concurrent,PX-26010012,CDM,96368,CPT,260,RC,,inpatient,,,257,231.3,,0.95,,244.15,Percent of total billed charges,,,0.98,,251.86,Percent of total billed charges,,,0.95,,244.15,Percent of total billed charges,,,0.97,,249.29,Percent of total billed charges,,,0.97,,249.29,Percent of total billed charges,,,0.96,,246.72,Percent of total billed charges,,,0.95,,244.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,244.15,Percent of total billed charges,,244.15,251.86,
HC IV Infusion Concurrent,PX-26010012,CDM,96368,CPT,260,RC,,outpatient,,,257,231.3,,0.95,,244.15,Percent of total billed charges,,,0.98,,251.86,Percent of total billed charges,,,0.95,,244.15,Percent of total billed charges,,,0.95,,244.15,Percent of total billed charges,,,0.97,,249.29,Percent of total billed charges,,,0.96,,246.72,Percent of total billed charges,,,0.95,,244.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,244.15,Percent of total billed charges,,244.15,251.86,
"Chemotherapy administration, subcutaneous or intramuscular; non-hormonal",PX-33110001,CDM,96401,CPT,331,RC,,inpatient,,,226,203.4,,0.95,,214.7,Percent of total billed charges,,,0.98,,221.48,Percent of total billed charges,,,0.95,,214.7,Percent of total billed charges,,,0.97,,219.22,Percent of total billed charges,,,0.97,,219.22,Percent of total billed charges,,,0.96,,216.96,Percent of total billed charges,,,0.95,,214.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,214.7,Percent of total billed charges,,214.7,221.48,
"Chemotherapy administration, subcutaneous or intramuscular; non-hormonal",PX-33110001,CDM,96401,CPT,331,RC,,outpatient,,,226,203.4,,0.95,,214.7,Percent of total billed charges,,,0.98,,221.48,Percent of total billed charges,,,0.95,,214.7,Percent of total billed charges,,,0.95,,214.7,Percent of total billed charges,,,0.97,,219.22,Percent of total billed charges,,,0.96,,216.96,Percent of total billed charges,,,0.95,,214.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,214.7,Percent of total billed charges,,214.7,221.48,
"Chemo admin, subcutaneous or intramuscular; hormonal anti-neoplastic",PX-33110002,CDM,96402,CPT,331,RC,,inpatient,,,228,205.2,,0.95,,216.6,Percent of total billed charges,,,0.98,,223.44,Percent of total billed charges,,,0.95,,216.6,Percent of total billed charges,,,0.97,,221.16,Percent of total billed charges,,,0.97,,221.16,Percent of total billed charges,,,0.96,,218.88,Percent of total billed charges,,,0.95,,216.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,216.6,Percent of total billed charges,,216.6,223.44,
"Chemo admin, subcutaneous or intramuscular; hormonal anti-neoplastic",PX-33110002,CDM,96402,CPT,331,RC,,outpatient,,,228,205.2,,0.95,,216.6,Percent of total billed charges,,,0.98,,223.44,Percent of total billed charges,,,0.95,,216.6,Percent of total billed charges,,,0.95,,216.6,Percent of total billed charges,,,0.97,,221.16,Percent of total billed charges,,,0.96,,218.88,Percent of total billed charges,,,0.95,,216.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,216.6,Percent of total billed charges,,216.6,223.44,
Injection of chemotherapy via reservoir under skin,PX-33110006,CDM,96542,CPT,331,RC,,inpatient,,,557,501.3,,0.95,,529.15,Percent of total billed charges,,,0.98,,545.86,Percent of total billed charges,,,0.95,,529.15,Percent of total billed charges,,,0.97,,540.29,Percent of total billed charges,,,0.97,,540.29,Percent of total billed charges,,,0.96,,534.72,Percent of total billed charges,,,0.95,,529.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,529.15,Percent of total billed charges,,529.15,545.86,
Injection of chemotherapy via reservoir under skin,PX-33110006,CDM,96542,CPT,331,RC,,outpatient,,,557,501.3,,0.95,,529.15,Percent of total billed charges,,,0.98,,545.86,Percent of total billed charges,,,0.95,,529.15,Percent of total billed charges,,,0.95,,529.15,Percent of total billed charges,,,0.97,,540.29,Percent of total billed charges,,,0.96,,534.72,Percent of total billed charges,,,0.95,,529.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,529.15,Percent of total billed charges,,529.15,545.86,
Administration of chemotherapy into vein using push,PX-33110007,CDM,96409,CPT,331,RC,,inpatient,,,284,255.6,,0.95,,269.8,Percent of total billed charges,,,0.98,,278.32,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,0.97,,275.48,Percent of total billed charges,,,0.97,,275.48,Percent of total billed charges,,,0.96,,272.64,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,269.8,Percent of total billed charges,,269.8,278.32,
Administration of chemotherapy into vein using push,PX-33110007,CDM,96409,CPT,331,RC,,outpatient,,,284,255.6,,0.95,,269.8,Percent of total billed charges,,,0.98,,278.32,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,0.97,,275.48,Percent of total billed charges,,,0.96,,272.64,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,269.8,Percent of total billed charges,,269.8,278.32,
HC Chemo IV Push Addl Drug,PX-33510002,CDM,96411,CPT,335,RC,,inpatient,,,248,223.2,,0.95,,235.6,Percent of total billed charges,,,0.98,,243.04,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,0.97,,240.56,Percent of total billed charges,,,0.97,,240.56,Percent of total billed charges,,,0.96,,238.08,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,235.6,Percent of total billed charges,,235.6,243.04,
HC Chemo IV Push Addl Drug,PX-33510002,CDM,96411,CPT,335,RC,,outpatient,,,248,223.2,,0.95,,235.6,Percent of total billed charges,,,0.98,,243.04,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,0.97,,240.56,Percent of total billed charges,,,0.96,,238.08,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,235.6,Percent of total billed charges,,235.6,243.04,
HC Chemo IV Infusion Initial Hr,PX-33510003,CDM,96413,CPT,335,RC,,inpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,440.8,Percent of total billed charges,,440.8,454.72,
HC Chemo IV Infusion Initial Hr,PX-33510003,CDM,96413,CPT,335,RC,,outpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,440.8,Percent of total billed charges,,440.8,454.72,
HC Chemo IV Infusion Addl Hr,PX-33510004,CDM,96415,CPT,335,RC,,inpatient,,,170,153,,0.95,,161.5,Percent of total billed charges,,,0.98,,166.6,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,0.97,,164.9,Percent of total billed charges,,,0.97,,164.9,Percent of total billed charges,,,0.96,,163.2,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,161.5,Percent of total billed charges,,161.5,166.6,
HC Chemo IV Infusion Addl Hr,PX-33510004,CDM,96415,CPT,335,RC,,outpatient,,,170,153,,0.95,,161.5,Percent of total billed charges,,,0.98,,166.6,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,0.97,,164.9,Percent of total billed charges,,,0.96,,163.2,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,161.5,Percent of total billed charges,,161.5,166.6,
HC Chemo IV Infusion Prolong via Portable or Implantable Pump > 8hrs Cdm,PX-33510005,CDM,96416,CPT,335,RC,,inpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,440.8,Percent of total billed charges,,440.8,454.72,
HC Chemo IV Infusion Prolong via Portable or Implantable Pump > 8hrs Cdm,PX-33510005,CDM,96416,CPT,335,RC,,outpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,440.8,Percent of total billed charges,,440.8,454.72,
HC Chemo IV Infusion Ea Addl Seq Drg,PX-33510006,CDM,96417,CPT,335,RC,,inpatient,,,206,185.4,,0.95,,195.7,Percent of total billed charges,,,0.98,,201.88,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.96,,197.76,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,195.7,Percent of total billed charges,,195.7,201.88,
HC Chemo IV Infusion Ea Addl Seq Drg,PX-33510006,CDM,96417,CPT,335,RC,,outpatient,,,206,185.4,,0.95,,195.7,Percent of total billed charges,,,0.98,,201.88,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.96,,197.76,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,195.7,Percent of total billed charges,,195.7,201.88,
Declotting of central venous tube,PX-36110005,CDM,36593,CPT,761,RC,,inpatient,,,96,86.4,,0.95,,91.2,Percent of total billed charges,,,0.98,,94.08,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.96,,92.16,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,91.2,Percent of total billed charges,,91.2,94.08,
Declotting of central venous tube,PX-36110005,CDM,36593,CPT,761,RC,,outpatient,,,96,86.4,,0.95,,91.2,Percent of total billed charges,,,0.98,,94.08,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.96,,92.16,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,91.2,Percent of total billed charges,,91.2,94.08,
Insertion of needle for IVinto bone,PX-45010308,CDM,36680,CPT,450,RC,,inpatient,,,341,306.9,,0.95,,323.95,Percent of total billed charges,,,0.98,,334.18,Percent of total billed charges,,,0.95,,323.95,Percent of total billed charges,,,0.97,,330.77,Percent of total billed charges,,,0.97,,330.77,Percent of total billed charges,,,0.96,,327.36,Percent of total billed charges,,,0.95,,323.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,323.95,Percent of total billed charges,,323.95,3950,
Insertion of needle for IVinto bone,PX-45010308,CDM,36680,CPT,450,RC,,outpatient,,,341,306.9,,0.95,,323.95,Percent of total billed charges,,,0.98,,334.18,Percent of total billed charges,,,0.95,,323.95,Percent of total billed charges,,,0.95,,323.95,Percent of total billed charges,,,0.97,,330.77,Percent of total billed charges,,,0.96,,327.36,Percent of total billed charges,,,0.95,,323.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,323.95,Percent of total billed charges,,323.95,3950,
Irrigation of implanted venous access drug delivery device,PX-76110307,CDM,96523,CPT,761,RC,,inpatient,,,237,213.3,,0.95,,225.15,Percent of total billed charges,,,0.98,,232.26,Percent of total billed charges,,,0.95,,225.15,Percent of total billed charges,,,0.97,,229.89,Percent of total billed charges,,,0.97,,229.89,Percent of total billed charges,,,0.96,,227.52,Percent of total billed charges,,,0.95,,225.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,225.15,Percent of total billed charges,,225.15,232.26,
Irrigation of implanted venous access drug delivery device,PX-76110307,CDM,96523,CPT,761,RC,,outpatient,,,237,213.3,,0.95,,225.15,Percent of total billed charges,,,0.98,,232.26,Percent of total billed charges,,,0.95,,225.15,Percent of total billed charges,,,0.95,,225.15,Percent of total billed charges,,,0.97,,229.89,Percent of total billed charges,,,0.96,,227.52,Percent of total billed charges,,,0.95,,225.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,225.15,Percent of total billed charges,,225.15,232.26,
Administration of vaccine,PX-77110001,CDM,90471,CPT,771,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Administration of vaccine,PX-77110001,CDM,90471,CPT,771,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
"Administration of vaccine, each additional vaccine",PX-77110002,CDM,90472,CPT,771,RC,,inpatient,,,37,33.3,,0.95,,35.15,Percent of total billed charges,,,0.98,,36.26,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.96,,35.52,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,35.15,Percent of total billed charges,,35.15,36.26,
"Administration of vaccine, each additional vaccine",PX-77110002,CDM,90472,CPT,771,RC,,outpatient,,,37,33.3,,0.95,,35.15,Percent of total billed charges,,,0.98,,36.26,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.96,,35.52,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,35.15,Percent of total billed charges,,35.15,36.26,
Administration of vaccine,PX-77110003,CDM,90471,CPT,771,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Administration of vaccine,PX-77110003,CDM,90471,CPT,771,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Administration of vaccine,PX-77110004,CDM,90471,CPT,771,RC,,inpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
Administration of vaccine,PX-77110004,CDM,90471,CPT,771,RC,,outpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
Administration of vaccine,PX-77110005,CDM,90471,CPT,771,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Administration of vaccine,PX-77110005,CDM,90471,CPT,771,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Injection of drug or substance under skin or into muscle,PX-94010205,CDM,96372,CPT,260,RC,,inpatient,,,164,147.6,,0.95,,155.8,Percent of total billed charges,,,0.98,,160.72,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.96,,157.44,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,155.8,Percent of total billed charges,,155.8,160.72,
Injection of drug or substance under skin or into muscle,PX-94010205,CDM,96372,CPT,260,RC,,outpatient,,,164,147.6,,0.95,,155.8,Percent of total billed charges,,,0.98,,160.72,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.96,,157.44,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,155.8,Percent of total billed charges,,155.8,160.72,
HC Inj IV Push Initial Drug,PX-94010207,CDM,96374,CPT,260,RC,,inpatient,,,286,257.4,,0.95,,271.7,Percent of total billed charges,,,0.98,,280.28,Percent of total billed charges,,,0.95,,271.7,Percent of total billed charges,,,0.97,,277.42,Percent of total billed charges,,,0.97,,277.42,Percent of total billed charges,,,0.96,,274.56,Percent of total billed charges,,,0.95,,271.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,271.7,Percent of total billed charges,,271.7,280.28,
HC Inj IV Push Initial Drug,PX-94010207,CDM,96374,CPT,260,RC,,outpatient,,,286,257.4,,0.95,,271.7,Percent of total billed charges,,,0.98,,280.28,Percent of total billed charges,,,0.95,,271.7,Percent of total billed charges,,,0.95,,271.7,Percent of total billed charges,,,0.97,,277.42,Percent of total billed charges,,,0.96,,274.56,Percent of total billed charges,,,0.95,,271.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,271.7,Percent of total billed charges,,271.7,280.28,
HC Inj IV Push Sequential New Drug,PX-94010208,CDM,96375,CPT,260,RC,,inpatient,,,126,113.4,,0.95,,119.7,Percent of total billed charges,,,0.98,,123.48,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.96,,120.96,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,119.7,Percent of total billed charges,,119.7,123.48,
HC Inj IV Push Sequential New Drug,PX-94010208,CDM,96375,CPT,260,RC,,outpatient,,,126,113.4,,0.95,,119.7,Percent of total billed charges,,,0.98,,123.48,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.96,,120.96,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,119.7,Percent of total billed charges,,119.7,123.48,
HC Ther Proph/Dx Njx Ea Seql IV Push Sbst/Drug Fac,PX-94010209,CDM,96376,CPT,260,RC,,inpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
HC Ther Proph/Dx Njx Ea Seql IV Push Sbst/Drug Fac,PX-94010209,CDM,96376,CPT,260,RC,,outpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
HC PR 90471 Immunization Admin,PX-96910463,CDM,90471,CPT,771,RC,,inpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
HC PR 90471 Immunization Admin,PX-96910463,CDM,90471,CPT,771,RC,,outpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
HC PR 90472 Immunization Admin Each Add,PX-96910464,CDM,90472,CPT,771,RC,,inpatient,,,37,33.3,,0.95,,35.15,Percent of total billed charges,,,0.98,,36.26,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.96,,35.52,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,35.15,Percent of total billed charges,,35.15,36.26,
HC PR 90472 Immunization Admin Each Add,PX-96910464,CDM,90472,CPT,771,RC,,outpatient,,,37,33.3,,0.95,,35.15,Percent of total billed charges,,,0.98,,36.26,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.96,,35.52,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,35.15,Percent of total billed charges,,35.15,36.26,
HC PR 95117 Immunotherapy Injections,PX-96910466,CDM,95117,CPT,983,RC,,inpatient,,,31,27.9,,0.95,,29.45,Percent of total billed charges,,,0.98,,30.38,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.96,,29.76,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,29.45,Percent of total billed charges,,29.45,30.38,
HC PR 95117 Immunotherapy Injections,PX-96910466,CDM,95117,CPT,983,RC,,outpatient,,,31,27.9,,0.95,,29.45,Percent of total billed charges,,,0.98,,30.38,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.96,,29.76,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,29.45,Percent of total billed charges,,29.45,30.38,
HC PR 96360 IV Infusion Hydration Initial 31 Min-1 Hour,PX-96910468,CDM,96360,CPT,983,RC,,inpatient,,,153,137.7,,0.95,,145.35,Percent of total billed charges,,,0.98,,149.94,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.96,,146.88,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,145.35,Percent of total billed charges,,145.35,149.94,
HC PR 96360 IV Infusion Hydration Initial 31 Min-1 Hour,PX-96910468,CDM,96360,CPT,983,RC,,outpatient,,,153,137.7,,0.95,,145.35,Percent of total billed charges,,,0.98,,149.94,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.96,,146.88,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,145.35,Percent of total billed charges,,145.35,149.94,
HC PR 96365 Ther/Proph/Diag IV Inf Init,PX-96910470,CDM,96365,CPT,983,RC,,inpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
HC PR 96365 Ther/Proph/Diag IV Inf Init,PX-96910470,CDM,96365,CPT,983,RC,,outpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
Therapeutic or diagnostic injection ; subcutaneous or intramuscular,PX-96910474,CDM,96372,CPT,940,RC,,inpatient,,,72,64.8,,0.95,,68.4,Percent of total billed charges,,,0.98,,70.56,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.96,,69.12,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,68.4,Percent of total billed charges,,68.4,70.56,
Therapeutic or diagnostic injection ; subcutaneous or intramuscular,PX-96910474,CDM,96372,CPT,940,RC,,outpatient,,,72,64.8,,0.95,,68.4,Percent of total billed charges,,,0.98,,70.56,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.96,,69.12,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,68.4,Percent of total billed charges,,68.4,70.56,
HC PR G0010 Medicare Admin Hepatitis B Vaccine,PX-96910483,CDM,G0010,HCPCS,771,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
HC PR G0010 Medicare Admin Hepatitis B Vaccine,PX-96910483,CDM,G0010,HCPCS,771,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
HC PR ED 36680 Insert Needle Bone Cavity Cdm,PX-98110226,CDM,36680,CPT,981,RC,,inpatient,,,340,306,,0.95,,323,Percent of total billed charges,,,0.98,,333.2,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.96,,326.4,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,323,Percent of total billed charges,,323,333.2,
HC PR ED 36680 Insert Needle Bone Cavity Cdm,PX-98110226,CDM,36680,CPT,981,RC,,outpatient,,,340,306,,0.95,,323,Percent of total billed charges,,,0.98,,333.2,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.96,,326.4,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,323,Percent of total billed charges,,323,333.2,
Transfusion of blood or blood products,PX-39110001,CDM,36430,CPT,391,RC,,inpatient,,,528,475.2,,0.95,,501.6,Percent of total billed charges,,,0.98,,517.44,Percent of total billed charges,,,0.95,,501.6,Percent of total billed charges,,,0.97,,512.16,Percent of total billed charges,,,0.97,,512.16,Percent of total billed charges,,,0.96,,506.88,Percent of total billed charges,,,0.95,,501.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,501.6,Percent of total billed charges,,501.6,517.44,
Transfusion of blood or blood products,PX-39110001,CDM,36430,CPT,391,RC,,outpatient,,,528,475.2,,0.95,,501.6,Percent of total billed charges,,,0.98,,517.44,Percent of total billed charges,,,0.95,,501.6,Percent of total billed charges,,,0.95,,501.6,Percent of total billed charges,,,0.97,,512.16,Percent of total billed charges,,,0.96,,506.88,Percent of total billed charges,,,0.95,,501.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,501.6,Percent of total billed charges,,501.6,517.44,
HC PR 36510 Insert Umbilical Cath Vein,PX-96910201,CDM,36510,CPT,983,RC,,inpatient,,,250,225,,0.95,,237.5,Percent of total billed charges,,,0.98,,245,Percent of total billed charges,,,0.95,,237.5,Percent of total billed charges,,,0.97,,242.5,Percent of total billed charges,,,0.97,,242.5,Percent of total billed charges,,,0.96,,240,Percent of total billed charges,,,0.95,,237.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,237.5,Percent of total billed charges,,237.5,245,
HC PR 36510 Insert Umbilical Cath Vein,PX-96910201,CDM,36510,CPT,983,RC,,outpatient,,,250,225,,0.95,,237.5,Percent of total billed charges,,,0.98,,245,Percent of total billed charges,,,0.95,,237.5,Percent of total billed charges,,,0.95,,237.5,Percent of total billed charges,,,0.97,,242.5,Percent of total billed charges,,,0.96,,240,Percent of total billed charges,,,0.95,,237.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,237.5,Percent of total billed charges,,237.5,245,
HC RBC Leukoreduced,PX-39010015,CDM,P9016,HCPCS,390,RC,,inpatient,,,439,395.1,,0.95,,417.05,Percent of total billed charges,,,0.98,,430.22,Percent of total billed charges,,,0.95,,417.05,Percent of total billed charges,,,0.97,,425.83,Percent of total billed charges,,,0.97,,425.83,Percent of total billed charges,,,0.96,,421.44,Percent of total billed charges,,,0.95,,417.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,417.05,Percent of total billed charges,,417.05,430.22,
HC RBC Leukoreduced,PX-39010015,CDM,P9016,HCPCS,390,RC,,outpatient,,,439,395.1,,0.95,,417.05,Percent of total billed charges,,,0.98,,430.22,Percent of total billed charges,,,0.95,,417.05,Percent of total billed charges,,,0.95,,417.05,Percent of total billed charges,,,0.97,,425.83,Percent of total billed charges,,,0.96,,421.44,Percent of total billed charges,,,0.95,,417.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,417.05,Percent of total billed charges,,417.05,430.22,
HC Platelet Pheresis Leukoreduced,PX-39010031,CDM,P9035,HCPCS,390,RC,,inpatient,,,1478,1330.2,,0.95,,1404.1,Percent of total billed charges,,,0.98,,1448.44,Percent of total billed charges,,,0.95,,1404.1,Percent of total billed charges,,,0.97,,1433.66,Percent of total billed charges,,,0.97,,1433.66,Percent of total billed charges,,,0.96,,1418.88,Percent of total billed charges,,,0.95,,1404.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1404.1,Percent of total billed charges,,1404.1,1448.44,
HC Platelet Pheresis Leukoreduced,PX-39010031,CDM,P9035,HCPCS,390,RC,,outpatient,,,1478,1330.2,,0.95,,1404.1,Percent of total billed charges,,,0.98,,1448.44,Percent of total billed charges,,,0.95,,1404.1,Percent of total billed charges,,,0.95,,1404.1,Percent of total billed charges,,,0.97,,1433.66,Percent of total billed charges,,,0.96,,1418.88,Percent of total billed charges,,,0.95,,1404.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1404.1,Percent of total billed charges,,1404.1,1448.44,
HC Plt Pheresis Lr Cmv Neg,PX-39010042,CDM,P9055,HCPCS,390,RC,,inpatient,,,954,858.6,,0.95,,906.3,Percent of total billed charges,,,0.98,,934.92,Percent of total billed charges,,,0.95,,906.3,Percent of total billed charges,,,0.97,,925.38,Percent of total billed charges,,,0.97,,925.38,Percent of total billed charges,,,0.96,,915.84,Percent of total billed charges,,,0.95,,906.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,906.3,Percent of total billed charges,,906.3,934.92,
HC Plt Pheresis Lr Cmv Neg,PX-39010042,CDM,P9055,HCPCS,390,RC,,outpatient,,,954,858.6,,0.95,,906.3,Percent of total billed charges,,,0.98,,934.92,Percent of total billed charges,,,0.95,,906.3,Percent of total billed charges,,,0.95,,906.3,Percent of total billed charges,,,0.97,,925.38,Percent of total billed charges,,,0.96,,915.84,Percent of total billed charges,,,0.95,,906.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,906.3,Percent of total billed charges,,906.3,934.92,
HC RBC Leukored Irrad Cmv Neg Ea,PX-39010044,CDM,P9058,HCPCS,390,RC,,inpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
HC RBC Leukored Irrad Cmv Neg Ea,PX-39010044,CDM,P9058,HCPCS,390,RC,,outpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
HC Fresh Frozen Plasma Frz Between 8-24hour,PX-39010045,CDM,P9059,HCPCS,390,RC,,inpatient,,,161,144.9,,0.95,,152.95,Percent of total billed charges,,,0.98,,157.78,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.96,,154.56,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,152.95,Percent of total billed charges,,152.95,157.78,
HC Fresh Frozen Plasma Frz Between 8-24hour,PX-39010045,CDM,P9059,HCPCS,390,RC,,outpatient,,,161,144.9,,0.95,,152.95,Percent of total billed charges,,,0.98,,157.78,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.96,,154.56,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,152.95,Percent of total billed charges,,152.95,157.78,
HC RBC Leukoreduced Irradiated,PX-39010055,CDM,P9040,HCPCS,390,RC,,inpatient,,,507,456.3,,0.95,,481.65,Percent of total billed charges,,,0.98,,496.86,Percent of total billed charges,,,0.95,,481.65,Percent of total billed charges,,,0.97,,491.79,Percent of total billed charges,,,0.97,,491.79,Percent of total billed charges,,,0.96,,486.72,Percent of total billed charges,,,0.95,,481.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,481.65,Percent of total billed charges,,481.65,496.86,
HC RBC Leukoreduced Irradiated,PX-39010055,CDM,P9040,HCPCS,390,RC,,outpatient,,,507,456.3,,0.95,,481.65,Percent of total billed charges,,,0.98,,496.86,Percent of total billed charges,,,0.95,,481.65,Percent of total billed charges,,,0.95,,481.65,Percent of total billed charges,,,0.97,,491.79,Percent of total billed charges,,,0.96,,486.72,Percent of total billed charges,,,0.95,,481.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,481.65,Percent of total billed charges,,481.65,496.86,
HC Operating Room Services Level 1 Add'l 15 Min,PX-36010211,CDM,36010211,LOCAL,360,RC,,inpatient,,,807,726.3,,0.95,,766.65,Percent of total billed charges,,,0.98,,790.86,Percent of total billed charges,,,0.95,,766.65,Percent of total billed charges,,,0.97,,782.79,Percent of total billed charges,,,0.97,,782.79,Percent of total billed charges,,,0.96,,774.72,Percent of total billed charges,,,0.95,,766.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,766.65,Percent of total billed charges,,766.65,790.86,
HC Operating Room Services Level 1 Add'l 15 Min,PX-36010211,CDM,36010211,LOCAL,360,RC,,outpatient,,,807,726.3,,0.95,,766.65,Percent of total billed charges,,,0.98,,790.86,Percent of total billed charges,,,0.95,,766.65,Percent of total billed charges,,,0.95,,766.65,Percent of total billed charges,,,0.97,,782.79,Percent of total billed charges,,,0.96,,774.72,Percent of total billed charges,,,0.95,,766.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,766.65,Percent of total billed charges,,766.65,790.86,
HC Operating Room Services Level 2 Add'l 15 Min,PX-36010213,CDM,36010213,LOCAL,360,RC,,inpatient,,,1093,983.7,,0.95,,1038.35,Percent of total billed charges,,,0.98,,1071.14,Percent of total billed charges,,,0.95,,1038.35,Percent of total billed charges,,,0.97,,1060.21,Percent of total billed charges,,,0.97,,1060.21,Percent of total billed charges,,,0.96,,1049.28,Percent of total billed charges,,,0.95,,1038.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1038.35,Percent of total billed charges,,1038.35,1071.14,
HC Operating Room Services Level 2 Add'l 15 Min,PX-36010213,CDM,36010213,LOCAL,360,RC,,outpatient,,,1093,983.7,,0.95,,1038.35,Percent of total billed charges,,,0.98,,1071.14,Percent of total billed charges,,,0.95,,1038.35,Percent of total billed charges,,,0.95,,1038.35,Percent of total billed charges,,,0.97,,1060.21,Percent of total billed charges,,,0.96,,1049.28,Percent of total billed charges,,,0.95,,1038.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1038.35,Percent of total billed charges,,1038.35,1071.14,
HC Operating Room Services Level 3 Add'l 15 Min,PX-36010215,CDM,36010215,LOCAL,360,RC,,inpatient,,,1155,1039.5,,0.95,,1097.25,Percent of total billed charges,,,0.98,,1131.9,Percent of total billed charges,,,0.95,,1097.25,Percent of total billed charges,,,0.97,,1120.35,Percent of total billed charges,,,0.97,,1120.35,Percent of total billed charges,,,0.96,,1108.8,Percent of total billed charges,,,0.95,,1097.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1097.25,Percent of total billed charges,,1097.25,1131.9,
HC Operating Room Services Level 3 Add'l 15 Min,PX-36010215,CDM,36010215,LOCAL,360,RC,,outpatient,,,1155,1039.5,,0.95,,1097.25,Percent of total billed charges,,,0.98,,1131.9,Percent of total billed charges,,,0.95,,1097.25,Percent of total billed charges,,,0.95,,1097.25,Percent of total billed charges,,,0.97,,1120.35,Percent of total billed charges,,,0.96,,1108.8,Percent of total billed charges,,,0.95,,1097.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1097.25,Percent of total billed charges,,1097.25,1131.9,
HC Operating Room Services Level 4 Add'l 15 Min,PX-36010217,CDM,36010217,LOCAL,360,RC,,inpatient,,,1265,1138.5,,0.95,,1201.75,Percent of total billed charges,,,0.98,,1239.7,Percent of total billed charges,,,0.95,,1201.75,Percent of total billed charges,,,0.97,,1227.05,Percent of total billed charges,,,0.97,,1227.05,Percent of total billed charges,,,0.96,,1214.4,Percent of total billed charges,,,0.95,,1201.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1201.75,Percent of total billed charges,,1201.75,1239.7,
HC Operating Room Services Level 4 Add'l 15 Min,PX-36010217,CDM,36010217,LOCAL,360,RC,,outpatient,,,1265,1138.5,,0.95,,1201.75,Percent of total billed charges,,,0.98,,1239.7,Percent of total billed charges,,,0.95,,1201.75,Percent of total billed charges,,,0.95,,1201.75,Percent of total billed charges,,,0.97,,1227.05,Percent of total billed charges,,,0.96,,1214.4,Percent of total billed charges,,,0.95,,1201.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1201.75,Percent of total billed charges,,1201.75,1239.7,
HC Operating Room Services Level 5 Add'l 15 Min,PX-36010219,CDM,36010219,LOCAL,360,RC,,inpatient,,,1375,1237.5,,0.95,,1306.25,Percent of total billed charges,,,0.98,,1347.5,Percent of total billed charges,,,0.95,,1306.25,Percent of total billed charges,,,0.97,,1333.75,Percent of total billed charges,,,0.97,,1333.75,Percent of total billed charges,,,0.96,,1320,Percent of total billed charges,,,0.95,,1306.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1306.25,Percent of total billed charges,,1306.25,1347.5,
HC Operating Room Services Level 5 Add'l 15 Min,PX-36010219,CDM,36010219,LOCAL,360,RC,,outpatient,,,1375,1237.5,,0.95,,1306.25,Percent of total billed charges,,,0.98,,1347.5,Percent of total billed charges,,,0.95,,1306.25,Percent of total billed charges,,,0.95,,1306.25,Percent of total billed charges,,,0.97,,1333.75,Percent of total billed charges,,,0.96,,1320,Percent of total billed charges,,,0.95,,1306.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1306.25,Percent of total billed charges,,1306.25,1347.5,
HC Operating Room Services Level 6 Add'l 15 Min,PX-36010221,CDM,36010221,LOCAL,360,RC,,inpatient,,,1485,1336.5,,0.95,,1410.75,Percent of total billed charges,,,0.98,,1455.3,Percent of total billed charges,,,0.95,,1410.75,Percent of total billed charges,,,0.97,,1440.45,Percent of total billed charges,,,0.97,,1440.45,Percent of total billed charges,,,0.96,,1425.6,Percent of total billed charges,,,0.95,,1410.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1410.75,Percent of total billed charges,,1410.75,1455.3,
HC Operating Room Services Level 6 Add'l 15 Min,PX-36010221,CDM,36010221,LOCAL,360,RC,,outpatient,,,1485,1336.5,,0.95,,1410.75,Percent of total billed charges,,,0.98,,1455.3,Percent of total billed charges,,,0.95,,1410.75,Percent of total billed charges,,,0.95,,1410.75,Percent of total billed charges,,,0.97,,1440.45,Percent of total billed charges,,,0.96,,1425.6,Percent of total billed charges,,,0.95,,1410.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1410.75,Percent of total billed charges,,1410.75,1455.3,
HC Operating Room Services Level 7 Add'l 15 Min,PX-36010223,CDM,36010223,LOCAL,360,RC,,inpatient,,,1595,1435.5,,0.95,,1515.25,Percent of total billed charges,,,0.98,,1563.1,Percent of total billed charges,,,0.95,,1515.25,Percent of total billed charges,,,0.97,,1547.15,Percent of total billed charges,,,0.97,,1547.15,Percent of total billed charges,,,0.96,,1531.2,Percent of total billed charges,,,0.95,,1515.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1515.25,Percent of total billed charges,,1515.25,1563.1,
HC Operating Room Services Level 7 Add'l 15 Min,PX-36010223,CDM,36010223,LOCAL,360,RC,,outpatient,,,1595,1435.5,,0.95,,1515.25,Percent of total billed charges,,,0.98,,1563.1,Percent of total billed charges,,,0.95,,1515.25,Percent of total billed charges,,,0.95,,1515.25,Percent of total billed charges,,,0.97,,1547.15,Percent of total billed charges,,,0.96,,1531.2,Percent of total billed charges,,,0.95,,1515.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1515.25,Percent of total billed charges,,1515.25,1563.1,
"Fine needle biopsy using ultrasound guidance, 1st growth",PX-36110239,CDM,10005,CPT,361,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Fine needle biopsy using ultrasound guidance, 1st growth",PX-36110239,CDM,10005,CPT,361,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
HC PR 99491 Chronic Care Mgmt Svc First 30 Min per Month,PX-96910402,CDM,99491,CPT,983,RC,,inpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
HC PR 99491 Chronic Care Mgmt Svc First 30 Min per Month,PX-96910402,CDM,99491,CPT,983,RC,,outpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
HC PR 10005 Fine Needle Aspiration Bx W/US Gdn 1st Lesion,PX-97511272,CDM,10005,CPT,975,RC,,inpatient,,,330,297,,0.95,,313.5,Percent of total billed charges,,,0.98,,323.4,Percent of total billed charges,,,0.95,,313.5,Percent of total billed charges,,,0.97,,320.1,Percent of total billed charges,,,0.97,,320.1,Percent of total billed charges,,,0.96,,316.8,Percent of total billed charges,,,0.95,,313.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,313.5,Percent of total billed charges,,313.5,323.4,
HC PR 10005 Fine Needle Aspiration Bx W/US Gdn 1st Lesion,PX-97511272,CDM,10005,CPT,975,RC,,outpatient,,,330,297,,0.95,,313.5,Percent of total billed charges,,,0.98,,323.4,Percent of total billed charges,,,0.95,,313.5,Percent of total billed charges,,,0.95,,313.5,Percent of total billed charges,,,0.97,,320.1,Percent of total billed charges,,,0.96,,316.8,Percent of total billed charges,,,0.95,,313.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,313.5,Percent of total billed charges,,313.5,323.4,
HC PR 10006 Fine Needle Aspiration Bx W/US Gdn Ea Addl,PX-97511275,CDM,10006,CPT,975,RC,,inpatient,,,148,133.2,,0.95,,140.6,Percent of total billed charges,,,0.98,,145.04,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.96,,142.08,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,140.6,Percent of total billed charges,,140.6,145.04,
HC PR 10006 Fine Needle Aspiration Bx W/US Gdn Ea Addl,PX-97511275,CDM,10006,CPT,975,RC,,outpatient,,,148,133.2,,0.95,,140.6,Percent of total billed charges,,,0.98,,145.04,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.96,,142.08,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,140.6,Percent of total billed charges,,140.6,145.04,
HC PR 11102 Tangential Biopsy Skin Single Lesion,PX-97511282,CDM,11102,CPT,975,RC,,inpatient,,,248,223.2,,0.95,,235.6,Percent of total billed charges,,,0.98,,243.04,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,0.97,,240.56,Percent of total billed charges,,,0.97,,240.56,Percent of total billed charges,,,0.96,,238.08,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,235.6,Percent of total billed charges,,235.6,243.04,
HC PR 11102 Tangential Biopsy Skin Single Lesion,PX-97511282,CDM,11102,CPT,975,RC,,outpatient,,,248,223.2,,0.95,,235.6,Percent of total billed charges,,,0.98,,243.04,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,0.97,,240.56,Percent of total billed charges,,,0.96,,238.08,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,235.6,Percent of total billed charges,,235.6,243.04,
HC PR 38531 Open Biopsy/Excision Inguinofemoral Nodes,PX-97511292,CDM,38531,CPT,975,RC,,inpatient,,,1107,996.3,,0.95,,1051.65,Percent of total billed charges,,,0.98,,1084.86,Percent of total billed charges,,,0.95,,1051.65,Percent of total billed charges,,,0.97,,1073.79,Percent of total billed charges,,,0.97,,1073.79,Percent of total billed charges,,,0.96,,1062.72,Percent of total billed charges,,,0.95,,1051.65,Percent of total billed charges,,,,,,,,,0.95,,1051.65,Percent of total billed charges,,1051.65,1084.86,
HC PR 38531 Open Biopsy/Excision Inguinofemoral Nodes,PX-97511292,CDM,38531,CPT,975,RC,,outpatient,,,1107,996.3,,0.95,,1051.65,Percent of total billed charges,,,0.98,,1084.86,Percent of total billed charges,,,0.95,,1051.65,Percent of total billed charges,,,0.95,,1051.65,Percent of total billed charges,,,0.97,,1073.79,Percent of total billed charges,,,0.96,,1062.72,Percent of total billed charges,,,0.95,,1051.65,Percent of total billed charges,,,,,,,,,0.95,,1051.65,Percent of total billed charges,,1051.65,1084.86,
Biochemical assays to evaluate chronic Hepatitis C,PX-30110219,CDM,81596,CPT,301,RC,,inpatient,,,247,222.3,,0.95,,234.65,Percent of total billed charges,,,0.98,,242.06,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.96,,237.12,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,234.65,Percent of total billed charges,,234.65,242.06,
Biochemical assays to evaluate chronic Hepatitis C,PX-30110219,CDM,81596,CPT,301,RC,,outpatient,,,247,222.3,,0.95,,234.65,Percent of total billed charges,,,0.98,,242.06,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.96,,237.12,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,234.65,Percent of total billed charges,,234.65,242.06,
HC PR 11104 Punch Biopsy Skin Single Lesion,PX-98310202,CDM,11104,CPT,983,RC,,inpatient,,,239,215.1,,0.95,,227.05,Percent of total billed charges,,,0.98,,234.22,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,0.97,,231.83,Percent of total billed charges,,,0.97,,231.83,Percent of total billed charges,,,0.96,,229.44,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,227.05,Percent of total billed charges,,227.05,234.22,
HC PR 11104 Punch Biopsy Skin Single Lesion,PX-98310202,CDM,11104,CPT,983,RC,,outpatient,,,239,215.1,,0.95,,227.05,Percent of total billed charges,,,0.98,,234.22,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,0.97,,231.83,Percent of total billed charges,,,0.96,,229.44,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,227.05,Percent of total billed charges,,227.05,234.22,
HC PR 11105 Punch Biopsy Skin Ea Sep/Additional Lesion,PX-98310203,CDM,11105,CPT,983,RC,,inpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
HC PR 11105 Punch Biopsy Skin Ea Sep/Additional Lesion,PX-98310203,CDM,11105,CPT,983,RC,,outpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
Incisional Biopsy Skin Single Lesion,PX-98310204,CDM,11106,CPT,983,RC,,inpatient,,,239,215.1,,0.95,,227.05,Percent of total billed charges,,,0.98,,234.22,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,0.97,,231.83,Percent of total billed charges,,,0.97,,231.83,Percent of total billed charges,,,0.96,,229.44,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,227.05,Percent of total billed charges,,227.05,234.22,
Incisional Biopsy Skin Single Lesion,PX-98310204,CDM,11106,CPT,983,RC,,outpatient,,,239,215.1,,0.95,,227.05,Percent of total billed charges,,,0.98,,234.22,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,0.97,,231.83,Percent of total billed charges,,,0.96,,229.44,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,227.05,Percent of total billed charges,,227.05,234.22,
Molecular pathology procedure level 4,PX-30110300,CDM,81403,CPT,310,RC,,inpatient,,,697,627.3,,0.95,,662.15,Percent of total billed charges,,,0.98,,683.06,Percent of total billed charges,,,0.95,,662.15,Percent of total billed charges,,,0.97,,676.09,Percent of total billed charges,,,0.97,,676.09,Percent of total billed charges,,,0.96,,669.12,Percent of total billed charges,,,0.95,,662.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,662.15,Percent of total billed charges,,662.15,683.06,
Molecular pathology procedure level 4,PX-30110300,CDM,81403,CPT,310,RC,,outpatient,,,697,627.3,,0.95,,662.15,Percent of total billed charges,,,0.98,,683.06,Percent of total billed charges,,,0.95,,662.15,Percent of total billed charges,,,0.95,,662.15,Percent of total billed charges,,,0.97,,676.09,Percent of total billed charges,,,0.96,,669.12,Percent of total billed charges,,,0.95,,662.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,662.15,Percent of total billed charges,,662.15,683.06,
HC PR 11107 Incisional Biopsy Skin Ea Sep/Additional Lesion,PX-98310454,CDM,11107,CPT,983,RC,,inpatient,,,96,86.4,,0.95,,91.2,Percent of total billed charges,,,0.98,,94.08,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.96,,92.16,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,91.2,Percent of total billed charges,,91.2,94.08,
HC PR 11107 Incisional Biopsy Skin Ea Sep/Additional Lesion,PX-98310454,CDM,11107,CPT,983,RC,,outpatient,,,96,86.4,,0.95,,91.2,Percent of total billed charges,,,0.98,,94.08,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.96,,92.16,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,91.2,Percent of total billed charges,,91.2,94.08,
HC PR ED 99175 Induction of Vomiting Cdm,PX-98110902,CDM,99175,CPT,981,RC,,inpatient,,,178,160.2,,0.95,,169.1,Percent of total billed charges,,,0.98,,174.44,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,0.97,,172.66,Percent of total billed charges,,,0.97,,172.66,Percent of total billed charges,,,0.96,,170.88,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,169.1,Percent of total billed charges,,169.1,174.44,
HC PR ED 99175 Induction of Vomiting Cdm,PX-98110902,CDM,99175,CPT,981,RC,,outpatient,,,178,160.2,,0.95,,169.1,Percent of total billed charges,,,0.98,,174.44,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,0.97,,172.66,Percent of total billed charges,,,0.96,,170.88,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,169.1,Percent of total billed charges,,169.1,174.44,
Analysis for antibody to Herpes simplex virus,PX-30010368,CDM,86694,CPT,302,RC,,inpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
Analysis for antibody to Herpes simplex virus,PX-30010368,CDM,86694,CPT,302,RC,,outpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
Measurement of antibody to infectious organism,PX-30010401,CDM,86000,CPT,302,RC,,inpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
Measurement of antibody to infectious organism,PX-30010401,CDM,86000,CPT,302,RC,,outpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
Measure C-reactive protein for detection of infection,PX-30010421,CDM,86141,CPT,302,RC,,inpatient,,,90,81,,0.95,,85.5,Percent of total billed charges,,,0.98,,88.2,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,0.97,,87.3,Percent of total billed charges,,,0.97,,87.3,Percent of total billed charges,,,0.96,,86.4,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,85.5,Percent of total billed charges,,85.5,88.2,
Measure C-reactive protein for detection of infection,PX-30010421,CDM,86141,CPT,302,RC,,outpatient,,,90,81,,0.95,,85.5,Percent of total billed charges,,,0.98,,88.2,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,0.97,,87.3,Percent of total billed charges,,,0.96,,86.4,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,85.5,Percent of total billed charges,,85.5,88.2,
Beta 2 glycoprotein 1 antibody measurement,PX-30010429,CDM,86146,CPT,302,RC,,inpatient,,,85,76.5,,0.95,,80.75,Percent of total billed charges,,,0.98,,83.3,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.96,,81.6,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,80.75,Percent of total billed charges,,80.75,83.3,
Beta 2 glycoprotein 1 antibody measurement,PX-30010429,CDM,86146,CPT,302,RC,,outpatient,,,85,76.5,,0.95,,80.75,Percent of total billed charges,,,0.98,,83.3,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.96,,81.6,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,80.75,Percent of total billed charges,,80.75,83.3,
Measurement of complement function (immune system proteins),PX-30010431,CDM,86161,CPT,302,RC,,inpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
Measurement of complement function (immune system proteins),PX-30010431,CDM,86161,CPT,302,RC,,outpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
Measurement of antibody for rheumatoid arthritis assessment,PX-30010438,CDM,86200,CPT,302,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Measurement of antibody for rheumatoid arthritis assessment,PX-30010438,CDM,86200,CPT,302,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Measurement of DNA antibody,PX-30010447,CDM,86215,CPT,302,RC,,inpatient,,,46,41.4,,0.95,,43.7,Percent of total billed charges,,,0.98,,45.08,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,0.97,,44.62,Percent of total billed charges,,,0.97,,44.62,Percent of total billed charges,,,0.96,,44.16,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,43.7,Percent of total billed charges,,43.7,45.08,
Measurement of DNA antibody,PX-30010447,CDM,86215,CPT,302,RC,,outpatient,,,46,41.4,,0.95,,43.7,Percent of total billed charges,,,0.98,,45.08,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,0.97,,44.62,Percent of total billed charges,,,0.96,,44.16,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,43.7,Percent of total billed charges,,43.7,45.08,
Hepatitis Be antibody measurement,PX-30010459,CDM,86707,CPT,302,RC,,inpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
Hepatitis Be antibody measurement,PX-30010459,CDM,86707,CPT,302,RC,,outpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
Analysis for detection of tumor marker,PX-30010472,CDM,86316,CPT,302,RC,,inpatient,,,206,185.4,,0.95,,195.7,Percent of total billed charges,,,0.98,,201.88,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.96,,197.76,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,195.7,Percent of total billed charges,,195.7,201.88,
Analysis for detection of tumor marker,PX-30010472,CDM,86316,CPT,302,RC,,outpatient,,,206,185.4,,0.95,,195.7,Percent of total billed charges,,,0.98,,201.88,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.96,,197.76,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,195.7,Percent of total billed charges,,195.7,201.88,
Screening test for antibody to noninfectious agent,PX-30010473,CDM,86255,CPT,302,RC,,inpatient,,,44,39.6,,0.95,,41.8,Percent of total billed charges,,,0.98,,43.12,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,0.97,,42.68,Percent of total billed charges,,,0.97,,42.68,Percent of total billed charges,,,0.96,,42.24,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,41.8,Percent of total billed charges,,41.8,43.12,
Screening test for antibody to noninfectious agent,PX-30010473,CDM,86255,CPT,302,RC,,outpatient,,,44,39.6,,0.95,,41.8,Percent of total billed charges,,,0.98,,43.12,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,0.97,,42.68,Percent of total billed charges,,,0.96,,42.24,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,41.8,Percent of total billed charges,,41.8,43.12,
Thyroglobulin (thyroid protein) antibody measurement,PX-30010478,CDM,86800,CPT,302,RC,,inpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
Thyroglobulin (thyroid protein) antibody measurement,PX-30010478,CDM,86800,CPT,302,RC,,outpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
"Immunologic analysis tumor antigen, quantitative; CA 15-3",PX-30010492,CDM,86300,CPT,302,RC,,inpatient,,,120,108,,0.95,,114,Percent of total billed charges,,,0.98,,117.6,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.96,,115.2,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114,Percent of total billed charges,,114,117.6,
"Immunologic analysis tumor antigen, quantitative; CA 15-3",PX-30010492,CDM,86300,CPT,302,RC,,outpatient,,,120,108,,0.95,,114,Percent of total billed charges,,,0.98,,117.6,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.96,,115.2,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114,Percent of total billed charges,,114,117.6,
Screening test for antibody to noninfectious agent,PX-30010495,CDM,86255,CPT,302,RC,,inpatient,,,44,39.6,,0.95,,41.8,Percent of total billed charges,,,0.98,,43.12,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,0.97,,42.68,Percent of total billed charges,,,0.97,,42.68,Percent of total billed charges,,,0.96,,42.24,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,41.8,Percent of total billed charges,,41.8,43.12,
Screening test for antibody to noninfectious agent,PX-30010495,CDM,86255,CPT,302,RC,,outpatient,,,44,39.6,,0.95,,41.8,Percent of total billed charges,,,0.98,,43.12,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,0.97,,42.68,Percent of total billed charges,,,0.96,,42.24,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,41.8,Percent of total billed charges,,41.8,43.12,
Measurement of antibody to noninfectious agent,PX-30010512,CDM,86256,CPT,302,RC,,inpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
Measurement of antibody to noninfectious agent,PX-30010512,CDM,86256,CPT,302,RC,,outpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
"Immunologic analysis tumor antigen, quantitative; CA 19-9",PX-30010558,CDM,86301,CPT,302,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
"Immunologic analysis tumor antigen, quantitative; CA 19-9",PX-30010558,CDM,86301,CPT,302,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
"Immunologic analysis of tumor antigen, quantitative; CA 125",PX-30010560,CDM,86304,CPT,302,RC,,inpatient,,,192,172.8,,0.95,,182.4,Percent of total billed charges,,,0.98,,188.16,Percent of total billed charges,,,0.95,,182.4,Percent of total billed charges,,,0.97,,186.24,Percent of total billed charges,,,0.97,,186.24,Percent of total billed charges,,,0.96,,184.32,Percent of total billed charges,,,0.95,,182.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,182.4,Percent of total billed charges,,182.4,188.16,
"Immunologic analysis of tumor antigen, quantitative; CA 125",PX-30010560,CDM,86304,CPT,302,RC,,outpatient,,,192,172.8,,0.95,,182.4,Percent of total billed charges,,,0.98,,188.16,Percent of total billed charges,,,0.95,,182.4,Percent of total billed charges,,,0.95,,182.4,Percent of total billed charges,,,0.97,,186.24,Percent of total billed charges,,,0.96,,184.32,Percent of total billed charges,,,0.95,,182.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,182.4,Percent of total billed charges,,182.4,188.16,
Analysis of female reproductive genetic marker,PX-30010564,CDM,86305,CPT,302,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
Analysis of female reproductive genetic marker,PX-30010564,CDM,86305,CPT,302,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
Immune complex measurement,PX-30010589,CDM,86332,CPT,302,RC,,inpatient,,,195,175.5,,0.95,,185.25,Percent of total billed charges,,,0.98,,191.1,Percent of total billed charges,,,0.95,,185.25,Percent of total billed charges,,,0.97,,189.15,Percent of total billed charges,,,0.97,,189.15,Percent of total billed charges,,,0.96,,187.2,Percent of total billed charges,,,0.95,,185.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,185.25,Percent of total billed charges,,185.25,191.1,
Immune complex measurement,PX-30010589,CDM,86332,CPT,302,RC,,outpatient,,,195,175.5,,0.95,,185.25,Percent of total billed charges,,,0.98,,191.1,Percent of total billed charges,,,0.95,,185.25,Percent of total billed charges,,,0.95,,185.25,Percent of total billed charges,,,0.97,,189.15,Percent of total billed charges,,,0.96,,187.2,Percent of total billed charges,,,0.95,,185.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,185.25,Percent of total billed charges,,185.25,191.1,
Immunologic analysis technique on serum (immunofixation),PX-30010599,CDM,86334,CPT,302,RC,,inpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
Immunologic analysis technique on serum (immunofixation),PX-30010599,CDM,86334,CPT,302,RC,,outpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
Immunologic analysis on body/other fluids w/ concentration,PX-30010605,CDM,86335,CPT,302,RC,,inpatient,,,45,40.5,,0.95,,42.75,Percent of total billed charges,,,0.98,,44.1,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.96,,43.2,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,42.75,Percent of total billed charges,,42.75,44.1,
Immunologic analysis on body/other fluids w/ concentration,PX-30010605,CDM,86335,CPT,302,RC,,outpatient,,,45,40.5,,0.95,,42.75,Percent of total billed charges,,,0.98,,44.1,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.96,,43.2,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,42.75,Percent of total billed charges,,42.75,44.1,
Insulin antibody measurement,PX-30010617,CDM,86337,CPT,302,RC,,inpatient,,,96,86.4,,0.95,,91.2,Percent of total billed charges,,,0.98,,94.08,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.96,,92.16,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,91.2,Percent of total billed charges,,91.2,94.08,
Insulin antibody measurement,PX-30010617,CDM,86337,CPT,302,RC,,outpatient,,,96,86.4,,0.95,,91.2,Percent of total billed charges,,,0.98,,94.08,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.96,,92.16,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,91.2,Percent of total billed charges,,91.2,94.08,
Islet cell (pancreas) antibody measurement,PX-30010623,CDM,86341,CPT,302,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Islet cell (pancreas) antibody measurement,PX-30010623,CDM,86341,CPT,302,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Total cell count for B cells (white blood cells),PX-30010637,CDM,86355,CPT,302,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
Total cell count for B cells (white blood cells),PX-30010637,CDM,86355,CPT,302,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
Total cell count for natural killer cells,PX-30010641,CDM,86357,CPT,302,RC,,inpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
Total cell count for natural killer cells,PX-30010641,CDM,86357,CPT,302,RC,,outpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
"T cell count and ratio, including ratio",PX-30010648,CDM,86360,CPT,302,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
"T cell count and ratio, including ratio",PX-30010648,CDM,86360,CPT,302,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
T cell count and ratio,PX-30010657,CDM,86361,CPT,302,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
T cell count and ratio,PX-30010657,CDM,86361,CPT,302,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Microsomal antibodies (autoantibody) measurement,PX-30010660,CDM,86376,CPT,302,RC,,inpatient,,,72,64.8,,0.95,,68.4,Percent of total billed charges,,,0.98,,70.56,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.96,,69.12,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,68.4,Percent of total billed charges,,68.4,70.56,
Microsomal antibodies (autoantibody) measurement,PX-30010660,CDM,86376,CPT,302,RC,,outpatient,,,72,64.8,,0.95,,68.4,Percent of total billed charges,,,0.98,,70.56,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.96,,69.12,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,68.4,Percent of total billed charges,,68.4,70.56,
Microsomal antibodies (autoantibody) measurement,PX-30010663,CDM,86376,CPT,302,RC,,inpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
Microsomal antibodies (autoantibody) measurement,PX-30010663,CDM,86376,CPT,302,RC,,outpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
Rheumatoid factor analysis,PX-30010675,CDM,86430,CPT,302,RC,,inpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
Rheumatoid factor analysis,PX-30010675,CDM,86430,CPT,302,RC,,outpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
White blood cell antigen measurement,PX-30010679,CDM,86356,CPT,302,RC,,inpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
White blood cell antigen measurement,PX-30010679,CDM,86356,CPT,302,RC,,outpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
Analysis for antibody bordetella (respiratory bacteria),PX-30010682,CDM,86615,CPT,302,RC,,inpatient,,,51,45.9,,0.95,,48.45,Percent of total billed charges,,,0.98,,49.98,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.96,,48.96,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,48.45,Percent of total billed charges,,48.45,49.98,
Analysis for antibody bordetella (respiratory bacteria),PX-30010682,CDM,86615,CPT,302,RC,,outpatient,,,51,45.9,,0.95,,48.45,Percent of total billed charges,,,0.98,,49.98,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.96,,48.96,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,48.45,Percent of total billed charges,,48.45,49.98,
Skin test for tuberculosis,PX-30010684,CDM,86580,CPT,302,RC,,inpatient,,,32,28.8,,0.95,,30.4,Percent of total billed charges,,,0.98,,31.36,Percent of total billed charges,,,0.95,,30.4,Percent of total billed charges,,,0.97,,31.04,Percent of total billed charges,,,0.97,,31.04,Percent of total billed charges,,,0.96,,30.72,Percent of total billed charges,,,0.95,,30.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,30.4,Percent of total billed charges,,30.4,31.36,
Skin test for tuberculosis,PX-30010684,CDM,86580,CPT,302,RC,,outpatient,,,32,28.8,,0.95,,30.4,Percent of total billed charges,,,0.98,,31.36,Percent of total billed charges,,,0.95,,30.4,Percent of total billed charges,,,0.95,,30.4,Percent of total billed charges,,,0.97,,31.04,Percent of total billed charges,,,0.96,,30.72,Percent of total billed charges,,,0.95,,30.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,30.4,Percent of total billed charges,,30.4,31.36,
"Measurement of DNA antibody, single stranded",PX-30010693,CDM,86226,CPT,302,RC,,inpatient,,,51,45.9,,0.95,,48.45,Percent of total billed charges,,,0.98,,49.98,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.96,,48.96,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,48.45,Percent of total billed charges,,48.45,49.98,
"Measurement of DNA antibody, single stranded",PX-30010693,CDM,86226,CPT,302,RC,,outpatient,,,51,45.9,,0.95,,48.45,Percent of total billed charges,,,0.98,,49.98,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.96,,48.96,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,48.45,Percent of total billed charges,,48.45,49.98,
Analysis for antibody to blastomyces (fungus),PX-30010706,CDM,86612,CPT,302,RC,,inpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
Analysis for antibody to blastomyces (fungus),PX-30010706,CDM,86612,CPT,302,RC,,outpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
Confirmation test for antibody to Lyme disease bacteria,PX-30010722,CDM,86617,LOCAL,302,RC,,inpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
Confirmation test for antibody to Lyme disease bacteria,PX-30010722,CDM,86617,LOCAL,302,RC,,outpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
Analysis for antibody Borrelia burgdorferi,PX-30010731,CDM,86618,CPT,302,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Analysis for antibody Borrelia burgdorferi,PX-30010731,CDM,86618,CPT,302,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Analysis for antibody to Candida (yeast),PX-30010736,CDM,86628,CPT,302,RC,,inpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
Analysis for antibody to Candida (yeast),PX-30010736,CDM,86628,CPT,302,RC,,outpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
Analysis for antibody to Coxiella burnetii,PX-30010743,CDM,86638,CPT,302,RC,,inpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
Analysis for antibody to Coxiella burnetii,PX-30010743,CDM,86638,CPT,302,RC,,outpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
Analysis for antibody to Cytomegalovirus (CMV),PX-30010753,CDM,86644,CPT,302,RC,,inpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
Analysis for antibody to Cytomegalovirus (CMV),PX-30010753,CDM,86644,CPT,302,RC,,outpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
Analysis for antibody (IgM) to Cytomegalovirus (CMV),PX-30010765,CDM,86645,CPT,302,RC,,inpatient,,,109,98.1,,0.95,,103.55,Percent of total billed charges,,,0.98,,106.82,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,0.97,,105.73,Percent of total billed charges,,,0.97,,105.73,Percent of total billed charges,,,0.96,,104.64,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,103.55,Percent of total billed charges,,103.55,106.82,
Analysis for antibody (IgM) to Cytomegalovirus (CMV),PX-30010765,CDM,86645,CPT,302,RC,,outpatient,,,109,98.1,,0.95,,103.55,Percent of total billed charges,,,0.98,,106.82,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,0.97,,105.73,Percent of total billed charges,,,0.96,,104.64,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,103.55,Percent of total billed charges,,103.55,106.82,
Analysis for antibody to La crosse (CA) virus,PX-30010775,CDM,86651,CPT,302,RC,,inpatient,,,51,45.9,,0.95,,48.45,Percent of total billed charges,,,0.98,,49.98,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.96,,48.96,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,48.45,Percent of total billed charges,,48.45,49.98,
Analysis for antibody to La crosse (CA) virus,PX-30010775,CDM,86651,CPT,302,RC,,outpatient,,,51,45.9,,0.95,,48.45,Percent of total billed charges,,,0.98,,49.98,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.96,,48.96,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,48.45,Percent of total billed charges,,48.45,49.98,
Analysis for antibody to St. Louis virus,PX-30010793,CDM,86653,CPT,302,RC,,inpatient,,,51,45.9,,0.95,,48.45,Percent of total billed charges,,,0.98,,49.98,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.96,,48.96,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,48.45,Percent of total billed charges,,48.45,49.98,
Analysis for antibody to St. Louis virus,PX-30010793,CDM,86653,CPT,302,RC,,outpatient,,,51,45.9,,0.95,,48.45,Percent of total billed charges,,,0.98,,49.98,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.96,,48.96,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,48.45,Percent of total billed charges,,48.45,49.98,
Analysis for antibody to Western equine virus,PX-30010805,CDM,86654,CPT,302,RC,,inpatient,,,51,45.9,,0.95,,48.45,Percent of total billed charges,,,0.98,,49.98,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.96,,48.96,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,48.45,Percent of total billed charges,,48.45,49.98,
Analysis for antibody to Western equine virus,PX-30010805,CDM,86654,CPT,302,RC,,outpatient,,,51,45.9,,0.95,,48.45,Percent of total billed charges,,,0.98,,49.98,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.96,,48.96,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,48.45,Percent of total billed charges,,48.45,49.98,
"Analysis for antibody to Epstein-Barr virus, early antigen",PX-30010809,CDM,86663,CPT,302,RC,,inpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
"Analysis for antibody to Epstein-Barr virus, early antigen",PX-30010809,CDM,86663,CPT,302,RC,,outpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
"Analysis for antibody to Epstein-Bar, nuclear antigen",PX-30010814,CDM,86664,CPT,302,RC,,inpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
"Analysis for antibody to Epstein-Bar, nuclear antigen",PX-30010814,CDM,86664,CPT,302,RC,,outpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
"Analysis for antibody to Epstein-Barr virus , viral capsid",PX-30010822,CDM,86665,CPT,302,RC,,inpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
"Analysis for antibody to Epstein-Barr virus , viral capsid",PX-30010822,CDM,86665,CPT,302,RC,,outpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
Analysis for antibody to Francisella tularensis,PX-30010836,CDM,86668,CPT,302,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Analysis for antibody to Francisella tularensis,PX-30010836,CDM,86668,CPT,302,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Analysis for antibody to Helicobacter pylori,PX-30010843,CDM,86677,CPT,302,RC,,inpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Analysis for antibody to Helicobacter pylori,PX-30010843,CDM,86677,CPT,302,RC,,outpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Analysis for antibody to Helicobacter pylori,PX-30010844,CDM,86677,CPT,302,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Analysis for antibody to Helicobacter pylori,PX-30010844,CDM,86677,CPT,302,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Analysis for antibody to Helicobacter pylori,PX-30010846,CDM,86677,CPT,302,RC,,inpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Analysis for antibody to Helicobacter pylori,PX-30010846,CDM,86677,CPT,302,RC,,outpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Analysis for antibody to helminth (intestinal worm),PX-30010853,CDM,86682,CPT,302,RC,,inpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
Analysis for antibody to helminth (intestinal worm),PX-30010853,CDM,86682,CPT,302,RC,,outpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
HC PR 33286 Removal Subcutaneous Cardiac Rhythm Monitor,PX-97511336,CDM,33286,CPT,975,RC,,inpatient,,,327,294.3,,0.95,,310.65,Percent of total billed charges,,,0.98,,320.46,Percent of total billed charges,,,0.95,,310.65,Percent of total billed charges,,,0.97,,317.19,Percent of total billed charges,,,0.97,,317.19,Percent of total billed charges,,,0.96,,313.92,Percent of total billed charges,,,0.95,,310.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,310.65,Percent of total billed charges,,310.65,320.46,
HC PR 33286 Removal Subcutaneous Cardiac Rhythm Monitor,PX-97511336,CDM,33286,CPT,975,RC,,outpatient,,,327,294.3,,0.95,,310.65,Percent of total billed charges,,,0.98,,320.46,Percent of total billed charges,,,0.95,,310.65,Percent of total billed charges,,,0.95,,310.65,Percent of total billed charges,,,0.97,,317.19,Percent of total billed charges,,,0.96,,313.92,Percent of total billed charges,,,0.95,,310.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,310.65,Percent of total billed charges,,310.65,320.46,
Confirmation test for antibody to HTLV or HIV,PX-30010867,CDM,86689,CPT,302,RC,,inpatient,,,157,141.3,,0.95,,149.15,Percent of total billed charges,,,0.98,,153.86,Percent of total billed charges,,,0.95,,149.15,Percent of total billed charges,,,0.97,,152.29,Percent of total billed charges,,,0.97,,152.29,Percent of total billed charges,,,0.96,,150.72,Percent of total billed charges,,,0.95,,149.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,149.15,Percent of total billed charges,,149.15,153.86,
Confirmation test for antibody to HTLV or HIV,PX-30010867,CDM,86689,CPT,302,RC,,outpatient,,,157,141.3,,0.95,,149.15,Percent of total billed charges,,,0.98,,153.86,Percent of total billed charges,,,0.95,,149.15,Percent of total billed charges,,,0.95,,149.15,Percent of total billed charges,,,0.97,,152.29,Percent of total billed charges,,,0.96,,150.72,Percent of total billed charges,,,0.95,,149.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,149.15,Percent of total billed charges,,149.15,153.86,
Analysis for antibody to Hepatitis D virus,PX-30010872,CDM,86692,CPT,302,RC,,inpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
Analysis for antibody to Hepatitis D virus,PX-30010872,CDM,86692,CPT,302,RC,,outpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
Analysis for antibody to histoplasma (fungus),PX-30010885,CDM,86698,CPT,302,RC,,inpatient,,,55,49.5,,0.95,,52.25,Percent of total billed charges,,,0.98,,53.9,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.96,,52.8,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,52.25,Percent of total billed charges,,52.25,53.9,
Analysis for antibody to histoplasma (fungus),PX-30010885,CDM,86698,CPT,302,RC,,outpatient,,,55,49.5,,0.95,,52.25,Percent of total billed charges,,,0.98,,53.9,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.96,,52.8,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,52.25,Percent of total billed charges,,52.25,53.9,
"Analysis for antibody to Herpes simplex virus, type 1",PX-30010889,CDM,86695,CPT,302,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
"Analysis for antibody to Herpes simplex virus, type 1",PX-30010889,CDM,86695,CPT,302,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
"Analysis for antibody to Herpes simplex virus, type 2",PX-30010903,CDM,86696,CPT,302,RC,,inpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
"Analysis for antibody to Herpes simplex virus, type 2",PX-30010903,CDM,86696,CPT,302,RC,,outpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
"Analysis for antibody to Herpes simplex virus, type 2",PX-30010910,CDM,86696,CPT,302,RC,,inpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
"Analysis for antibody to Herpes simplex virus, type 2",PX-30010910,CDM,86696,CPT,302,RC,,outpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
Analysis for antibody to HIV-2 virus,PX-30010922,CDM,86702,CPT,302,RC,,inpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
Analysis for antibody to HIV-2 virus,PX-30010922,CDM,86702,CPT,302,RC,,outpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
Hepatitis B core antibody (IgM) measurement,PX-30010926,CDM,86705,CPT,300,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Hepatitis B core antibody (IgM) measurement,PX-30010926,CDM,86705,CPT,300,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Measurement of Hepatitis A antibody (IgM),PX-30010931,CDM,86709,CPT,300,RC,,inpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
Measurement of Hepatitis A antibody (IgM),PX-30010931,CDM,86709,CPT,300,RC,,outpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
Analysis for antibody to Legionella (waterborne bacteria),PX-30010936,CDM,86713,CPT,302,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
Analysis for antibody to Legionella (waterborne bacteria),PX-30010936,CDM,86713,CPT,302,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
Analysis for antibody to Leptospira,PX-30010939,CDM,86720,CPT,302,RC,,inpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
Analysis for antibody to Leptospira,PX-30010939,CDM,86720,CPT,302,RC,,outpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
Analysis for antibody to parvovirus,PX-30010954,CDM,86747,CPT,302,RC,,inpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
Analysis for antibody to parvovirus,PX-30010954,CDM,86747,CPT,302,RC,,outpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
Analysis for antibody to Plasmodium (malaria parasite),PX-30010962,CDM,86750,CPT,302,RC,,inpatient,,,195,175.5,,0.95,,185.25,Percent of total billed charges,,,0.98,,191.1,Percent of total billed charges,,,0.95,,185.25,Percent of total billed charges,,,0.97,,189.15,Percent of total billed charges,,,0.97,,189.15,Percent of total billed charges,,,0.96,,187.2,Percent of total billed charges,,,0.95,,185.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,185.25,Percent of total billed charges,,185.25,191.1,
Analysis for antibody to Plasmodium (malaria parasite),PX-30010962,CDM,86750,CPT,302,RC,,outpatient,,,195,175.5,,0.95,,185.25,Percent of total billed charges,,,0.98,,191.1,Percent of total billed charges,,,0.95,,185.25,Percent of total billed charges,,,0.95,,185.25,Percent of total billed charges,,,0.97,,189.15,Percent of total billed charges,,,0.96,,187.2,Percent of total billed charges,,,0.95,,185.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,185.25,Percent of total billed charges,,185.25,191.1,
Analysis for antibody to Rubeola (measles virus),PX-30010975,CDM,86765,CPT,302,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Analysis for antibody to Rubeola (measles virus),PX-30010975,CDM,86765,CPT,302,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Analysis for antibody to Toxoplasma (parasite),PX-30010982,CDM,86777,CPT,302,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Analysis for antibody to Toxoplasma (parasite),PX-30010982,CDM,86777,CPT,302,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Analysis for antibody (IgM) to Toxoplasma (parasite),PX-30010990,CDM,86778,CPT,302,RC,,inpatient,,,166,149.4,,0.95,,157.7,Percent of total billed charges,,,0.98,,162.68,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.96,,159.36,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,157.7,Percent of total billed charges,,157.7,162.68,
Analysis for antibody (IgM) to Toxoplasma (parasite),PX-30010990,CDM,86778,CPT,302,RC,,outpatient,,,166,149.4,,0.95,,157.7,Percent of total billed charges,,,0.98,,162.68,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.96,,159.36,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,157.7,Percent of total billed charges,,157.7,162.68,
"Analysis for antibody, Treponema pallidum",PX-30010996,CDM,86780,CPT,302,RC,,inpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
"Analysis for antibody, Treponema pallidum",PX-30010996,CDM,86780,CPT,302,RC,,outpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
Analysis for antibody to varicella-zoster virus,PX-30011006,CDM,86787,CPT,302,RC,,inpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
Analysis for antibody to varicella-zoster virus,PX-30011006,CDM,86787,CPT,302,RC,,outpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
Analysis for antibody to varicella-zoster virus,PX-30011007,CDM,86787,CPT,302,RC,,inpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
Analysis for antibody to varicella-zoster virus,PX-30011007,CDM,86787,CPT,302,RC,,outpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
Thyroglobulin (thyroid protein) antibody measurement,PX-30011019,CDM,86800,CPT,302,RC,,inpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
Thyroglobulin (thyroid protein) antibody measurement,PX-30011019,CDM,86800,CPT,302,RC,,outpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
Confirmation test for Hepatitis C antibody,PX-30011021,CDM,86804,CPT,302,RC,,inpatient,,,139,125.1,,0.95,,132.05,Percent of total billed charges,,,0.98,,136.22,Percent of total billed charges,,,0.95,,132.05,Percent of total billed charges,,,0.97,,134.83,Percent of total billed charges,,,0.97,,134.83,Percent of total billed charges,,,0.96,,133.44,Percent of total billed charges,,,0.95,,132.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,132.05,Percent of total billed charges,,132.05,136.22,
Confirmation test for Hepatitis C antibody,PX-30011021,CDM,86804,CPT,302,RC,,outpatient,,,139,125.1,,0.95,,132.05,Percent of total billed charges,,,0.98,,136.22,Percent of total billed charges,,,0.95,,132.05,Percent of total billed charges,,,0.95,,132.05,Percent of total billed charges,,,0.97,,134.83,Percent of total billed charges,,,0.96,,133.44,Percent of total billed charges,,,0.95,,132.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,132.05,Percent of total billed charges,,132.05,136.22,
Screening test for autoimmune disorder,PX-30011023,CDM,86038,CPT,302,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
Screening test for autoimmune disorder,PX-30011023,CDM,86038,CPT,302,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
"Analysis for autoimmune disease, A, B, or C, single antigen",PX-30011030,CDM,86812,LOCAL,302,RC,,inpatient,,,119,107.1,,0.95,,113.05,Percent of total billed charges,,,0.98,,116.62,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.96,,114.24,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,113.05,Percent of total billed charges,,113.05,116.62,
"Analysis for autoimmune disease, A, B, or C, single antigen",PX-30011030,CDM,86812,LOCAL,302,RC,,outpatient,,,119,107.1,,0.95,,113.05,Percent of total billed charges,,,0.98,,116.62,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.96,,114.24,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,113.05,Percent of total billed charges,,113.05,116.62,
Screening test for red blood cell antibodies,PX-30011040,CDM,86850,CPT,302,RC,,inpatient,,,161,144.9,,0.95,,152.95,Percent of total billed charges,,,0.98,,157.78,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.96,,154.56,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,152.95,Percent of total billed charges,,152.95,157.78,
Screening test for red blood cell antibodies,PX-30011040,CDM,86850,CPT,302,RC,,outpatient,,,161,144.9,,0.95,,152.95,Percent of total billed charges,,,0.98,,157.78,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.96,,154.56,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,152.95,Percent of total billed charges,,152.95,157.78,
Identification of red blood cell antibodies,PX-30011046,CDM,86870,CPT,302,RC,,inpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
Identification of red blood cell antibodies,PX-30011046,CDM,86870,CPT,302,RC,,outpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
Identification of red blood cell antibodies,PX-30011053,CDM,86870,CPT,302,RC,,inpatient,,,220,198,,0.95,,209,Percent of total billed charges,,,0.98,,215.6,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,0.97,,213.4,Percent of total billed charges,,,0.97,,213.4,Percent of total billed charges,,,0.96,,211.2,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,209,Percent of total billed charges,,209,215.6,
Identification of red blood cell antibodies,PX-30011053,CDM,86870,CPT,302,RC,,outpatient,,,220,198,,0.95,,209,Percent of total billed charges,,,0.98,,215.6,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,0.97,,213.4,Percent of total billed charges,,,0.96,,211.2,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,209,Percent of total billed charges,,209,215.6,
"Red blood cell antibody detection test, direct",PX-30011070,CDM,86880,CPT,302,RC,,inpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
"Red blood cell antibody detection test, direct",PX-30011070,CDM,86880,CPT,302,RC,,outpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
"Red blood cell antibody detection test, direct",PX-30011075,CDM,86880,CPT,302,RC,,inpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
"Red blood cell antibody detection test, direct",PX-30011075,CDM,86880,CPT,302,RC,,outpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
"Red blood cell antibody detection test, indirect",PX-30011076,CDM,86885,CPT,302,RC,,inpatient,,,58,52.2,,0.95,,55.1,Percent of total billed charges,,,0.98,,56.84,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,0.97,,56.26,Percent of total billed charges,,,0.97,,56.26,Percent of total billed charges,,,0.96,,55.68,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,55.1,Percent of total billed charges,,55.1,56.84,
"Red blood cell antibody detection test, indirect",PX-30011076,CDM,86885,CPT,302,RC,,outpatient,,,58,52.2,,0.95,,55.1,Percent of total billed charges,,,0.98,,56.84,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,0.97,,56.26,Percent of total billed charges,,,0.96,,55.68,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,55.1,Percent of total billed charges,,55.1,56.84,
Red blood cell antibody level,PX-30011079,CDM,86886,CPT,302,RC,,inpatient,,,135,121.5,,0.95,,128.25,Percent of total billed charges,,,0.98,,132.3,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,0.97,,130.95,Percent of total billed charges,,,0.97,,130.95,Percent of total billed charges,,,0.96,,129.6,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,128.25,Percent of total billed charges,,128.25,132.3,
Red blood cell antibody level,PX-30011079,CDM,86886,CPT,302,RC,,outpatient,,,135,121.5,,0.95,,128.25,Percent of total billed charges,,,0.98,,132.3,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,0.97,,130.95,Percent of total billed charges,,,0.96,,129.6,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,128.25,Percent of total billed charges,,128.25,132.3,
Blood group typing (ABO),PX-30011083,CDM,86900,CPT,302,RC,,inpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
Blood group typing (ABO),PX-30011083,CDM,86900,CPT,302,RC,,outpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
"Screening test for compatible blood unit, w/ reagent serum",PX-30011095,CDM,86902,CPT,302,RC,,inpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
"Screening test for compatible blood unit, w/ reagent serum",PX-30011095,CDM,86902,CPT,302,RC,,outpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
"Screening test for compatible blood unit, w/reagent serum",PX-30011111,CDM,86904,CPT,302,RC,,inpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
"Screening test for compatible blood unit, w/reagent serum",PX-30011111,CDM,86904,CPT,302,RC,,outpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
Blood typing for red blood cell antigens,PX-30011114,CDM,86905,CPT,302,RC,,inpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
Blood typing for red blood cell antigens,PX-30011114,CDM,86905,CPT,302,RC,,outpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
"Blood unit compatibility test, antiglobulin technique",PX-30011123,CDM,86922,CPT,302,RC,,inpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
"Blood unit compatibility test, antiglobulin technique",PX-30011123,CDM,86922,CPT,302,RC,,outpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
Pretreat serum for use in RBC antibody analysis and test,PX-30011134,CDM,86976,CPT,302,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Pretreat serum for use in RBC antibody analysis and test,PX-30011134,CDM,86976,CPT,302,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Concentration of specimen for infectious agents,PX-30011141,CDM,87015,CPT,306,RC,,inpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
Concentration of specimen for infectious agents,PX-30011141,CDM,87015,CPT,306,RC,,outpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
"Bacterial culture, any source, except blood, anaerobic",PX-30011159,CDM,87075,CPT,306,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
"Bacterial culture, any source, except blood, anaerobic",PX-30011159,CDM,87075,CPT,306,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Mycoplasma culture,PX-30011168,CDM,87109,CPT,306,RC,,inpatient,,,66,59.4,,0.95,,62.7,Percent of total billed charges,,,0.98,,64.68,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,0.97,,64.02,Percent of total billed charges,,,0.97,,64.02,Percent of total billed charges,,,0.96,,63.36,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,62.7,Percent of total billed charges,,62.7,64.68,
Mycoplasma culture,PX-30011168,CDM,87109,CPT,306,RC,,outpatient,,,66,59.4,,0.95,,62.7,Percent of total billed charges,,,0.98,,64.68,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,0.97,,64.02,Percent of total billed charges,,,0.96,,63.36,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,62.7,Percent of total billed charges,,62.7,64.68,
Culture for chlamydia,PX-30011169,CDM,87110,CPT,306,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Culture for chlamydia,PX-30011169,CDM,87110,CPT,306,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Macroscopic examination (visual inspection) of parasite,PX-30011197,CDM,87169,CPT,306,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
Macroscopic examination (visual inspection) of parasite,PX-30011197,CDM,87169,CPT,306,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
Smear for parasites,PX-30011200,CDM,87177,CPT,306,RC,,inpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
Smear for parasites,PX-30011200,CDM,87177,CPT,306,RC,,outpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
Special fluorescent/acid fast stain for microorganism,PX-30011226,CDM,87206,CPT,306,RC,,inpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
Special fluorescent/acid fast stain for microorganism,PX-30011226,CDM,87206,CPT,306,RC,,outpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
Special stain for inclusion bodies or parasites,PX-30011248,CDM,87207,CPT,306,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
Special stain for inclusion bodies or parasites,PX-30011248,CDM,87207,CPT,306,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
Special stain for parasites,PX-30011257,CDM,87209,CPT,306,RC,,inpatient,,,54,48.6,,0.95,,51.3,Percent of total billed charges,,,0.98,,52.92,Percent of total billed charges,,,0.95,,51.3,Percent of total billed charges,,,0.97,,52.38,Percent of total billed charges,,,0.97,,52.38,Percent of total billed charges,,,0.96,,51.84,Percent of total billed charges,,,0.95,,51.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,51.3,Percent of total billed charges,,51.3,52.92,
Special stain for parasites,PX-30011257,CDM,87209,CPT,306,RC,,outpatient,,,54,48.6,,0.95,,51.3,Percent of total billed charges,,,0.98,,52.92,Percent of total billed charges,,,0.95,,51.3,Percent of total billed charges,,,0.95,,51.3,Percent of total billed charges,,,0.97,,52.38,Percent of total billed charges,,,0.96,,51.84,Percent of total billed charges,,,0.95,,51.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,51.3,Percent of total billed charges,,51.3,52.92,
Smear for infectious agents,PX-30011260,CDM,87210,CPT,306,RC,,inpatient,,,63,56.7,,0.95,,59.85,Percent of total billed charges,,,0.98,,61.74,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.96,,60.48,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,59.85,Percent of total billed charges,,59.85,61.74,
Smear for infectious agents,PX-30011260,CDM,87210,CPT,306,RC,,outpatient,,,63,56.7,,0.95,,59.85,Percent of total billed charges,,,0.98,,61.74,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.96,,60.48,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,59.85,Percent of total billed charges,,59.85,61.74,
Smear for infectious agents,PX-30011261,CDM,87210,CPT,306,RC,,inpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
Smear for infectious agents,PX-30011261,CDM,87210,CPT,306,RC,,outpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
Tissue culture inoculation for virus isolation,PX-30011280,CDM,87252,CPT,306,RC,,inpatient,,,155,139.5,,0.95,,147.25,Percent of total billed charges,,,0.98,,151.9,Percent of total billed charges,,,0.95,,147.25,Percent of total billed charges,,,0.97,,150.35,Percent of total billed charges,,,0.97,,150.35,Percent of total billed charges,,,0.96,,148.8,Percent of total billed charges,,,0.95,,147.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,147.25,Percent of total billed charges,,147.25,151.9,
Tissue culture inoculation for virus isolation,PX-30011280,CDM,87252,CPT,306,RC,,outpatient,,,155,139.5,,0.95,,147.25,Percent of total billed charges,,,0.98,,151.9,Percent of total billed charges,,,0.95,,147.25,Percent of total billed charges,,,0.95,,147.25,Percent of total billed charges,,,0.97,,150.35,Percent of total billed charges,,,0.96,,148.8,Percent of total billed charges,,,0.95,,147.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,147.25,Percent of total billed charges,,147.25,151.9,
Tissue culture for virus isolation,PX-30011299,CDM,87253,CPT,306,RC,,inpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
Tissue culture for virus isolation,PX-30011299,CDM,87253,CPT,306,RC,,outpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
Virus isolation,PX-30011308,CDM,87255,CPT,306,RC,,inpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Virus isolation,PX-30011308,CDM,87255,CPT,306,RC,,outpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Detection test for adenovirus (virus),PX-30011309,CDM,87260,CPT,306,RC,,inpatient,,,23,20.7,,0.95,,21.85,Percent of total billed charges,,,0.98,,22.54,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.96,,22.08,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,21.85,Percent of total billed charges,,21.85,22.54,
Detection test for adenovirus (virus),PX-30011309,CDM,87260,CPT,306,RC,,outpatient,,,23,20.7,,0.95,,21.85,Percent of total billed charges,,,0.98,,22.54,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.96,,22.08,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,21.85,Percent of total billed charges,,21.85,22.54,
Test for bordetella pertussis or parapertussis,PX-30011311,CDM,87265,CPT,306,RC,,inpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
Test for bordetella pertussis or parapertussis,PX-30011311,CDM,87265,CPT,306,RC,,outpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
Test byimmunofluorescent for herpes simplex virus type 2,PX-30011315,CDM,87273,CPT,306,RC,,inpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
Test byimmunofluorescent for herpes simplex virus type 2,PX-30011315,CDM,87273,CPT,306,RC,,outpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
Test byimmunofluorescent for herpes simplex virus type 1,PX-30011316,CDM,87274,CPT,306,RC,,inpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
Test byimmunofluorescent for herpes simplex virus type 1,PX-30011316,CDM,87274,CPT,306,RC,,outpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
Detection test by immunofluorescent for influenza B virus,PX-30011318,CDM,87275,CPT,306,RC,,inpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
Detection test by immunofluorescent for influenza B virus,PX-30011318,CDM,87275,CPT,306,RC,,outpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
Detection test by immunofluorescent for influenza A virus,PX-30011321,CDM,87276,CPT,306,RC,,inpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
Detection test by immunofluorescent for influenza A virus,PX-30011321,CDM,87276,CPT,306,RC,,outpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
Detection test by immunofluorescent for parainfluenza virus,PX-30011326,CDM,87279,CPT,306,RC,,inpatient,,,23,20.7,,0.95,,21.85,Percent of total billed charges,,,0.98,,22.54,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.96,,22.08,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,21.85,Percent of total billed charges,,21.85,22.54,
Detection test by immunofluorescent for parainfluenza virus,PX-30011326,CDM,87279,CPT,306,RC,,outpatient,,,23,20.7,,0.95,,21.85,Percent of total billed charges,,,0.98,,22.54,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.96,,22.08,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,21.85,Percent of total billed charges,,21.85,22.54,
Test by immunofluorescent for respiratory syncytial virus,PX-30011328,CDM,87280,CPT,306,RC,,inpatient,,,23,20.7,,0.95,,21.85,Percent of total billed charges,,,0.98,,22.54,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.96,,22.08,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,21.85,Percent of total billed charges,,21.85,22.54,
Test by immunofluorescent for respiratory syncytial virus,PX-30011328,CDM,87280,CPT,306,RC,,outpatient,,,23,20.7,,0.95,,21.85,Percent of total billed charges,,,0.98,,22.54,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.96,,22.08,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,21.85,Percent of total billed charges,,21.85,22.54,
Test by immunofluorescent for varicella zoster virus,PX-30011337,CDM,87290,CPT,306,RC,,inpatient,,,170,153,,0.95,,161.5,Percent of total billed charges,,,0.98,,166.6,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,0.97,,164.9,Percent of total billed charges,,,0.97,,164.9,Percent of total billed charges,,,0.96,,163.2,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,161.5,Percent of total billed charges,,161.5,166.6,
Test by immunofluorescent for varicella zoster virus,PX-30011337,CDM,87290,CPT,306,RC,,outpatient,,,170,153,,0.95,,161.5,Percent of total billed charges,,,0.98,,166.6,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,0.97,,164.9,Percent of total billed charges,,,0.96,,163.2,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,161.5,Percent of total billed charges,,161.5,166.6,
"Test by immunoassay, multistep method, for yeast",PX-30011353,CDM,87327,CPT,306,RC,,inpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
"Test by immunoassay, multistep method, for yeast",PX-30011353,CDM,87327,CPT,306,RC,,outpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
Test byimmunoassay for Cryptosporidium (parasite),PX-30011355,CDM,87328,CPT,306,RC,,inpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
Test byimmunoassay for Cryptosporidium (parasite),PX-30011355,CDM,87328,CPT,306,RC,,outpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
"Measure antibody(IgG) to allergic substance, each allergen",PX-30011359,CDM,86001,CPT,302,RC,,inpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
"Measure antibody(IgG) to allergic substance, each allergen",PX-30011359,CDM,86001,CPT,302,RC,,outpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
Analysis for antibody to Neisseria meningitidis,PX-30011368,CDM,86741,CPT,302,RC,,inpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
Analysis for antibody to Neisseria meningitidis,PX-30011368,CDM,86741,CPT,302,RC,,outpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
Test byimmunoassay for hepatitis Be surface antigen,PX-30011394,CDM,87350,CPT,306,RC,,inpatient,,,55,49.5,,0.95,,52.25,Percent of total billed charges,,,0.98,,53.9,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.96,,52.8,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,52.25,Percent of total billed charges,,52.25,53.9,
Test byimmunoassay for hepatitis Be surface antigen,PX-30011394,CDM,87350,CPT,306,RC,,outpatient,,,55,49.5,,0.95,,52.25,Percent of total billed charges,,,0.98,,53.9,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.96,,52.8,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,52.25,Percent of total billed charges,,52.25,53.9,
Test byimmunoassay for hepatitis Be surface antigen,PX-30011397,CDM,87350,CPT,306,RC,,inpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
Test byimmunoassay for hepatitis Be surface antigen,PX-30011397,CDM,87350,CPT,306,RC,,outpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
Test byimmunoassay for Histoplasma capsulatum (parasite),PX-30011405,CDM,87385,CPT,302,RC,,inpatient,,,250,225,,0.95,,237.5,Percent of total billed charges,,,0.98,,245,Percent of total billed charges,,,0.95,,237.5,Percent of total billed charges,,,0.97,,242.5,Percent of total billed charges,,,0.97,,242.5,Percent of total billed charges,,,0.96,,240,Percent of total billed charges,,,0.95,,237.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,237.5,Percent of total billed charges,,237.5,245,
Test byimmunoassay for Histoplasma capsulatum (parasite),PX-30011405,CDM,87385,CPT,302,RC,,outpatient,,,250,225,,0.95,,237.5,Percent of total billed charges,,,0.98,,245,Percent of total billed charges,,,0.95,,237.5,Percent of total billed charges,,,0.95,,237.5,Percent of total billed charges,,,0.97,,242.5,Percent of total billed charges,,,0.96,,240,Percent of total billed charges,,,0.95,,237.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,237.5,Percent of total billed charges,,237.5,245,
"Test by nucleic acid for borrelia burgdorferi, amplified",PX-30011418,CDM,87476,CPT,306,RC,,inpatient,,,127,114.3,,0.95,,120.65,Percent of total billed charges,,,0.98,,124.46,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,0.97,,123.19,Percent of total billed charges,,,0.97,,123.19,Percent of total billed charges,,,0.96,,121.92,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,120.65,Percent of total billed charges,,120.65,124.46,
"Test by nucleic acid for borrelia burgdorferi, amplified",PX-30011418,CDM,87476,CPT,306,RC,,outpatient,,,127,114.3,,0.95,,120.65,Percent of total billed charges,,,0.98,,124.46,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,0.97,,123.19,Percent of total billed charges,,,0.96,,121.92,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,120.65,Percent of total billed charges,,120.65,124.46,
Measurement of bilirubin,PX-30011424,CDM,88720,CPT,301,RC,,inpatient,,,24,21.6,,0.95,,22.8,Percent of total billed charges,,,0.98,,23.52,Percent of total billed charges,,,0.95,,22.8,Percent of total billed charges,,,0.97,,23.28,Percent of total billed charges,,,0.97,,23.28,Percent of total billed charges,,,0.96,,23.04,Percent of total billed charges,,,0.95,,22.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,22.8,Percent of total billed charges,,22.8,23.52,
Measurement of bilirubin,PX-30011424,CDM,88720,CPT,301,RC,,outpatient,,,24,21.6,,0.95,,22.8,Percent of total billed charges,,,0.98,,23.52,Percent of total billed charges,,,0.95,,22.8,Percent of total billed charges,,,0.95,,22.8,Percent of total billed charges,,,0.97,,23.28,Percent of total billed charges,,,0.96,,23.04,Percent of total billed charges,,,0.95,,22.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,22.8,Percent of total billed charges,,22.8,23.52,
"Measure antibody to allergic, crude allergen extract, each",PX-30011463,CDM,86003,CPT,302,RC,,inpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
"Measure antibody to allergic, crude allergen extract, each",PX-30011463,CDM,86003,CPT,302,RC,,outpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
"Measure antibody to assess autoimmune disorder, any method",PX-30011469,CDM,86235,CPT,302,RC,,inpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
"Measure antibody to assess autoimmune disorder, any method",PX-30011469,CDM,86235,CPT,302,RC,,outpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
"Measure of complement (immune system proteins), antigen,",PX-30011484,CDM,86160,CPT,302,RC,,inpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
"Measure of complement (immune system proteins), antigen,",PX-30011484,CDM,86160,CPT,302,RC,,outpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
Measure antibody to assess autoimmune disorder any method,PX-30011488,CDM,86235,CPT,302,RC,,inpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
Measure antibody to assess autoimmune disorder any method,PX-30011488,CDM,86235,CPT,302,RC,,outpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
"Measure antibody to assess autoimmune disorder, any method",PX-30011493,CDM,86235,CPT,302,RC,,inpatient,,,87,78.3,,0.95,,82.65,Percent of total billed charges,,,0.98,,85.26,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.96,,83.52,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,82.65,Percent of total billed charges,,82.65,85.26,
"Measure antibody to assess autoimmune disorder, any method",PX-30011493,CDM,86235,CPT,302,RC,,outpatient,,,87,78.3,,0.95,,82.65,Percent of total billed charges,,,0.98,,85.26,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.96,,83.52,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,82.65,Percent of total billed charges,,82.65,85.26,
Body fluid cell count with cell identification,PX-30011520,CDM,89051,CPT,300,RC,,inpatient,,,148,133.2,,0.95,,140.6,Percent of total billed charges,,,0.98,,145.04,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.96,,142.08,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,140.6,Percent of total billed charges,,140.6,145.04,
Body fluid cell count with cell identification,PX-30011520,CDM,89051,CPT,300,RC,,outpatient,,,148,133.2,,0.95,,140.6,Percent of total billed charges,,,0.98,,145.04,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.96,,142.08,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,140.6,Percent of total billed charges,,140.6,145.04,
Body fluid cell count with cell identification,PX-30011521,CDM,89051,CPT,300,RC,,inpatient,,,148,133.2,,0.95,,140.6,Percent of total billed charges,,,0.98,,145.04,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.96,,142.08,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,140.6,Percent of total billed charges,,140.6,145.04,
Body fluid cell count with cell identification,PX-30011521,CDM,89051,CPT,300,RC,,outpatient,,,148,133.2,,0.95,,140.6,Percent of total billed charges,,,0.98,,145.04,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.96,,142.08,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,140.6,Percent of total billed charges,,140.6,145.04,
"Test by nucleic acid for multiple organisms, amplified",PX-30011530,CDM,87801,CPT,306,RC,,inpatient,,,215,193.5,,0.95,,204.25,Percent of total billed charges,,,0.98,,210.7,Percent of total billed charges,,,0.95,,204.25,Percent of total billed charges,,,0.97,,208.55,Percent of total billed charges,,,0.97,,208.55,Percent of total billed charges,,,0.96,,206.4,Percent of total billed charges,,,0.95,,204.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,204.25,Percent of total billed charges,,204.25,210.7,
"Test by nucleic acid for multiple organisms, amplified",PX-30011530,CDM,87801,CPT,306,RC,,outpatient,,,215,193.5,,0.95,,204.25,Percent of total billed charges,,,0.98,,210.7,Percent of total billed charges,,,0.95,,204.25,Percent of total billed charges,,,0.95,,204.25,Percent of total billed charges,,,0.97,,208.55,Percent of total billed charges,,,0.96,,206.4,Percent of total billed charges,,,0.95,,204.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,204.25,Percent of total billed charges,,204.25,210.7,
"Test by nucleic acid for clostridium difficile, amplified",PX-30011532,CDM,87493,CPT,306,RC,,inpatient,,,166,149.4,,0.95,,157.7,Percent of total billed charges,,,0.98,,162.68,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.96,,159.36,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,157.7,Percent of total billed charges,,157.7,162.68,
"Test by nucleic acid for clostridium difficile, amplified",PX-30011532,CDM,87493,CPT,306,RC,,outpatient,,,166,149.4,,0.95,,157.7,Percent of total billed charges,,,0.98,,162.68,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.96,,159.36,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,157.7,Percent of total billed charges,,157.7,162.68,
"Detection test for candida species (yeast), direct probe",PX-30011540,CDM,87480,CPT,306,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
"Detection test for candida species (yeast), direct probe",PX-30011540,CDM,87480,CPT,306,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
"Test bynucleic acid for chlamydia trachomatis, amplified",PX-30011572,CDM,87491,CPT,306,RC,,inpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
"Test bynucleic acid for chlamydia trachomatis, amplified",PX-30011572,CDM,87491,CPT,306,RC,,outpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
"Test bynucleic acid for chlamydia trachomatis, amplified",PX-30011573,CDM,87491,CPT,306,RC,,inpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
"Test bynucleic acid for chlamydia trachomatis, amplified",PX-30011573,CDM,87491,CPT,306,RC,,outpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
"Test bynucleic acid for chlamydia trachomatis, amplified",PX-30011574,CDM,87491,CPT,306,RC,,inpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
"Test bynucleic acid for chlamydia trachomatis, amplified",PX-30011574,CDM,87491,CPT,306,RC,,outpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
"Test by nucleic acid for cytomegalovirus, quantification",PX-30011582,CDM,87497,CPT,306,RC,,inpatient,,,459,413.1,,0.95,,436.05,Percent of total billed charges,,,0.98,,449.82,Percent of total billed charges,,,0.95,,436.05,Percent of total billed charges,,,0.97,,445.23,Percent of total billed charges,,,0.97,,445.23,Percent of total billed charges,,,0.96,,440.64,Percent of total billed charges,,,0.95,,436.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,436.05,Percent of total billed charges,,436.05,449.82,
"Test by nucleic acid for cytomegalovirus, quantification",PX-30011582,CDM,87497,CPT,306,RC,,outpatient,,,459,413.1,,0.95,,436.05,Percent of total billed charges,,,0.98,,449.82,Percent of total billed charges,,,0.95,,436.05,Percent of total billed charges,,,0.95,,436.05,Percent of total billed charges,,,0.97,,445.23,Percent of total billed charges,,,0.96,,440.64,Percent of total billed charges,,,0.95,,436.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,436.05,Percent of total billed charges,,436.05,449.82,
Crystal identification from tissue or body fluid,PX-30011585,CDM,89060,CPT,300,RC,,inpatient,,,104,93.6,,0.95,,98.8,Percent of total billed charges,,,0.98,,101.92,Percent of total billed charges,,,0.95,,98.8,Percent of total billed charges,,,0.97,,100.88,Percent of total billed charges,,,0.97,,100.88,Percent of total billed charges,,,0.96,,99.84,Percent of total billed charges,,,0.95,,98.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,98.8,Percent of total billed charges,,98.8,101.92,
Crystal identification from tissue or body fluid,PX-30011585,CDM,89060,CPT,300,RC,,outpatient,,,104,93.6,,0.95,,98.8,Percent of total billed charges,,,0.98,,101.92,Percent of total billed charges,,,0.95,,98.8,Percent of total billed charges,,,0.95,,98.8,Percent of total billed charges,,,0.97,,100.88,Percent of total billed charges,,,0.96,,99.84,Percent of total billed charges,,,0.95,,98.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,98.8,Percent of total billed charges,,98.8,101.92,
Pap test automated thin layer preparation,PX-30011594,CDM,88175,CPT,311,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
Pap test automated thin layer preparation,PX-30011594,CDM,88175,CPT,311,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
Nasal smear for eosinophils,PX-30011609,CDM,89190,CPT,300,RC,,inpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
Nasal smear for eosinophils,PX-30011609,CDM,89190,CPT,300,RC,,outpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
"Detection test by nucleic acid for organism, quantification",PX-30011613,CDM,87799,CPT,306,RC,,inpatient,,,248,223.2,,0.95,,235.6,Percent of total billed charges,,,0.98,,243.04,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,0.97,,240.56,Percent of total billed charges,,,0.97,,240.56,Percent of total billed charges,,,0.96,,238.08,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,235.6,Percent of total billed charges,,235.6,243.04,
"Detection test by nucleic acid for organism, quantification",PX-30011613,CDM,87799,CPT,306,RC,,outpatient,,,248,223.2,,0.95,,235.6,Percent of total billed charges,,,0.98,,243.04,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,0.97,,240.56,Percent of total billed charges,,,0.96,,238.08,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,235.6,Percent of total billed charges,,235.6,243.04,
"Fat stain of stool, urine, or respiratory secretions",PX-30011616,CDM,89125,CPT,300,RC,,inpatient,,,22,19.8,,0.95,,20.9,Percent of total billed charges,,,0.98,,21.56,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.96,,21.12,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,20.9,Percent of total billed charges,,20.9,21.56,
"Fat stain of stool, urine, or respiratory secretions",PX-30011616,CDM,89125,CPT,300,RC,,outpatient,,,22,19.8,,0.95,,20.9,Percent of total billed charges,,,0.98,,21.56,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.96,,21.12,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,20.9,Percent of total billed charges,,20.9,21.56,
HC Flow Cytometry Cell Surf Marker Techl Only Ea Addtl #,PX-30011621,CDM,88185,CPT,311,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
HC Flow Cytometry Cell Surf Marker Techl Only Ea Addtl #,PX-30011621,CDM,88185,CPT,311,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
Flow cytometry for DNA or cell analysis first marker,PX-30011626,CDM,88184,CPT,311,RC,,inpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
Flow cytometry for DNA or cell analysis first marker,PX-30011626,CDM,88184,CPT,311,RC,,outpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
"Test for gardnerella vaginalis (bacteria), direct",PX-30011637,CDM,87510,CPT,306,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
"Test for gardnerella vaginalis (bacteria), direct",PX-30011637,CDM,87510,CPT,306,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Test byimmunoassay for hepatitis B surface antigen,PX-30011646,CDM,87340,CPT,306,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
Test byimmunoassay for hepatitis B surface antigen,PX-30011646,CDM,87340,CPT,306,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"Test by nucleic acid for Hepatitis C virus, quantification",PX-30011653,CDM,87522,CPT,306,RC,,inpatient,,,320,288,,0.95,,304,Percent of total billed charges,,,0.98,,313.6,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,0.97,,310.4,Percent of total billed charges,,,0.97,,310.4,Percent of total billed charges,,,0.96,,307.2,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,304,Percent of total billed charges,,304,313.6,
"Test by nucleic acid for Hepatitis C virus, quantification",PX-30011653,CDM,87522,CPT,306,RC,,outpatient,,,320,288,,0.95,,304,Percent of total billed charges,,,0.98,,313.6,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,0.97,,310.4,Percent of total billed charges,,,0.96,,307.2,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,304,Percent of total billed charges,,304,313.6,
"Test by nucleic acid for Hepatitis C virus, quantification",PX-30011655,CDM,87522,CPT,306,RC,,inpatient,,,306,275.4,,0.95,,290.7,Percent of total billed charges,,,0.98,,299.88,Percent of total billed charges,,,0.95,,290.7,Percent of total billed charges,,,0.97,,296.82,Percent of total billed charges,,,0.97,,296.82,Percent of total billed charges,,,0.96,,293.76,Percent of total billed charges,,,0.95,,290.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,290.7,Percent of total billed charges,,290.7,299.88,
"Test by nucleic acid for Hepatitis C virus, quantification",PX-30011655,CDM,87522,CPT,306,RC,,outpatient,,,306,275.4,,0.95,,290.7,Percent of total billed charges,,,0.98,,299.88,Percent of total billed charges,,,0.95,,290.7,Percent of total billed charges,,,0.95,,290.7,Percent of total billed charges,,,0.97,,296.82,Percent of total billed charges,,,0.96,,293.76,Percent of total billed charges,,,0.95,,290.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,290.7,Percent of total billed charges,,290.7,299.88,
Test by immunoassay w/direct observation influenza virus,PX-30011697,CDM,87804,CPT,306,RC,,inpatient,,,156,140.4,,0.95,,148.2,Percent of total billed charges,,,0.98,,152.88,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,0.97,,151.32,Percent of total billed charges,,,0.97,,151.32,Percent of total billed charges,,,0.96,,149.76,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,148.2,Percent of total billed charges,,148.2,152.88,
Test by immunoassay w/direct observation influenza virus,PX-30011697,CDM,87804,CPT,306,RC,,outpatient,,,156,140.4,,0.95,,148.2,Percent of total billed charges,,,0.98,,152.88,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,0.97,,151.32,Percent of total billed charges,,,0.96,,149.76,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,148.2,Percent of total billed charges,,148.2,152.88,
Inhibin A (reproductive organ hormone) measurement,PX-30011698,CDM,86336,CPT,302,RC,,inpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
Inhibin A (reproductive organ hormone) measurement,PX-30011698,CDM,86336,CPT,302,RC,,outpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
Test by immunoassay w/direct observation other organism,PX-30011703,CDM,87899,CPT,306,RC,,inpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
Test by immunoassay w/direct observation other organism,PX-30011703,CDM,87899,CPT,306,RC,,outpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
"Test by nucleic acid for Mycoplasma pneumoniae , amplified",PX-30011710,CDM,87581,CPT,306,RC,,inpatient,,,254,228.6,,0.95,,241.3,Percent of total billed charges,,,0.98,,248.92,Percent of total billed charges,,,0.95,,241.3,Percent of total billed charges,,,0.97,,246.38,Percent of total billed charges,,,0.97,,246.38,Percent of total billed charges,,,0.96,,243.84,Percent of total billed charges,,,0.95,,241.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,241.3,Percent of total billed charges,,241.3,248.92,
"Test by nucleic acid for Mycoplasma pneumoniae , amplified",PX-30011710,CDM,87581,CPT,306,RC,,outpatient,,,254,228.6,,0.95,,241.3,Percent of total billed charges,,,0.98,,248.92,Percent of total billed charges,,,0.95,,241.3,Percent of total billed charges,,,0.95,,241.3,Percent of total billed charges,,,0.97,,246.38,Percent of total billed charges,,,0.96,,243.84,Percent of total billed charges,,,0.95,,241.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,241.3,Percent of total billed charges,,241.3,248.92,
Test by immunoassay w/ direct visual observation for Strep,PX-30011741,CDM,87880,CPT,306,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
Test by immunoassay w/ direct visual observation for Strep,PX-30011741,CDM,87880,CPT,306,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
Removal of antibodies from surface of red blood cell,PX-30011742,CDM,86860,CPT,302,RC,,inpatient,,,142,127.8,,0.95,,134.9,Percent of total billed charges,,,0.98,,139.16,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,0.97,,137.74,Percent of total billed charges,,,0.97,,137.74,Percent of total billed charges,,,0.96,,136.32,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,134.9,Percent of total billed charges,,134.9,139.16,
Removal of antibodies from surface of red blood cell,PX-30011742,CDM,86860,CPT,302,RC,,outpatient,,,142,127.8,,0.95,,134.9,Percent of total billed charges,,,0.98,,139.16,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,0.97,,137.74,Percent of total billed charges,,,0.96,,136.32,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,134.9,Percent of total billed charges,,134.9,139.16,
Semen analysis for sperm presence,PX-30011752,CDM,89321,CPT,300,RC,,inpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
Semen analysis for sperm presence,PX-30011752,CDM,89321,CPT,300,RC,,outpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
Test by immunoassay w/direct observation other organism,PX-30011756,CDM,87899,CPT,306,RC,,inpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
Test by immunoassay w/direct observation other organism,PX-30011756,CDM,87899,CPT,306,RC,,outpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
Test by immunoassay w/direct observation other organism,PX-30011762,CDM,87899,CPT,306,RC,,inpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
Test by immunoassay w/direct observation other organism,PX-30011762,CDM,87899,CPT,306,RC,,outpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
"Test by nucleic acid for Trichomonas vaginalis , direct",PX-30011799,CDM,87660,CPT,306,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
"Test by nucleic acid for Trichomonas vaginalis , direct",PX-30011799,CDM,87660,CPT,306,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Measurement of Hepatitis A antibody (IgM),PX-30011859,CDM,86709,CPT,302,RC,,inpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
Measurement of Hepatitis A antibody (IgM),PX-30011859,CDM,86709,CPT,302,RC,,outpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
"T cells count, total",PX-30011868,CDM,86359,CPT,302,RC,,inpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
"T cells count, total",PX-30011868,CDM,86359,CPT,302,RC,,outpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
"Measure antibody to assess autoimmune disorder, any method",PX-30011905,CDM,86235,CPT,302,RC,,inpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
"Measure antibody to assess autoimmune disorder, any method",PX-30011905,CDM,86235,CPT,302,RC,,outpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
Blood typing Rh phenotyping,PX-30011963,CDM,86906,CPT,302,RC,,inpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
Blood typing Rh phenotyping,PX-30011963,CDM,86906,CPT,302,RC,,outpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
"Bacterial culture, any other source except urine, blood",PX-30011966,CDM,87070,CPT,306,RC,,inpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
"Bacterial culture, any other source except urine, blood",PX-30011966,CDM,87070,CPT,306,RC,,outpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
Urine pregnancy test,PX-30013001,CDM,81025,CPT,307,RC,,inpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
Urine pregnancy test,PX-30013001,CDM,81025,CPT,307,RC,,outpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
Specific gravity (liquid weight) measurement,PX-30013003,CDM,84315,CPT,301,RC,,inpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
Specific gravity (liquid weight) measurement,PX-30013003,CDM,84315,CPT,301,RC,,outpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
Ceruloplasmin (protein) level,PX-30013004,CDM,82390,CPT,301,RC,,inpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
Ceruloplasmin (protein) level,PX-30013004,CDM,82390,CPT,301,RC,,outpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
Myoglobin (muscle protein) level,PX-30013007,CDM,83874,CPT,301,RC,,inpatient,,,30,27,,0.95,,28.5,Percent of total billed charges,,,0.98,,29.4,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,0.97,,29.1,Percent of total billed charges,,,0.97,,29.1,Percent of total billed charges,,,0.96,,28.8,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,28.5,Percent of total billed charges,,28.5,29.4,
Myoglobin (muscle protein) level,PX-30013007,CDM,83874,CPT,301,RC,,outpatient,,,30,27,,0.95,,28.5,Percent of total billed charges,,,0.98,,29.4,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,0.97,,29.1,Percent of total billed charges,,,0.96,,28.8,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,28.5,Percent of total billed charges,,28.5,29.4,
"Stool analysis for blood, by peroxidase activity",PX-30013008,CDM,82272,CPT,301,RC,,inpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
"Stool analysis for blood, by peroxidase activity",PX-30013008,CDM,82272,CPT,301,RC,,outpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
"Urinalysis, manual test",PX-30013009,CDM,81002,CPT,300,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
"Urinalysis, manual test",PX-30013009,CDM,81002,CPT,300,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
Vitamin D-3 level,PX-30013010,CDM,82306,CPT,301,RC,,inpatient,,,250,225,,0.95,,237.5,Percent of total billed charges,,,0.98,,245,Percent of total billed charges,,,0.95,,237.5,Percent of total billed charges,,,0.97,,242.5,Percent of total billed charges,,,0.97,,242.5,Percent of total billed charges,,,0.96,,240,Percent of total billed charges,,,0.95,,237.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,237.5,Percent of total billed charges,,237.5,245,
Vitamin D-3 level,PX-30013010,CDM,82306,CPT,301,RC,,outpatient,,,250,225,,0.95,,237.5,Percent of total billed charges,,,0.98,,245,Percent of total billed charges,,,0.95,,237.5,Percent of total billed charges,,,0.95,,237.5,Percent of total billed charges,,,0.97,,242.5,Percent of total billed charges,,,0.96,,240,Percent of total billed charges,,,0.95,,237.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,237.5,Percent of total billed charges,,237.5,245,
C-peptide (protein) level,PX-30013013,CDM,84681,CPT,301,RC,,inpatient,,,98,88.2,,0.95,,93.1,Percent of total billed charges,,,0.98,,96.04,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,0.97,,95.06,Percent of total billed charges,,,0.97,,95.06,Percent of total billed charges,,,0.96,,94.08,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,93.1,Percent of total billed charges,,93.1,96.04,
C-peptide (protein) level,PX-30013013,CDM,84681,CPT,301,RC,,outpatient,,,98,88.2,,0.95,,93.1,Percent of total billed charges,,,0.98,,96.04,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,0.97,,95.06,Percent of total billed charges,,,0.96,,94.08,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,93.1,Percent of total billed charges,,93.1,96.04,
Urine volume measurement,PX-30013017,CDM,81050,CPT,307,RC,,inpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
Urine volume measurement,PX-30013017,CDM,81050,CPT,307,RC,,outpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
Adrenocorticotropic hormone (ACTH) level,PX-30013018,CDM,82024,CPT,301,RC,,inpatient,,,181,162.9,,0.95,,171.95,Percent of total billed charges,,,0.98,,177.38,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,0.97,,175.57,Percent of total billed charges,,,0.97,,175.57,Percent of total billed charges,,,0.96,,173.76,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,171.95,Percent of total billed charges,,171.95,177.38,
Adrenocorticotropic hormone (ACTH) level,PX-30013018,CDM,82024,CPT,301,RC,,outpatient,,,181,162.9,,0.95,,171.95,Percent of total billed charges,,,0.98,,177.38,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,0.97,,175.57,Percent of total billed charges,,,0.96,,173.76,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,171.95,Percent of total billed charges,,171.95,177.38,
Aldolase (enzyme) level,PX-30013019,CDM,82085,CPT,301,RC,,inpatient,,,45,40.5,,0.95,,42.75,Percent of total billed charges,,,0.98,,44.1,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.96,,43.2,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,42.75,Percent of total billed charges,,42.75,44.1,
Aldolase (enzyme) level,PX-30013019,CDM,82085,CPT,301,RC,,outpatient,,,45,40.5,,0.95,,42.75,Percent of total billed charges,,,0.98,,44.1,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.96,,43.2,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,42.75,Percent of total billed charges,,42.75,44.1,
Thyroglobulin (thyroid related hormone) level,PX-30013021,CDM,84432,CPT,301,RC,,inpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
Thyroglobulin (thyroid related hormone) level,PX-30013021,CDM,84432,CPT,301,RC,,outpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
Organic acids level,PX-30013034,CDM,83918,CPT,301,RC,,inpatient,,,220,198,,0.95,,209,Percent of total billed charges,,,0.98,,215.6,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,0.97,,213.4,Percent of total billed charges,,,0.97,,213.4,Percent of total billed charges,,,0.96,,211.2,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,209,Percent of total billed charges,,209,215.6,
Organic acids level,PX-30013034,CDM,83918,CPT,301,RC,,outpatient,,,220,198,,0.95,,209,Percent of total billed charges,,,0.98,,215.6,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,0.97,,213.4,Percent of total billed charges,,,0.96,,211.2,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,209,Percent of total billed charges,,209,215.6,
Haloperidol level,PX-30013038,CDM,80173,CPT,301,RC,,inpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Haloperidol level,PX-30013038,CDM,80173,CPT,301,RC,,outpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Carboxyhemoglobin (protein) level,PX-30013039,CDM,82375,CPT,301,RC,,inpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
Carboxyhemoglobin (protein) level,PX-30013039,CDM,82375,CPT,301,RC,,outpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
General health panel,PX-30013040,CDM,80050,CPT,301,RC,,inpatient,,,309,278.1,,0.95,,293.55,Percent of total billed charges,,,0.98,,302.82,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,0.97,,299.73,Percent of total billed charges,,,0.97,,299.73,Percent of total billed charges,,,0.96,,296.64,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,293.55,Percent of total billed charges,,293.55,302.82,
General health panel,PX-30013040,CDM,80050,CPT,301,RC,,outpatient,,,309,278.1,,0.95,,293.55,Percent of total billed charges,,,0.98,,302.82,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,0.97,,299.73,Percent of total billed charges,,,0.96,,296.64,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,293.55,Percent of total billed charges,,293.55,302.82,
"Hemoglobin analysis and measurement, electrophoresis",PX-30013048,CDM,83020,CPT,301,RC,,inpatient,,,41,36.9,,0.95,,38.95,Percent of total billed charges,,,0.98,,40.18,Percent of total billed charges,,,0.95,,38.95,Percent of total billed charges,,,0.97,,39.77,Percent of total billed charges,,,0.97,,39.77,Percent of total billed charges,,,0.96,,39.36,Percent of total billed charges,,,0.95,,38.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38.95,Percent of total billed charges,,38.95,40.18,
"Hemoglobin analysis and measurement, electrophoresis",PX-30013048,CDM,83020,CPT,301,RC,,outpatient,,,41,36.9,,0.95,,38.95,Percent of total billed charges,,,0.98,,40.18,Percent of total billed charges,,,0.95,,38.95,Percent of total billed charges,,,0.95,,38.95,Percent of total billed charges,,,0.97,,39.77,Percent of total billed charges,,,0.96,,39.36,Percent of total billed charges,,,0.95,,38.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38.95,Percent of total billed charges,,38.95,40.18,
Selenium (vitamin) level,PX-30013049,CDM,84255,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Selenium (vitamin) level,PX-30013049,CDM,84255,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Lipoprotein-associated phospholipase A2 (enzyme) level,PX-30013061,CDM,83698,CPT,301,RC,,inpatient,,,132,118.8,,0.95,,125.4,Percent of total billed charges,,,0.98,,129.36,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.96,,126.72,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,125.4,Percent of total billed charges,,125.4,129.36,
Lipoprotein-associated phospholipase A2 (enzyme) level,PX-30013061,CDM,83698,CPT,301,RC,,outpatient,,,132,118.8,,0.95,,125.4,Percent of total billed charges,,,0.98,,129.36,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.96,,126.72,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,125.4,Percent of total billed charges,,125.4,129.36,
"Lipoprotein level, quantitation of lipoprotein particle",PX-30013080,CDM,83704,CPT,301,RC,,inpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
"Lipoprotein level, quantitation of lipoprotein particle",PX-30013080,CDM,83704,CPT,301,RC,,outpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
Procalcitonin (hormone) level,PX-30013086,CDM,84145,CPT,301,RC,,inpatient,,,299,269.1,,0.95,,284.05,Percent of total billed charges,,,0.98,,293.02,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,0.97,,290.03,Percent of total billed charges,,,0.97,,290.03,Percent of total billed charges,,,0.96,,287.04,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,284.05,Percent of total billed charges,,284.05,293.02,
Procalcitonin (hormone) level,PX-30013086,CDM,84145,CPT,301,RC,,outpatient,,,299,269.1,,0.95,,284.05,Percent of total billed charges,,,0.98,,293.02,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,0.97,,290.03,Percent of total billed charges,,,0.96,,287.04,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,284.05,Percent of total billed charges,,284.05,293.02,
"Total protein level, body fluid",PX-30013090,CDM,84157,CPT,301,RC,,inpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
"Total protein level, body fluid",PX-30013090,CDM,84157,CPT,301,RC,,outpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
"Total protein level, urine",PX-30013098,CDM,84156,CPT,301,RC,,inpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
"Total protein level, urine",PX-30013098,CDM,84156,CPT,301,RC,,outpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
Vitamin measurement,PX-30013102,CDM,84591,CPT,301,RC,,inpatient,,,177,159.3,,0.95,,168.15,Percent of total billed charges,,,0.98,,173.46,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.96,,169.92,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,168.15,Percent of total billed charges,,168.15,173.46,
Vitamin measurement,PX-30013102,CDM,84591,CPT,301,RC,,outpatient,,,177,159.3,,0.95,,168.15,Percent of total billed charges,,,0.98,,173.46,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.96,,169.92,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,168.15,Percent of total billed charges,,168.15,173.46,
Urine porphyrins (metabolism substance) analysis,PX-30013108,CDM,84119,CPT,301,RC,,inpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
Urine porphyrins (metabolism substance) analysis,PX-30013108,CDM,84119,CPT,301,RC,,outpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
Pregnenolone (reproductive hormone) level,PX-30013109,CDM,84140,CPT,301,RC,,inpatient,,,185,166.5,,0.95,,175.75,Percent of total billed charges,,,0.98,,181.3,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,0.97,,179.45,Percent of total billed charges,,,0.97,,179.45,Percent of total billed charges,,,0.96,,177.6,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,175.75,Percent of total billed charges,,175.75,181.3,
Pregnenolone (reproductive hormone) level,PX-30013109,CDM,84140,CPT,301,RC,,outpatient,,,185,166.5,,0.95,,175.75,Percent of total billed charges,,,0.98,,181.3,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,0.97,,179.45,Percent of total billed charges,,,0.96,,177.6,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,175.75,Percent of total billed charges,,175.75,181.3,
Chemical analysis using chromatography technique,PX-30013115,CDM,82542,CPT,301,RC,,inpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
Chemical analysis using chromatography technique,PX-30013115,CDM,82542,CPT,301,RC,,outpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
"Analysis of substance w/ immunoassay, multiple step method",PX-30013138,CDM,83516,CPT,301,RC,,inpatient,,,138,124.2,,0.95,,131.1,Percent of total billed charges,,,0.98,,135.24,Percent of total billed charges,,,0.95,,131.1,Percent of total billed charges,,,0.97,,133.86,Percent of total billed charges,,,0.97,,133.86,Percent of total billed charges,,,0.96,,132.48,Percent of total billed charges,,,0.95,,131.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,131.1,Percent of total billed charges,,131.1,135.24,
"Analysis of substance w/ immunoassay, multiple step method",PX-30013138,CDM,83516,CPT,301,RC,,outpatient,,,138,124.2,,0.95,,131.1,Percent of total billed charges,,,0.98,,135.24,Percent of total billed charges,,,0.95,,131.1,Percent of total billed charges,,,0.95,,131.1,Percent of total billed charges,,,0.97,,133.86,Percent of total billed charges,,,0.96,,132.48,Percent of total billed charges,,,0.95,,131.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,131.1,Percent of total billed charges,,131.1,135.24,
"Clotting factor X assessment test, diluted",PX-30013139,CDM,85613,CPT,305,RC,,inpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
"Clotting factor X assessment test, diluted",PX-30013139,CDM,85613,CPT,305,RC,,outpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
Aminolevulinic acid (protein) level,PX-30013151,CDM,82135,CPT,301,RC,,inpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
Aminolevulinic acid (protein) level,PX-30013151,CDM,82135,CPT,301,RC,,outpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
"Analysis of substance w/ immunoassay, multiple step method",PX-30013189,CDM,83516,CPT,301,RC,,inpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95,Percent of total billed charges,,95,98,
"Analysis of substance w/ immunoassay, multiple step method",PX-30013189,CDM,83516,CPT,301,RC,,outpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95,Percent of total billed charges,,95,98,
Urine porphyrins (metabolism substance) measurement,PX-30013218,CDM,84120,CPT,301,RC,,inpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
Urine porphyrins (metabolism substance) measurement,PX-30013218,CDM,84120,CPT,301,RC,,outpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
Quinidine level,PX-30013266,CDM,80194,CPT,301,RC,,inpatient,,,63,56.7,,0.95,,59.85,Percent of total billed charges,,,0.98,,61.74,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.96,,60.48,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,59.85,Percent of total billed charges,,59.85,61.74,
Quinidine level,PX-30013266,CDM,80194,CPT,301,RC,,outpatient,,,63,56.7,,0.95,,59.85,Percent of total billed charges,,,0.98,,61.74,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.96,,60.48,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,59.85,Percent of total billed charges,,59.85,61.74,
Fluoride level,PX-30013365,CDM,82735,CPT,301,RC,,inpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
Fluoride level,PX-30013365,CDM,82735,CPT,301,RC,,outpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
Urine hemoglobin level,PX-30013391,CDM,83069,CPT,301,RC,,inpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Urine hemoglobin level,PX-30013391,CDM,83069,CPT,301,RC,,outpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Phenobarbital level,PX-30013730,CDM,80184,CPT,301,RC,,inpatient,,,31,27.9,,0.95,,29.45,Percent of total billed charges,,,0.98,,30.38,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.96,,29.76,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,29.45,Percent of total billed charges,,29.45,30.38,
Phenobarbital level,PX-30013730,CDM,80184,CPT,301,RC,,outpatient,,,31,27.9,,0.95,,29.45,Percent of total billed charges,,,0.98,,30.38,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.96,,29.76,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,29.45,Percent of total billed charges,,29.45,30.38,
Primidone level,PX-30013733,CDM,80188,CPT,301,RC,,inpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
Primidone level,PX-30013733,CDM,80188,CPT,301,RC,,outpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
Parathormone (parathyroid hormone) level,PX-30110189,CDM,83970,CPT,301,RC,,inpatient,,,206,185.4,,0.95,,195.7,Percent of total billed charges,,,0.98,,201.88,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.96,,197.76,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,195.7,Percent of total billed charges,,195.7,201.88,
Parathormone (parathyroid hormone) level,PX-30110189,CDM,83970,CPT,301,RC,,outpatient,,,206,185.4,,0.95,,195.7,Percent of total billed charges,,,0.98,,201.88,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.96,,197.76,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,195.7,Percent of total billed charges,,195.7,201.88,
Stool calprotectin (protein) level,PX-30013774,CDM,83993,CPT,301,RC,,inpatient,,,332,298.8,,0.95,,315.4,Percent of total billed charges,,,0.98,,325.36,Percent of total billed charges,,,0.95,,315.4,Percent of total billed charges,,,0.97,,322.04,Percent of total billed charges,,,0.97,,322.04,Percent of total billed charges,,,0.96,,318.72,Percent of total billed charges,,,0.95,,315.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,315.4,Percent of total billed charges,,315.4,325.36,
Stool calprotectin (protein) level,PX-30013774,CDM,83993,CPT,301,RC,,outpatient,,,332,298.8,,0.95,,315.4,Percent of total billed charges,,,0.98,,325.36,Percent of total billed charges,,,0.95,,315.4,Percent of total billed charges,,,0.95,,315.4,Percent of total billed charges,,,0.97,,322.04,Percent of total billed charges,,,0.96,,318.72,Percent of total billed charges,,,0.95,,315.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,315.4,Percent of total billed charges,,315.4,325.36,
Cervicovaginal secretion of placenta protein,PX-30013783,CDM,84112,CPT,301,RC,,inpatient,,,267,240.3,,0.95,,253.65,Percent of total billed charges,,,0.98,,261.66,Percent of total billed charges,,,0.95,,253.65,Percent of total billed charges,,,0.97,,258.99,Percent of total billed charges,,,0.97,,258.99,Percent of total billed charges,,,0.96,,256.32,Percent of total billed charges,,,0.95,,253.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,253.65,Percent of total billed charges,,253.65,261.66,
Cervicovaginal secretion of placenta protein,PX-30013783,CDM,84112,CPT,301,RC,,outpatient,,,267,240.3,,0.95,,253.65,Percent of total billed charges,,,0.98,,261.66,Percent of total billed charges,,,0.95,,253.65,Percent of total billed charges,,,0.95,,253.65,Percent of total billed charges,,,0.97,,258.99,Percent of total billed charges,,,0.96,,256.32,Percent of total billed charges,,,0.95,,253.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,253.65,Percent of total billed charges,,253.65,261.66,
"Calcium level, total",PX-30013847,CDM,82310,CPT,301,RC,,inpatient,,,70,63,,0.95,,66.5,Percent of total billed charges,,,0.98,,68.6,Percent of total billed charges,,,0.95,,66.5,Percent of total billed charges,,,0.97,,67.9,Percent of total billed charges,,,0.97,,67.9,Percent of total billed charges,,,0.96,,67.2,Percent of total billed charges,,,0.95,,66.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,66.5,Percent of total billed charges,,66.5,68.6,
"Calcium level, total",PX-30013847,CDM,82310,CPT,301,RC,,outpatient,,,70,63,,0.95,,66.5,Percent of total billed charges,,,0.98,,68.6,Percent of total billed charges,,,0.95,,66.5,Percent of total billed charges,,,0.95,,66.5,Percent of total billed charges,,,0.97,,67.9,Percent of total billed charges,,,0.96,,67.2,Percent of total billed charges,,,0.95,,66.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,66.5,Percent of total billed charges,,66.5,68.6,
Ferritin (blood protein) level,PX-30013881,CDM,82728,CPT,301,RC,,inpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
Ferritin (blood protein) level,PX-30013881,CDM,82728,CPT,301,RC,,outpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
Lipase (fat enzyme) level,PX-30013912,CDM,83690,CPT,301,RC,,inpatient,,,156,140.4,,0.95,,148.2,Percent of total billed charges,,,0.98,,152.88,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,0.97,,151.32,Percent of total billed charges,,,0.97,,151.32,Percent of total billed charges,,,0.96,,149.76,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,148.2,Percent of total billed charges,,148.2,152.88,
Lipase (fat enzyme) level,PX-30013912,CDM,83690,CPT,301,RC,,outpatient,,,156,140.4,,0.95,,148.2,Percent of total billed charges,,,0.98,,152.88,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,0.97,,151.32,Percent of total billed charges,,,0.96,,149.76,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,148.2,Percent of total billed charges,,148.2,152.88,
"Myelin basic protein (nerve protein) level, spinal fluid",PX-30013923,CDM,83873,CPT,301,RC,,inpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19,Percent of total billed charges,,19,19.6,
"Myelin basic protein (nerve protein) level, spinal fluid",PX-30013923,CDM,83873,CPT,301,RC,,outpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19,Percent of total billed charges,,19,19.6,
"Blood test, clotting time",PX-30013952,CDM,85610,CPT,305,RC,,inpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95,Percent of total billed charges,,95,98,
"Blood test, clotting time",PX-30013952,CDM,85610,CPT,305,RC,,outpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95,Percent of total billed charges,,95,98,
"Red blood count automated, with additional calculations",PX-30013969,CDM,85046,CPT,305,RC,,inpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
"Red blood count automated, with additional calculations",PX-30013969,CDM,85046,CPT,305,RC,,outpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
Blood sodium level,PX-30013978,CDM,84295,CPT,301,RC,,inpatient,,,90,81,,0.95,,85.5,Percent of total billed charges,,,0.98,,88.2,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,0.97,,87.3,Percent of total billed charges,,,0.97,,87.3,Percent of total billed charges,,,0.96,,86.4,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,85.5,Percent of total billed charges,,85.5,88.2,
Blood sodium level,PX-30013978,CDM,84295,CPT,301,RC,,outpatient,,,90,81,,0.95,,85.5,Percent of total billed charges,,,0.98,,88.2,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,0.97,,87.3,Percent of total billed charges,,,0.96,,86.4,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,85.5,Percent of total billed charges,,85.5,88.2,
17-hydroxypregnenolone (hormone) level,PX-30014006,CDM,84143,CPT,301,RC,,inpatient,,,171,153.9,,0.95,,162.45,Percent of total billed charges,,,0.98,,167.58,Percent of total billed charges,,,0.95,,162.45,Percent of total billed charges,,,0.97,,165.87,Percent of total billed charges,,,0.97,,165.87,Percent of total billed charges,,,0.96,,164.16,Percent of total billed charges,,,0.95,,162.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,162.45,Percent of total billed charges,,162.45,167.58,
17-hydroxypregnenolone (hormone) level,PX-30014006,CDM,84143,CPT,301,RC,,outpatient,,,171,153.9,,0.95,,162.45,Percent of total billed charges,,,0.98,,167.58,Percent of total billed charges,,,0.95,,162.45,Percent of total billed charges,,,0.95,,162.45,Percent of total billed charges,,,0.97,,165.87,Percent of total billed charges,,,0.96,,164.16,Percent of total billed charges,,,0.95,,162.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,162.45,Percent of total billed charges,,162.45,167.58,
Hydroxyindolacetic acid (product of metabolism) level,PX-30014009,CDM,83497,CPT,301,RC,,inpatient,,,128,115.2,,0.95,,121.6,Percent of total billed charges,,,0.98,,125.44,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.96,,122.88,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,121.6,Percent of total billed charges,,121.6,125.44,
Hydroxyindolacetic acid (product of metabolism) level,PX-30014009,CDM,83497,CPT,301,RC,,outpatient,,,128,115.2,,0.95,,121.6,Percent of total billed charges,,,0.98,,125.44,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.96,,122.88,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,121.6,Percent of total billed charges,,121.6,125.44,
"IV Hydration, each additional hr",PX-45010930,CDM,96361,CPT,450,RC,,inpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
"IV Hydration, each additional hr",PX-45010930,CDM,96361,CPT,450,RC,,outpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
"Alpha-1-antitrypsin (protein) blood test, phenotype",PX-30014053,CDM,82104,CPT,301,RC,,inpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
"Alpha-1-antitrypsin (protein) blood test, phenotype",PX-30014053,CDM,82104,CPT,301,RC,,outpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
"IV Hydration, initial hr",PX-45011001,CDM,96360,CPT,450,RC,,inpatient,,,340,306,,0.95,,323,Percent of total billed charges,,,0.98,,333.2,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.96,,326.4,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,323,Percent of total billed charges,,323,333.2,
"IV Hydration, initial hr",PX-45011001,CDM,96360,CPT,450,RC,,outpatient,,,340,306,,0.95,,323,Percent of total billed charges,,,0.98,,333.2,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.96,,326.4,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,323,Percent of total billed charges,,323,333.2,
IV IV sequential hr,PX-45011002,CDM,96367,CPT,450,RC,,inpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
IV IV sequential hr,PX-45011002,CDM,96367,CPT,450,RC,,outpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
IV IV each additional hr,PX-45011003,CDM,96366,CPT,450,RC,,inpatient,,,127,114.3,,0.95,,120.65,Percent of total billed charges,,,0.98,,124.46,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,0.97,,123.19,Percent of total billed charges,,,0.97,,123.19,Percent of total billed charges,,,0.96,,121.92,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,120.65,Percent of total billed charges,,120.65,124.46,
IV IV each additional hr,PX-45011003,CDM,96366,CPT,450,RC,,outpatient,,,127,114.3,,0.95,,120.65,Percent of total billed charges,,,0.98,,124.46,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,0.97,,123.19,Percent of total billed charges,,,0.96,,121.92,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,120.65,Percent of total billed charges,,120.65,124.46,
"Ketone bodies analysis, quantitative",PX-30014072,CDM,82010,CPT,301,RC,,inpatient,,,58,52.2,,0.95,,55.1,Percent of total billed charges,,,0.98,,56.84,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,0.97,,56.26,Percent of total billed charges,,,0.97,,56.26,Percent of total billed charges,,,0.96,,55.68,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,55.1,Percent of total billed charges,,55.1,56.84,
"Ketone bodies analysis, quantitative",PX-30014072,CDM,82010,CPT,301,RC,,outpatient,,,58,52.2,,0.95,,55.1,Percent of total billed charges,,,0.98,,56.84,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,0.97,,56.26,Percent of total billed charges,,,0.96,,55.68,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,55.1,Percent of total billed charges,,55.1,56.84,
IV IV initial hr,PX-45011004,CDM,96365,CPT,450,RC,,inpatient,,,340,306,,0.95,,323,Percent of total billed charges,,,0.98,,333.2,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.96,,326.4,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,323,Percent of total billed charges,,323,333.2,
IV IV initial hr,PX-45011004,CDM,96365,CPT,450,RC,,outpatient,,,340,306,,0.95,,323,Percent of total billed charges,,,0.98,,333.2,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.96,,326.4,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,323,Percent of total billed charges,,323,333.2,
IV Concurrent with another IV,PX-45011005,CDM,96368,CPT,450,RC,,inpatient,,,257,231.3,,0.95,,244.15,Percent of total billed charges,,,0.98,,251.86,Percent of total billed charges,,,0.95,,244.15,Percent of total billed charges,,,0.97,,249.29,Percent of total billed charges,,,0.97,,249.29,Percent of total billed charges,,,0.96,,246.72,Percent of total billed charges,,,0.95,,244.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,244.15,Percent of total billed charges,,244.15,251.86,
IV Concurrent with another IV,PX-45011005,CDM,96368,CPT,450,RC,,outpatient,,,257,231.3,,0.95,,244.15,Percent of total billed charges,,,0.98,,251.86,Percent of total billed charges,,,0.95,,244.15,Percent of total billed charges,,,0.95,,244.15,Percent of total billed charges,,,0.97,,249.29,Percent of total billed charges,,,0.96,,246.72,Percent of total billed charges,,,0.95,,244.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,244.15,Percent of total billed charges,,244.15,251.86,
Inject additional drug or substance into vein,PX-45011010,CDM,96376,CPT,450,RC,,inpatient,,,126,113.4,,0.95,,119.7,Percent of total billed charges,,,0.98,,123.48,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.96,,120.96,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,119.7,Percent of total billed charges,,119.7,123.48,
Inject additional drug or substance into vein,PX-45011010,CDM,96376,CPT,450,RC,,outpatient,,,126,113.4,,0.95,,119.7,Percent of total billed charges,,,0.98,,123.48,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.96,,120.96,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,119.7,Percent of total billed charges,,119.7,123.48,
Injection of drug or substance into vein,PX-45011011,CDM,96374,CPT,450,RC,,inpatient,,,212,190.8,,0.95,,201.4,Percent of total billed charges,,,0.98,,207.76,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,0.97,,205.64,Percent of total billed charges,,,0.97,,205.64,Percent of total billed charges,,,0.96,,203.52,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,201.4,Percent of total billed charges,,201.4,207.76,
Injection of drug or substance into vein,PX-45011011,CDM,96374,CPT,450,RC,,outpatient,,,212,190.8,,0.95,,201.4,Percent of total billed charges,,,0.98,,207.76,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,0.97,,205.64,Percent of total billed charges,,,0.96,,203.52,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,201.4,Percent of total billed charges,,201.4,207.76,
Injection of additional new drug or substance into vein,PX-45011012,CDM,96375,CPT,450,RC,,inpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
Injection of additional new drug or substance into vein,PX-45011012,CDM,96375,CPT,450,RC,,outpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
Injection of drug or substance under skin or into muscle,PX-45011013,CDM,96372,CPT,450,RC,,inpatient,,,163,146.7,,0.95,,154.85,Percent of total billed charges,,,0.98,,159.74,Percent of total billed charges,,,0.95,,154.85,Percent of total billed charges,,,0.97,,158.11,Percent of total billed charges,,,0.97,,158.11,Percent of total billed charges,,,0.96,,156.48,Percent of total billed charges,,,0.95,,154.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,154.85,Percent of total billed charges,,154.85,159.74,
Injection of drug or substance under skin or into muscle,PX-45011013,CDM,96372,CPT,450,RC,,outpatient,,,163,146.7,,0.95,,154.85,Percent of total billed charges,,,0.98,,159.74,Percent of total billed charges,,,0.95,,154.85,Percent of total billed charges,,,0.95,,154.85,Percent of total billed charges,,,0.97,,158.11,Percent of total billed charges,,,0.96,,156.48,Percent of total billed charges,,,0.95,,154.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,154.85,Percent of total billed charges,,154.85,159.74,
"Alpha-fetoprotein (AFP) level, serum",PX-30014113,CDM,82105,CPT,301,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
"Alpha-fetoprotein (AFP) level, serum",PX-30014113,CDM,82105,CPT,301,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Aldosterone hormone level,PX-30014129,CDM,82088,CPT,301,RC,,inpatient,,,151,135.9,,0.95,,143.45,Percent of total billed charges,,,0.98,,147.98,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,0.97,,146.47,Percent of total billed charges,,,0.97,,146.47,Percent of total billed charges,,,0.96,,144.96,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,143.45,Percent of total billed charges,,143.45,147.98,
Aldosterone hormone level,PX-30014129,CDM,82088,CPT,301,RC,,outpatient,,,151,135.9,,0.95,,143.45,Percent of total billed charges,,,0.98,,147.98,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,0.97,,146.47,Percent of total billed charges,,,0.96,,144.96,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,143.45,Percent of total billed charges,,143.45,147.98,
"Phosphatase (enzyme) level, alkaline",PX-30014138,CDM,84075,CPT,301,RC,,inpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
"Phosphatase (enzyme) level, alkaline",PX-30014138,CDM,84075,CPT,301,RC,,outpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
"Alpha-1-antitrypsin (protein) blood test, total",PX-30014151,CDM,82103,CPT,301,RC,,inpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
"Alpha-1-antitrypsin (protein) blood test, total",PX-30014151,CDM,82103,CPT,301,RC,,outpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
Aluminum level,PX-30014159,CDM,82108,CPT,301,RC,,inpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
Aluminum level,PX-30014159,CDM,82108,CPT,301,RC,,outpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
"Amino acid level, 6 or more, quantitative, each specimen",PX-30014174,CDM,82139,CPT,301,RC,,inpatient,,,161,144.9,,0.95,,152.95,Percent of total billed charges,,,0.98,,157.78,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.96,,154.56,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,152.95,Percent of total billed charges,,152.95,157.78,
"Amino acid level, 6 or more, quantitative, each specimen",PX-30014174,CDM,82139,CPT,301,RC,,outpatient,,,161,144.9,,0.95,,152.95,Percent of total billed charges,,,0.98,,157.78,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.96,,154.56,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,152.95,Percent of total billed charges,,152.95,157.78,
Chemical analysis using chromatography technique,PX-30014232,CDM,82542,CPT,301,RC,,inpatient,,,97,87.3,,0.95,,92.15,Percent of total billed charges,,,0.98,,95.06,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,0.97,,94.09,Percent of total billed charges,,,0.97,,94.09,Percent of total billed charges,,,0.96,,93.12,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,92.15,Percent of total billed charges,,92.15,95.06,
Chemical analysis using chromatography technique,PX-30014232,CDM,82542,CPT,301,RC,,outpatient,,,97,87.3,,0.95,,92.15,Percent of total billed charges,,,0.98,,95.06,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,0.97,,94.09,Percent of total billed charges,,,0.96,,93.12,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,92.15,Percent of total billed charges,,92.15,95.06,
"Analysis of substance using immunoassay, multiple step",PX-30014233,CDM,83516,CPT,301,RC,,inpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
"Analysis of substance using immunoassay, multiple step",PX-30014233,CDM,83516,CPT,301,RC,,outpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
"Analysis of substance using immunoassay, multiple step",PX-30014234,CDM,83516,CPT,301,RC,,inpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
"Analysis of substance using immunoassay, multiple step",PX-30014234,CDM,83516,CPT,301,RC,,outpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
Angiotensin l - converting enzyme (ACE) level,PX-30014236,CDM,82164,CPT,301,RC,,inpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
Angiotensin l - converting enzyme (ACE) level,PX-30014236,CDM,82164,CPT,301,RC,,outpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
Transferrin (iron binding protein) level,PX-30014358,CDM,84466,CPT,301,RC,,inpatient,,,133,119.7,,0.95,,126.35,Percent of total billed charges,,,0.98,,130.34,Percent of total billed charges,,,0.95,,126.35,Percent of total billed charges,,,0.97,,129.01,Percent of total billed charges,,,0.97,,129.01,Percent of total billed charges,,,0.96,,127.68,Percent of total billed charges,,,0.95,,126.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,126.35,Percent of total billed charges,,126.35,130.34,
Transferrin (iron binding protein) level,PX-30014358,CDM,84466,CPT,301,RC,,outpatient,,,133,119.7,,0.95,,126.35,Percent of total billed charges,,,0.98,,130.34,Percent of total billed charges,,,0.95,,126.35,Percent of total billed charges,,,0.95,,126.35,Percent of total billed charges,,,0.97,,129.01,Percent of total billed charges,,,0.96,,127.68,Percent of total billed charges,,,0.95,,126.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,126.35,Percent of total billed charges,,126.35,130.34,
"Cyanocobalamin level, unsaturated binding capacity",PX-30014366,CDM,82608,CPT,301,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
"Cyanocobalamin level, unsaturated binding capacity",PX-30014366,CDM,82608,CPT,301,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
"Bile acids level, total",PX-30014414,CDM,82239,CPT,301,RC,,inpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
"Bile acids level, total",PX-30014414,CDM,82239,CPT,301,RC,,outpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
"Testosterone (hormone) level, total",PX-30014441,CDM,84403,CPT,301,RC,,inpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
"Testosterone (hormone) level, total",PX-30014441,CDM,84403,CPT,301,RC,,outpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
"Complete blood cell count, automated test",PX-30014447,CDM,85027,CPT,305,RC,,inpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
"Complete blood cell count, automated test",PX-30014447,CDM,85027,CPT,305,RC,,outpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
Automated white blood cell count,PX-30014448,CDM,85048,CPT,305,RC,,inpatient,,,49,44.1,,0.95,,46.55,Percent of total billed charges,,,0.98,,48.02,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.96,,47.04,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,46.55,Percent of total billed charges,,46.55,48.02,
Automated white blood cell count,PX-30014448,CDM,85048,CPT,305,RC,,outpatient,,,49,44.1,,0.95,,46.55,Percent of total billed charges,,,0.98,,48.02,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.96,,47.04,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,46.55,Percent of total billed charges,,46.55,48.02,
Blood gases measurement,PX-30014449,CDM,82803,CPT,301,RC,,inpatient,,,270,243,,0.95,,256.5,Percent of total billed charges,,,0.98,,264.6,Percent of total billed charges,,,0.95,,256.5,Percent of total billed charges,,,0.97,,261.9,Percent of total billed charges,,,0.97,,261.9,Percent of total billed charges,,,0.96,,259.2,Percent of total billed charges,,,0.95,,256.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,256.5,Percent of total billed charges,,256.5,264.6,
Blood gases measurement,PX-30014449,CDM,82803,CPT,301,RC,,outpatient,,,270,243,,0.95,,256.5,Percent of total billed charges,,,0.98,,264.6,Percent of total billed charges,,,0.95,,256.5,Percent of total billed charges,,,0.95,,256.5,Percent of total billed charges,,,0.97,,261.9,Percent of total billed charges,,,0.96,,259.2,Percent of total billed charges,,,0.95,,256.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,256.5,Percent of total billed charges,,256.5,264.6,
"Urea nitrogen level to assess kidney function, quantitative",PX-30014459,CDM,84520,CPT,301,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
"Urea nitrogen level to assess kidney function, quantitative",PX-30014459,CDM,84520,CPT,301,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
C-peptide (protein) level,PX-30014462,CDM,84681,CPT,301,RC,,inpatient,,,165,148.5,,0.95,,156.75,Percent of total billed charges,,,0.98,,161.7,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.96,,158.4,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,156.75,Percent of total billed charges,,156.75,161.7,
C-peptide (protein) level,PX-30014462,CDM,84681,CPT,301,RC,,outpatient,,,165,148.5,,0.95,,156.75,Percent of total billed charges,,,0.98,,161.7,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.96,,158.4,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,156.75,Percent of total billed charges,,156.75,161.7,
Calcitonin (hormone) level,PX-30014480,CDM,82308,CPT,301,RC,,inpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
Calcitonin (hormone) level,PX-30014480,CDM,82308,CPT,301,RC,,outpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
"Calcium level, ionized",PX-30014481,CDM,82330,CPT,301,RC,,inpatient,,,156,140.4,,0.95,,148.2,Percent of total billed charges,,,0.98,,152.88,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,0.97,,151.32,Percent of total billed charges,,,0.97,,151.32,Percent of total billed charges,,,0.96,,149.76,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,148.2,Percent of total billed charges,,148.2,152.88,
"Calcium level, ionized",PX-30014481,CDM,82330,CPT,301,RC,,outpatient,,,156,140.4,,0.95,,148.2,Percent of total billed charges,,,0.98,,152.88,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,0.97,,151.32,Percent of total billed charges,,,0.96,,149.76,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,148.2,Percent of total billed charges,,148.2,152.88,
Urine calcium level,PX-30014484,CDM,82340,CPT,301,RC,,inpatient,,,94,84.6,,0.95,,89.3,Percent of total billed charges,,,0.98,,92.12,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.96,,90.24,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,89.3,Percent of total billed charges,,89.3,92.12,
Urine calcium level,PX-30014484,CDM,82340,CPT,301,RC,,outpatient,,,94,84.6,,0.95,,89.3,Percent of total billed charges,,,0.98,,92.12,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.96,,90.24,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,89.3,Percent of total billed charges,,89.3,92.12,
Carbon dioxide (bicarbonate) level,PX-30014495,CDM,82374,CPT,301,RC,,inpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
Carbon dioxide (bicarbonate) level,PX-30014495,CDM,82374,CPT,301,RC,,outpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
Carboxyhemoglobin (protein) level,PX-30014496,CDM,82375,CPT,301,RC,,inpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
Carboxyhemoglobin (protein) level,PX-30014496,CDM,82375,CPT,301,RC,,outpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
Catecholamines (organic nitrogen) level,PX-30014500,CDM,82384,CPT,301,RC,,inpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
Catecholamines (organic nitrogen) level,PX-30014500,CDM,82384,CPT,301,RC,,outpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
"CBC, automated test and differential WBC count",PX-30014514,CDM,85025,CPT,305,RC,,inpatient,,,127,114.3,,0.95,,120.65,Percent of total billed charges,,,0.98,,124.46,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,0.97,,123.19,Percent of total billed charges,,,0.97,,123.19,Percent of total billed charges,,,0.96,,121.92,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,120.65,Percent of total billed charges,,120.65,124.46,
"CBC, automated test and differential WBC count",PX-30014514,CDM,85025,CPT,305,RC,,outpatient,,,127,114.3,,0.95,,120.65,Percent of total billed charges,,,0.98,,124.46,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,0.97,,123.19,Percent of total billed charges,,,0.96,,121.92,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,120.65,Percent of total billed charges,,120.65,124.46,
Carcinoembryonic antigen (CEA) protein level,PX-30014520,CDM,82378,CPT,301,RC,,inpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
Carcinoembryonic antigen (CEA) protein level,PX-30014520,CDM,82378,CPT,301,RC,,outpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
Measurement of substance using immunoassay technique,PX-30014525,CDM,83520,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Measurement of substance using immunoassay technique,PX-30014525,CDM,83520,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Ceruloplasmin (protein) level,PX-30014527,CDM,82390,CPT,301,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Ceruloplasmin (protein) level,PX-30014527,CDM,82390,CPT,301,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Analysis w/ chemiluminescent (light and chemical )reaction,PX-30014538,CDM,82397,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Analysis w/ chemiluminescent (light and chemical )reaction,PX-30014538,CDM,82397,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Blood chloride level,PX-30014542,CDM,82435,CPT,301,RC,,inpatient,,,40,36,,0.95,,38,Percent of total billed charges,,,0.98,,39.2,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.96,,38.4,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38,Percent of total billed charges,,38,39.2,
Blood chloride level,PX-30014542,CDM,82435,CPT,301,RC,,outpatient,,,40,36,,0.95,,38,Percent of total billed charges,,,0.98,,39.2,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.96,,38.4,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38,Percent of total billed charges,,38,39.2,
Urine chloride level,PX-30014544,CDM,82436,CPT,301,RC,,inpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
Urine chloride level,PX-30014544,CDM,82436,CPT,301,RC,,outpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
Citrate level,PX-30014564,CDM,82507,CPT,301,RC,,inpatient,,,206,185.4,,0.95,,195.7,Percent of total billed charges,,,0.98,,201.88,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.96,,197.76,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,195.7,Percent of total billed charges,,195.7,201.88,
Citrate level,PX-30014564,CDM,82507,CPT,301,RC,,outpatient,,,206,185.4,,0.95,,195.7,Percent of total billed charges,,,0.98,,201.88,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.96,,197.76,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,195.7,Percent of total billed charges,,195.7,201.88,
"Creatine kinase (cardiac enzyme) level, total",PX-30014566,CDM,82550,CPT,301,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
"Creatine kinase (cardiac enzyme) level, total",PX-30014566,CDM,82550,CPT,301,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
"Creatine kinase (cardiac enzyme) level, MB fraction only",PX-30014567,CDM,82553,CPT,301,RC,,inpatient,,,211,189.9,,0.95,,200.45,Percent of total billed charges,,,0.98,,206.78,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,0.97,,204.67,Percent of total billed charges,,,0.97,,204.67,Percent of total billed charges,,,0.96,,202.56,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,200.45,Percent of total billed charges,,200.45,206.78,
"Creatine kinase (cardiac enzyme) level, MB fraction only",PX-30014567,CDM,82553,CPT,301,RC,,outpatient,,,211,189.9,,0.95,,200.45,Percent of total billed charges,,,0.98,,206.78,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,0.97,,204.67,Percent of total billed charges,,,0.96,,202.56,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,200.45,Percent of total billed charges,,200.45,206.78,
Copper level,PX-30014603,CDM,82525,CPT,301,RC,,inpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
Copper level,PX-30014603,CDM,82525,CPT,301,RC,,outpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
"Cortisol (hormone) measurement, total",PX-30014605,CDM,82533,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
"Cortisol (hormone) measurement, total",PX-30014605,CDM,82533,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
"Cortisol (hormone) measurement, free",PX-30014608,CDM,82530,CPT,301,RC,,inpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
"Cortisol (hormone) measurement, free",PX-30014608,CDM,82530,CPT,301,RC,,outpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
Creatinine clearance test to test for kidney function,PX-30014631,CDM,82575,CPT,301,RC,,inpatient,,,222,199.8,,0.95,,210.9,Percent of total billed charges,,,0.98,,217.56,Percent of total billed charges,,,0.95,,210.9,Percent of total billed charges,,,0.97,,215.34,Percent of total billed charges,,,0.97,,215.34,Percent of total billed charges,,,0.96,,213.12,Percent of total billed charges,,,0.95,,210.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,210.9,Percent of total billed charges,,210.9,217.56,
Creatinine clearance test to test for kidney function,PX-30014631,CDM,82575,CPT,301,RC,,outpatient,,,222,199.8,,0.95,,210.9,Percent of total billed charges,,,0.98,,217.56,Percent of total billed charges,,,0.95,,210.9,Percent of total billed charges,,,0.95,,210.9,Percent of total billed charges,,,0.97,,215.34,Percent of total billed charges,,,0.96,,213.12,Percent of total billed charges,,,0.95,,210.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,210.9,Percent of total billed charges,,210.9,217.56,
Cryoglobulin (protein) measurement,PX-30014642,CDM,82595,CPT,301,RC,,inpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
Cryoglobulin (protein) measurement,PX-30014642,CDM,82595,CPT,301,RC,,outpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
Cystatin C (enzyme inhibitor) level,PX-30014653,CDM,82610,CPT,301,RC,,inpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
Cystatin C (enzyme inhibitor) level,PX-30014653,CDM,82610,CPT,301,RC,,outpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
"Coagulation function measurement, D-dimer; quantitative",PX-30014674,CDM,85379,CPT,305,RC,,inpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
"Coagulation function measurement, D-dimer; quantitative",PX-30014674,CDM,85379,CPT,305,RC,,outpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
Dehydroepiandrosterone (DHEA) hormone level,PX-30014683,CDM,82626,CPT,301,RC,,inpatient,,,153,137.7,,0.95,,145.35,Percent of total billed charges,,,0.98,,149.94,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.96,,146.88,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,145.35,Percent of total billed charges,,145.35,149.94,
Dehydroepiandrosterone (DHEA) hormone level,PX-30014683,CDM,82626,CPT,301,RC,,outpatient,,,153,137.7,,0.95,,145.35,Percent of total billed charges,,,0.98,,149.94,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.96,,146.88,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,145.35,Percent of total billed charges,,145.35,149.94,
Dehydroepiandrosterone (DHEA-S) hormone level,PX-30014685,CDM,82627,CPT,301,RC,,inpatient,,,202,181.8,,0.95,,191.9,Percent of total billed charges,,,0.98,,197.96,Percent of total billed charges,,,0.95,,191.9,Percent of total billed charges,,,0.97,,195.94,Percent of total billed charges,,,0.97,,195.94,Percent of total billed charges,,,0.96,,193.92,Percent of total billed charges,,,0.95,,191.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,191.9,Percent of total billed charges,,191.9,197.96,
Dehydroepiandrosterone (DHEA-S) hormone level,PX-30014685,CDM,82627,CPT,301,RC,,outpatient,,,202,181.8,,0.95,,191.9,Percent of total billed charges,,,0.98,,197.96,Percent of total billed charges,,,0.95,,191.9,Percent of total billed charges,,,0.95,,191.9,Percent of total billed charges,,,0.97,,195.94,Percent of total billed charges,,,0.96,,193.92,Percent of total billed charges,,,0.95,,191.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,191.9,Percent of total billed charges,,191.9,197.96,
Molecular pathology procedure level 7,PX-30110385,CDM,81406,CPT,310,RC,,inpatient,,,1063,956.7,,0.95,,1009.85,Percent of total billed charges,,,0.98,,1041.74,Percent of total billed charges,,,0.95,,1009.85,Percent of total billed charges,,,0.97,,1031.11,Percent of total billed charges,,,0.97,,1031.11,Percent of total billed charges,,,0.96,,1020.48,Percent of total billed charges,,,0.95,,1009.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1009.85,Percent of total billed charges,,1009.85,1041.74,
Molecular pathology procedure level 7,PX-30110385,CDM,81406,CPT,310,RC,,outpatient,,,1063,956.7,,0.95,,1009.85,Percent of total billed charges,,,0.98,,1041.74,Percent of total billed charges,,,0.95,,1009.85,Percent of total billed charges,,,0.95,,1009.85,Percent of total billed charges,,,0.97,,1031.11,Percent of total billed charges,,,0.96,,1020.48,Percent of total billed charges,,,0.95,,1009.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1009.85,Percent of total billed charges,,1009.85,1041.74,
"Protein measurement, body fluid",PX-30014775,CDM,84166,CPT,301,RC,,inpatient,,,134,120.6,,0.95,,127.3,Percent of total billed charges,,,0.98,,131.32,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,0.97,,129.98,Percent of total billed charges,,,0.97,,129.98,Percent of total billed charges,,,0.96,,128.64,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,127.3,Percent of total billed charges,,127.3,131.32,
"Protein measurement, body fluid",PX-30014775,CDM,84166,CPT,301,RC,,outpatient,,,134,120.6,,0.95,,127.3,Percent of total billed charges,,,0.98,,131.32,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,0.97,,129.98,Percent of total billed charges,,,0.96,,128.64,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,127.3,Percent of total billed charges,,127.3,131.32,
"Total protein level, urine",PX-30014776,CDM,84156,CPT,301,RC,,inpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
"Total protein level, urine",PX-30014776,CDM,84156,CPT,301,RC,,outpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
Erythropoietin (protein) level,PX-30014795,CDM,82668,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Erythropoietin (protein) level,PX-30014795,CDM,82668,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Measurement of total estradiol (hormone),PX-30014796,CDM,82670,CPT,301,RC,,inpatient,,,206,185.4,,0.95,,195.7,Percent of total billed charges,,,0.98,,201.88,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.96,,197.76,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,195.7,Percent of total billed charges,,195.7,201.88,
Measurement of total estradiol (hormone),PX-30014796,CDM,82670,CPT,301,RC,,outpatient,,,206,185.4,,0.95,,195.7,Percent of total billed charges,,,0.98,,201.88,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.96,,197.76,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,195.7,Percent of total billed charges,,195.7,201.88,
Estriol (hormone) level,PX-30014801,CDM,82677,CPT,301,RC,,inpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
Estriol (hormone) level,PX-30014801,CDM,82677,CPT,301,RC,,outpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
Clotting factor VIII (von Willebrand factor) measurement,PX-30014828,CDM,85247,CPT,305,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Clotting factor VIII (von Willebrand factor) measurement,PX-30014828,CDM,85247,CPT,305,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Molecular pathology procedure level 9,PX-30110425,CDM,81408,CPT,310,RC,,inpatient,,,930,837,,0.95,,883.5,Percent of total billed charges,,,0.98,,911.4,Percent of total billed charges,,,0.95,,883.5,Percent of total billed charges,,,0.97,,902.1,Percent of total billed charges,,,0.97,,902.1,Percent of total billed charges,,,0.96,,892.8,Percent of total billed charges,,,0.95,,883.5,Percent of total billed charges,,,,,,,,,0.95,,883.5,Percent of total billed charges,,883.5,911.4,
Molecular pathology procedure level 9,PX-30110425,CDM,81408,CPT,310,RC,,outpatient,,,930,837,,0.95,,883.5,Percent of total billed charges,,,0.98,,911.4,Percent of total billed charges,,,0.95,,883.5,Percent of total billed charges,,,0.95,,883.5,Percent of total billed charges,,,0.97,,902.1,Percent of total billed charges,,,0.96,,892.8,Percent of total billed charges,,,0.95,,883.5,Percent of total billed charges,,,,,,,,,0.95,,883.5,Percent of total billed charges,,883.5,911.4,
"Clotting factor VII (proconvertin, stable factor)",PX-30014848,CDM,85230,CPT,305,RC,,inpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
"Clotting factor VII (proconvertin, stable factor)",PX-30014848,CDM,85230,CPT,305,RC,,outpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
Clotting factor XI (PTA) measurement,PX-30014867,CDM,85270,CPT,305,RC,,inpatient,,,168,151.2,,0.95,,159.6,Percent of total billed charges,,,0.98,,164.64,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,0.97,,162.96,Percent of total billed charges,,,0.97,,162.96,Percent of total billed charges,,,0.96,,161.28,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,159.6,Percent of total billed charges,,159.6,164.64,
Clotting factor XI (PTA) measurement,PX-30014867,CDM,85270,CPT,305,RC,,outpatient,,,168,151.2,,0.95,,159.6,Percent of total billed charges,,,0.98,,164.64,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,0.97,,162.96,Percent of total billed charges,,,0.96,,161.28,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,159.6,Percent of total billed charges,,159.6,164.64,
Stool analysis for blood to screen for colon tumors,PX-30014877,CDM,82270,CPT,301,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Stool analysis for blood to screen for colon tumors,PX-30014877,CDM,82270,CPT,301,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Fetal fibronectin (protein) analysis,PX-30014881,CDM,82731,CPT,301,RC,,inpatient,,,352,316.8,,0.95,,334.4,Percent of total billed charges,,,0.98,,344.96,Percent of total billed charges,,,0.95,,334.4,Percent of total billed charges,,,0.97,,341.44,Percent of total billed charges,,,0.97,,341.44,Percent of total billed charges,,,0.96,,337.92,Percent of total billed charges,,,0.95,,334.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,334.4,Percent of total billed charges,,334.4,344.96,
Fetal fibronectin (protein) analysis,PX-30014881,CDM,82731,CPT,301,RC,,outpatient,,,352,316.8,,0.95,,334.4,Percent of total billed charges,,,0.98,,344.96,Percent of total billed charges,,,0.95,,334.4,Percent of total billed charges,,,0.95,,334.4,Percent of total billed charges,,,0.97,,341.44,Percent of total billed charges,,,0.96,,337.92,Percent of total billed charges,,,0.95,,334.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,334.4,Percent of total billed charges,,334.4,344.96,
Tacrolimus level,PX-30014892,CDM,80197,CPT,301,RC,,inpatient,,,119,107.1,,0.95,,113.05,Percent of total billed charges,,,0.98,,116.62,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.96,,114.24,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,113.05,Percent of total billed charges,,113.05,116.62,
Tacrolimus level,PX-30014892,CDM,80197,CPT,301,RC,,outpatient,,,119,107.1,,0.95,,113.05,Percent of total billed charges,,,0.98,,116.62,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.96,,114.24,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,113.05,Percent of total billed charges,,113.05,116.62,
"Folic acid level, serum",PX-30014898,CDM,82746,CPT,301,RC,,inpatient,,,130,117,,0.95,,123.5,Percent of total billed charges,,,0.98,,127.4,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.96,,124.8,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,123.5,Percent of total billed charges,,123.5,127.4,
"Folic acid level, serum",PX-30014898,CDM,82746,CPT,301,RC,,outpatient,,,130,117,,0.95,,123.5,Percent of total billed charges,,,0.98,,127.4,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.96,,124.8,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,123.5,Percent of total billed charges,,123.5,127.4,
"Thyroid hormone, T3 measurement, free",PX-30014932,CDM,84481,CPT,301,RC,,inpatient,,,233,209.7,,0.95,,221.35,Percent of total billed charges,,,0.98,,228.34,Percent of total billed charges,,,0.95,,221.35,Percent of total billed charges,,,0.97,,226.01,Percent of total billed charges,,,0.97,,226.01,Percent of total billed charges,,,0.96,,223.68,Percent of total billed charges,,,0.95,,221.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,221.35,Percent of total billed charges,,221.35,228.34,
"Thyroid hormone, T3 measurement, free",PX-30014932,CDM,84481,CPT,301,RC,,outpatient,,,233,209.7,,0.95,,221.35,Percent of total billed charges,,,0.98,,228.34,Percent of total billed charges,,,0.95,,221.35,Percent of total billed charges,,,0.95,,221.35,Percent of total billed charges,,,0.97,,226.01,Percent of total billed charges,,,0.96,,223.68,Percent of total billed charges,,,0.95,,221.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,221.35,Percent of total billed charges,,221.35,228.34,
"Thyroxine (thyroid chemical), free",PX-30014933,CDM,84439,CPT,301,RC,,inpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
"Thyroxine (thyroid chemical), free",PX-30014933,CDM,84439,CPT,301,RC,,outpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
"Gonadotropin, follicle stimulating level",PX-30014937,CDM,83001,CPT,301,RC,,inpatient,,,183,164.7,,0.95,,173.85,Percent of total billed charges,,,0.98,,179.34,Percent of total billed charges,,,0.95,,173.85,Percent of total billed charges,,,0.97,,177.51,Percent of total billed charges,,,0.97,,177.51,Percent of total billed charges,,,0.96,,175.68,Percent of total billed charges,,,0.95,,173.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,173.85,Percent of total billed charges,,173.85,179.34,
"Gonadotropin, follicle stimulating level",PX-30014937,CDM,83001,CPT,301,RC,,outpatient,,,183,164.7,,0.95,,173.85,Percent of total billed charges,,,0.98,,179.34,Percent of total billed charges,,,0.95,,173.85,Percent of total billed charges,,,0.95,,173.85,Percent of total billed charges,,,0.97,,177.51,Percent of total billed charges,,,0.96,,175.68,Percent of total billed charges,,,0.95,,173.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,173.85,Percent of total billed charges,,173.85,179.34,
G6PD (enzyme) level,PX-30014945,CDM,82955,CPT,300,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
G6PD (enzyme) level,PX-30014945,CDM,82955,CPT,300,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Glutamyltransferase (liver enzyme) level,PX-30014949,CDM,82977,CPT,301,RC,,inpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
Glutamyltransferase (liver enzyme) level,PX-30014949,CDM,82977,CPT,301,RC,,outpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
Gammaglobulin test,PX-30014950,CDM,82784,CPT,301,RC,,inpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
Gammaglobulin test,PX-30014950,CDM,82784,CPT,301,RC,,outpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
Gammaglobulin test,PX-30014951,CDM,82784,CPT,301,RC,,inpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
Gammaglobulin test,PX-30014951,CDM,82784,CPT,301,RC,,outpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
Gastrin (GI tract hormone) level,PX-30014962,CDM,82941,CPT,300,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Gastrin (GI tract hormone) level,PX-30014962,CDM,82941,CPT,300,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
"Analysis of substance w/ immunoassay, multiple step method",PX-30014972,CDM,83516,CPT,301,RC,,inpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
"Analysis of substance w/ immunoassay, multiple step method",PX-30014972,CDM,83516,CPT,301,RC,,outpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
Blood glucose level after receiving glucose,PX-30014980,CDM,82950,CPT,301,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Blood glucose level after receiving glucose,PX-30014980,CDM,82950,CPT,301,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Glucose (sugar) level on body fluid,PX-30014981,CDM,82945,CPT,301,RC,,inpatient,,,82,73.8,,0.95,,77.9,Percent of total billed charges,,,0.98,,80.36,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,0.97,,79.54,Percent of total billed charges,,,0.97,,79.54,Percent of total billed charges,,,0.96,,78.72,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,77.9,Percent of total billed charges,,77.9,80.36,
Glucose (sugar) level on body fluid,PX-30014981,CDM,82945,CPT,301,RC,,outpatient,,,82,73.8,,0.95,,77.9,Percent of total billed charges,,,0.98,,80.36,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,0.97,,79.54,Percent of total billed charges,,,0.96,,78.72,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,77.9,Percent of total billed charges,,77.9,80.36,
Blood glucose (sugar) level,PX-30014986,CDM,82947,CPT,301,RC,,inpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
Blood glucose (sugar) level,PX-30014986,CDM,82947,CPT,301,RC,,outpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
"Blood glucose (sugar) tolerance test, 3 specimens",PX-30014990,CDM,82951,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
"Blood glucose (sugar) tolerance test, 3 specimens",PX-30014990,CDM,82951,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Hemoglobin A1C level,PX-30015020,CDM,83036,CPT,301,RC,,inpatient,,,85,76.5,,0.95,,80.75,Percent of total billed charges,,,0.98,,83.3,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.96,,81.6,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,80.75,Percent of total billed charges,,80.75,83.3,
Hemoglobin A1C level,PX-30015020,CDM,83036,CPT,301,RC,,outpatient,,,85,76.5,,0.95,,80.75,Percent of total billed charges,,,0.98,,83.3,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.96,,81.6,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,80.75,Percent of total billed charges,,80.75,83.3,
"Gonadotropin, chorionic (reproductive hormone) level",PX-30015025,CDM,84702,CPT,301,RC,,inpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
"Gonadotropin, chorionic (reproductive hormone) level",PX-30015025,CDM,84702,CPT,301,RC,,outpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
Haptoglobin (serum protein) level,PX-30015036,CDM,83010,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Haptoglobin (serum protein) level,PX-30015036,CDM,83010,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Gonadotropin (reproductive hormone) analysis,PX-30015043,CDM,84703,CPT,301,RC,,inpatient,,,144,129.6,,0.95,,136.8,Percent of total billed charges,,,0.98,,141.12,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,0.97,,139.68,Percent of total billed charges,,,0.97,,139.68,Percent of total billed charges,,,0.96,,138.24,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,136.8,Percent of total billed charges,,136.8,141.12,
Gonadotropin (reproductive hormone) analysis,PX-30015043,CDM,84703,CPT,301,RC,,outpatient,,,144,129.6,,0.95,,136.8,Percent of total billed charges,,,0.98,,141.12,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,0.97,,139.68,Percent of total billed charges,,,0.96,,138.24,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,136.8,Percent of total billed charges,,136.8,141.12,
HDL cholesterol level,PX-30015059,CDM,83718,CPT,301,RC,,inpatient,,,125,112.5,,0.95,,118.75,Percent of total billed charges,,,0.98,,122.5,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.96,,120,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,118.75,Percent of total billed charges,,118.75,122.5,
HDL cholesterol level,PX-30015059,CDM,83718,CPT,301,RC,,outpatient,,,125,112.5,,0.95,,118.75,Percent of total billed charges,,,0.98,,122.5,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.96,,120,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,118.75,Percent of total billed charges,,118.75,122.5,
Breath test analysis for helicobacter pylori,PX-30015065,CDM,83013,CPT,301,RC,,inpatient,,,297,267.3,,0.95,,282.15,Percent of total billed charges,,,0.98,,291.06,Percent of total billed charges,,,0.95,,282.15,Percent of total billed charges,,,0.97,,288.09,Percent of total billed charges,,,0.97,,288.09,Percent of total billed charges,,,0.96,,285.12,Percent of total billed charges,,,0.95,,282.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,282.15,Percent of total billed charges,,282.15,291.06,
Breath test analysis for helicobacter pylori,PX-30015065,CDM,83013,CPT,301,RC,,outpatient,,,297,267.3,,0.95,,282.15,Percent of total billed charges,,,0.98,,291.06,Percent of total billed charges,,,0.95,,282.15,Percent of total billed charges,,,0.95,,282.15,Percent of total billed charges,,,0.97,,288.09,Percent of total billed charges,,,0.96,,285.12,Percent of total billed charges,,,0.95,,282.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,282.15,Percent of total billed charges,,282.15,291.06,
Red blood cell concentration measurement,PX-30015067,CDM,85014,CPT,300,RC,,inpatient,,,48,43.2,,0.95,,45.6,Percent of total billed charges,,,0.98,,47.04,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.96,,46.08,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,45.6,Percent of total billed charges,,45.6,47.04,
Red blood cell concentration measurement,PX-30015067,CDM,85014,CPT,300,RC,,outpatient,,,48,43.2,,0.95,,45.6,Percent of total billed charges,,,0.98,,47.04,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.96,,46.08,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,45.6,Percent of total billed charges,,45.6,47.04,
Red blood cell hemoglobin concentration,PX-30015068,CDM,85013,CPT,300,RC,,inpatient,,,22,19.8,,0.95,,20.9,Percent of total billed charges,,,0.98,,21.56,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.96,,21.12,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,20.9,Percent of total billed charges,,20.9,21.56,
Red blood cell hemoglobin concentration,PX-30015068,CDM,85013,CPT,300,RC,,outpatient,,,22,19.8,,0.95,,20.9,Percent of total billed charges,,,0.98,,21.56,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.96,,21.12,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,20.9,Percent of total billed charges,,20.9,21.56,
"Methemoglobin (hemoglobin) analysis, quantitative",PX-30015078,CDM,83050,CPT,301,RC,,inpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
"Methemoglobin (hemoglobin) analysis, quantitative",PX-30015078,CDM,83050,CPT,301,RC,,outpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
"Blood count, hemoglobin",PX-30015080,CDM,85018,CPT,305,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"Blood count, hemoglobin",PX-30015080,CDM,85018,CPT,305,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
Plasma hemoglobin level,PX-30015152,CDM,83051,CPT,301,RC,,inpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
Plasma hemoglobin level,PX-30015152,CDM,83051,CPT,301,RC,,outpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
Homovanillic acid (organic acid) level,PX-30015183,CDM,83150,CPT,301,RC,,inpatient,,,86,77.4,,0.95,,81.7,Percent of total billed charges,,,0.98,,84.28,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,0.97,,83.42,Percent of total billed charges,,,0.97,,83.42,Percent of total billed charges,,,0.96,,82.56,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,81.7,Percent of total billed charges,,81.7,84.28,
Homovanillic acid (organic acid) level,PX-30015183,CDM,83150,CPT,301,RC,,outpatient,,,86,77.4,,0.95,,81.7,Percent of total billed charges,,,0.98,,84.28,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,0.97,,83.42,Percent of total billed charges,,,0.96,,82.56,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,81.7,Percent of total billed charges,,81.7,84.28,
Arsenic level,PX-30015188,CDM,82175,CPT,301,RC,,inpatient,,,97,87.3,,0.95,,92.15,Percent of total billed charges,,,0.98,,95.06,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,0.97,,94.09,Percent of total billed charges,,,0.97,,94.09,Percent of total billed charges,,,0.96,,93.12,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,92.15,Percent of total billed charges,,92.15,95.06,
Arsenic level,PX-30015188,CDM,82175,CPT,301,RC,,outpatient,,,97,87.3,,0.95,,92.15,Percent of total billed charges,,,0.98,,95.06,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,0.97,,94.09,Percent of total billed charges,,,0.96,,93.12,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,92.15,Percent of total billed charges,,92.15,95.06,
Lead level,PX-30015190,CDM,83655,CPT,301,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
Lead level,PX-30015190,CDM,83655,CPT,301,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
Mercury level,PX-30015191,CDM,83825,CPT,301,RC,,inpatient,,,97,87.3,,0.95,,92.15,Percent of total billed charges,,,0.98,,95.06,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,0.97,,94.09,Percent of total billed charges,,,0.97,,94.09,Percent of total billed charges,,,0.96,,93.12,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,92.15,Percent of total billed charges,,92.15,95.06,
Mercury level,PX-30015191,CDM,83825,CPT,301,RC,,outpatient,,,97,87.3,,0.95,,92.15,Percent of total billed charges,,,0.98,,95.06,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,0.97,,94.09,Percent of total billed charges,,,0.96,,93.12,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,92.15,Percent of total billed charges,,92.15,95.06,
Cadmium level,PX-30015193,CDM,82300,CPT,301,RC,,inpatient,,,85,76.5,,0.95,,80.75,Percent of total billed charges,,,0.98,,83.3,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.96,,81.6,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,80.75,Percent of total billed charges,,80.75,83.3,
Cadmium level,PX-30015193,CDM,82300,CPT,301,RC,,outpatient,,,85,76.5,,0.95,,80.75,Percent of total billed charges,,,0.98,,83.3,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.96,,81.6,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,80.75,Percent of total billed charges,,80.75,83.3,
"Protein measurement, serum",PX-30015206,CDM,84165,CPT,301,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
"Protein measurement, serum",PX-30015206,CDM,84165,CPT,301,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
"Total protein level, blood",PX-30015207,CDM,84155,CPT,301,RC,,inpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
"Total protein level, blood",PX-30015207,CDM,84155,CPT,301,RC,,outpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
IgE (immune system protein) level,PX-30015213,CDM,82785,CPT,301,RC,,inpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
IgE (immune system protein) level,PX-30015213,CDM,82785,CPT,301,RC,,outpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
Somatomedin (growth factor) level,PX-30015218,CDM,84305,CPT,301,RC,,inpatient,,,177,159.3,,0.95,,168.15,Percent of total billed charges,,,0.98,,173.46,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.96,,169.92,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,168.15,Percent of total billed charges,,168.15,173.46,
Somatomedin (growth factor) level,PX-30015218,CDM,84305,CPT,301,RC,,outpatient,,,177,159.3,,0.95,,168.15,Percent of total billed charges,,,0.98,,173.46,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.96,,169.92,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,168.15,Percent of total billed charges,,168.15,173.46,
"Measure substance w/ immunoassay, by radioimmunoassay",PX-30015239,CDM,83519,CPT,301,RC,,inpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
"Measure substance w/ immunoassay, by radioimmunoassay",PX-30015239,CDM,83519,CPT,301,RC,,outpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Iron level,PX-30015298,CDM,83540,CPT,301,RC,,inpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
Iron level,PX-30015298,CDM,83540,CPT,301,RC,,outpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
Iron binding capacity,PX-30015300,CDM,83550,CPT,301,RC,,inpatient,,,131,117.9,,0.95,,124.45,Percent of total billed charges,,,0.98,,128.38,Percent of total billed charges,,,0.95,,124.45,Percent of total billed charges,,,0.97,,127.07,Percent of total billed charges,,,0.97,,127.07,Percent of total billed charges,,,0.96,,125.76,Percent of total billed charges,,,0.95,,124.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,124.45,Percent of total billed charges,,124.45,128.38,
Iron binding capacity,PX-30015300,CDM,83550,CPT,301,RC,,outpatient,,,131,117.9,,0.95,,124.45,Percent of total billed charges,,,0.98,,128.38,Percent of total billed charges,,,0.95,,124.45,Percent of total billed charges,,,0.95,,124.45,Percent of total billed charges,,,0.97,,127.07,Percent of total billed charges,,,0.96,,125.76,Percent of total billed charges,,,0.95,,124.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,124.45,Percent of total billed charges,,124.45,128.38,
Quantitation of therapeutic drug,PX-30015346,CDM,80299,CPT,301,RC,,inpatient,,,218,196.2,,0.95,,207.1,Percent of total billed charges,,,0.98,,213.64,Percent of total billed charges,,,0.95,,207.1,Percent of total billed charges,,,0.97,,211.46,Percent of total billed charges,,,0.97,,211.46,Percent of total billed charges,,,0.96,,209.28,Percent of total billed charges,,,0.95,,207.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,207.1,Percent of total billed charges,,207.1,213.64,
Quantitation of therapeutic drug,PX-30015346,CDM,80299,CPT,301,RC,,outpatient,,,218,196.2,,0.95,,207.1,Percent of total billed charges,,,0.98,,213.64,Percent of total billed charges,,,0.95,,207.1,Percent of total billed charges,,,0.95,,207.1,Percent of total billed charges,,,0.97,,211.46,Percent of total billed charges,,,0.96,,209.28,Percent of total billed charges,,,0.95,,207.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,207.1,Percent of total billed charges,,207.1,213.64,
Mass spectrometry (laboratory testing method),PX-30015355,CDM,83789,CPT,301,RC,,inpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
Mass spectrometry (laboratory testing method),PX-30015355,CDM,83789,CPT,301,RC,,outpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
Lactic acid level,PX-30015357,CDM,83605,CPT,301,RC,,inpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
Lactic acid level,PX-30015357,CDM,83605,CPT,301,RC,,outpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
Stool lactoferrin (immune system protein) analysis,PX-30015358,CDM,83630,CPT,301,RC,,inpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
Stool lactoferrin (immune system protein) analysis,PX-30015358,CDM,83630,CPT,301,RC,,outpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
Lactate dehydrogenase (enzyme) level,PX-30015373,CDM,83615,CPT,301,RC,,inpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
Lactate dehydrogenase (enzyme) level,PX-30015373,CDM,83615,CPT,301,RC,,outpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
Lead level,PX-30015376,CDM,83655,CPT,301,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
Lead level,PX-30015376,CDM,83655,CPT,301,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
"Gonadotropin, luteinizing (reproductive hormone) level",PX-30015391,CDM,83002,CPT,301,RC,,inpatient,,,177,159.3,,0.95,,168.15,Percent of total billed charges,,,0.98,,173.46,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.96,,169.92,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,168.15,Percent of total billed charges,,168.15,173.46,
"Gonadotropin, luteinizing (reproductive hormone) level",PX-30015391,CDM,83002,CPT,301,RC,,outpatient,,,177,159.3,,0.95,,168.15,Percent of total billed charges,,,0.98,,173.46,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.96,,169.92,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,168.15,Percent of total billed charges,,168.15,173.46,
Cyclosporine level,PX-30015394,CDM,80158,CPT,301,RC,,inpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
Cyclosporine level,PX-30015394,CDM,80158,CPT,301,RC,,outpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
Lipoprotein (A) level,PX-30015399,CDM,83695,CPT,301,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Lipoprotein (A) level,PX-30015399,CDM,83695,CPT,301,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Phosphatidylglycerol (amniotic fluid organic acid) level,PX-30015406,CDM,84081,CPT,301,RC,,inpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
Phosphatidylglycerol (amniotic fluid organic acid) level,PX-30015406,CDM,84081,CPT,301,RC,,outpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
"Clotting factor X assessment test, diluted",PX-30015407,CDM,85613,CPT,305,RC,,inpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
"Clotting factor X assessment test, diluted",PX-30015407,CDM,85613,CPT,305,RC,,outpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
"Blood test, clotting time",PX-30015408,CDM,85610,CPT,305,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
"Blood test, clotting time",PX-30015408,CDM,85610,CPT,305,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
"Coagulation assessment blood test, plasma or whole blood",PX-30015409,CDM,85730,CPT,305,RC,,inpatient,,,123,110.7,,0.95,,116.85,Percent of total billed charges,,,0.98,,120.54,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.96,,118.08,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,116.85,Percent of total billed charges,,116.85,120.54,
"Coagulation assessment blood test, plasma or whole blood",PX-30015409,CDM,85730,CPT,305,RC,,outpatient,,,123,110.7,,0.95,,116.85,Percent of total billed charges,,,0.98,,120.54,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.96,,118.08,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,116.85,Percent of total billed charges,,116.85,120.54,
"Virus isolation, centrifuge enhanced",PX-30610271,CDM,87254,CPT,306,RC,,inpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
"Virus isolation, centrifuge enhanced",PX-30610271,CDM,87254,CPT,306,RC,,outpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
Magnesium level,PX-30015421,CDM,83735,CPT,301,RC,,inpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
Magnesium level,PX-30015421,CDM,83735,CPT,301,RC,,outpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
Metanephrines level,PX-30015448,CDM,83835,CPT,301,RC,,inpatient,,,119,107.1,,0.95,,113.05,Percent of total billed charges,,,0.98,,116.62,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.96,,114.24,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,113.05,Percent of total billed charges,,113.05,116.62,
Metanephrines level,PX-30015448,CDM,83835,CPT,301,RC,,outpatient,,,119,107.1,,0.95,,113.05,Percent of total billed charges,,,0.98,,116.62,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.96,,114.24,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,113.05,Percent of total billed charges,,113.05,116.62,
Organic acid level,PX-30015460,CDM,83921,CPT,301,RC,,inpatient,,,181,162.9,,0.95,,171.95,Percent of total billed charges,,,0.98,,177.38,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,0.97,,175.57,Percent of total billed charges,,,0.97,,175.57,Percent of total billed charges,,,0.96,,173.76,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,171.95,Percent of total billed charges,,171.95,177.38,
Organic acid level,PX-30015460,CDM,83921,CPT,301,RC,,outpatient,,,181,162.9,,0.95,,171.95,Percent of total billed charges,,,0.98,,177.38,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,0.97,,175.57,Percent of total billed charges,,,0.96,,173.76,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,171.95,Percent of total billed charges,,171.95,177.38,
Mucopolysaccharides (protein) level,PX-30015518,CDM,83864,CPT,301,RC,,inpatient,,,330,297,,0.95,,313.5,Percent of total billed charges,,,0.98,,323.4,Percent of total billed charges,,,0.95,,313.5,Percent of total billed charges,,,0.97,,320.1,Percent of total billed charges,,,0.97,,320.1,Percent of total billed charges,,,0.96,,316.8,Percent of total billed charges,,,0.95,,313.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,313.5,Percent of total billed charges,,313.5,323.4,
Mucopolysaccharides (protein) level,PX-30015518,CDM,83864,CPT,301,RC,,outpatient,,,330,297,,0.95,,313.5,Percent of total billed charges,,,0.98,,323.4,Percent of total billed charges,,,0.95,,313.5,Percent of total billed charges,,,0.95,,313.5,Percent of total billed charges,,,0.97,,320.1,Percent of total billed charges,,,0.96,,316.8,Percent of total billed charges,,,0.95,,313.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,313.5,Percent of total billed charges,,313.5,323.4,
Albumin (protein) level,PX-30110482,CDM,82040,CPT,301,RC,,inpatient,,,22,19.8,,0.95,,20.9,Percent of total billed charges,,,0.98,,21.56,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.96,,21.12,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,20.9,Percent of total billed charges,,20.9,21.56,
Albumin (protein) level,PX-30110482,CDM,82040,CPT,301,RC,,outpatient,,,22,19.8,,0.95,,20.9,Percent of total billed charges,,,0.98,,21.56,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.96,,21.12,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,20.9,Percent of total billed charges,,20.9,21.56,
"Nephelometry, test method using light",PX-30015571,CDM,83883,CPT,301,RC,,inpatient,,,98,88.2,,0.95,,93.1,Percent of total billed charges,,,0.98,,96.04,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,0.97,,95.06,Percent of total billed charges,,,0.97,,95.06,Percent of total billed charges,,,0.96,,94.08,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,93.1,Percent of total billed charges,,93.1,96.04,
"Nephelometry, test method using light",PX-30015571,CDM,83883,CPT,301,RC,,outpatient,,,98,88.2,,0.95,,93.1,Percent of total billed charges,,,0.98,,96.04,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,0.97,,95.06,Percent of total billed charges,,,0.96,,94.08,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,93.1,Percent of total billed charges,,93.1,96.04,
"Phenylalanine, PKU (amino acid) level",PX-30015575,CDM,84030,CPT,300,RC,,inpatient,,,150,135,,0.95,,142.5,Percent of total billed charges,,,0.98,,147,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,0.97,,145.5,Percent of total billed charges,,,0.97,,145.5,Percent of total billed charges,,,0.96,,144,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,142.5,Percent of total billed charges,,142.5,147,
"Phenylalanine, PKU (amino acid) level",PX-30015575,CDM,84030,CPT,300,RC,,outpatient,,,150,135,,0.95,,142.5,Percent of total billed charges,,,0.98,,147,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,0.97,,145.5,Percent of total billed charges,,,0.96,,144,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,142.5,Percent of total billed charges,,142.5,147,
"Lipoprotein level, quantitation of lipoprotein particle",PX-30015580,CDM,83704,CPT,300,RC,,inpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
"Lipoprotein level, quantitation of lipoprotein particle",PX-30015580,CDM,83704,CPT,300,RC,,outpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
Collagen cross links test,PX-30015589,CDM,82523,CPT,301,RC,,inpatient,,,130,117,,0.95,,123.5,Percent of total billed charges,,,0.98,,127.4,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.96,,124.8,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,123.5,Percent of total billed charges,,123.5,127.4,
Collagen cross links test,PX-30015589,CDM,82523,CPT,301,RC,,outpatient,,,130,117,,0.95,,123.5,Percent of total billed charges,,,0.98,,127.4,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.96,,124.8,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,123.5,Percent of total billed charges,,123.5,127.4,
Specimen analysis for blood,PX-30015613,CDM,82271,CPT,301,RC,,inpatient,,,21,18.9,,0.95,,19.95,Percent of total billed charges,,,0.98,,20.58,Percent of total billed charges,,,0.95,,19.95,Percent of total billed charges,,,0.97,,20.37,Percent of total billed charges,,,0.97,,20.37,Percent of total billed charges,,,0.96,,20.16,Percent of total billed charges,,,0.95,,19.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19.95,Percent of total billed charges,,19.95,20.58,
Specimen analysis for blood,PX-30015613,CDM,82271,CPT,301,RC,,outpatient,,,21,18.9,,0.95,,19.95,Percent of total billed charges,,,0.98,,20.58,Percent of total billed charges,,,0.95,,19.95,Percent of total billed charges,,,0.95,,19.95,Percent of total billed charges,,,0.97,,20.37,Percent of total billed charges,,,0.96,,20.16,Percent of total billed charges,,,0.95,,19.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19.95,Percent of total billed charges,,19.95,20.58,
HC OSMOLALITY STOOL Clinical Chem Test,PX-30015630,CDM,84999,CPT,301,RC,,inpatient,,,76,68.4,,0.95,,72.2,Percent of total billed charges,,,0.98,,74.48,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,0.97,,73.72,Percent of total billed charges,,,0.97,,73.72,Percent of total billed charges,,,0.96,,72.96,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,72.2,Percent of total billed charges,,72.2,74.48,
HC OSMOLALITY STOOL Clinical Chem Test,PX-30015630,CDM,84999,CPT,301,RC,,outpatient,,,76,68.4,,0.95,,72.2,Percent of total billed charges,,,0.98,,74.48,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,0.97,,73.72,Percent of total billed charges,,,0.96,,72.96,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,72.2,Percent of total billed charges,,72.2,74.48,
Oxalate level,PX-30015633,CDM,83945,CPT,301,RC,,inpatient,,,145,130.5,,0.95,,137.75,Percent of total billed charges,,,0.98,,142.1,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,0.97,,140.65,Percent of total billed charges,,,0.97,,140.65,Percent of total billed charges,,,0.96,,139.2,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,137.75,Percent of total billed charges,,137.75,142.1,
Oxalate level,PX-30015633,CDM,83945,CPT,301,RC,,outpatient,,,145,130.5,,0.95,,137.75,Percent of total billed charges,,,0.98,,142.1,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,0.97,,140.65,Percent of total billed charges,,,0.96,,139.2,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,137.75,Percent of total billed charges,,137.75,142.1,
Parathormone (parathyroid hormone) level,PX-30015655,CDM,83970,CPT,301,RC,,inpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
Parathormone (parathyroid hormone) level,PX-30015655,CDM,83970,CPT,301,RC,,outpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
Biopsy of related skin growth first growth,PX-98310205,CDM,11102,CPT,983,RC,,inpatient,,,248,223.2,,0.95,,235.6,Percent of total billed charges,,,0.98,,243.04,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,0.97,,240.56,Percent of total billed charges,,,0.97,,240.56,Percent of total billed charges,,,0.96,,238.08,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,235.6,Percent of total billed charges,,235.6,243.04,
Biopsy of related skin growth first growth,PX-98310205,CDM,11102,CPT,983,RC,,outpatient,,,248,223.2,,0.95,,235.6,Percent of total billed charges,,,0.98,,243.04,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,0.97,,240.56,Percent of total billed charges,,,0.96,,238.08,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,235.6,Percent of total billed charges,,235.6,243.04,
Biopsy related skin growth each additional growth,PX-98310206,CDM,11103,CPT,983,RC,,inpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
Biopsy related skin growth each additional growth,PX-98310206,CDM,11103,CPT,983,RC,,outpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
Urine phosphate level,PX-30015691,CDM,84105,CPT,301,RC,,inpatient,,,121,108.9,,0.95,,114.95,Percent of total billed charges,,,0.98,,118.58,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.96,,116.16,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114.95,Percent of total billed charges,,114.95,118.58,
Urine phosphate level,PX-30015691,CDM,84105,CPT,301,RC,,outpatient,,,121,108.9,,0.95,,114.95,Percent of total billed charges,,,0.98,,118.58,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.96,,116.16,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114.95,Percent of total billed charges,,114.95,118.58,
Plasminogen (fibrinolytic factor) measurement,PX-30015693,CDM,85420,CPT,305,RC,,inpatient,,,63,56.7,,0.95,,59.85,Percent of total billed charges,,,0.98,,61.74,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.96,,60.48,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,59.85,Percent of total billed charges,,59.85,61.74,
Plasminogen (fibrinolytic factor) measurement,PX-30015693,CDM,85420,CPT,305,RC,,outpatient,,,63,56.7,,0.95,,59.85,Percent of total billed charges,,,0.98,,61.74,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.96,,60.48,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,59.85,Percent of total billed charges,,59.85,61.74,
Blood glucose test performed by hand-held instrument,PX-30015715,CDM,82962,CPT,300,RC,,inpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
Blood glucose test performed by hand-held instrument,PX-30015715,CDM,82962,CPT,300,RC,,outpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
Urine porphobilinogen (metabolism substance) level,PX-30015719,CDM,84110,CPT,301,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Urine porphobilinogen (metabolism substance) level,PX-30015719,CDM,84110,CPT,301,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
"Alpha-fetoprotein (AFP) level, serum",PX-30015745,CDM,82105,CPT,300,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
"Alpha-fetoprotein (AFP) level, serum",PX-30015745,CDM,82105,CPT,300,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Estriol (hormone) level,PX-30015746,CDM,82677,CPT,300,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Estriol (hormone) level,PX-30015746,CDM,82677,CPT,300,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
"Gonadotropin, chorionic (reproductive hormone) level",PX-30015747,CDM,84702,CPT,300,RC,,inpatient,,,185,166.5,,0.95,,175.75,Percent of total billed charges,,,0.98,,181.3,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,0.97,,179.45,Percent of total billed charges,,,0.97,,179.45,Percent of total billed charges,,,0.96,,177.6,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,175.75,Percent of total billed charges,,175.75,181.3,
"Gonadotropin, chorionic (reproductive hormone) level",PX-30015747,CDM,84702,CPT,300,RC,,outpatient,,,185,166.5,,0.95,,175.75,Percent of total billed charges,,,0.98,,181.3,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,0.97,,179.45,Percent of total billed charges,,,0.96,,177.6,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,175.75,Percent of total billed charges,,175.75,181.3,
Proinsulin (pancreatic hormone) level,PX-30015755,CDM,84206,CPT,300,RC,,inpatient,,,84,75.6,,0.95,,79.8,Percent of total billed charges,,,0.98,,82.32,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,0.97,,81.48,Percent of total billed charges,,,0.97,,81.48,Percent of total billed charges,,,0.96,,80.64,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,79.8,Percent of total billed charges,,79.8,82.32,
Proinsulin (pancreatic hormone) level,PX-30015755,CDM,84206,CPT,300,RC,,outpatient,,,84,75.6,,0.95,,79.8,Percent of total billed charges,,,0.98,,82.32,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,0.97,,81.48,Percent of total billed charges,,,0.96,,80.64,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,79.8,Percent of total billed charges,,79.8,82.32,
"PSA (prostate specific antigen) measurement, total",PX-30015761,CDM,84153,CPT,301,RC,,inpatient,,,150,135,,0.95,,142.5,Percent of total billed charges,,,0.98,,147,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,0.97,,145.5,Percent of total billed charges,,,0.97,,145.5,Percent of total billed charges,,,0.96,,144,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,142.5,Percent of total billed charges,,142.5,147,
"PSA (prostate specific antigen) measurement, total",PX-30015761,CDM,84153,CPT,301,RC,,outpatient,,,150,135,,0.95,,142.5,Percent of total billed charges,,,0.98,,147,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,0.97,,145.5,Percent of total billed charges,,,0.96,,144,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,142.5,Percent of total billed charges,,142.5,147,
"Protein measurement, serum",PX-30015763,CDM,84165,CPT,301,RC,,inpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
"Protein measurement, serum",PX-30015763,CDM,84165,CPT,301,RC,,outpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
"Total protein level, blood",PX-30015764,CDM,84155,CPT,301,RC,,inpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
"Total protein level, blood",PX-30015764,CDM,84155,CPT,301,RC,,outpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
"Total protein level, urine",PX-30015783,CDM,84156,CPT,301,RC,,inpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
"Total protein level, urine",PX-30015783,CDM,84156,CPT,301,RC,,outpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
"Protein test, immunological probe for band identification",PX-30015785,CDM,84182,CPT,300,RC,,inpatient,,,390,351,,0.95,,370.5,Percent of total billed charges,,,0.98,,382.2,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,0.97,,378.3,Percent of total billed charges,,,0.97,,378.3,Percent of total billed charges,,,0.96,,374.4,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,370.5,Percent of total billed charges,,370.5,382.2,
"Protein test, immunological probe for band identification",PX-30015785,CDM,84182,CPT,300,RC,,outpatient,,,390,351,,0.95,,370.5,Percent of total billed charges,,,0.98,,382.2,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,0.97,,378.3,Percent of total billed charges,,,0.96,,374.4,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,370.5,Percent of total billed charges,,370.5,382.2,
"PSA (prostate specific antigen) measurement, free",PX-30015809,CDM,84154,CPT,301,RC,,inpatient,,,130,117,,0.95,,123.5,Percent of total billed charges,,,0.98,,127.4,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.96,,124.8,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,123.5,Percent of total billed charges,,123.5,127.4,
"PSA (prostate specific antigen) measurement, free",PX-30015809,CDM,84154,CPT,301,RC,,outpatient,,,130,117,,0.95,,123.5,Percent of total billed charges,,,0.98,,127.4,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.96,,124.8,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,123.5,Percent of total billed charges,,123.5,127.4,
"PSA (prostate specific antigen) measurement, total",PX-30015810,CDM,84153,CPT,301,RC,,inpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
"PSA (prostate specific antigen) measurement, total",PX-30015810,CDM,84153,CPT,301,RC,,outpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
Magnesium level,PX-30015863,CDM,83735,CPT,301,RC,,inpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
Magnesium level,PX-30015863,CDM,83735,CPT,301,RC,,outpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
Renin (kidney enzyme) level,PX-30015879,CDM,84244,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Renin (kidney enzyme) level,PX-30015879,CDM,84244,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
"Red blood count, automated test",PX-30015882,CDM,85045,CPT,305,RC,,inpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
"Red blood count, automated test",PX-30015882,CDM,85045,CPT,305,RC,,outpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
Reticulated (young) platelet measurement,PX-30015883,CDM,85055,CPT,305,RC,,inpatient,,,123,110.7,,0.95,,116.85,Percent of total billed charges,,,0.98,,120.54,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.96,,118.08,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,,,,,,,0.95,,116.85,Percent of total billed charges,,116.85,120.54,
Reticulated (young) platelet measurement,PX-30015883,CDM,85055,CPT,305,RC,,outpatient,,,123,110.7,,0.95,,116.85,Percent of total billed charges,,,0.98,,120.54,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.96,,118.08,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,,,,,,,0.95,,116.85,Percent of total billed charges,,116.85,120.54,
"Red blood count, manual test",PX-30015884,CDM,85044,CPT,300,RC,,inpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
"Red blood count, manual test",PX-30015884,CDM,85044,CPT,300,RC,,outpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
Sex hormone binding globulin (protein) level,PX-30015928,CDM,84270,CPT,301,RC,,inpatient,,,132,118.8,,0.95,,125.4,Percent of total billed charges,,,0.98,,129.36,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.96,,126.72,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,125.4,Percent of total billed charges,,125.4,129.36,
Sex hormone binding globulin (protein) level,PX-30015928,CDM,84270,CPT,301,RC,,outpatient,,,132,118.8,,0.95,,125.4,Percent of total billed charges,,,0.98,,129.36,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.96,,126.72,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,125.4,Percent of total billed charges,,125.4,129.36,
"Liver enzyme (SGPT), level",PX-30015931,CDM,84460,CPT,301,RC,,inpatient,,,132,118.8,,0.95,,125.4,Percent of total billed charges,,,0.98,,129.36,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.96,,126.72,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,125.4,Percent of total billed charges,,125.4,129.36,
"Liver enzyme (SGPT), level",PX-30015931,CDM,84460,CPT,301,RC,,outpatient,,,132,118.8,,0.95,,125.4,Percent of total billed charges,,,0.98,,129.36,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.96,,126.72,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,125.4,Percent of total billed charges,,125.4,129.36,
"Measure antibody to allergic substance, multiallergen",PX-30211254,CDM,86005,CPT,302,RC,,inpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
"Measure antibody to allergic substance, multiallergen",PX-30211254,CDM,86005,CPT,302,RC,,outpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
"Thyroid hormone, T3 measurement, total",PX-30015997,CDM,84480,CPT,301,RC,,inpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
"Thyroid hormone, T3 measurement, total",PX-30015997,CDM,84480,CPT,301,RC,,outpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
"Thyroid hormone, T3 measurement, reverse",PX-30015998,CDM,84482,CPT,301,RC,,inpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
"Thyroid hormone, T3 measurement, reverse",PX-30015998,CDM,84482,CPT,301,RC,,outpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
Thyroid hormone evaluation,PX-30016000,CDM,84479,CPT,301,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Thyroid hormone evaluation,PX-30016000,CDM,84479,CPT,301,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Antithrombin III antigen (clotting inhibitor) activity,PX-30016030,CDM,85300,CPT,305,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Antithrombin III antigen (clotting inhibitor) activity,PX-30016030,CDM,85300,CPT,305,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Thyroid stimulating immune globulins level,PX-30016040,CDM,84445,CPT,301,RC,,inpatient,,,294,264.6,,0.95,,279.3,Percent of total billed charges,,,0.98,,288.12,Percent of total billed charges,,,0.95,,279.3,Percent of total billed charges,,,0.97,,285.18,Percent of total billed charges,,,0.97,,285.18,Percent of total billed charges,,,0.96,,282.24,Percent of total billed charges,,,0.95,,279.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,279.3,Percent of total billed charges,,279.3,288.12,
Thyroid stimulating immune globulins level,PX-30016040,CDM,84445,CPT,301,RC,,outpatient,,,294,264.6,,0.95,,279.3,Percent of total billed charges,,,0.98,,288.12,Percent of total billed charges,,,0.95,,279.3,Percent of total billed charges,,,0.95,,279.3,Percent of total billed charges,,,0.97,,285.18,Percent of total billed charges,,,0.96,,282.24,Percent of total billed charges,,,0.95,,279.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,279.3,Percent of total billed charges,,279.3,288.12,
"Thyroxine (thyroid chemical), total",PX-30016044,CDM,84436,CPT,301,RC,,inpatient,,,90,81,,0.95,,85.5,Percent of total billed charges,,,0.98,,88.2,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,0.97,,87.3,Percent of total billed charges,,,0.97,,87.3,Percent of total billed charges,,,0.96,,86.4,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,85.5,Percent of total billed charges,,85.5,88.2,
"Thyroxine (thyroid chemical), total",PX-30016044,CDM,84436,CPT,301,RC,,outpatient,,,90,81,,0.95,,85.5,Percent of total billed charges,,,0.98,,88.2,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,0.97,,87.3,Percent of total billed charges,,,0.96,,86.4,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,85.5,Percent of total billed charges,,85.5,88.2,
"Analysis of substance w/ immunoassay, multiple step method",PX-30016055,CDM,83516,CPT,301,RC,,inpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
"Analysis of substance w/ immunoassay, multiple step method",PX-30016055,CDM,83516,CPT,301,RC,,outpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
"Enzyme activity measurement, nonradioactive substrate",PX-30016070,CDM,82657,CPT,300,RC,,inpatient,,,491,441.9,,0.95,,466.45,Percent of total billed charges,,,0.98,,481.18,Percent of total billed charges,,,0.95,,466.45,Percent of total billed charges,,,0.97,,476.27,Percent of total billed charges,,,0.97,,476.27,Percent of total billed charges,,,0.96,,471.36,Percent of total billed charges,,,0.95,,466.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,466.45,Percent of total billed charges,,466.45,481.18,
"Enzyme activity measurement, nonradioactive substrate",PX-30016070,CDM,82657,CPT,300,RC,,outpatient,,,491,441.9,,0.95,,466.45,Percent of total billed charges,,,0.98,,481.18,Percent of total billed charges,,,0.95,,466.45,Percent of total billed charges,,,0.95,,466.45,Percent of total billed charges,,,0.97,,476.27,Percent of total billed charges,,,0.96,,471.36,Percent of total billed charges,,,0.95,,466.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,466.45,Percent of total billed charges,,466.45,481.18,
Triglycerides level,PX-30016086,CDM,84478,CPT,301,RC,,inpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
Triglycerides level,PX-30016086,CDM,84478,CPT,301,RC,,outpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
"Troponin (protein) analysis, quantitative",PX-30016091,CDM,84484,CPT,301,RC,,inpatient,,,155,139.5,,0.95,,147.25,Percent of total billed charges,,,0.98,,151.9,Percent of total billed charges,,,0.95,,147.25,Percent of total billed charges,,,0.97,,150.35,Percent of total billed charges,,,0.97,,150.35,Percent of total billed charges,,,0.96,,148.8,Percent of total billed charges,,,0.95,,147.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,147.25,Percent of total billed charges,,147.25,151.9,
"Troponin (protein) analysis, quantitative",PX-30016091,CDM,84484,CPT,301,RC,,outpatient,,,155,139.5,,0.95,,147.25,Percent of total billed charges,,,0.98,,151.9,Percent of total billed charges,,,0.95,,147.25,Percent of total billed charges,,,0.95,,147.25,Percent of total billed charges,,,0.97,,150.35,Percent of total billed charges,,,0.96,,148.8,Percent of total billed charges,,,0.95,,147.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,147.25,Percent of total billed charges,,147.25,151.9,
Test by nucleic acid for human papillomavirus,PX-30610807,CDM,87625,CPT,306,RC,,inpatient,,,115,103.5,,0.95,,109.25,Percent of total billed charges,,,0.98,,112.7,Percent of total billed charges,,,0.95,,109.25,Percent of total billed charges,,,0.97,,111.55,Percent of total billed charges,,,0.97,,111.55,Percent of total billed charges,,,0.96,,110.4,Percent of total billed charges,,,0.95,,109.25,Percent of total billed charges,,,,,,,,,0.95,,109.25,Percent of total billed charges,,109.25,112.7,
Test by nucleic acid for human papillomavirus,PX-30610807,CDM,87625,CPT,306,RC,,outpatient,,,115,103.5,,0.95,,109.25,Percent of total billed charges,,,0.98,,112.7,Percent of total billed charges,,,0.95,,109.25,Percent of total billed charges,,,0.95,,109.25,Percent of total billed charges,,,0.97,,111.55,Percent of total billed charges,,,0.96,,110.4,Percent of total billed charges,,,0.95,,109.25,Percent of total billed charges,,,,,,,,,0.95,,109.25,Percent of total billed charges,,109.25,112.7,
"Urea nitrogen level to assess kidney function, urine",PX-30016112,CDM,84540,CPT,301,RC,,inpatient,,,85,76.5,,0.95,,80.75,Percent of total billed charges,,,0.98,,83.3,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.96,,81.6,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,80.75,Percent of total billed charges,,80.75,83.3,
"Urea nitrogen level to assess kidney function, urine",PX-30016112,CDM,84540,CPT,301,RC,,outpatient,,,85,76.5,,0.95,,80.75,Percent of total billed charges,,,0.98,,83.3,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.96,,81.6,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,80.75,Percent of total billed charges,,80.75,83.3,
Uric acid level,PX-30016119,CDM,84560,CPT,301,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Uric acid level,PX-30016119,CDM,84560,CPT,301,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Lipoprotein measurement,PX-30016167,CDM,83701,CPT,301,RC,,inpatient,,,94,84.6,,0.95,,89.3,Percent of total billed charges,,,0.98,,92.12,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.96,,90.24,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,89.3,Percent of total billed charges,,89.3,92.12,
Lipoprotein measurement,PX-30016167,CDM,83701,CPT,301,RC,,outpatient,,,94,84.6,,0.95,,89.3,Percent of total billed charges,,,0.98,,92.12,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.96,,90.24,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,89.3,Percent of total billed charges,,89.3,92.12,
Vitamin B-1 (thiamine) level,PX-30016184,CDM,84425,CPT,301,RC,,inpatient,,,96,86.4,,0.95,,91.2,Percent of total billed charges,,,0.98,,94.08,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.96,,92.16,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,91.2,Percent of total billed charges,,91.2,94.08,
Vitamin B-1 (thiamine) level,PX-30016184,CDM,84425,CPT,301,RC,,outpatient,,,96,86.4,,0.95,,91.2,Percent of total billed charges,,,0.98,,94.08,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.96,,92.16,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,91.2,Percent of total billed charges,,91.2,94.08,
Vitamin B-6 level,PX-30016188,CDM,84207,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Vitamin B-6 level,PX-30016188,CDM,84207,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
"Dihydroxyvitamin D, 1, 25 level",PX-30016189,CDM,82652,CPT,301,RC,,inpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
"Dihydroxyvitamin D, 1, 25 level",PX-30016189,CDM,82652,CPT,301,RC,,outpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
Cyanocobalamin (vitamin B-12) level,PX-30016196,CDM,82607,CPT,301,RC,,inpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
Cyanocobalamin (vitamin B-12) level,PX-30016196,CDM,82607,CPT,301,RC,,outpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
Clotting factor VIII (AHG) measurement,PX-30016212,CDM,85240,CPT,305,RC,,inpatient,,,130,117,,0.95,,123.5,Percent of total billed charges,,,0.98,,127.4,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.96,,124.8,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,123.5,Percent of total billed charges,,123.5,127.4,
Clotting factor VIII (AHG) measurement,PX-30016212,CDM,85240,CPT,305,RC,,outpatient,,,130,117,,0.95,,123.5,Percent of total billed charges,,,0.98,,127.4,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.96,,124.8,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,123.5,Percent of total billed charges,,123.5,127.4,
Clotting factor VIII (VW factor) measurement,PX-30016213,CDM,85245,CPT,305,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
Clotting factor VIII (VW factor) measurement,PX-30016213,CDM,85245,CPT,305,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
Clotting factor VIII (VW factor) antigen,PX-30016214,CDM,85246,CPT,305,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
Clotting factor VIII (VW factor) antigen,PX-30016214,CDM,85246,CPT,305,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC Gown Bair Hugger #84003,PX-3254176WWM,CDM,3254176WWM,LOCAL,270,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
HC Gown Bair Hugger #84003,PX-3254176WWM,CDM,3254176WWM,LOCAL,270,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
Zinc level,PX-30016230,CDM,84630,CPT,301,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Zinc level,PX-30016230,CDM,84630,CPT,301,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
"Test by nucleic acid for herpes virus-6, quantification",PX-30110054,CDM,87533,CPT,301,RC,,inpatient,,,151,135.9,,0.95,,143.45,Percent of total billed charges,,,0.98,,147.98,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,0.97,,146.47,Percent of total billed charges,,,0.97,,146.47,Percent of total billed charges,,,0.96,,144.96,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,143.45,Percent of total billed charges,,143.45,147.98,
"Test by nucleic acid for herpes virus-6, quantification",PX-30110054,CDM,87533,CPT,301,RC,,outpatient,,,151,135.9,,0.95,,143.45,Percent of total billed charges,,,0.98,,147.98,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,0.97,,146.47,Percent of total billed charges,,,0.96,,144.96,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,143.45,Percent of total billed charges,,143.45,147.98,
"PSA (prostate specific antigen) measurement, total",PX-30110064,CDM,84153,CPT,301,RC,,inpatient,,,174,156.6,,0.95,,165.3,Percent of total billed charges,,,0.98,,170.52,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,0.97,,168.78,Percent of total billed charges,,,0.97,,168.78,Percent of total billed charges,,,0.96,,167.04,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,165.3,Percent of total billed charges,,165.3,170.52,
"PSA (prostate specific antigen) measurement, total",PX-30110064,CDM,84153,CPT,301,RC,,outpatient,,,174,156.6,,0.95,,165.3,Percent of total billed charges,,,0.98,,170.52,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,0.97,,168.78,Percent of total billed charges,,,0.96,,167.04,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,165.3,Percent of total billed charges,,165.3,170.52,
"Uric acid level, blood",PX-30110077,CDM,84550,CPT,301,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
"Uric acid level, blood",PX-30110077,CDM,84550,CPT,301,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Phenobarbital level,PX-30110510,CDM,80184,CPT,301,RC,,inpatient,,,134,120.6,,0.95,,127.3,Percent of total billed charges,,,0.98,,131.32,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,0.97,,129.98,Percent of total billed charges,,,0.97,,129.98,Percent of total billed charges,,,0.96,,128.64,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,127.3,Percent of total billed charges,,127.3,131.32,
Phenobarbital level,PX-30110510,CDM,80184,CPT,301,RC,,outpatient,,,134,120.6,,0.95,,127.3,Percent of total billed charges,,,0.98,,131.32,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,0.97,,129.98,Percent of total billed charges,,,0.96,,128.64,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,127.3,Percent of total billed charges,,127.3,131.32,
Aldosterone hormone level,PX-30110584,CDM,82088,CPT,301,RC,,inpatient,,,151,135.9,,0.95,,143.45,Percent of total billed charges,,,0.98,,147.98,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,0.97,,146.47,Percent of total billed charges,,,0.97,,146.47,Percent of total billed charges,,,0.96,,144.96,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,143.45,Percent of total billed charges,,143.45,147.98,
Aldosterone hormone level,PX-30110584,CDM,82088,CPT,301,RC,,outpatient,,,151,135.9,,0.95,,143.45,Percent of total billed charges,,,0.98,,147.98,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,0.97,,146.47,Percent of total billed charges,,,0.96,,144.96,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,143.45,Percent of total billed charges,,143.45,147.98,
Vancomycin (antibiotic) level,PX-30110602,CDM,80202,CPT,301,RC,,inpatient,,,192,172.8,,0.95,,182.4,Percent of total billed charges,,,0.98,,188.16,Percent of total billed charges,,,0.95,,182.4,Percent of total billed charges,,,0.97,,186.24,Percent of total billed charges,,,0.97,,186.24,Percent of total billed charges,,,0.96,,184.32,Percent of total billed charges,,,0.95,,182.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,182.4,Percent of total billed charges,,182.4,188.16,
Vancomycin (antibiotic) level,PX-30110602,CDM,80202,CPT,301,RC,,outpatient,,,192,172.8,,0.95,,182.4,Percent of total billed charges,,,0.98,,188.16,Percent of total billed charges,,,0.95,,182.4,Percent of total billed charges,,,0.95,,182.4,Percent of total billed charges,,,0.97,,186.24,Percent of total billed charges,,,0.96,,184.32,Percent of total billed charges,,,0.95,,182.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,182.4,Percent of total billed charges,,182.4,188.16,
Albumin (protein) level,PX-30112003,CDM,82040,CPT,301,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Albumin (protein) level,PX-30112003,CDM,82040,CPT,301,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Somatomedin (growth factor) level,PX-30112012,CDM,84305,CPT,301,RC,,inpatient,,,180,162,,0.95,,171,Percent of total billed charges,,,0.98,,176.4,Percent of total billed charges,,,0.95,,171,Percent of total billed charges,,,0.97,,174.6,Percent of total billed charges,,,0.97,,174.6,Percent of total billed charges,,,0.96,,172.8,Percent of total billed charges,,,0.95,,171,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,171,Percent of total billed charges,,171,176.4,
Somatomedin (growth factor) level,PX-30112012,CDM,84305,CPT,301,RC,,outpatient,,,180,162,,0.95,,171,Percent of total billed charges,,,0.98,,176.4,Percent of total billed charges,,,0.95,,171,Percent of total billed charges,,,0.95,,171,Percent of total billed charges,,,0.97,,174.6,Percent of total billed charges,,,0.96,,172.8,Percent of total billed charges,,,0.95,,171,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,171,Percent of total billed charges,,171,176.4,
"Blood test, thyroid stimulating hormone (TSH)",PX-30112017,CDM,84443,CPT,301,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"Blood test, thyroid stimulating hormone (TSH)",PX-30112017,CDM,84443,CPT,301,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
LDL cholesterol level,PX-30112018,CDM,83721,CPT,301,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
LDL cholesterol level,PX-30112018,CDM,83721,CPT,301,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Tacrolimus level,PX-30112019,CDM,80197,CPT,301,RC,,inpatient,,,119,107.1,,0.95,,113.05,Percent of total billed charges,,,0.98,,116.62,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.96,,114.24,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,113.05,Percent of total billed charges,,113.05,116.62,
Tacrolimus level,PX-30112019,CDM,80197,CPT,301,RC,,outpatient,,,119,107.1,,0.95,,113.05,Percent of total billed charges,,,0.98,,116.62,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.96,,114.24,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,113.05,Percent of total billed charges,,113.05,116.62,
Urine microalbumin (protein) level,PX-30112020,CDM,82043,CPT,301,RC,,inpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
Urine microalbumin (protein) level,PX-30112020,CDM,82043,CPT,301,RC,,outpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
"Bilirubin level, total",PX-30112023,CDM,82247,CPT,300,RC,,inpatient,,,135,121.5,,0.95,,128.25,Percent of total billed charges,,,0.98,,132.3,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,0.97,,130.95,Percent of total billed charges,,,0.97,,130.95,Percent of total billed charges,,,0.96,,129.6,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,128.25,Percent of total billed charges,,128.25,132.3,
"Bilirubin level, total",PX-30112023,CDM,82247,CPT,300,RC,,outpatient,,,135,121.5,,0.95,,128.25,Percent of total billed charges,,,0.98,,132.3,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,0.97,,130.95,Percent of total billed charges,,,0.96,,129.6,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,128.25,Percent of total billed charges,,128.25,132.3,
Natriuretic peptide (heart and blood vessel protein) level,PX-30112024,CDM,83880,CPT,301,RC,,inpatient,,,284,255.6,,0.95,,269.8,Percent of total billed charges,,,0.98,,278.32,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,0.97,,275.48,Percent of total billed charges,,,0.97,,275.48,Percent of total billed charges,,,0.96,,272.64,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,269.8,Percent of total billed charges,,269.8,278.32,
Natriuretic peptide (heart and blood vessel protein) level,PX-30112024,CDM,83880,CPT,301,RC,,outpatient,,,284,255.6,,0.95,,269.8,Percent of total billed charges,,,0.98,,278.32,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,0.97,,275.48,Percent of total billed charges,,,0.96,,272.64,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,269.8,Percent of total billed charges,,269.8,278.32,
"Ketone bodies analysis, qualitative",PX-30112025,CDM,82009,CPT,301,RC,,inpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
"Ketone bodies analysis, qualitative",PX-30112025,CDM,82009,CPT,301,RC,,outpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
Acute hepatitis panel,PX-30112029,CDM,80074,CPT,301,RC,,inpatient,,,196,176.4,,0.95,,186.2,Percent of total billed charges,,,0.98,,192.08,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,0.97,,190.12,Percent of total billed charges,,,0.97,,190.12,Percent of total billed charges,,,0.96,,188.16,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,186.2,Percent of total billed charges,,186.2,192.08,
Acute hepatitis panel,PX-30112029,CDM,80074,CPT,301,RC,,outpatient,,,196,176.4,,0.95,,186.2,Percent of total billed charges,,,0.98,,192.08,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,0.97,,190.12,Percent of total billed charges,,,0.96,,188.16,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,186.2,Percent of total billed charges,,186.2,192.08,
Gonadotropin (reproductive hormone) analysis,PX-30112030,CDM,84703,CPT,301,RC,,inpatient,,,120,108,,0.95,,114,Percent of total billed charges,,,0.98,,117.6,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.96,,115.2,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114,Percent of total billed charges,,114,117.6,
Gonadotropin (reproductive hormone) analysis,PX-30112030,CDM,84703,CPT,301,RC,,outpatient,,,120,108,,0.95,,114,Percent of total billed charges,,,0.98,,117.6,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.96,,115.2,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114,Percent of total billed charges,,114,117.6,
Blood test panel for electrolytes,PX-30112031,CDM,80051,CPT,301,RC,,inpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
Blood test panel for electrolytes,PX-30112031,CDM,80051,CPT,301,RC,,outpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
Body fluid pH level,PX-30112035,CDM,83986,CPT,301,RC,,inpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
Body fluid pH level,PX-30112035,CDM,83986,CPT,301,RC,,outpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
Urine vanillylmandelic acid,PX-30112036,CDM,84585,CPT,301,RC,,inpatient,,,81,72.9,,0.95,,76.95,Percent of total billed charges,,,0.98,,79.38,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.96,,77.76,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76.95,Percent of total billed charges,,76.95,79.38,
Urine vanillylmandelic acid,PX-30112036,CDM,84585,CPT,301,RC,,outpatient,,,81,72.9,,0.95,,76.95,Percent of total billed charges,,,0.98,,79.38,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.96,,77.76,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76.95,Percent of total billed charges,,76.95,79.38,
Vitamin A level,PX-30112039,CDM,84590,CPT,301,RC,,inpatient,,,98,88.2,,0.95,,93.1,Percent of total billed charges,,,0.98,,96.04,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,0.97,,95.06,Percent of total billed charges,,,0.97,,95.06,Percent of total billed charges,,,0.96,,94.08,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,93.1,Percent of total billed charges,,93.1,96.04,
Vitamin A level,PX-30112039,CDM,84590,CPT,301,RC,,outpatient,,,98,88.2,,0.95,,93.1,Percent of total billed charges,,,0.98,,96.04,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,0.97,,95.06,Percent of total billed charges,,,0.96,,94.08,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,93.1,Percent of total billed charges,,93.1,96.04,
"Bilirubin level, direct",PX-30112043,CDM,82248,CPT,301,RC,,inpatient,,,86,77.4,,0.95,,81.7,Percent of total billed charges,,,0.98,,84.28,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,0.97,,83.42,Percent of total billed charges,,,0.97,,83.42,Percent of total billed charges,,,0.96,,82.56,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,81.7,Percent of total billed charges,,81.7,84.28,
"Bilirubin level, direct",PX-30112043,CDM,82248,CPT,301,RC,,outpatient,,,86,77.4,,0.95,,81.7,Percent of total billed charges,,,0.98,,84.28,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,0.97,,83.42,Percent of total billed charges,,,0.96,,82.56,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,81.7,Percent of total billed charges,,81.7,84.28,
Urine osmolality (concentration) measurement,PX-30112044,CDM,83935,CPT,301,RC,,inpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
Urine osmolality (concentration) measurement,PX-30112044,CDM,83935,CPT,301,RC,,outpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
Prealbumin (protein) level,PX-30112045,CDM,84134,CPT,301,RC,,inpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
Prealbumin (protein) level,PX-30112045,CDM,84134,CPT,301,RC,,outpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
"Carbamazepine level, total",PX-30112046,CDM,80156,CPT,301,RC,,inpatient,,,177,159.3,,0.95,,168.15,Percent of total billed charges,,,0.98,,173.46,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.96,,169.92,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,168.15,Percent of total billed charges,,168.15,173.46,
"Carbamazepine level, total",PX-30112046,CDM,80156,CPT,301,RC,,outpatient,,,177,159.3,,0.95,,168.15,Percent of total billed charges,,,0.98,,173.46,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.96,,169.92,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,168.15,Percent of total billed charges,,168.15,173.46,
"Testosterone (hormone) level, free",PX-30112048,CDM,84402,CPT,301,RC,,inpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
"Testosterone (hormone) level, free",PX-30112048,CDM,84402,CPT,301,RC,,outpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
Renin (kidney enzyme) level,PX-30112051,CDM,84244,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Renin (kidney enzyme) level,PX-30112051,CDM,84244,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
"Cortisol (hormone) measurement, free",PX-30112054,CDM,82530,CPT,301,RC,,inpatient,,,112,100.8,,0.95,,106.4,Percent of total billed charges,,,0.98,,109.76,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.96,,107.52,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,106.4,Percent of total billed charges,,106.4,109.76,
"Cortisol (hormone) measurement, free",PX-30112054,CDM,82530,CPT,301,RC,,outpatient,,,112,100.8,,0.95,,106.4,Percent of total billed charges,,,0.98,,109.76,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.96,,107.52,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,106.4,Percent of total billed charges,,106.4,109.76,
Urine potassium level,PX-30112055,CDM,84133,CPT,301,RC,,inpatient,,,94,84.6,,0.95,,89.3,Percent of total billed charges,,,0.98,,92.12,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.96,,90.24,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,89.3,Percent of total billed charges,,89.3,92.12,
Urine potassium level,PX-30112055,CDM,84133,CPT,301,RC,,outpatient,,,94,84.6,,0.95,,89.3,Percent of total billed charges,,,0.98,,92.12,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.96,,90.24,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,89.3,Percent of total billed charges,,89.3,92.12,
"Calcium level, total",PX-30112060,CDM,82310,CPT,301,RC,,inpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
"Calcium level, total",PX-30112060,CDM,82310,CPT,301,RC,,outpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
"Blood test, basic group of blood chemicals",PX-30112061,CDM,80048,CPT,301,RC,,inpatient,,,145,130.5,,0.95,,137.75,Percent of total billed charges,,,0.98,,142.1,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,0.97,,140.65,Percent of total billed charges,,,0.97,,140.65,Percent of total billed charges,,,0.96,,139.2,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,137.75,Percent of total billed charges,,137.75,142.1,
"Blood test, basic group of blood chemicals",PX-30112061,CDM,80048,CPT,301,RC,,outpatient,,,145,130.5,,0.95,,137.75,Percent of total billed charges,,,0.98,,142.1,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,0.97,,140.65,Percent of total billed charges,,,0.96,,139.2,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,137.75,Percent of total billed charges,,137.75,142.1,
"Blood test, comprehensive group of blood chemicals",PX-30112062,CDM,80053,CPT,301,RC,,inpatient,,,170,153,,0.95,,161.5,Percent of total billed charges,,,0.98,,166.6,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,0.97,,164.9,Percent of total billed charges,,,0.97,,164.9,Percent of total billed charges,,,0.96,,163.2,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,161.5,Percent of total billed charges,,161.5,166.6,
"Blood test, comprehensive group of blood chemicals",PX-30112062,CDM,80053,CPT,301,RC,,outpatient,,,170,153,,0.95,,161.5,Percent of total billed charges,,,0.98,,166.6,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,0.97,,164.9,Percent of total billed charges,,,0.96,,163.2,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,161.5,Percent of total billed charges,,161.5,166.6,
"Blood test, lipids (cholesterol and triglycerides)",PX-30112063,CDM,80061,CPT,301,RC,,inpatient,,,170,153,,0.95,,161.5,Percent of total billed charges,,,0.98,,166.6,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,0.97,,164.9,Percent of total billed charges,,,0.97,,164.9,Percent of total billed charges,,,0.96,,163.2,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,161.5,Percent of total billed charges,,161.5,166.6,
"Blood test, lipids (cholesterol and triglycerides)",PX-30112063,CDM,80061,CPT,301,RC,,outpatient,,,170,153,,0.95,,161.5,Percent of total billed charges,,,0.98,,166.6,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,0.97,,164.9,Percent of total billed charges,,,0.96,,163.2,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,161.5,Percent of total billed charges,,161.5,166.6,
Kidney function blood test panel,PX-30112064,CDM,80069,CPT,301,RC,,inpatient,,,134,120.6,,0.95,,127.3,Percent of total billed charges,,,0.98,,131.32,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,0.97,,129.98,Percent of total billed charges,,,0.97,,129.98,Percent of total billed charges,,,0.96,,128.64,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,127.3,Percent of total billed charges,,127.3,131.32,
Kidney function blood test panel,PX-30112064,CDM,80069,CPT,301,RC,,outpatient,,,134,120.6,,0.95,,127.3,Percent of total billed charges,,,0.98,,131.32,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,0.97,,129.98,Percent of total billed charges,,,0.96,,128.64,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,127.3,Percent of total billed charges,,127.3,131.32,
Progesterone (reproductive hormone) level,PX-30112067,CDM,84144,CPT,301,RC,,inpatient,,,177,159.3,,0.95,,168.15,Percent of total billed charges,,,0.98,,173.46,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.96,,169.92,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,168.15,Percent of total billed charges,,168.15,173.46,
Progesterone (reproductive hormone) level,PX-30112067,CDM,84144,CPT,301,RC,,outpatient,,,177,159.3,,0.95,,168.15,Percent of total billed charges,,,0.98,,173.46,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.96,,169.92,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,168.15,Percent of total billed charges,,168.15,173.46,
"Blood glucose test, each additional beyond 3 specimens",PX-30112068,CDM,82952,CPT,301,RC,,inpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
"Blood glucose test, each additional beyond 3 specimens",PX-30112068,CDM,82952,CPT,301,RC,,outpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
Theophylline level,PX-30112071,CDM,80198,CPT,301,RC,,inpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
Theophylline level,PX-30112071,CDM,80198,CPT,301,RC,,outpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
Urine phosphate level,PX-30112072,CDM,84105,CPT,301,RC,,inpatient,,,66,59.4,,0.95,,62.7,Percent of total billed charges,,,0.98,,64.68,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,0.97,,64.02,Percent of total billed charges,,,0.97,,64.02,Percent of total billed charges,,,0.96,,63.36,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,62.7,Percent of total billed charges,,62.7,64.68,
Urine phosphate level,PX-30112072,CDM,84105,CPT,301,RC,,outpatient,,,66,59.4,,0.95,,62.7,Percent of total billed charges,,,0.98,,64.68,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,0.97,,64.02,Percent of total billed charges,,,0.96,,63.36,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,62.7,Percent of total billed charges,,62.7,64.68,
Prolactin (milk producing hormone) level,PX-30112073,CDM,84146,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Prolactin (milk producing hormone) level,PX-30112073,CDM,84146,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
"Folic acid level, RBC",PX-30112074,CDM,82747,CPT,301,RC,,inpatient,,,112,100.8,,0.95,,106.4,Percent of total billed charges,,,0.98,,109.76,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.96,,107.52,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,106.4,Percent of total billed charges,,106.4,109.76,
"Folic acid level, RBC",PX-30112074,CDM,82747,CPT,301,RC,,outpatient,,,112,100.8,,0.95,,106.4,Percent of total billed charges,,,0.98,,109.76,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.96,,107.52,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,106.4,Percent of total billed charges,,106.4,109.76,
Obstetric blood test panel,PX-30112076,CDM,80055,CPT,301,RC,,inpatient,,,279,251.1,,0.95,,265.05,Percent of total billed charges,,,0.98,,273.42,Percent of total billed charges,,,0.95,,265.05,Percent of total billed charges,,,0.97,,270.63,Percent of total billed charges,,,0.97,,270.63,Percent of total billed charges,,,0.96,,267.84,Percent of total billed charges,,,0.95,,265.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,265.05,Percent of total billed charges,,265.05,273.42,
Obstetric blood test panel,PX-30112076,CDM,80055,CPT,301,RC,,outpatient,,,279,251.1,,0.95,,265.05,Percent of total billed charges,,,0.98,,273.42,Percent of total billed charges,,,0.95,,265.05,Percent of total billed charges,,,0.95,,265.05,Percent of total billed charges,,,0.97,,270.63,Percent of total billed charges,,,0.96,,267.84,Percent of total billed charges,,,0.95,,265.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,265.05,Percent of total billed charges,,265.05,273.42,
Oxalate level,PX-30112077,CDM,83945,CPT,301,RC,,inpatient,,,145,130.5,,0.95,,137.75,Percent of total billed charges,,,0.98,,142.1,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,0.97,,140.65,Percent of total billed charges,,,0.97,,140.65,Percent of total billed charges,,,0.96,,139.2,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,137.75,Percent of total billed charges,,137.75,142.1,
Oxalate level,PX-30112077,CDM,83945,CPT,301,RC,,outpatient,,,145,130.5,,0.95,,137.75,Percent of total billed charges,,,0.98,,142.1,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,0.97,,140.65,Percent of total billed charges,,,0.96,,139.2,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,137.75,Percent of total billed charges,,137.75,142.1,
Human growth hormone level,PX-30112080,CDM,83003,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Human growth hormone level,PX-30112080,CDM,83003,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
"Phenytoin level, free",PX-30112088,CDM,80186,CPT,301,RC,,inpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
"Phenytoin level, free",PX-30112088,CDM,80186,CPT,301,RC,,outpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
Sirolimus level,PX-30112093,CDM,80195,CPT,301,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Sirolimus level,PX-30112093,CDM,80195,CPT,301,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Topiramate level,PX-30112094,CDM,80201,CPT,301,RC,,inpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Topiramate level,PX-30112094,CDM,80201,CPT,301,RC,,outpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
ADH (antidiuretic hormone) level,PX-30112098,CDM,84588,CPT,301,RC,,inpatient,,,153,137.7,,0.95,,145.35,Percent of total billed charges,,,0.98,,149.94,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.96,,146.88,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,145.35,Percent of total billed charges,,145.35,149.94,
ADH (antidiuretic hormone) level,PX-30112098,CDM,84588,CPT,301,RC,,outpatient,,,153,137.7,,0.95,,145.35,Percent of total billed charges,,,0.98,,149.94,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.96,,146.88,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,145.35,Percent of total billed charges,,145.35,149.94,
"Insulin measurement, total",PX-30112100,CDM,83525,CPT,301,RC,,inpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
"Insulin measurement, total",PX-30112100,CDM,83525,CPT,301,RC,,outpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
Carbon dioxide (bicarbonate) level,PX-30112102,CDM,82374,CPT,301,RC,,inpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
Carbon dioxide (bicarbonate) level,PX-30112102,CDM,82374,CPT,301,RC,,outpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
Liver function blood test panel,PX-30112103,CDM,80076,CPT,301,RC,,inpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
Liver function blood test panel,PX-30112103,CDM,80076,CPT,301,RC,,outpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
"Folic acid level, serum",PX-30112106,CDM,82746,CPT,301,RC,,inpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
"Folic acid level, serum",PX-30112106,CDM,82746,CPT,301,RC,,outpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
Phosphate level,PX-30112107,CDM,84100,CPT,301,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Phosphate level,PX-30112107,CDM,84100,CPT,301,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Ammonia level,PX-30112108,CDM,82140,CPT,301,RC,,inpatient,,,259,233.1,,0.95,,246.05,Percent of total billed charges,,,0.98,,253.82,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,0.97,,251.23,Percent of total billed charges,,,0.97,,251.23,Percent of total billed charges,,,0.96,,248.64,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,246.05,Percent of total billed charges,,246.05,253.82,
Ammonia level,PX-30112108,CDM,82140,CPT,301,RC,,outpatient,,,259,233.1,,0.95,,246.05,Percent of total billed charges,,,0.98,,253.82,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,0.97,,251.23,Percent of total billed charges,,,0.96,,248.64,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,246.05,Percent of total billed charges,,246.05,253.82,
"Digoxin level, total",PX-30112109,CDM,80162,CPT,301,RC,,inpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"Digoxin level, total",PX-30112109,CDM,80162,CPT,301,RC,,outpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
Iron level,PX-30112112,CDM,83540,CPT,301,RC,,inpatient,,,107,96.3,,0.95,,101.65,Percent of total billed charges,,,0.98,,104.86,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.96,,102.72,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,101.65,Percent of total billed charges,,101.65,104.86,
Iron level,PX-30112112,CDM,83540,CPT,301,RC,,outpatient,,,107,96.3,,0.95,,101.65,Percent of total billed charges,,,0.98,,104.86,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.96,,102.72,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,101.65,Percent of total billed charges,,101.65,104.86,
"Testosterone (hormone) level, total",PX-30112115,CDM,84403,CPT,301,RC,,inpatient,,,119,107.1,,0.95,,113.05,Percent of total billed charges,,,0.98,,116.62,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.96,,114.24,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,113.05,Percent of total billed charges,,113.05,116.62,
"Testosterone (hormone) level, total",PX-30112115,CDM,84403,CPT,301,RC,,outpatient,,,119,107.1,,0.95,,113.05,Percent of total billed charges,,,0.98,,116.62,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.96,,114.24,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,113.05,Percent of total billed charges,,113.05,116.62,
Lithium level,PX-30112116,CDM,80178,CPT,301,RC,,inpatient,,,119,107.1,,0.95,,113.05,Percent of total billed charges,,,0.98,,116.62,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.96,,114.24,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,113.05,Percent of total billed charges,,113.05,116.62,
Lithium level,PX-30112116,CDM,80178,CPT,301,RC,,outpatient,,,119,107.1,,0.95,,113.05,Percent of total billed charges,,,0.98,,116.62,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.96,,114.24,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,113.05,Percent of total billed charges,,113.05,116.62,
Iron binding capacity,PX-30112117,CDM,83550,CPT,301,RC,,inpatient,,,86,77.4,,0.95,,81.7,Percent of total billed charges,,,0.98,,84.28,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,0.97,,83.42,Percent of total billed charges,,,0.97,,83.42,Percent of total billed charges,,,0.96,,82.56,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,81.7,Percent of total billed charges,,81.7,84.28,
Iron binding capacity,PX-30112117,CDM,83550,CPT,301,RC,,outpatient,,,86,77.4,,0.95,,81.7,Percent of total billed charges,,,0.98,,84.28,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,0.97,,83.42,Percent of total billed charges,,,0.96,,82.56,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,81.7,Percent of total billed charges,,81.7,84.28,
"Thyroxine (thyroid chemical), total",PX-30112118,CDM,84436,CPT,301,RC,,inpatient,,,94,84.6,,0.95,,89.3,Percent of total billed charges,,,0.98,,92.12,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.96,,90.24,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,89.3,Percent of total billed charges,,89.3,92.12,
"Thyroxine (thyroid chemical), total",PX-30112118,CDM,84436,CPT,301,RC,,outpatient,,,94,84.6,,0.95,,89.3,Percent of total billed charges,,,0.98,,92.12,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.96,,90.24,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,89.3,Percent of total billed charges,,89.3,92.12,
Lactate dehydrogenase (enzyme) measurement,PX-30112122,CDM,83625,CPT,301,RC,,inpatient,,,55,49.5,,0.95,,52.25,Percent of total billed charges,,,0.98,,53.9,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.96,,52.8,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,52.25,Percent of total billed charges,,52.25,53.9,
Lactate dehydrogenase (enzyme) measurement,PX-30112122,CDM,83625,CPT,301,RC,,outpatient,,,55,49.5,,0.95,,52.25,Percent of total billed charges,,,0.98,,53.9,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.96,,52.8,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,52.25,Percent of total billed charges,,52.25,53.9,
Blood pH level,PX-30112126,CDM,82800,CPT,301,RC,,inpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
Blood pH level,PX-30112126,CDM,82800,CPT,301,RC,,outpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
"Ketosteroids, 17 (hormone) measurement, total",PX-30112127,CDM,83586,CPT,301,RC,,inpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
"Ketosteroids, 17 (hormone) measurement, total",PX-30112127,CDM,83586,CPT,301,RC,,outpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
Quantitation of therapeutic drug,PX-30112130,CDM,80299,CPT,301,RC,,inpatient,,,72,64.8,,0.95,,68.4,Percent of total billed charges,,,0.98,,70.56,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.96,,69.12,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,68.4,Percent of total billed charges,,68.4,70.56,
Quantitation of therapeutic drug,PX-30112130,CDM,80299,CPT,301,RC,,outpatient,,,72,64.8,,0.95,,68.4,Percent of total billed charges,,,0.98,,70.56,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.96,,69.12,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,68.4,Percent of total billed charges,,68.4,70.56,
Vasoactive intestinal peptide (intestinal hormone) level,PX-30112134,CDM,84586,CPT,301,RC,,inpatient,,,144,129.6,,0.95,,136.8,Percent of total billed charges,,,0.98,,141.12,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,0.97,,139.68,Percent of total billed charges,,,0.97,,139.68,Percent of total billed charges,,,0.96,,138.24,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,136.8,Percent of total billed charges,,136.8,141.12,
Vasoactive intestinal peptide (intestinal hormone) level,PX-30112134,CDM,84586,CPT,301,RC,,outpatient,,,144,129.6,,0.95,,136.8,Percent of total billed charges,,,0.98,,141.12,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,0.97,,139.68,Percent of total billed charges,,,0.96,,138.24,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,136.8,Percent of total billed charges,,136.8,141.12,
Infrared analysis of stone,PX-30112138,CDM,82365,CPT,301,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Infrared analysis of stone,PX-30112138,CDM,82365,CPT,301,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
"Hemoglobin analysis and measurement, chromatography",PX-30112142,CDM,83021,CPT,301,RC,,inpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
"Hemoglobin analysis and measurement, chromatography",PX-30112142,CDM,83021,CPT,301,RC,,outpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Heavy metal level,PX-30112144,CDM,83018,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Heavy metal level,PX-30112144,CDM,83018,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Hormonal panel for adrenal gland assessment,PX-30112151,CDM,80400,CPT,301,RC,,inpatient,,,246,221.4,,0.95,,233.7,Percent of total billed charges,,,0.98,,241.08,Percent of total billed charges,,,0.95,,233.7,Percent of total billed charges,,,0.97,,238.62,Percent of total billed charges,,,0.97,,238.62,Percent of total billed charges,,,0.96,,236.16,Percent of total billed charges,,,0.95,,233.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,233.7,Percent of total billed charges,,233.7,241.08,
Hormonal panel for adrenal gland assessment,PX-30112151,CDM,80400,CPT,301,RC,,outpatient,,,246,221.4,,0.95,,233.7,Percent of total billed charges,,,0.98,,241.08,Percent of total billed charges,,,0.95,,233.7,Percent of total billed charges,,,0.95,,233.7,Percent of total billed charges,,,0.97,,238.62,Percent of total billed charges,,,0.96,,236.16,Percent of total billed charges,,,0.95,,233.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,233.7,Percent of total billed charges,,233.7,241.08,
Aldosterone hormone level,PX-30112152,CDM,82088,CPT,301,RC,,inpatient,,,151,135.9,,0.95,,143.45,Percent of total billed charges,,,0.98,,147.98,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,0.97,,146.47,Percent of total billed charges,,,0.97,,146.47,Percent of total billed charges,,,0.96,,144.96,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,143.45,Percent of total billed charges,,143.45,147.98,
Aldosterone hormone level,PX-30112152,CDM,82088,CPT,301,RC,,outpatient,,,151,135.9,,0.95,,143.45,Percent of total billed charges,,,0.98,,147.98,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,0.97,,146.47,Percent of total billed charges,,,0.96,,144.96,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,143.45,Percent of total billed charges,,143.45,147.98,
"Creatine kinase (cardiac enzyme) level, total",PX-30112160,CDM,82550,CPT,301,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
"Creatine kinase (cardiac enzyme) level, total",PX-30112160,CDM,82550,CPT,301,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
Parathormone (parathyroid hormone) level,PX-30112161,CDM,83970,CPT,301,RC,,inpatient,,,389,350.1,,0.95,,369.55,Percent of total billed charges,,,0.98,,381.22,Percent of total billed charges,,,0.95,,369.55,Percent of total billed charges,,,0.97,,377.33,Percent of total billed charges,,,0.97,,377.33,Percent of total billed charges,,,0.96,,373.44,Percent of total billed charges,,,0.95,,369.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,369.55,Percent of total billed charges,,369.55,381.22,
Parathormone (parathyroid hormone) level,PX-30112161,CDM,83970,CPT,301,RC,,outpatient,,,389,350.1,,0.95,,369.55,Percent of total billed charges,,,0.98,,381.22,Percent of total billed charges,,,0.95,,369.55,Percent of total billed charges,,,0.95,,369.55,Percent of total billed charges,,,0.97,,377.33,Percent of total billed charges,,,0.96,,373.44,Percent of total billed charges,,,0.95,,369.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,369.55,Percent of total billed charges,,369.55,381.22,
Gentamicin (antibiotic) level,PX-30112164,CDM,80170,CPT,301,RC,,inpatient,,,193,173.7,,0.95,,183.35,Percent of total billed charges,,,0.98,,189.14,Percent of total billed charges,,,0.95,,183.35,Percent of total billed charges,,,0.97,,187.21,Percent of total billed charges,,,0.97,,187.21,Percent of total billed charges,,,0.96,,185.28,Percent of total billed charges,,,0.95,,183.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,183.35,Percent of total billed charges,,183.35,189.14,
Gentamicin (antibiotic) level,PX-30112164,CDM,80170,CPT,301,RC,,outpatient,,,193,173.7,,0.95,,183.35,Percent of total billed charges,,,0.98,,189.14,Percent of total billed charges,,,0.95,,183.35,Percent of total billed charges,,,0.95,,183.35,Percent of total billed charges,,,0.97,,187.21,Percent of total billed charges,,,0.96,,185.28,Percent of total billed charges,,,0.95,,183.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,183.35,Percent of total billed charges,,183.35,189.14,
"PSA (prostate specific antigen) measurement, free",PX-30112165,CDM,84154,CPT,301,RC,,inpatient,,,49,44.1,,0.95,,46.55,Percent of total billed charges,,,0.98,,48.02,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.96,,47.04,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,46.55,Percent of total billed charges,,46.55,48.02,
"PSA (prostate specific antigen) measurement, free",PX-30112165,CDM,84154,CPT,301,RC,,outpatient,,,49,44.1,,0.95,,46.55,Percent of total billed charges,,,0.98,,48.02,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.96,,47.04,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,46.55,Percent of total billed charges,,46.55,48.02,
Urine sodium level,PX-30112172,CDM,84300,CPT,301,RC,,inpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
Urine sodium level,PX-30112172,CDM,84300,CPT,301,RC,,outpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
"Valproic acid level, total",PX-30112174,CDM,80164,CPT,301,RC,,inpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
"Valproic acid level, total",PX-30112174,CDM,80164,CPT,301,RC,,outpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
Vitamin E level,PX-30112175,CDM,84446,CPT,301,RC,,inpatient,,,81,72.9,,0.95,,76.95,Percent of total billed charges,,,0.98,,79.38,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.96,,77.76,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76.95,Percent of total billed charges,,76.95,79.38,
Vitamin E level,PX-30112175,CDM,84446,CPT,301,RC,,outpatient,,,81,72.9,,0.95,,76.95,Percent of total billed charges,,,0.98,,79.38,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.96,,77.76,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76.95,Percent of total billed charges,,76.95,79.38,
Measurement of immune substance (oligoclonal bands),PX-30112178,CDM,83916,CPT,301,RC,,inpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19,Percent of total billed charges,,19,19.6,
Measurement of immune substance (oligoclonal bands),PX-30112178,CDM,83916,CPT,301,RC,,outpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19,Percent of total billed charges,,19,19.6,
Vitamin K level,PX-30112185,CDM,84597,CPT,301,RC,,inpatient,,,164,147.6,,0.95,,155.8,Percent of total billed charges,,,0.98,,160.72,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.96,,157.44,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,155.8,Percent of total billed charges,,155.8,160.72,
Vitamin K level,PX-30112185,CDM,84597,CPT,301,RC,,outpatient,,,164,147.6,,0.95,,155.8,Percent of total billed charges,,,0.98,,160.72,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.96,,157.44,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,155.8,Percent of total billed charges,,155.8,160.72,
Sodium level,PX-30112190,CDM,84302,CPT,301,RC,,inpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19,Percent of total billed charges,,19,19.6,
Sodium level,PX-30112190,CDM,84302,CPT,301,RC,,outpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19,Percent of total billed charges,,19,19.6,
Glucagon (pancreatic hormone) level,PX-30112198,CDM,82943,CPT,301,RC,,inpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
Glucagon (pancreatic hormone) level,PX-30112198,CDM,82943,CPT,301,RC,,outpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
Quantitation of therapeutic drug,PX-30112215,CDM,80299,CPT,301,RC,,inpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
Quantitation of therapeutic drug,PX-30112215,CDM,80299,CPT,301,RC,,outpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
Blood creatinine level,PX-30112217,CDM,82565,CPT,301,RC,,inpatient,,,107,96.3,,0.95,,101.65,Percent of total billed charges,,,0.98,,104.86,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.96,,102.72,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,101.65,Percent of total billed charges,,101.65,104.86,
Blood creatinine level,PX-30112217,CDM,82565,CPT,301,RC,,outpatient,,,107,96.3,,0.95,,101.65,Percent of total billed charges,,,0.98,,104.86,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.96,,102.72,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,101.65,Percent of total billed charges,,101.65,104.86,
"Estrogen analysis, total",PX-30112220,CDM,82672,CPT,301,RC,,inpatient,,,132,118.8,,0.95,,125.4,Percent of total billed charges,,,0.98,,129.36,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.96,,126.72,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,125.4,Percent of total billed charges,,125.4,129.36,
"Estrogen analysis, total",PX-30112220,CDM,82672,CPT,301,RC,,outpatient,,,132,118.8,,0.95,,125.4,Percent of total billed charges,,,0.98,,129.36,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.96,,126.72,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,125.4,Percent of total billed charges,,125.4,129.36,
"Phosphatase (enzyme) measurement, alkaline, isoenzymes",PX-30112222,CDM,84080,CPT,301,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
"Phosphatase (enzyme) measurement, alkaline, isoenzymes",PX-30112222,CDM,84080,CPT,301,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
"Phenytoin level, total",PX-30112228,CDM,80185,CPT,301,RC,,inpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
"Phenytoin level, total",PX-30112228,CDM,80185,CPT,301,RC,,outpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
Blood potassium level,PX-30112229,CDM,84132,CPT,301,RC,,inpatient,,,94,84.6,,0.95,,89.3,Percent of total billed charges,,,0.98,,92.12,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.96,,90.24,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,89.3,Percent of total billed charges,,89.3,92.12,
Blood potassium level,PX-30112229,CDM,84132,CPT,301,RC,,outpatient,,,94,84.6,,0.95,,89.3,Percent of total billed charges,,,0.98,,92.12,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.96,,90.24,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,89.3,Percent of total billed charges,,89.3,92.12,
Chloride level,PX-30112233,CDM,82438,CPT,301,RC,,inpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
Chloride level,PX-30112233,CDM,82438,CPT,301,RC,,outpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
Magnesium level,PX-30112248,CDM,83735,CPT,301,RC,,inpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
Magnesium level,PX-30112248,CDM,83735,CPT,301,RC,,outpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
Cholesterol level,PX-30112251,CDM,82465,CPT,301,RC,,inpatient,,,54,48.6,,0.95,,51.3,Percent of total billed charges,,,0.98,,52.92,Percent of total billed charges,,,0.95,,51.3,Percent of total billed charges,,,0.97,,52.38,Percent of total billed charges,,,0.97,,52.38,Percent of total billed charges,,,0.96,,51.84,Percent of total billed charges,,,0.95,,51.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,51.3,Percent of total billed charges,,51.3,52.92,
Cholesterol level,PX-30112251,CDM,82465,CPT,301,RC,,outpatient,,,54,48.6,,0.95,,51.3,Percent of total billed charges,,,0.98,,52.92,Percent of total billed charges,,,0.95,,51.3,Percent of total billed charges,,,0.95,,51.3,Percent of total billed charges,,,0.97,,52.38,Percent of total billed charges,,,0.96,,51.84,Percent of total billed charges,,,0.95,,51.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,51.3,Percent of total billed charges,,51.3,52.92,
"Urea nitrogen level to assess kidney function, clearance",PX-30112261,CDM,84545,CPT,301,RC,,inpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
"Urea nitrogen level to assess kidney function, clearance",PX-30112261,CDM,84545,CPT,301,RC,,outpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
"Blood stool analysis, by fecal hemoglobin determination",PX-30112278,CDM,82274,CPT,301,RC,,inpatient,,,85,76.5,,0.95,,80.75,Percent of total billed charges,,,0.98,,83.3,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.96,,81.6,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,80.75,Percent of total billed charges,,80.75,83.3,
"Blood stool analysis, by fecal hemoglobin determination",PX-30112278,CDM,82274,CPT,301,RC,,outpatient,,,85,76.5,,0.95,,80.75,Percent of total billed charges,,,0.98,,83.3,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.96,,81.6,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,80.75,Percent of total billed charges,,80.75,83.3,
Vitamin B-2 (riboflavin) level,PX-30112286,CDM,84252,CPT,301,RC,,inpatient,,,309,278.1,,0.95,,293.55,Percent of total billed charges,,,0.98,,302.82,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,0.97,,299.73,Percent of total billed charges,,,0.97,,299.73,Percent of total billed charges,,,0.96,,296.64,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,293.55,Percent of total billed charges,,293.55,302.82,
Vitamin B-2 (riboflavin) level,PX-30112286,CDM,84252,CPT,301,RC,,outpatient,,,309,278.1,,0.95,,293.55,Percent of total billed charges,,,0.98,,302.82,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,0.97,,299.73,Percent of total billed charges,,,0.96,,296.64,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,293.55,Percent of total billed charges,,293.55,302.82,
"Measure substance using immunoassay, by radioimmunoassay",PX-30112297,CDM,83519,CPT,301,RC,,inpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
"Measure substance using immunoassay, by radioimmunoassay",PX-30112297,CDM,83519,CPT,301,RC,,outpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
Amylase (enzyme) level,PX-30112298,CDM,82150,CPT,301,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
Amylase (enzyme) level,PX-30112298,CDM,82150,CPT,301,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
Homocysteine (amino acid) level,PX-30112310,CDM,83090,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Homocysteine (amino acid) level,PX-30112310,CDM,83090,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
"Total protein level, blood",PX-30112314,CDM,84155,CPT,301,RC,,inpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
"Total protein level, blood",PX-30112314,CDM,84155,CPT,301,RC,,outpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
Androstenedione (hormone) level,PX-30112315,CDM,82157,CPT,301,RC,,inpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
Androstenedione (hormone) level,PX-30112315,CDM,82157,CPT,301,RC,,outpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
Apolipoprotein level,PX-30112316,CDM,82172,CPT,301,RC,,inpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
Apolipoprotein level,PX-30112316,CDM,82172,CPT,301,RC,,outpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
Fluoride level,PX-30112319,CDM,82735,CPT,301,RC,,inpatient,,,87,78.3,,0.95,,82.65,Percent of total billed charges,,,0.98,,85.26,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.96,,83.52,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,82.65,Percent of total billed charges,,82.65,85.26,
Fluoride level,PX-30112319,CDM,82735,CPT,301,RC,,outpatient,,,87,78.3,,0.95,,82.65,Percent of total billed charges,,,0.98,,85.26,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.96,,83.52,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,82.65,Percent of total billed charges,,82.65,85.26,
Histamine (immune system substance) level,PX-30112330,CDM,83088,CPT,301,RC,,inpatient,,,136,122.4,,0.95,,129.2,Percent of total billed charges,,,0.98,,133.28,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,0.97,,131.92,Percent of total billed charges,,,0.97,,131.92,Percent of total billed charges,,,0.96,,130.56,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,129.2,Percent of total billed charges,,129.2,133.28,
Histamine (immune system substance) level,PX-30112330,CDM,83088,CPT,301,RC,,outpatient,,,136,122.4,,0.95,,129.2,Percent of total billed charges,,,0.98,,133.28,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,0.97,,131.92,Percent of total billed charges,,,0.96,,130.56,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,129.2,Percent of total billed charges,,129.2,133.28,
"Testosterone (hormone) level, total",PX-30112336,CDM,84403,CPT,301,RC,,inpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
"Testosterone (hormone) level, total",PX-30112336,CDM,84403,CPT,301,RC,,outpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
"Cerebrospinal fluid, or amniotic fluid albumin level",PX-30112351,CDM,82042,CPT,301,RC,,inpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
"Cerebrospinal fluid, or amniotic fluid albumin level",PX-30112351,CDM,82042,CPT,301,RC,,outpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
Beta-2 microglobulin (protein) level,PX-30112352,CDM,82232,CPT,301,RC,,inpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
Beta-2 microglobulin (protein) level,PX-30112352,CDM,82232,CPT,301,RC,,outpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
Catecholamines (organic nitrogen) level,PX-30112353,CDM,82384,CPT,301,RC,,inpatient,,,144,129.6,,0.95,,136.8,Percent of total billed charges,,,0.98,,141.12,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,0.97,,139.68,Percent of total billed charges,,,0.97,,139.68,Percent of total billed charges,,,0.96,,138.24,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,136.8,Percent of total billed charges,,136.8,141.12,
Catecholamines (organic nitrogen) level,PX-30112353,CDM,82384,CPT,301,RC,,outpatient,,,144,129.6,,0.95,,136.8,Percent of total billed charges,,,0.98,,141.12,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,0.97,,139.68,Percent of total billed charges,,,0.96,,138.24,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,136.8,Percent of total billed charges,,136.8,141.12,
Creatinine level to test for kidney function/muscle injury,PX-30112358,CDM,82570,CPT,301,RC,,inpatient,,,94,84.6,,0.95,,89.3,Percent of total billed charges,,,0.98,,92.12,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.96,,90.24,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,89.3,Percent of total billed charges,,89.3,92.12,
Creatinine level to test for kidney function/muscle injury,PX-30112358,CDM,82570,CPT,301,RC,,outpatient,,,94,84.6,,0.95,,89.3,Percent of total billed charges,,,0.98,,92.12,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.96,,90.24,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,89.3,Percent of total billed charges,,89.3,92.12,
HC Assay of Hydroxyprogesterone 17 D,PX-30112365,CDM,83498,CPT,301,RC,,inpatient,,,119,107.1,,0.95,,113.05,Percent of total billed charges,,,0.98,,116.62,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.96,,114.24,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,113.05,Percent of total billed charges,,113.05,116.62,
HC Assay of Hydroxyprogesterone 17 D,PX-30112365,CDM,83498,CPT,301,RC,,outpatient,,,119,107.1,,0.95,,113.05,Percent of total billed charges,,,0.98,,116.62,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.96,,114.24,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,113.05,Percent of total billed charges,,113.05,116.62,
LDL cholesterol level,PX-30112370,CDM,83721,CPT,301,RC,,inpatient,,,41,36.9,,0.95,,38.95,Percent of total billed charges,,,0.98,,40.18,Percent of total billed charges,,,0.95,,38.95,Percent of total billed charges,,,0.97,,39.77,Percent of total billed charges,,,0.97,,39.77,Percent of total billed charges,,,0.96,,39.36,Percent of total billed charges,,,0.95,,38.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38.95,Percent of total billed charges,,38.95,40.18,
LDL cholesterol level,PX-30112370,CDM,83721,CPT,301,RC,,outpatient,,,41,36.9,,0.95,,38.95,Percent of total billed charges,,,0.98,,40.18,Percent of total billed charges,,,0.95,,38.95,Percent of total billed charges,,,0.95,,38.95,Percent of total billed charges,,,0.97,,39.77,Percent of total billed charges,,,0.96,,39.36,Percent of total billed charges,,,0.95,,38.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38.95,Percent of total billed charges,,38.95,40.18,
Blood osmolality (concentration) measurement,PX-30112375,CDM,83930,CPT,301,RC,,inpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
Blood osmolality (concentration) measurement,PX-30112375,CDM,83930,CPT,301,RC,,outpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
Prostaglandin (hormone) level,PX-30112377,CDM,84150,CPT,301,RC,,inpatient,,,604,543.6,,0.95,,573.8,Percent of total billed charges,,,0.98,,591.92,Percent of total billed charges,,,0.95,,573.8,Percent of total billed charges,,,0.97,,585.88,Percent of total billed charges,,,0.97,,585.88,Percent of total billed charges,,,0.96,,579.84,Percent of total billed charges,,,0.95,,573.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,573.8,Percent of total billed charges,,573.8,591.92,
Prostaglandin (hormone) level,PX-30112377,CDM,84150,CPT,301,RC,,outpatient,,,604,543.6,,0.95,,573.8,Percent of total billed charges,,,0.98,,591.92,Percent of total billed charges,,,0.95,,573.8,Percent of total billed charges,,,0.95,,573.8,Percent of total billed charges,,,0.97,,585.88,Percent of total billed charges,,,0.96,,579.84,Percent of total billed charges,,,0.95,,573.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,573.8,Percent of total billed charges,,573.8,591.92,
"Liver enzyme (SGOT), level",PX-30112384,CDM,84450,CPT,301,RC,,inpatient,,,82,73.8,,0.95,,77.9,Percent of total billed charges,,,0.98,,80.36,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,0.97,,79.54,Percent of total billed charges,,,0.97,,79.54,Percent of total billed charges,,,0.96,,78.72,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,77.9,Percent of total billed charges,,77.9,80.36,
"Liver enzyme (SGOT), level",PX-30112384,CDM,84450,CPT,301,RC,,outpatient,,,82,73.8,,0.95,,77.9,Percent of total billed charges,,,0.98,,80.36,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,0.97,,79.54,Percent of total billed charges,,,0.96,,78.72,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,77.9,Percent of total billed charges,,77.9,80.36,
Amikacin (antibiotic) level,PX-30112403,CDM,80150,CPT,301,RC,,inpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
Amikacin (antibiotic) level,PX-30112403,CDM,80150,CPT,301,RC,,outpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
Chemical analysis using chromatography technique,PX-30112424,CDM,82542,CPT,301,RC,,inpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
Chemical analysis using chromatography technique,PX-30112424,CDM,82542,CPT,301,RC,,outpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
Vitamin B-1 (thiamine) level,PX-30112443,CDM,84425,CPT,301,RC,,inpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
Vitamin B-1 (thiamine) level,PX-30112443,CDM,84425,CPT,301,RC,,outpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
"Analysis of substance w/ immunoassay, multiple step method",PX-30112483,CDM,83516,CPT,301,RC,,inpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
"Analysis of substance w/ immunoassay, multiple step method",PX-30112483,CDM,83516,CPT,301,RC,,outpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
Glucose (sugar) level on body fluid,PX-30112504,CDM,82945,CPT,301,RC,,inpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
Glucose (sugar) level on body fluid,PX-30112504,CDM,82945,CPT,301,RC,,outpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
"Nephelometry, test method using light",PX-30112517,CDM,83883,CPT,301,RC,,inpatient,,,98,88.2,,0.95,,93.1,Percent of total billed charges,,,0.98,,96.04,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,0.97,,95.06,Percent of total billed charges,,,0.97,,95.06,Percent of total billed charges,,,0.96,,94.08,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,93.1,Percent of total billed charges,,93.1,96.04,
"Nephelometry, test method using light",PX-30112517,CDM,83883,CPT,301,RC,,outpatient,,,98,88.2,,0.95,,93.1,Percent of total billed charges,,,0.98,,96.04,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,0.97,,95.06,Percent of total billed charges,,,0.96,,94.08,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,93.1,Percent of total billed charges,,93.1,96.04,
Pregnancy-associated plasma protein-A level,PX-30112528,CDM,84163,CPT,301,RC,,inpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
Pregnancy-associated plasma protein-A level,PX-30112528,CDM,84163,CPT,301,RC,,outpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
"Gammaglobulin test, immunoglobulin subclasses",PX-30112599,CDM,82787,CPT,301,RC,,inpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
"Gammaglobulin test, immunoglobulin subclasses",PX-30112599,CDM,82787,CPT,301,RC,,outpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
Estrone (hormone) level,PX-30112650,CDM,82679,CPT,301,RC,,inpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
Estrone (hormone) level,PX-30112650,CDM,82679,CPT,301,RC,,outpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
"Blood test, thyroid stimulating hormone (TSH)",PX-30112660,CDM,84443,CPT,301,RC,,inpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
"Blood test, thyroid stimulating hormone (TSH)",PX-30112660,CDM,84443,CPT,301,RC,,outpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
Amylase (enzyme) level,PX-30112672,CDM,82150,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Amylase (enzyme) level,PX-30112672,CDM,82150,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Urine chloride level,PX-30112700,CDM,82436,CPT,301,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Urine chloride level,PX-30112700,CDM,82436,CPT,301,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Creatinine level to test for kidney function/muscle injury,PX-30112705,CDM,82570,CPT,301,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Creatinine level to test for kidney function/muscle injury,PX-30112705,CDM,82570,CPT,301,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Creatinine level to test for kidney function/muscle injury,PX-30112707,CDM,82570,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Creatinine level to test for kidney function/muscle injury,PX-30112707,CDM,82570,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Fetal hemoglobin level,PX-30112710,CDM,83030,CPT,301,RC,,inpatient,,,43,38.7,,0.95,,40.85,Percent of total billed charges,,,0.98,,42.14,Percent of total billed charges,,,0.95,,40.85,Percent of total billed charges,,,0.97,,41.71,Percent of total billed charges,,,0.97,,41.71,Percent of total billed charges,,,0.96,,41.28,Percent of total billed charges,,,0.95,,40.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,40.85,Percent of total billed charges,,40.85,42.14,
Fetal hemoglobin level,PX-30112710,CDM,83030,CPT,301,RC,,outpatient,,,43,38.7,,0.95,,40.85,Percent of total billed charges,,,0.98,,42.14,Percent of total billed charges,,,0.95,,40.85,Percent of total billed charges,,,0.95,,40.85,Percent of total billed charges,,,0.97,,41.71,Percent of total billed charges,,,0.96,,41.28,Percent of total billed charges,,,0.95,,40.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,40.85,Percent of total billed charges,,40.85,42.14,
Glycated protein level,PX-30112712,CDM,82985,CPT,301,RC,,inpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
Glycated protein level,PX-30112712,CDM,82985,CPT,301,RC,,outpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
"Blood glucose (sugar) tolerance test, 3 specimens",PX-30112719,CDM,82951,CPT,301,RC,,inpatient,,,187,168.3,,0.95,,177.65,Percent of total billed charges,,,0.98,,183.26,Percent of total billed charges,,,0.95,,177.65,Percent of total billed charges,,,0.97,,181.39,Percent of total billed charges,,,0.97,,181.39,Percent of total billed charges,,,0.96,,179.52,Percent of total billed charges,,,0.95,,177.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,177.65,Percent of total billed charges,,177.65,183.26,
"Blood glucose (sugar) tolerance test, 3 specimens",PX-30112719,CDM,82951,CPT,301,RC,,outpatient,,,187,168.3,,0.95,,177.65,Percent of total billed charges,,,0.98,,183.26,Percent of total billed charges,,,0.95,,177.65,Percent of total billed charges,,,0.95,,177.65,Percent of total billed charges,,,0.97,,181.39,Percent of total billed charges,,,0.96,,179.52,Percent of total billed charges,,,0.95,,177.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,177.65,Percent of total billed charges,,177.65,183.26,
Lactate dehydrogenase (enzyme) level,PX-30112736,CDM,83615,CPT,301,RC,,inpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
Lactate dehydrogenase (enzyme) level,PX-30112736,CDM,83615,CPT,301,RC,,outpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
Body fluid pH level,PX-30112756,CDM,83986,CPT,301,RC,,inpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
Body fluid pH level,PX-30112756,CDM,83986,CPT,301,RC,,outpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
Phospholipid test,PX-30510373,CDM,85598,CPT,305,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Phospholipid test,PX-30510373,CDM,85598,CPT,305,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
"Urea nitrogen level to assess kidney function, urine",PX-30112778,CDM,84540,CPT,301,RC,,inpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
"Urea nitrogen level to assess kidney function, urine",PX-30112778,CDM,84540,CPT,301,RC,,outpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
"Hydroxycorticosteroids, 17 (adrenal gland hormone) level",PX-30112786,CDM,83491,CPT,301,RC,,inpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
"Hydroxycorticosteroids, 17 (adrenal gland hormone) level",PX-30112786,CDM,83491,CPT,301,RC,,outpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
"Gene analysis (calreticulin), common variants",PX-31010757,CDM,81219,CPT,310,RC,,inpatient,,,622,559.8,,0.95,,590.9,Percent of total billed charges,,,0.98,,609.56,Percent of total billed charges,,,0.95,,590.9,Percent of total billed charges,,,0.97,,603.34,Percent of total billed charges,,,0.97,,603.34,Percent of total billed charges,,,0.96,,597.12,Percent of total billed charges,,,0.95,,590.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,590.9,Percent of total billed charges,,590.9,609.56,
"Gene analysis (calreticulin), common variants",PX-31010757,CDM,81219,CPT,310,RC,,outpatient,,,622,559.8,,0.95,,590.9,Percent of total billed charges,,,0.98,,609.56,Percent of total billed charges,,,0.95,,590.9,Percent of total billed charges,,,0.95,,590.9,Percent of total billed charges,,,0.97,,603.34,Percent of total billed charges,,,0.96,,597.12,Percent of total billed charges,,,0.95,,590.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,590.9,Percent of total billed charges,,590.9,609.56,
"Phosphatase (enzyme) measurement, alkaline, isoenzymes",PX-30112845,CDM,84080,CPT,301,RC,,inpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
"Phosphatase (enzyme) measurement, alkaline, isoenzymes",PX-30112845,CDM,84080,CPT,301,RC,,outpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
"Amino acid analysis, quantitative, each specimen",PX-30112867,CDM,82131,CPT,301,RC,,inpatient,,,232,208.8,,0.95,,220.4,Percent of total billed charges,,,0.98,,227.36,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,0.97,,225.04,Percent of total billed charges,,,0.97,,225.04,Percent of total billed charges,,,0.96,,222.72,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,220.4,Percent of total billed charges,,220.4,227.36,
"Amino acid analysis, quantitative, each specimen",PX-30112867,CDM,82131,CPT,301,RC,,outpatient,,,232,208.8,,0.95,,220.4,Percent of total billed charges,,,0.98,,227.36,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,0.97,,225.04,Percent of total billed charges,,,0.96,,222.72,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,220.4,Percent of total billed charges,,220.4,227.36,
"Protein measurement, serum",PX-30112989,CDM,84165,CPT,301,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
"Protein measurement, serum",PX-30112989,CDM,84165,CPT,301,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
"Ketone bodies analysis, quantitative",PX-30113011,CDM,82010,CPT,301,RC,,inpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
"Ketone bodies analysis, quantitative",PX-30113011,CDM,82010,CPT,301,RC,,outpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
Urine calcium level,PX-30113075,CDM,82340,CPT,301,RC,,inpatient,,,94,84.6,,0.95,,89.3,Percent of total billed charges,,,0.98,,92.12,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.96,,90.24,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,89.3,Percent of total billed charges,,89.3,92.12,
Urine calcium level,PX-30113075,CDM,82340,CPT,301,RC,,outpatient,,,94,84.6,,0.95,,89.3,Percent of total billed charges,,,0.98,,92.12,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.96,,90.24,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,89.3,Percent of total billed charges,,89.3,92.12,
HC Spectrophotometry Analyt Cholesterol Fluid,PX-30113110,CDM,84311,CPT,301,RC,,inpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
HC Spectrophotometry Analyt Cholesterol Fluid,PX-30113110,CDM,84311,CPT,301,RC,,outpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
"Protein measurement, body fluid",PX-30113284,CDM,84166,CPT,301,RC,,inpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
"Protein measurement, body fluid",PX-30113284,CDM,84166,CPT,301,RC,,outpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
"Analysis of substance w/ immunoassay, multiple step method",PX-30113289,CDM,83516,CPT,301,RC,,inpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
"Analysis of substance w/ immunoassay, multiple step method",PX-30113289,CDM,83516,CPT,301,RC,,outpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
Glucose (sugar) level on body fluid,PX-30113387,CDM,82945,CPT,301,RC,,inpatient,,,81,72.9,,0.95,,76.95,Percent of total billed charges,,,0.98,,79.38,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.96,,77.76,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76.95,Percent of total billed charges,,76.95,79.38,
Glucose (sugar) level on body fluid,PX-30113387,CDM,82945,CPT,301,RC,,outpatient,,,81,72.9,,0.95,,76.95,Percent of total billed charges,,,0.98,,79.38,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.96,,77.76,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76.95,Percent of total billed charges,,76.95,79.38,
"Hemoglobin analysis and measurement, chromatography",PX-30113422,CDM,83021,CPT,301,RC,,inpatient,,,70,63,,0.95,,66.5,Percent of total billed charges,,,0.98,,68.6,Percent of total billed charges,,,0.95,,66.5,Percent of total billed charges,,,0.97,,67.9,Percent of total billed charges,,,0.97,,67.9,Percent of total billed charges,,,0.96,,67.2,Percent of total billed charges,,,0.95,,66.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,66.5,Percent of total billed charges,,66.5,68.6,
"Hemoglobin analysis and measurement, chromatography",PX-30113422,CDM,83021,CPT,301,RC,,outpatient,,,70,63,,0.95,,66.5,Percent of total billed charges,,,0.98,,68.6,Percent of total billed charges,,,0.95,,66.5,Percent of total billed charges,,,0.95,,66.5,Percent of total billed charges,,,0.97,,67.9,Percent of total billed charges,,,0.96,,67.2,Percent of total billed charges,,,0.95,,66.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,66.5,Percent of total billed charges,,66.5,68.6,
"Analysis of substance w/ immunoassay, multiple step method",PX-30113450,CDM,83516,CPT,301,RC,,inpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
"Analysis of substance w/ immunoassay, multiple step method",PX-30113450,CDM,83516,CPT,301,RC,,outpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
HC Immunoassay Analyte Quantitative Nos,PX-30113501,CDM,83520,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
HC Immunoassay Analyte Quantitative Nos,PX-30113501,CDM,83520,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Iron level,PX-30113527,CDM,83540,CPT,301,RC,,inpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
Iron level,PX-30113527,CDM,83540,CPT,301,RC,,outpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
Iron binding capacity,PX-30113528,CDM,83550,CPT,301,RC,,inpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
Iron binding capacity,PX-30113528,CDM,83550,CPT,301,RC,,outpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
"Nephelometry, test method using light",PX-30113548,CDM,83883,CPT,301,RC,,inpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
"Nephelometry, test method using light",PX-30113548,CDM,83883,CPT,301,RC,,outpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
Magnesium level,PX-30113587,CDM,83735,CPT,301,RC,,inpatient,,,134,120.6,,0.95,,127.3,Percent of total billed charges,,,0.98,,131.32,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,0.97,,129.98,Percent of total billed charges,,,0.97,,129.98,Percent of total billed charges,,,0.96,,128.64,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,127.3,Percent of total billed charges,,127.3,131.32,
Magnesium level,PX-30113587,CDM,83735,CPT,301,RC,,outpatient,,,134,120.6,,0.95,,127.3,Percent of total billed charges,,,0.98,,131.32,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,0.97,,129.98,Percent of total billed charges,,,0.96,,128.64,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,127.3,Percent of total billed charges,,127.3,131.32,
Manganese (heavy metal) level,PX-30113595,CDM,83785,CPT,301,RC,,inpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
Manganese (heavy metal) level,PX-30113595,CDM,83785,CPT,301,RC,,outpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
Mass spectrometry (laboratory testing method),PX-30113596,CDM,83789,CPT,301,RC,,inpatient,,,92,82.8,,0.95,,87.4,Percent of total billed charges,,,0.98,,90.16,Percent of total billed charges,,,0.95,,87.4,Percent of total billed charges,,,0.97,,89.24,Percent of total billed charges,,,0.97,,89.24,Percent of total billed charges,,,0.96,,88.32,Percent of total billed charges,,,0.95,,87.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,87.4,Percent of total billed charges,,87.4,90.16,
Mass spectrometry (laboratory testing method),PX-30113596,CDM,83789,CPT,301,RC,,outpatient,,,92,82.8,,0.95,,87.4,Percent of total billed charges,,,0.98,,90.16,Percent of total billed charges,,,0.95,,87.4,Percent of total billed charges,,,0.95,,87.4,Percent of total billed charges,,,0.97,,89.24,Percent of total billed charges,,,0.96,,88.32,Percent of total billed charges,,,0.95,,87.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,87.4,Percent of total billed charges,,87.4,90.16,
Metanephrines level,PX-30113625,CDM,83835,CPT,301,RC,,inpatient,,,119,107.1,,0.95,,113.05,Percent of total billed charges,,,0.98,,116.62,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.96,,114.24,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,113.05,Percent of total billed charges,,113.05,116.62,
Metanephrines level,PX-30113625,CDM,83835,CPT,301,RC,,outpatient,,,119,107.1,,0.95,,113.05,Percent of total billed charges,,,0.98,,116.62,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.96,,114.24,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,113.05,Percent of total billed charges,,113.05,116.62,
Mass spectrometry (laboratory testing method),PX-30113659,CDM,83789,CPT,301,RC,,inpatient,,,147,132.3,,0.95,,139.65,Percent of total billed charges,,,0.98,,144.06,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,0.97,,142.59,Percent of total billed charges,,,0.97,,142.59,Percent of total billed charges,,,0.96,,141.12,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,139.65,Percent of total billed charges,,139.65,144.06,
Mass spectrometry (laboratory testing method),PX-30113659,CDM,83789,CPT,301,RC,,outpatient,,,147,132.3,,0.95,,139.65,Percent of total billed charges,,,0.98,,144.06,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,0.97,,142.59,Percent of total billed charges,,,0.96,,141.12,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,139.65,Percent of total billed charges,,139.65,144.06,
"Total protein level, urine",PX-30113805,CDM,84156,CPT,301,RC,,inpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
"Total protein level, urine",PX-30113805,CDM,84156,CPT,301,RC,,outpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
Catecholamines (organic nitrogen) level,PX-30113956,CDM,82384,CPT,301,RC,,inpatient,,,155,139.5,,0.95,,147.25,Percent of total billed charges,,,0.98,,151.9,Percent of total billed charges,,,0.95,,147.25,Percent of total billed charges,,,0.97,,150.35,Percent of total billed charges,,,0.97,,150.35,Percent of total billed charges,,,0.96,,148.8,Percent of total billed charges,,,0.95,,147.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,147.25,Percent of total billed charges,,147.25,151.9,
Catecholamines (organic nitrogen) level,PX-30113956,CDM,82384,CPT,301,RC,,outpatient,,,155,139.5,,0.95,,147.25,Percent of total billed charges,,,0.98,,151.9,Percent of total billed charges,,,0.95,,147.25,Percent of total billed charges,,,0.95,,147.25,Percent of total billed charges,,,0.97,,150.35,Percent of total billed charges,,,0.96,,148.8,Percent of total billed charges,,,0.95,,147.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,147.25,Percent of total billed charges,,147.25,151.9,
Thyroxine binding globulin (thyroid related protein) level,PX-30114165,CDM,84442,CPT,301,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
Thyroxine binding globulin (thyroid related protein) level,PX-30114165,CDM,84442,CPT,301,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
Tobramycin (antibiotic) level,PX-30114183,CDM,80200,CPT,301,RC,,inpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Tobramycin (antibiotic) level,PX-30114183,CDM,80200,CPT,301,RC,,outpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Aspiration of fluid from chest cavity w/imaging,PX-45010787,CDM,32555,CPT,450,RC,,inpatient,,,976,878.4,,0.95,,927.2,Percent of total billed charges,,,0.98,,956.48,Percent of total billed charges,,,0.95,,927.2,Percent of total billed charges,,,0.97,,946.72,Percent of total billed charges,,,0.97,,946.72,Percent of total billed charges,,,0.96,,936.96,Percent of total billed charges,,,0.95,,927.2,Percent of total billed charges,,,,,,,,,0.95,,927.2,Percent of total billed charges,,927.2,956.48,
Aspiration of fluid from chest cavity w/imaging,PX-45010787,CDM,32555,CPT,450,RC,,outpatient,,,976,878.4,,0.95,,927.2,Percent of total billed charges,,,0.98,,956.48,Percent of total billed charges,,,0.95,,927.2,Percent of total billed charges,,,0.95,,927.2,Percent of total billed charges,,,0.97,,946.72,Percent of total billed charges,,,0.96,,936.96,Percent of total billed charges,,,0.95,,927.2,Percent of total billed charges,,,,,,,,,0.95,,927.2,Percent of total billed charges,,927.2,956.48,
Drain fluid from chest cavity w/ Insert indwelling tube,PX-45010789,CDM,32556,CPT,450,RC,,inpatient,,,1806,1625.4,,0.95,,1715.7,Percent of total billed charges,,,0.98,,1769.88,Percent of total billed charges,,,0.95,,1715.7,Percent of total billed charges,,,0.97,,1751.82,Percent of total billed charges,,,0.97,,1751.82,Percent of total billed charges,,,0.96,,1733.76,Percent of total billed charges,,,0.95,,1715.7,Percent of total billed charges,,,,,,,,,0.95,,1715.7,Percent of total billed charges,,1715.7,1769.88,
Drain fluid from chest cavity w/ Insert indwelling tube,PX-45010789,CDM,32556,CPT,450,RC,,outpatient,,,1806,1625.4,,0.95,,1715.7,Percent of total billed charges,,,0.98,,1769.88,Percent of total billed charges,,,0.95,,1715.7,Percent of total billed charges,,,0.95,,1715.7,Percent of total billed charges,,,0.97,,1751.82,Percent of total billed charges,,,0.96,,1733.76,Percent of total billed charges,,,0.95,,1715.7,Percent of total billed charges,,,,,,,,,0.95,,1715.7,Percent of total billed charges,,1715.7,1769.88,
"Blood test, thyroid stimulating hormone (TSH)",PX-30114208,CDM,84443,CPT,301,RC,,inpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
"Blood test, thyroid stimulating hormone (TSH)",PX-30114208,CDM,84443,CPT,301,RC,,outpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
Uric acid level,PX-30114230,CDM,84560,CPT,301,RC,,inpatient,,,82,73.8,,0.95,,77.9,Percent of total billed charges,,,0.98,,80.36,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,0.97,,79.54,Percent of total billed charges,,,0.97,,79.54,Percent of total billed charges,,,0.96,,78.72,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,77.9,Percent of total billed charges,,77.9,80.36,
Uric acid level,PX-30114230,CDM,84560,CPT,301,RC,,outpatient,,,82,73.8,,0.95,,77.9,Percent of total billed charges,,,0.98,,80.36,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,0.97,,79.54,Percent of total billed charges,,,0.96,,78.72,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,77.9,Percent of total billed charges,,77.9,80.36,
"Ascorbic acid (Vitamin C) level, blood",PX-30114257,CDM,82180,CPT,301,RC,,inpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
"Ascorbic acid (Vitamin C) level, blood",PX-30114257,CDM,82180,CPT,301,RC,,outpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
Vitamin D-3 level,PX-30114261,CDM,82306,CPT,301,RC,,inpatient,,,125,112.5,,0.95,,118.75,Percent of total billed charges,,,0.98,,122.5,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.96,,120,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,118.75,Percent of total billed charges,,118.75,122.5,
Vitamin D-3 level,PX-30114261,CDM,82306,CPT,301,RC,,outpatient,,,125,112.5,,0.95,,118.75,Percent of total billed charges,,,0.98,,122.5,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.96,,120,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,118.75,Percent of total billed charges,,118.75,122.5,
"Measure antibody to allergic, crude allergen extract, each",PX-30210302,CDM,86003,CPT,302,RC,,inpatient,,,23,20.7,,0.95,,21.85,Percent of total billed charges,,,0.98,,22.54,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.96,,22.08,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,21.85,Percent of total billed charges,,21.85,22.54,
"Measure antibody to allergic, crude allergen extract, each",PX-30210302,CDM,86003,CPT,302,RC,,outpatient,,,23,20.7,,0.95,,21.85,Percent of total billed charges,,,0.98,,22.54,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.96,,22.08,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,21.85,Percent of total billed charges,,21.85,22.54,
"Measure antibody to assess autoimmune disorder, any method",PX-30210311,CDM,86235,CPT,302,RC,,inpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19,Percent of total billed charges,,19,19.6,
"Measure antibody to assess autoimmune disorder, any method",PX-30210311,CDM,86235,CPT,302,RC,,outpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19,Percent of total billed charges,,19,19.6,
"Measure antibody to assess autoimmune disorder, any method",PX-30210312,CDM,86235,CPT,302,RC,,inpatient,,,87,78.3,,0.95,,82.65,Percent of total billed charges,,,0.98,,85.26,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.96,,83.52,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,82.65,Percent of total billed charges,,82.65,85.26,
"Measure antibody to assess autoimmune disorder, any method",PX-30210312,CDM,86235,CPT,302,RC,,outpatient,,,87,78.3,,0.95,,82.65,Percent of total billed charges,,,0.98,,85.26,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.96,,83.52,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,82.65,Percent of total billed charges,,82.65,85.26,
Pretreat RBCs for use in RBCs antibody analysis and test,PX-30210330,CDM,86972,CPT,302,RC,,inpatient,,,212,190.8,,0.95,,201.4,Percent of total billed charges,,,0.98,,207.76,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,0.97,,205.64,Percent of total billed charges,,,0.97,,205.64,Percent of total billed charges,,,0.96,,203.52,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,201.4,Percent of total billed charges,,201.4,207.76,
Pretreat RBCs for use in RBCs antibody analysis and test,PX-30210330,CDM,86972,CPT,302,RC,,outpatient,,,212,190.8,,0.95,,201.4,Percent of total billed charges,,,0.98,,207.76,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,0.97,,205.64,Percent of total billed charges,,,0.96,,203.52,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,201.4,Percent of total billed charges,,201.4,207.76,
Pretreat serum for use in RBC antibody analysis and test,PX-30210331,CDM,86976,CPT,302,RC,,inpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
Pretreat serum for use in RBC antibody analysis and test,PX-30210331,CDM,86976,CPT,302,RC,,outpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
Analysis for antibody to Bartonella (bacteria),PX-30210339,CDM,86611,CPT,302,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Analysis for antibody to Bartonella (bacteria),PX-30210339,CDM,86611,CPT,302,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
"Antibody identification test, platelet antibodies",PX-30210346,CDM,86022,CPT,302,RC,,inpatient,,,232,208.8,,0.95,,220.4,Percent of total billed charges,,,0.98,,227.36,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,0.97,,225.04,Percent of total billed charges,,,0.97,,225.04,Percent of total billed charges,,,0.96,,222.72,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,220.4,Percent of total billed charges,,220.4,227.36,
"Antibody identification test, platelet antibodies",PX-30210346,CDM,86022,CPT,302,RC,,outpatient,,,232,208.8,,0.95,,220.4,Percent of total billed charges,,,0.98,,227.36,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,0.97,,225.04,Percent of total billed charges,,,0.96,,222.72,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,220.4,Percent of total billed charges,,220.4,227.36,
Analysis for antibody to Mycoplasma (bacteria),PX-30210350,CDM,86738,CPT,302,RC,,inpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
Analysis for antibody to Mycoplasma (bacteria),PX-30210350,CDM,86738,CPT,302,RC,,outpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
"Measure antibody to assess autoimmune disorder, titer",PX-30210354,CDM,86039,CPT,302,RC,,inpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
"Measure antibody to assess autoimmune disorder, titer",PX-30210354,CDM,86039,CPT,302,RC,,outpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
"Analysis for antibody, Treponema pallidum",PX-30210360,CDM,86780,CPT,302,RC,,inpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
"Analysis for antibody, Treponema pallidum",PX-30210360,CDM,86780,CPT,302,RC,,outpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
Thyroglobulin (thyroid protein) antibody measurement,PX-30210361,CDM,86800,CPT,302,RC,,inpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Thyroglobulin (thyroid protein) antibody measurement,PX-30210361,CDM,86800,CPT,302,RC,,outpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Screening test for autoimmune disorder,PX-30210369,CDM,86038,CPT,302,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
Screening test for autoimmune disorder,PX-30210369,CDM,86038,CPT,302,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
Measurement for Strep antibody (strep throat),PX-30210393,CDM,86060,CPT,302,RC,,inpatient,,,81,72.9,,0.95,,76.95,Percent of total billed charges,,,0.98,,79.38,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.96,,77.76,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76.95,Percent of total billed charges,,76.95,79.38,
Measurement for Strep antibody (strep throat),PX-30210393,CDM,86060,CPT,302,RC,,outpatient,,,81,72.9,,0.95,,76.95,Percent of total billed charges,,,0.98,,79.38,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.96,,77.76,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76.95,Percent of total billed charges,,76.95,79.38,
Measure C-reactive protein to detect infection/inflammation,PX-30210399,CDM,86140,CPT,302,RC,,inpatient,,,76,68.4,,0.95,,72.2,Percent of total billed charges,,,0.98,,74.48,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,0.97,,73.72,Percent of total billed charges,,,0.97,,73.72,Percent of total billed charges,,,0.96,,72.96,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,72.2,Percent of total billed charges,,72.2,74.48,
Measure C-reactive protein to detect infection/inflammation,PX-30210399,CDM,86140,CPT,302,RC,,outpatient,,,76,68.4,,0.95,,72.2,Percent of total billed charges,,,0.98,,74.48,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,0.97,,73.72,Percent of total billed charges,,,0.96,,72.96,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,72.2,Percent of total billed charges,,72.2,74.48,
Cardiolipin antibody (tissue antibody) measurement,PX-30210405,CDM,86147,CPT,302,RC,,inpatient,,,40,36,,0.95,,38,Percent of total billed charges,,,0.98,,39.2,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.96,,38.4,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38,Percent of total billed charges,,38,39.2,
Cardiolipin antibody (tissue antibody) measurement,PX-30210405,CDM,86147,CPT,302,RC,,outpatient,,,40,36,,0.95,,38,Percent of total billed charges,,,0.98,,39.2,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.96,,38.4,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38,Percent of total billed charges,,38,39.2,
Analysis for antibody (IgM) to Chlamydia (bacteria),PX-30210406,CDM,86632,CPT,302,RC,,inpatient,,,43,38.7,,0.95,,40.85,Percent of total billed charges,,,0.98,,42.14,Percent of total billed charges,,,0.95,,40.85,Percent of total billed charges,,,0.97,,41.71,Percent of total billed charges,,,0.97,,41.71,Percent of total billed charges,,,0.96,,41.28,Percent of total billed charges,,,0.95,,40.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,40.85,Percent of total billed charges,,40.85,42.14,
Analysis for antibody (IgM) to Chlamydia (bacteria),PX-30210406,CDM,86632,CPT,302,RC,,outpatient,,,43,38.7,,0.95,,40.85,Percent of total billed charges,,,0.98,,42.14,Percent of total billed charges,,,0.95,,40.85,Percent of total billed charges,,,0.95,,40.85,Percent of total billed charges,,,0.97,,41.71,Percent of total billed charges,,,0.96,,41.28,Percent of total billed charges,,,0.95,,40.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,40.85,Percent of total billed charges,,40.85,42.14,
Cardiolipin antibody (tissue antibody) measurement,PX-30210409,CDM,86147,CPT,302,RC,,inpatient,,,40,36,,0.95,,38,Percent of total billed charges,,,0.98,,39.2,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.96,,38.4,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38,Percent of total billed charges,,38,39.2,
Cardiolipin antibody (tissue antibody) measurement,PX-30210409,CDM,86147,CPT,302,RC,,outpatient,,,40,36,,0.95,,38,Percent of total billed charges,,,0.98,,39.2,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.96,,38.4,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38,Percent of total billed charges,,38,39.2,
Measurement of substance using immunoassay technique,PX-30210416,CDM,83520,CPT,300,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Measurement of substance using immunoassay technique,PX-30210416,CDM,83520,CPT,300,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
"Measure of complement (immune proteins), total hemolytic",PX-30210418,CDM,86162,CPT,302,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
"Measure of complement (immune proteins), total hemolytic",PX-30210418,CDM,86162,CPT,302,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
Measure cold agglutinin to screen for infection or disease,PX-30210423,CDM,86156,CPT,302,RC,,inpatient,,,30,27,,0.95,,28.5,Percent of total billed charges,,,0.98,,29.4,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,0.97,,29.1,Percent of total billed charges,,,0.97,,29.1,Percent of total billed charges,,,0.96,,28.8,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,28.5,Percent of total billed charges,,28.5,29.4,
Measure cold agglutinin to screen for infection or disease,PX-30210423,CDM,86156,CPT,302,RC,,outpatient,,,30,27,,0.95,,28.5,Percent of total billed charges,,,0.98,,29.4,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,0.97,,29.1,Percent of total billed charges,,,0.96,,28.8,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,28.5,Percent of total billed charges,,28.5,29.4,
"Measure of complement (immune system proteins), antigen,",PX-30210429,CDM,86160,CPT,302,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
"Measure of complement (immune system proteins), antigen,",PX-30210429,CDM,86160,CPT,302,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
"Measure of complement (immune system proteins), antigen,",PX-30210430,CDM,86160,CPT,302,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
"Measure of complement (immune system proteins), antigen,",PX-30210430,CDM,86160,CPT,302,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Apply moveable or hinged forearm to hand splint,PX-45010825,CDM,29126,CPT,450,RC,,inpatient,,,189,170.1,,0.95,,179.55,Percent of total billed charges,,,0.98,,185.22,Percent of total billed charges,,,0.95,,179.55,Percent of total billed charges,,,0.97,,183.33,Percent of total billed charges,,,0.97,,183.33,Percent of total billed charges,,,0.96,,181.44,Percent of total billed charges,,,0.95,,179.55,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,179.55,Percent of total billed charges,,179.55,3950,
Apply moveable or hinged forearm to hand splint,PX-45010825,CDM,29126,CPT,450,RC,,outpatient,,,189,170.1,,0.95,,179.55,Percent of total billed charges,,,0.98,,185.22,Percent of total billed charges,,,0.95,,179.55,Percent of total billed charges,,,0.95,,179.55,Percent of total billed charges,,,0.97,,183.33,Percent of total billed charges,,,0.96,,181.44,Percent of total billed charges,,,0.95,,179.55,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,179.55,Percent of total billed charges,,179.55,3950,
"Measure of complement (immune system proteins), antigen,",PX-30210459,CDM,86160,CPT,302,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
"Measure of complement (immune system proteins), antigen,",PX-30210459,CDM,86160,CPT,302,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
"Measurement of DNA antibody, native or double stranded",PX-30210468,CDM,86225,CPT,302,RC,,inpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
"Measurement of DNA antibody, native or double stranded",PX-30210468,CDM,86225,CPT,302,RC,,outpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
"Measurement of DNA antibody, native or double stranded",PX-30210470,CDM,86225,CPT,302,RC,,inpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
"Measurement of DNA antibody, native or double stranded",PX-30210470,CDM,86225,CPT,302,RC,,outpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
"Measure antibody to assess autoimmune disorder, any method",PX-30210486,CDM,86235,CPT,302,RC,,inpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
"Measure antibody to assess autoimmune disorder, any method",PX-30210486,CDM,86235,CPT,302,RC,,outpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
"Measure antibody to assess autoimmune disorder, any method",PX-30210487,CDM,86235,CPT,302,RC,,inpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
"Measure antibody to assess autoimmune disorder, any method",PX-30210487,CDM,86235,CPT,302,RC,,outpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
"Measure antibody to assess autoimmune disorder, any method",PX-30210501,CDM,86235,CPT,302,RC,,inpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
"Measure antibody to assess autoimmune disorder, any method",PX-30210501,CDM,86235,CPT,302,RC,,outpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
Rheumatoid factor level,PX-30210522,CDM,86431,CPT,302,RC,,inpatient,,,48,43.2,,0.95,,45.6,Percent of total billed charges,,,0.98,,47.04,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.96,,46.08,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,45.6,Percent of total billed charges,,45.6,47.04,
Rheumatoid factor level,PX-30210522,CDM,86431,CPT,302,RC,,outpatient,,,48,43.2,,0.95,,45.6,Percent of total billed charges,,,0.98,,47.04,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.96,,46.08,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,45.6,Percent of total billed charges,,45.6,47.04,
"Analysis for antibody to Herpes simplex virus, type 1",PX-30210524,CDM,86695,CPT,302,RC,,inpatient,,,87,78.3,,0.95,,82.65,Percent of total billed charges,,,0.98,,85.26,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.96,,83.52,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,82.65,Percent of total billed charges,,82.65,85.26,
"Analysis for antibody to Herpes simplex virus, type 1",PX-30210524,CDM,86695,CPT,302,RC,,outpatient,,,87,78.3,,0.95,,82.65,Percent of total billed charges,,,0.98,,85.26,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.96,,83.52,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,82.65,Percent of total billed charges,,82.65,85.26,
"Analysis for antibody to Herpes simplex virus, type 1",PX-30210526,CDM,86695,CPT,302,RC,,inpatient,,,90,81,,0.95,,85.5,Percent of total billed charges,,,0.98,,88.2,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,0.97,,87.3,Percent of total billed charges,,,0.97,,87.3,Percent of total billed charges,,,0.96,,86.4,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,85.5,Percent of total billed charges,,85.5,88.2,
"Analysis for antibody to Herpes simplex virus, type 1",PX-30210526,CDM,86695,CPT,302,RC,,outpatient,,,90,81,,0.95,,85.5,Percent of total billed charges,,,0.98,,88.2,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,0.97,,87.3,Percent of total billed charges,,,0.96,,86.4,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,85.5,Percent of total billed charges,,85.5,88.2,
"Measure antibody to assess autoimmune disorder, any method",PX-30210527,CDM,86235,CPT,302,RC,,inpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
"Measure antibody to assess autoimmune disorder, any method",PX-30210527,CDM,86235,CPT,302,RC,,outpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
"Measure antibody to assess autoimmune disorder, any method",PX-30210528,CDM,86235,CPT,302,RC,,inpatient,,,87,78.3,,0.95,,82.65,Percent of total billed charges,,,0.98,,85.26,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.96,,83.52,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,82.65,Percent of total billed charges,,82.65,85.26,
"Measure antibody to assess autoimmune disorder, any method",PX-30210528,CDM,86235,CPT,302,RC,,outpatient,,,87,78.3,,0.95,,82.65,Percent of total billed charges,,,0.98,,85.26,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.96,,83.52,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,82.65,Percent of total billed charges,,82.65,85.26,
"Measure antibody to assess autoimmune disorder, any method",PX-30210532,CDM,86235,CPT,302,RC,,inpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
"Measure antibody to assess autoimmune disorder, any method",PX-30210532,CDM,86235,CPT,302,RC,,outpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
"Measure antibody to assess autoimmune disorder, any method",PX-30210534,CDM,86235,CPT,302,RC,,inpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
"Measure antibody to assess autoimmune disorder, any method",PX-30210534,CDM,86235,CPT,302,RC,,outpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
Screening test for mononucleosis (mono),PX-30210538,CDM,86308,CPT,302,RC,,inpatient,,,90,81,,0.95,,85.5,Percent of total billed charges,,,0.98,,88.2,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,0.97,,87.3,Percent of total billed charges,,,0.97,,87.3,Percent of total billed charges,,,0.96,,86.4,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,85.5,Percent of total billed charges,,85.5,88.2,
Screening test for mononucleosis (mono),PX-30210538,CDM,86308,CPT,302,RC,,outpatient,,,90,81,,0.95,,85.5,Percent of total billed charges,,,0.98,,88.2,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,0.97,,87.3,Percent of total billed charges,,,0.96,,86.4,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,85.5,Percent of total billed charges,,85.5,88.2,
HC Immunoassay Infectious Agent Antibody Quan Nos,PX-30210547,CDM,86317,CPT,302,RC,,inpatient,,,46,41.4,,0.95,,43.7,Percent of total billed charges,,,0.98,,45.08,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,0.97,,44.62,Percent of total billed charges,,,0.97,,44.62,Percent of total billed charges,,,0.96,,44.16,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,43.7,Percent of total billed charges,,43.7,45.08,
HC Immunoassay Infectious Agent Antibody Quan Nos,PX-30210547,CDM,86317,CPT,302,RC,,outpatient,,,46,41.4,,0.95,,43.7,Percent of total billed charges,,,0.98,,45.08,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,0.97,,44.62,Percent of total billed charges,,,0.96,,44.16,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,43.7,Percent of total billed charges,,43.7,45.08,
Intrinsic factor (stomach protein) antibody measurement,PX-30210572,CDM,86340,CPT,302,RC,,inpatient,,,54,48.6,,0.95,,51.3,Percent of total billed charges,,,0.98,,52.92,Percent of total billed charges,,,0.95,,51.3,Percent of total billed charges,,,0.97,,52.38,Percent of total billed charges,,,0.97,,52.38,Percent of total billed charges,,,0.96,,51.84,Percent of total billed charges,,,0.95,,51.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,51.3,Percent of total billed charges,,51.3,52.92,
Intrinsic factor (stomach protein) antibody measurement,PX-30210572,CDM,86340,CPT,302,RC,,outpatient,,,54,48.6,,0.95,,51.3,Percent of total billed charges,,,0.98,,52.92,Percent of total billed charges,,,0.95,,51.3,Percent of total billed charges,,,0.95,,51.3,Percent of total billed charges,,,0.97,,52.38,Percent of total billed charges,,,0.96,,51.84,Percent of total billed charges,,,0.95,,51.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,51.3,Percent of total billed charges,,51.3,52.92,
Viral neutralization test to detect viral antibody level,PX-30210575,CDM,86382,CPT,302,RC,,inpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
Viral neutralization test to detect viral antibody level,PX-30210575,CDM,86382,CPT,302,RC,,outpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
"Tuberculosis test, gamma interferon",PX-30210598,CDM,86480,CPT,300,RC,,inpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
"Tuberculosis test, gamma interferon",PX-30210598,CDM,86480,CPT,300,RC,,outpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
Syphilis detection test,PX-30210605,CDM,86592,CPT,302,RC,,inpatient,,,92,82.8,,0.95,,87.4,Percent of total billed charges,,,0.98,,90.16,Percent of total billed charges,,,0.95,,87.4,Percent of total billed charges,,,0.97,,89.24,Percent of total billed charges,,,0.97,,89.24,Percent of total billed charges,,,0.96,,88.32,Percent of total billed charges,,,0.95,,87.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,87.4,Percent of total billed charges,,87.4,90.16,
Syphilis detection test,PX-30210605,CDM,86592,CPT,302,RC,,outpatient,,,92,82.8,,0.95,,87.4,Percent of total billed charges,,,0.98,,90.16,Percent of total billed charges,,,0.95,,87.4,Percent of total billed charges,,,0.95,,87.4,Percent of total billed charges,,,0.97,,89.24,Percent of total billed charges,,,0.96,,88.32,Percent of total billed charges,,,0.95,,87.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,87.4,Percent of total billed charges,,87.4,90.16,
Syphilis detection test,PX-30210608,CDM,86592,CPT,302,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Syphilis detection test,PX-30210608,CDM,86592,CPT,302,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Analysis for antibody to aspergillus (fungus),PX-30210616,CDM,86606,CPT,302,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
Analysis for antibody to aspergillus (fungus),PX-30210616,CDM,86606,CPT,302,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
Analysis for antibody to Brucella (bacteria),PX-30210627,CDM,86622,CPT,302,RC,,inpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
Analysis for antibody to Brucella (bacteria),PX-30210627,CDM,86622,CPT,302,RC,,outpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
Heparin neutralization test,PX-30510454,CDM,85525,CPT,305,RC,,inpatient,,,40,36,,0.95,,38,Percent of total billed charges,,,0.98,,39.2,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.96,,38.4,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38,Percent of total billed charges,,38,39.2,
Heparin neutralization test,PX-30510454,CDM,85525,CPT,305,RC,,outpatient,,,40,36,,0.95,,38,Percent of total billed charges,,,0.98,,39.2,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.96,,38.4,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38,Percent of total billed charges,,38,39.2,
Platelet function test,PX-30510455,CDM,85597,CPT,305,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Platelet function test,PX-30510455,CDM,85597,CPT,305,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Analysis for antibody to Chlamydia (bacteria),PX-30210636,CDM,86631,CPT,300,RC,,inpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
Analysis for antibody to Chlamydia (bacteria),PX-30210636,CDM,86631,CPT,300,RC,,outpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
Blood coagulation screening test,PX-30510458,CDM,85635,CPT,305,RC,,inpatient,,,32,28.8,,0.95,,30.4,Percent of total billed charges,,,0.98,,31.36,Percent of total billed charges,,,0.95,,30.4,Percent of total billed charges,,,0.97,,31.04,Percent of total billed charges,,,0.97,,31.04,Percent of total billed charges,,,0.96,,30.72,Percent of total billed charges,,,0.95,,30.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,30.4,Percent of total billed charges,,30.4,31.36,
Blood coagulation screening test,PX-30510458,CDM,85635,CPT,305,RC,,outpatient,,,32,28.8,,0.95,,30.4,Percent of total billed charges,,,0.98,,31.36,Percent of total billed charges,,,0.95,,30.4,Percent of total billed charges,,,0.95,,30.4,Percent of total billed charges,,,0.97,,31.04,Percent of total billed charges,,,0.96,,30.72,Percent of total billed charges,,,0.95,,30.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,30.4,Percent of total billed charges,,30.4,31.36,
Analysis for antibody (IgM) to Chlamydia (bacteria),PX-30210646,CDM,86632,CPT,300,RC,,inpatient,,,44,39.6,,0.95,,41.8,Percent of total billed charges,,,0.98,,43.12,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,0.97,,42.68,Percent of total billed charges,,,0.97,,42.68,Percent of total billed charges,,,0.96,,42.24,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,41.8,Percent of total billed charges,,41.8,43.12,
Analysis for antibody (IgM) to Chlamydia (bacteria),PX-30210646,CDM,86632,CPT,300,RC,,outpatient,,,44,39.6,,0.95,,41.8,Percent of total billed charges,,,0.98,,43.12,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,0.97,,42.68,Percent of total billed charges,,,0.96,,42.24,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,41.8,Percent of total billed charges,,41.8,43.12,
Analysis for antibody to Coccidioides (bacteria),PX-30210650,CDM,86635,CPT,302,RC,,inpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Analysis for antibody to Coccidioides (bacteria),PX-30210650,CDM,86635,CPT,302,RC,,outpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Analysis for antibody to Coccidioides (bacteria),PX-30210657,CDM,86635,CPT,302,RC,,inpatient,,,58,52.2,,0.95,,55.1,Percent of total billed charges,,,0.98,,56.84,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,0.97,,56.26,Percent of total billed charges,,,0.97,,56.26,Percent of total billed charges,,,0.96,,55.68,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,55.1,Percent of total billed charges,,55.1,56.84,
Analysis for antibody to Coccidioides (bacteria),PX-30210657,CDM,86635,CPT,302,RC,,outpatient,,,58,52.2,,0.95,,55.1,Percent of total billed charges,,,0.98,,56.84,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,0.97,,56.26,Percent of total billed charges,,,0.96,,55.68,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,55.1,Percent of total billed charges,,55.1,56.84,
Analysis for antibody to Enterovirus,PX-30210671,CDM,86658,CPT,300,RC,,inpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
Analysis for antibody to Enterovirus,PX-30210671,CDM,86658,CPT,300,RC,,outpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
Analysis for antibody to fungus,PX-30210707,CDM,86671,CPT,302,RC,,inpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
Analysis for antibody to fungus,PX-30210707,CDM,86671,CPT,302,RC,,outpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
Analysis for antibody to HIV -1 virus,PX-30210715,CDM,86701,CPT,302,RC,,inpatient,,,130,117,,0.95,,123.5,Percent of total billed charges,,,0.98,,127.4,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.96,,124.8,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,123.5,Percent of total billed charges,,123.5,127.4,
Analysis for antibody to HIV -1 virus,PX-30210715,CDM,86701,CPT,302,RC,,outpatient,,,130,117,,0.95,,123.5,Percent of total billed charges,,,0.98,,127.4,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.96,,124.8,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,123.5,Percent of total billed charges,,123.5,127.4,
Analysis for antibody to HIV-1 and HIV-2 virus,PX-30210719,CDM,86703,CPT,300,RC,,inpatient,,,137,123.3,,0.95,,130.15,Percent of total billed charges,,,0.98,,134.26,Percent of total billed charges,,,0.95,,130.15,Percent of total billed charges,,,0.97,,132.89,Percent of total billed charges,,,0.97,,132.89,Percent of total billed charges,,,0.96,,131.52,Percent of total billed charges,,,0.95,,130.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,130.15,Percent of total billed charges,,130.15,134.26,
Analysis for antibody to HIV-1 and HIV-2 virus,PX-30210719,CDM,86703,CPT,300,RC,,outpatient,,,137,123.3,,0.95,,130.15,Percent of total billed charges,,,0.98,,134.26,Percent of total billed charges,,,0.95,,130.15,Percent of total billed charges,,,0.95,,130.15,Percent of total billed charges,,,0.97,,132.89,Percent of total billed charges,,,0.96,,131.52,Percent of total billed charges,,,0.95,,130.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,130.15,Percent of total billed charges,,130.15,134.26,
Hepatitis B surface antibody measurement,PX-30210735,CDM,86706,CPT,302,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Hepatitis B surface antibody measurement,PX-30210735,CDM,86706,CPT,302,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Measurement of Hepatitis A antibody,PX-30210737,CDM,86708,CPT,302,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Measurement of Hepatitis A antibody,PX-30210737,CDM,86708,CPT,302,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Measurement of Hepatitis A antibody,PX-30210738,CDM,86708,CPT,302,RC,,inpatient,,,66,59.4,,0.95,,62.7,Percent of total billed charges,,,0.98,,64.68,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,0.97,,64.02,Percent of total billed charges,,,0.97,,64.02,Percent of total billed charges,,,0.96,,63.36,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,62.7,Percent of total billed charges,,62.7,64.68,
Measurement of Hepatitis A antibody,PX-30210738,CDM,86708,CPT,302,RC,,outpatient,,,66,59.4,,0.95,,62.7,Percent of total billed charges,,,0.98,,64.68,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,0.97,,64.02,Percent of total billed charges,,,0.96,,63.36,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,62.7,Percent of total billed charges,,62.7,64.68,
Analysis for antibody to lymphocytic choriomeningitis,PX-30210741,CDM,86727,CPT,302,RC,,inpatient,,,51,45.9,,0.95,,48.45,Percent of total billed charges,,,0.98,,49.98,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.96,,48.96,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,48.45,Percent of total billed charges,,48.45,49.98,
Analysis for antibody to lymphocytic choriomeningitis,PX-30210741,CDM,86727,CPT,302,RC,,outpatient,,,51,45.9,,0.95,,48.45,Percent of total billed charges,,,0.98,,49.98,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.96,,48.96,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,48.45,Percent of total billed charges,,48.45,49.98,
Analysis for antibody to mumps virus,PX-30210745,CDM,86735,CPT,300,RC,,inpatient,,,125,112.5,,0.95,,118.75,Percent of total billed charges,,,0.98,,122.5,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.96,,120,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,118.75,Percent of total billed charges,,118.75,122.5,
Analysis for antibody to mumps virus,PX-30210745,CDM,86735,CPT,300,RC,,outpatient,,,125,112.5,,0.95,,118.75,Percent of total billed charges,,,0.98,,122.5,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.96,,120,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,118.75,Percent of total billed charges,,118.75,122.5,
Analysis for antibody to protozoa (parasite),PX-30210750,CDM,86753,CPT,302,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Analysis for antibody to protozoa (parasite),PX-30210750,CDM,86753,CPT,302,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Analysis for antibody to Rickettsia (bacteria),PX-30210757,CDM,86757,CPT,300,RC,,inpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Analysis for antibody to Rickettsia (bacteria),PX-30210757,CDM,86757,CPT,300,RC,,outpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Analysis for antibody to Rubella (German measles virus),PX-30210766,CDM,86762,CPT,302,RC,,inpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
Analysis for antibody to Rubella (German measles virus),PX-30210766,CDM,86762,CPT,302,RC,,outpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
Analysis for antibody (IgM) to West Nile virus,PX-30210773,CDM,86788,CPT,302,RC,,inpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
Analysis for antibody (IgM) to West Nile virus,PX-30210773,CDM,86788,CPT,302,RC,,outpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
Analysis for antibody to West Nile virus,PX-30210776,CDM,86789,CPT,302,RC,,inpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
Analysis for antibody to West Nile virus,PX-30210776,CDM,86789,CPT,302,RC,,outpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
Analysis for antibody to virus,PX-30210794,CDM,86790,CPT,302,RC,,inpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
Analysis for antibody to virus,PX-30210794,CDM,86790,CPT,302,RC,,outpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
Hepatitis C antibody measurement,PX-30210798,CDM,86803,CPT,300,RC,,inpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
Hepatitis C antibody measurement,PX-30210798,CDM,86803,CPT,300,RC,,outpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
HC Blood Typing Serologic Rh (D),PX-30210856,CDM,86901,CPT,302,RC,,inpatient,,,108,97.2,,0.95,,102.6,Percent of total billed charges,,,0.98,,105.84,Percent of total billed charges,,,0.95,,102.6,Percent of total billed charges,,,0.97,,104.76,Percent of total billed charges,,,0.97,,104.76,Percent of total billed charges,,,0.96,,103.68,Percent of total billed charges,,,0.95,,102.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,102.6,Percent of total billed charges,,102.6,105.84,
HC Blood Typing Serologic Rh (D),PX-30210856,CDM,86901,CPT,302,RC,,outpatient,,,108,97.2,,0.95,,102.6,Percent of total billed charges,,,0.98,,105.84,Percent of total billed charges,,,0.95,,102.6,Percent of total billed charges,,,0.95,,102.6,Percent of total billed charges,,,0.97,,104.76,Percent of total billed charges,,,0.96,,103.68,Percent of total billed charges,,,0.95,,102.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,102.6,Percent of total billed charges,,102.6,105.84,
"Blood unit compatibility test, immediate spin technique",PX-30210867,CDM,86920,CPT,300,RC,,inpatient,,,152,136.8,,0.95,,144.4,Percent of total billed charges,,,0.98,,148.96,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,0.97,,147.44,Percent of total billed charges,,,0.97,,147.44,Percent of total billed charges,,,0.96,,145.92,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,144.4,Percent of total billed charges,,144.4,148.96,
"Blood unit compatibility test, immediate spin technique",PX-30210867,CDM,86920,CPT,300,RC,,outpatient,,,152,136.8,,0.95,,144.4,Percent of total billed charges,,,0.98,,148.96,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,0.97,,147.44,Percent of total billed charges,,,0.96,,145.92,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,144.4,Percent of total billed charges,,144.4,148.96,
"Blood unit compatibility test, immediate spin technique",PX-30210868,CDM,86920,CPT,300,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
"Blood unit compatibility test, immediate spin technique",PX-30210868,CDM,86920,CPT,300,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
"Measure antibody to allergic, crude allergen extract, each",PX-30210903,CDM,86003,CPT,302,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
"Measure antibody to allergic, crude allergen extract, each",PX-30210903,CDM,86003,CPT,302,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
Red blood cell antibody level,PX-30210906,CDM,86886,CPT,302,RC,,inpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
Red blood cell antibody level,PX-30210906,CDM,86886,CPT,302,RC,,outpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
Blood group typing (ABO),PX-30210907,CDM,86900,CPT,302,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Blood group typing (ABO),PX-30210907,CDM,86900,CPT,302,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Identify organisms by immunologic analysis,PX-30210911,CDM,87140,CPT,300,RC,,inpatient,,,22,19.8,,0.95,,20.9,Percent of total billed charges,,,0.98,,21.56,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.96,,21.12,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,20.9,Percent of total billed charges,,20.9,21.56,
Identify organisms by immunologic analysis,PX-30210911,CDM,87140,CPT,300,RC,,outpatient,,,22,19.8,,0.95,,20.9,Percent of total billed charges,,,0.98,,21.56,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.96,,21.12,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,20.9,Percent of total billed charges,,20.9,21.56,
Blood bank MD services to investigate transfusion reaction,PX-30210923,CDM,86078,CPT,302,RC,,inpatient,,,364,327.6,,0.95,,345.8,Percent of total billed charges,,,0.98,,356.72,Percent of total billed charges,,,0.95,,345.8,Percent of total billed charges,,,0.97,,353.08,Percent of total billed charges,,,0.97,,353.08,Percent of total billed charges,,,0.96,,349.44,Percent of total billed charges,,,0.95,,345.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,345.8,Percent of total billed charges,,345.8,356.72,
Blood bank MD services to investigate transfusion reaction,PX-30210923,CDM,86078,CPT,302,RC,,outpatient,,,364,327.6,,0.95,,345.8,Percent of total billed charges,,,0.98,,356.72,Percent of total billed charges,,,0.95,,345.8,Percent of total billed charges,,,0.95,,345.8,Percent of total billed charges,,,0.97,,353.08,Percent of total billed charges,,,0.96,,349.44,Percent of total billed charges,,,0.95,,345.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,345.8,Percent of total billed charges,,345.8,356.72,
Measure of complement fixation tests,PX-30210925,CDM,86171,CPT,302,RC,,inpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
Measure of complement fixation tests,PX-30210925,CDM,86171,CPT,302,RC,,outpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
"Tuberculosis test, gamma interferon",PX-30210934,CDM,86480,CPT,302,RC,,inpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
"Tuberculosis test, gamma interferon",PX-30210934,CDM,86480,CPT,302,RC,,outpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
Analysis for antibody to HIV-1 and HIV-2 virus,PX-30210940,CDM,86703,CPT,302,RC,,inpatient,,,130,117,,0.95,,123.5,Percent of total billed charges,,,0.98,,127.4,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.96,,124.8,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,123.5,Percent of total billed charges,,123.5,127.4,
Analysis for antibody to HIV-1 and HIV-2 virus,PX-30210940,CDM,86703,CPT,302,RC,,outpatient,,,130,117,,0.95,,123.5,Percent of total billed charges,,,0.98,,127.4,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.96,,124.8,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,123.5,Percent of total billed charges,,123.5,127.4,
Hepatitis B core antibody measurement,PX-30210943,CDM,86704,CPT,302,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Hepatitis B core antibody measurement,PX-30210943,CDM,86704,CPT,302,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
"Test bynucleic acid for Cytomegalovirus (CMV), amplified",PX-30210986,CDM,87496,CPT,300,RC,,inpatient,,,196,176.4,,0.95,,186.2,Percent of total billed charges,,,0.98,,192.08,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,0.97,,190.12,Percent of total billed charges,,,0.97,,190.12,Percent of total billed charges,,,0.96,,188.16,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,186.2,Percent of total billed charges,,186.2,192.08,
"Test bynucleic acid for Cytomegalovirus (CMV), amplified",PX-30210986,CDM,87496,CPT,300,RC,,outpatient,,,196,176.4,,0.95,,186.2,Percent of total billed charges,,,0.98,,192.08,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,0.97,,190.12,Percent of total billed charges,,,0.96,,188.16,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,186.2,Percent of total billed charges,,186.2,192.08,
"Test by nucleic acid for organism, amplified probe",PX-30210995,CDM,87798,CPT,300,RC,,inpatient,,,127,114.3,,0.95,,120.65,Percent of total billed charges,,,0.98,,124.46,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,0.97,,123.19,Percent of total billed charges,,,0.97,,123.19,Percent of total billed charges,,,0.96,,121.92,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,120.65,Percent of total billed charges,,120.65,124.46,
"Test by nucleic acid for organism, amplified probe",PX-30210995,CDM,87798,CPT,300,RC,,outpatient,,,127,114.3,,0.95,,120.65,Percent of total billed charges,,,0.98,,124.46,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,0.97,,123.19,Percent of total billed charges,,,0.96,,121.92,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,120.65,Percent of total billed charges,,120.65,124.46,
"Test by nucleic acid for enterovirus, amplified",PX-30211001,CDM,87498,CPT,300,RC,,inpatient,,,352,316.8,,0.95,,334.4,Percent of total billed charges,,,0.98,,344.96,Percent of total billed charges,,,0.95,,334.4,Percent of total billed charges,,,0.97,,341.44,Percent of total billed charges,,,0.97,,341.44,Percent of total billed charges,,,0.96,,337.92,Percent of total billed charges,,,0.95,,334.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,334.4,Percent of total billed charges,,334.4,344.96,
"Test by nucleic acid for enterovirus, amplified",PX-30211001,CDM,87498,CPT,300,RC,,outpatient,,,352,316.8,,0.95,,334.4,Percent of total billed charges,,,0.98,,344.96,Percent of total billed charges,,,0.95,,334.4,Percent of total billed charges,,,0.95,,334.4,Percent of total billed charges,,,0.97,,341.44,Percent of total billed charges,,,0.96,,337.92,Percent of total billed charges,,,0.95,,334.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,334.4,Percent of total billed charges,,334.4,344.96,
Test by nucleic acid for Neisseria gonorrhoeae amplified,PX-30211006,CDM,87591,CPT,300,RC,,inpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
Test by nucleic acid for Neisseria gonorrhoeae amplified,PX-30211006,CDM,87591,CPT,300,RC,,outpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
"Test bynucleic acid for Hepatitis C virus, amplified",PX-30211012,CDM,87521,CPT,300,RC,,inpatient,,,176,158.4,,0.95,,167.2,Percent of total billed charges,,,0.98,,172.48,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,0.97,,170.72,Percent of total billed charges,,,0.97,,170.72,Percent of total billed charges,,,0.96,,168.96,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,167.2,Percent of total billed charges,,167.2,172.48,
"Test bynucleic acid for Hepatitis C virus, amplified",PX-30211012,CDM,87521,CPT,300,RC,,outpatient,,,176,158.4,,0.95,,167.2,Percent of total billed charges,,,0.98,,172.48,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,0.97,,170.72,Percent of total billed charges,,,0.96,,168.96,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,167.2,Percent of total billed charges,,167.2,172.48,
Analysis test by nucleic acid for Hepatitis C virus,PX-30211015,CDM,87902,CPT,300,RC,,inpatient,,,670,603,,0.95,,636.5,Percent of total billed charges,,,0.98,,656.6,Percent of total billed charges,,,0.95,,636.5,Percent of total billed charges,,,0.97,,649.9,Percent of total billed charges,,,0.97,,649.9,Percent of total billed charges,,,0.96,,643.2,Percent of total billed charges,,,0.95,,636.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,636.5,Percent of total billed charges,,636.5,656.6,
Analysis test by nucleic acid for Hepatitis C virus,PX-30211015,CDM,87902,CPT,300,RC,,outpatient,,,670,603,,0.95,,636.5,Percent of total billed charges,,,0.98,,656.6,Percent of total billed charges,,,0.95,,636.5,Percent of total billed charges,,,0.95,,636.5,Percent of total billed charges,,,0.97,,649.9,Percent of total billed charges,,,0.96,,643.2,Percent of total billed charges,,,0.95,,636.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,636.5,Percent of total billed charges,,636.5,656.6,
"Test bynucleic acid for herpes simplex virus, amplified",PX-30211017,CDM,87529,CPT,300,RC,,inpatient,,,261,234.9,,0.95,,247.95,Percent of total billed charges,,,0.98,,255.78,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,0.97,,253.17,Percent of total billed charges,,,0.97,,253.17,Percent of total billed charges,,,0.96,,250.56,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,247.95,Percent of total billed charges,,247.95,255.78,
"Test bynucleic acid for herpes simplex virus, amplified",PX-30211017,CDM,87529,CPT,300,RC,,outpatient,,,261,234.9,,0.95,,247.95,Percent of total billed charges,,,0.98,,255.78,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,0.97,,253.17,Percent of total billed charges,,,0.96,,250.56,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,247.95,Percent of total billed charges,,247.95,255.78,
Analysis test by nucleic acid for HIV-1 virus,PX-30211018,CDM,87901,CPT,300,RC,,inpatient,,,958,862.2,,0.95,,910.1,Percent of total billed charges,,,0.98,,938.84,Percent of total billed charges,,,0.95,,910.1,Percent of total billed charges,,,0.97,,929.26,Percent of total billed charges,,,0.97,,929.26,Percent of total billed charges,,,0.96,,919.68,Percent of total billed charges,,,0.95,,910.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,910.1,Percent of total billed charges,,910.1,938.84,
Analysis test by nucleic acid for HIV-1 virus,PX-30211018,CDM,87901,CPT,300,RC,,outpatient,,,958,862.2,,0.95,,910.1,Percent of total billed charges,,,0.98,,938.84,Percent of total billed charges,,,0.95,,910.1,Percent of total billed charges,,,0.95,,910.1,Percent of total billed charges,,,0.97,,929.26,Percent of total billed charges,,,0.96,,919.68,Percent of total billed charges,,,0.95,,910.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,910.1,Percent of total billed charges,,910.1,938.84,
"Test by nucleic acid for HIV-1 virus, quantification",PX-30211020,CDM,87536,CPT,300,RC,,inpatient,,,404,363.6,,0.95,,383.8,Percent of total billed charges,,,0.98,,395.92,Percent of total billed charges,,,0.95,,383.8,Percent of total billed charges,,,0.97,,391.88,Percent of total billed charges,,,0.97,,391.88,Percent of total billed charges,,,0.96,,387.84,Percent of total billed charges,,,0.95,,383.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,383.8,Percent of total billed charges,,383.8,395.92,
"Test by nucleic acid for HIV-1 virus, quantification",PX-30211020,CDM,87536,CPT,300,RC,,outpatient,,,404,363.6,,0.95,,383.8,Percent of total billed charges,,,0.98,,395.92,Percent of total billed charges,,,0.95,,383.8,Percent of total billed charges,,,0.95,,383.8,Percent of total billed charges,,,0.97,,391.88,Percent of total billed charges,,,0.96,,387.84,Percent of total billed charges,,,0.95,,383.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,383.8,Percent of total billed charges,,383.8,395.92,
"Test by nucleic acid for Staphylococcus aureus, MRSA",PX-30211050,CDM,87641,CPT,300,RC,,inpatient,,,161,144.9,,0.95,,152.95,Percent of total billed charges,,,0.98,,157.78,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.96,,154.56,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,152.95,Percent of total billed charges,,152.95,157.78,
"Test by nucleic acid for Staphylococcus aureus, MRSA",PX-30211050,CDM,87641,CPT,300,RC,,outpatient,,,161,144.9,,0.95,,152.95,Percent of total billed charges,,,0.98,,157.78,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.96,,154.56,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,152.95,Percent of total billed charges,,152.95,157.78,
"Antibody test, platelet associated immunoglobulin assay",PX-30211074,CDM,86023,CPT,302,RC,,inpatient,,,86,77.4,,0.95,,81.7,Percent of total billed charges,,,0.98,,84.28,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,0.97,,83.42,Percent of total billed charges,,,0.97,,83.42,Percent of total billed charges,,,0.96,,82.56,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,81.7,Percent of total billed charges,,81.7,84.28,
"Antibody test, platelet associated immunoglobulin assay",PX-30211074,CDM,86023,CPT,302,RC,,outpatient,,,86,77.4,,0.95,,81.7,Percent of total billed charges,,,0.98,,84.28,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,0.97,,83.42,Percent of total billed charges,,,0.96,,82.56,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,81.7,Percent of total billed charges,,81.7,84.28,
Immunologic analysis on body/other fluids w/ concentration,PX-30211079,CDM,86335,CPT,302,RC,,inpatient,,,132,118.8,,0.95,,125.4,Percent of total billed charges,,,0.98,,129.36,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.96,,126.72,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,125.4,Percent of total billed charges,,125.4,129.36,
Immunologic analysis on body/other fluids w/ concentration,PX-30211079,CDM,86335,CPT,302,RC,,outpatient,,,132,118.8,,0.95,,125.4,Percent of total billed charges,,,0.98,,129.36,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.96,,126.72,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,125.4,Percent of total billed charges,,125.4,129.36,
Screening test for red blood cell antibodies,PX-30211093,CDM,86850,CPT,302,RC,,inpatient,,,150,135,,0.95,,142.5,Percent of total billed charges,,,0.98,,147,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,0.97,,145.5,Percent of total billed charges,,,0.97,,145.5,Percent of total billed charges,,,0.96,,144,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,142.5,Percent of total billed charges,,142.5,147,
Screening test for red blood cell antibodies,PX-30211093,CDM,86850,CPT,302,RC,,outpatient,,,150,135,,0.95,,142.5,Percent of total billed charges,,,0.98,,147,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,0.97,,145.5,Percent of total billed charges,,,0.96,,144,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,142.5,Percent of total billed charges,,142.5,147,
Measurement for Strep antibody (strep throat),PX-30211128,CDM,86060,CPT,300,RC,,inpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
Measurement for Strep antibody (strep throat),PX-30211128,CDM,86060,CPT,300,RC,,outpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
"Measure antibody to assess autoimmune disorder, any method",PX-30211132,CDM,86235,CPT,302,RC,,inpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19,Percent of total billed charges,,19,19.6,
"Measure antibody to assess autoimmune disorder, any method",PX-30211132,CDM,86235,CPT,302,RC,,outpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19,Percent of total billed charges,,19,19.6,
"Measure antibody to assess autoimmune disorder, any method",PX-30211136,CDM,86235,CPT,300,RC,,inpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
"Measure antibody to assess autoimmune disorder, any method",PX-30211136,CDM,86235,CPT,300,RC,,outpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
Blood typing for Rh (D) antigen,PX-30211142,CDM,86901,CPT,302,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Blood typing for Rh (D) antigen,PX-30211142,CDM,86901,CPT,302,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Syphilis test,PX-30211505,CDM,86593,CPT,302,RC,,inpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
Syphilis test,PX-30211505,CDM,86593,CPT,302,RC,,outpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
"RBC sedimentation rate, to detect inflammation no-automated",PX-30510027,CDM,85651,CPT,305,RC,,inpatient,,,63,56.7,,0.95,,59.85,Percent of total billed charges,,,0.98,,61.74,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.96,,60.48,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,59.85,Percent of total billed charges,,59.85,61.74,
"RBC sedimentation rate, to detect inflammation no-automated",PX-30510027,CDM,85651,CPT,305,RC,,outpatient,,,63,56.7,,0.95,,59.85,Percent of total billed charges,,,0.98,,61.74,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.96,,60.48,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,59.85,Percent of total billed charges,,59.85,61.74,
"CBC, automated test and differential WBC count",PX-30510029,CDM,85025,CPT,305,RC,,inpatient,,,37,33.3,,0.95,,35.15,Percent of total billed charges,,,0.98,,36.26,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.96,,35.52,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,35.15,Percent of total billed charges,,35.15,36.26,
"CBC, automated test and differential WBC count",PX-30510029,CDM,85025,CPT,305,RC,,outpatient,,,37,33.3,,0.95,,35.15,Percent of total billed charges,,,0.98,,36.26,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.96,,35.52,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,35.15,Percent of total billed charges,,35.15,36.26,
"Blood test, clotting time",PX-30510032,CDM,85610,CPT,300,RC,,inpatient,,,97,87.3,,0.95,,92.15,Percent of total billed charges,,,0.98,,95.06,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,0.97,,94.09,Percent of total billed charges,,,0.97,,94.09,Percent of total billed charges,,,0.96,,93.12,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,92.15,Percent of total billed charges,,92.15,95.06,
"Blood test, clotting time",PX-30510032,CDM,85610,CPT,300,RC,,outpatient,,,97,87.3,,0.95,,92.15,Percent of total billed charges,,,0.98,,95.06,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,0.97,,94.09,Percent of total billed charges,,,0.96,,93.12,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,92.15,Percent of total billed charges,,92.15,95.06,
"Coagulation assessment blood test, plasma or whole blood",PX-30510033,CDM,85730,CPT,305,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"Coagulation assessment blood test, plasma or whole blood",PX-30510033,CDM,85730,CPT,305,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
Blood viscosity measurement,PX-30510035,CDM,85810,CPT,305,RC,,inpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
Blood viscosity measurement,PX-30510035,CDM,85810,CPT,305,RC,,outpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
Heparin assay,PX-30510038,CDM,85520,CPT,305,RC,,inpatient,,,261,234.9,,0.95,,247.95,Percent of total billed charges,,,0.98,,255.78,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,0.97,,253.17,Percent of total billed charges,,,0.97,,253.17,Percent of total billed charges,,,0.96,,250.56,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,247.95,Percent of total billed charges,,247.95,255.78,
Heparin assay,PX-30510038,CDM,85520,CPT,305,RC,,outpatient,,,261,234.9,,0.95,,247.95,Percent of total billed charges,,,0.98,,255.78,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,0.97,,253.17,Percent of total billed charges,,,0.96,,250.56,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,247.95,Percent of total billed charges,,247.95,255.78,
Clotting factor IX (PTC or Christmas) measurement,PX-30510040,CDM,85250,CPT,305,RC,,inpatient,,,149,134.1,,0.95,,141.55,Percent of total billed charges,,,0.98,,146.02,Percent of total billed charges,,,0.95,,141.55,Percent of total billed charges,,,0.97,,144.53,Percent of total billed charges,,,0.97,,144.53,Percent of total billed charges,,,0.96,,143.04,Percent of total billed charges,,,0.95,,141.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,141.55,Percent of total billed charges,,141.55,146.02,
Clotting factor IX (PTC or Christmas) measurement,PX-30510040,CDM,85250,CPT,305,RC,,outpatient,,,149,134.1,,0.95,,141.55,Percent of total billed charges,,,0.98,,146.02,Percent of total billed charges,,,0.95,,141.55,Percent of total billed charges,,,0.95,,141.55,Percent of total billed charges,,,0.97,,144.53,Percent of total billed charges,,,0.96,,143.04,Percent of total billed charges,,,0.95,,141.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,141.55,Percent of total billed charges,,141.55,146.02,
Red blood cell sickling measurement,PX-30510042,CDM,85660,CPT,305,RC,,inpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
Red blood cell sickling measurement,PX-30510042,CDM,85660,CPT,305,RC,,outpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
"Protein C, (clotting inhibitor) activity",PX-30510046,CDM,85302,CPT,305,RC,,inpatient,,,81,72.9,,0.95,,76.95,Percent of total billed charges,,,0.98,,79.38,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.96,,77.76,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76.95,Percent of total billed charges,,76.95,79.38,
"Protein C, (clotting inhibitor) activity",PX-30510046,CDM,85302,CPT,305,RC,,outpatient,,,81,72.9,,0.95,,76.95,Percent of total billed charges,,,0.98,,79.38,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.96,,77.76,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76.95,Percent of total billed charges,,76.95,79.38,
White blood cell count,PX-30510047,CDM,85004,CPT,305,RC,,inpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
White blood cell count,PX-30510047,CDM,85004,CPT,305,RC,,outpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
WBC alkaline phosphatase (enzyme) test w/cell count,PX-30510048,CDM,85540,CPT,305,RC,,inpatient,,,130,117,,0.95,,123.5,Percent of total billed charges,,,0.98,,127.4,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.96,,124.8,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,123.5,Percent of total billed charges,,123.5,127.4,
WBC alkaline phosphatase (enzyme) test w/cell count,PX-30510048,CDM,85540,CPT,305,RC,,outpatient,,,130,117,,0.95,,123.5,Percent of total billed charges,,,0.98,,127.4,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.96,,124.8,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,123.5,Percent of total billed charges,,123.5,127.4,
"Thrombin time, fibrinogen screening test, plasma",PX-30510050,CDM,85670,CPT,305,RC,,inpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
"Thrombin time, fibrinogen screening test, plasma",PX-30510050,CDM,85670,CPT,305,RC,,outpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
White blood cell enzyme activity measurement,PX-30510057,CDM,85549,CPT,305,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
White blood cell enzyme activity measurement,PX-30510057,CDM,85549,CPT,305,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
Fibrinogen (factor 1) activity measurement,PX-30510063,CDM,85384,CPT,305,RC,,inpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
Fibrinogen (factor 1) activity measurement,PX-30510063,CDM,85384,CPT,305,RC,,outpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
"Coagulation function measurement, D-dimer; quantitative",PX-30510069,CDM,85379,CPT,305,RC,,inpatient,,,49,44.1,,0.95,,46.55,Percent of total billed charges,,,0.98,,48.02,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.96,,47.04,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,46.55,Percent of total billed charges,,46.55,48.02,
"Coagulation function measurement, D-dimer; quantitative",PX-30510069,CDM,85379,CPT,305,RC,,outpatient,,,49,44.1,,0.95,,46.55,Percent of total billed charges,,,0.98,,48.02,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.96,,47.04,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,46.55,Percent of total billed charges,,46.55,48.02,
Protein S (clotting inhibitor) measurement,PX-30510071,CDM,85306,CPT,305,RC,,inpatient,,,121,108.9,,0.95,,114.95,Percent of total billed charges,,,0.98,,118.58,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.96,,116.16,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114.95,Percent of total billed charges,,114.95,118.58,
Protein S (clotting inhibitor) measurement,PX-30510071,CDM,85306,CPT,305,RC,,outpatient,,,121,108.9,,0.95,,114.95,Percent of total billed charges,,,0.98,,118.58,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.96,,116.16,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114.95,Percent of total billed charges,,114.95,118.58,
Clotting factor VIII (AHG) measurement,PX-30510072,CDM,85240,CPT,305,RC,,inpatient,,,128,115.2,,0.95,,121.6,Percent of total billed charges,,,0.98,,125.44,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.96,,122.88,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,121.6,Percent of total billed charges,,121.6,125.44,
Clotting factor VIII (AHG) measurement,PX-30510072,CDM,85240,CPT,305,RC,,outpatient,,,128,115.2,,0.95,,121.6,Percent of total billed charges,,,0.98,,125.44,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.96,,122.88,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,121.6,Percent of total billed charges,,121.6,125.44,
Protein C antigen (clotting inhibitor) measurement,PX-30510074,CDM,85303,CPT,305,RC,,inpatient,,,98,88.2,,0.95,,93.1,Percent of total billed charges,,,0.98,,96.04,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,0.97,,95.06,Percent of total billed charges,,,0.97,,95.06,Percent of total billed charges,,,0.96,,94.08,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,93.1,Percent of total billed charges,,93.1,96.04,
Protein C antigen (clotting inhibitor) measurement,PX-30510074,CDM,85303,CPT,305,RC,,outpatient,,,98,88.2,,0.95,,93.1,Percent of total billed charges,,,0.98,,96.04,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,0.97,,95.06,Percent of total billed charges,,,0.96,,94.08,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,93.1,Percent of total billed charges,,93.1,96.04,
"RBC sedimentation rate, to detect inflammation, automated",PX-30510076,CDM,85652,CPT,305,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
"RBC sedimentation rate, to detect inflammation, automated",PX-30510076,CDM,85652,CPT,305,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
"Red blood cell count, automated test",PX-30510077,CDM,85041,CPT,305,RC,,inpatient,,,36,32.4,,0.95,,34.2,Percent of total billed charges,,,0.98,,35.28,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.96,,34.56,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,34.2,Percent of total billed charges,,34.2,35.28,
"Red blood cell count, automated test",PX-30510077,CDM,85041,CPT,305,RC,,outpatient,,,36,32.4,,0.95,,34.2,Percent of total billed charges,,,0.98,,35.28,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.96,,34.56,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,34.2,Percent of total billed charges,,34.2,35.28,
"Coagulation function test, qualitative or semiquantitative",PX-30510080,CDM,85378,CPT,305,RC,,inpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
"Coagulation function test, qualitative or semiquantitative",PX-30510080,CDM,85378,CPT,305,RC,,outpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
"Platelet count, automated test",PX-30510082,CDM,85049,CPT,305,RC,,inpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
"Platelet count, automated test",PX-30510082,CDM,85049,CPT,305,RC,,outpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Activated protein resistance assay,PX-30510084,CDM,85307,CPT,305,RC,,inpatient,,,148,133.2,,0.95,,140.6,Percent of total billed charges,,,0.98,,145.04,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.96,,142.08,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,140.6,Percent of total billed charges,,140.6,145.04,
Activated protein resistance assay,PX-30510084,CDM,85307,CPT,305,RC,,outpatient,,,148,133.2,,0.95,,140.6,Percent of total billed charges,,,0.98,,145.04,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.96,,142.08,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,140.6,Percent of total billed charges,,140.6,145.04,
"Clotting factor X assessment test, undiluted",PX-30510094,CDM,85612,CPT,305,RC,,inpatient,,,204,183.6,,0.95,,193.8,Percent of total billed charges,,,0.98,,199.92,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.96,,195.84,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,193.8,Percent of total billed charges,,193.8,199.92,
"Clotting factor X assessment test, undiluted",PX-30510094,CDM,85612,CPT,305,RC,,outpatient,,,204,183.6,,0.95,,193.8,Percent of total billed charges,,,0.98,,199.92,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.96,,195.84,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,193.8,Percent of total billed charges,,193.8,199.92,
Protein C antigen (clotting inhibitor) measurement,PX-30510207,CDM,85303,CPT,305,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Protein C antigen (clotting inhibitor) measurement,PX-30510207,CDM,85303,CPT,305,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Protein S (clotting inhibitor) level,PX-30510231,CDM,85305,CPT,305,RC,,inpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
Protein S (clotting inhibitor) level,PX-30510231,CDM,85305,CPT,305,RC,,outpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
Protein S (clotting inhibitor) measurement,PX-30510233,CDM,85306,CPT,305,RC,,inpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
Protein S (clotting inhibitor) measurement,PX-30510233,CDM,85306,CPT,305,RC,,outpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
Tramadol level,PX-30110552,CDM,80373,CPT,301,RC,,inpatient,,,186,167.4,,0.95,,176.7,Percent of total billed charges,,,0.98,,182.28,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.96,,178.56,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,176.7,Percent of total billed charges,,176.7,182.28,
Tramadol level,PX-30110552,CDM,80373,CPT,301,RC,,outpatient,,,186,167.4,,0.95,,176.7,Percent of total billed charges,,,0.98,,182.28,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.96,,178.56,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,176.7,Percent of total billed charges,,176.7,182.28,
Automated white blood cell count,PX-30510310,CDM,85048,CPT,305,RC,,inpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
Automated white blood cell count,PX-30510310,CDM,85048,CPT,305,RC,,outpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
"Test by nucleic acid for Hepatitis C virus, quantification",PX-30610103,CDM,87522,CPT,306,RC,,inpatient,,,425,382.5,,0.95,,403.75,Percent of total billed charges,,,0.98,,416.5,Percent of total billed charges,,,0.95,,403.75,Percent of total billed charges,,,0.97,,412.25,Percent of total billed charges,,,0.97,,412.25,Percent of total billed charges,,,0.96,,408,Percent of total billed charges,,,0.95,,403.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,403.75,Percent of total billed charges,,403.75,416.5,
"Test by nucleic acid for Hepatitis C virus, quantification",PX-30610103,CDM,87522,CPT,306,RC,,outpatient,,,425,382.5,,0.95,,403.75,Percent of total billed charges,,,0.98,,416.5,Percent of total billed charges,,,0.95,,403.75,Percent of total billed charges,,,0.95,,403.75,Percent of total billed charges,,,0.97,,412.25,Percent of total billed charges,,,0.96,,408,Percent of total billed charges,,,0.95,,403.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,403.75,Percent of total billed charges,,403.75,416.5,
"Test by nucleic acid for Neisseria gonorrhoeae , amplified",PX-30610129,CDM,87591,CPT,306,RC,,inpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
"Test by nucleic acid for Neisseria gonorrhoeae , amplified",PX-30610129,CDM,87591,CPT,306,RC,,outpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
Detection test by immunoassay technique for rotavirus,PX-30610142,CDM,87425,CPT,306,RC,,inpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
Detection test by immunoassay technique for rotavirus,PX-30610142,CDM,87425,CPT,306,RC,,outpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
Test by immunoassay w/visual observation for RSV,PX-30610144,CDM,87807,CPT,306,RC,,inpatient,,,135,121.5,,0.95,,128.25,Percent of total billed charges,,,0.98,,132.3,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,0.97,,130.95,Percent of total billed charges,,,0.97,,130.95,Percent of total billed charges,,,0.96,,129.6,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,128.25,Percent of total billed charges,,128.25,132.3,
Test by immunoassay w/visual observation for RSV,PX-30610144,CDM,87807,CPT,306,RC,,outpatient,,,135,121.5,,0.95,,128.25,Percent of total billed charges,,,0.98,,132.3,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,0.97,,130.95,Percent of total billed charges,,,0.96,,129.6,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,128.25,Percent of total billed charges,,128.25,132.3,
Bacterial blood culture,PX-30610301,CDM,87040,CPT,300,RC,,inpatient,,,259,233.1,,0.95,,246.05,Percent of total billed charges,,,0.98,,253.82,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,0.97,,251.23,Percent of total billed charges,,,0.97,,251.23,Percent of total billed charges,,,0.96,,248.64,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,246.05,Percent of total billed charges,,246.05,253.82,
Bacterial blood culture,PX-30610301,CDM,87040,CPT,300,RC,,outpatient,,,259,233.1,,0.95,,246.05,Percent of total billed charges,,,0.98,,253.82,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,0.97,,251.23,Percent of total billed charges,,,0.96,,248.64,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,246.05,Percent of total billed charges,,246.05,253.82,
Stool culture,PX-30610304,CDM,87045,CPT,300,RC,,inpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Stool culture,PX-30610304,CDM,87045,CPT,300,RC,,outpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
"Bacterial culture, any other source except urine, blood",PX-30610321,CDM,87070,CPT,306,RC,,inpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
"Bacterial culture, any other source except urine, blood",PX-30610321,CDM,87070,CPT,306,RC,,outpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
Bacterial culture for anaerobic isolates,PX-30610356,CDM,87076,CPT,306,RC,,inpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
Bacterial culture for anaerobic isolates,PX-30610356,CDM,87076,CPT,306,RC,,outpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
HC Cul Bact Aerobic Addl Meths Definitive Ea Isol #,PX-30610359,CDM,87077,CPT,300,RC,,inpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
HC Cul Bact Aerobic Addl Meths Definitive Ea Isol #,PX-30610359,CDM,87077,CPT,300,RC,,outpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
Screening test for pathogenic organisms,PX-30610387,CDM,87081,CPT,300,RC,,inpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
Screening test for pathogenic organisms,PX-30610387,CDM,87081,CPT,300,RC,,outpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
"Bacterial colony count, urine",PX-30610417,CDM,87086,CPT,300,RC,,inpatient,,,130,117,,0.95,,123.5,Percent of total billed charges,,,0.98,,127.4,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.96,,124.8,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,123.5,Percent of total billed charges,,123.5,127.4,
"Bacterial colony count, urine",PX-30610417,CDM,87086,CPT,300,RC,,outpatient,,,130,117,,0.95,,123.5,Percent of total billed charges,,,0.98,,127.4,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.96,,124.8,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,123.5,Percent of total billed charges,,123.5,127.4,
Bacterial urine culture,PX-30610419,CDM,87088,CPT,300,RC,,inpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
Bacterial urine culture,PX-30610419,CDM,87088,CPT,300,RC,,outpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
"Fungal culture (mold or yeast) of skin, hair, or nail",PX-30610420,CDM,87101,CPT,300,RC,,inpatient,,,121,108.9,,0.95,,114.95,Percent of total billed charges,,,0.98,,118.58,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.96,,116.16,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114.95,Percent of total billed charges,,114.95,118.58,
"Fungal culture (mold or yeast) of skin, hair, or nail",PX-30610420,CDM,87101,CPT,300,RC,,outpatient,,,121,108.9,,0.95,,114.95,Percent of total billed charges,,,0.98,,118.58,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.96,,116.16,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114.95,Percent of total billed charges,,114.95,118.58,
Fungal culture (mold or yeast),PX-30610421,CDM,87102,CPT,300,RC,,inpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
Fungal culture (mold or yeast),PX-30610421,CDM,87102,CPT,300,RC,,outpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
Fungal culture yeast,PX-30610436,CDM,87106,CPT,300,RC,,inpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Fungal culture yeast,PX-30610436,CDM,87106,CPT,300,RC,,outpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Culture for acid-fast bacilli,PX-30610448,CDM,87116,CPT,300,RC,,inpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
Culture for acid-fast bacilli,PX-30610448,CDM,87116,CPT,300,RC,,outpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
Culture for acid-fast bacilli,PX-30610449,CDM,87116,CPT,306,RC,,inpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
Culture for acid-fast bacilli,PX-30610449,CDM,87116,CPT,306,RC,,outpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
Identify organisms by immunologic analysis,PX-30610463,CDM,87147,CPT,306,RC,,inpatient,,,22,19.8,,0.95,,20.9,Percent of total billed charges,,,0.98,,21.56,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.96,,21.12,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,20.9,Percent of total billed charges,,20.9,21.56,
Identify organisms by immunologic analysis,PX-30610463,CDM,87147,CPT,306,RC,,outpatient,,,22,19.8,,0.95,,20.9,Percent of total billed charges,,,0.98,,21.56,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.96,,21.12,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,20.9,Percent of total billed charges,,20.9,21.56,
Pinworm test,PX-30610477,CDM,87172,CPT,306,RC,,inpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19,Percent of total billed charges,,19,19.6,
Pinworm test,PX-30610477,CDM,87172,CPT,306,RC,,outpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19,Percent of total billed charges,,19,19.6,
Tissue preparation for culture,PX-30610479,CDM,87176,CPT,300,RC,,inpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
Tissue preparation for culture,PX-30610479,CDM,87176,CPT,300,RC,,outpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
"Evaluate antimicrobial drug, agar dilution",PX-30610483,CDM,87181,CPT,306,RC,,inpatient,,,10,9,,0.95,,9.5,Percent of total billed charges,,,0.98,,9.8,Percent of total billed charges,,,0.95,,9.5,Percent of total billed charges,,,0.97,,9.7,Percent of total billed charges,,,0.97,,9.7,Percent of total billed charges,,,0.96,,9.6,Percent of total billed charges,,,0.95,,9.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,9.5,Percent of total billed charges,,9.5,9.8,
"Evaluate antimicrobial drug, agar dilution",PX-30610483,CDM,87181,CPT,306,RC,,outpatient,,,10,9,,0.95,,9.5,Percent of total billed charges,,,0.98,,9.8,Percent of total billed charges,,,0.95,,9.5,Percent of total billed charges,,,0.95,,9.5,Percent of total billed charges,,,0.97,,9.7,Percent of total billed charges,,,0.96,,9.6,Percent of total billed charges,,,0.95,,9.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,9.5,Percent of total billed charges,,9.5,9.8,
Evaluate antimicrobial drug,PX-30610491,CDM,87184,CPT,306,RC,,inpatient,,,36,32.4,,0.95,,34.2,Percent of total billed charges,,,0.98,,35.28,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.96,,34.56,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,34.2,Percent of total billed charges,,34.2,35.28,
Evaluate antimicrobial drug,PX-30610491,CDM,87184,CPT,306,RC,,outpatient,,,36,32.4,,0.95,,34.2,Percent of total billed charges,,,0.98,,35.28,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.96,,34.56,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,34.2,Percent of total billed charges,,34.2,35.28,
HC Susceptiblty Stdy Antimicrbial Micro/Agar Dilutj #,PX-30610504,CDM,87186,CPT,300,RC,,inpatient,,,145,130.5,,0.95,,137.75,Percent of total billed charges,,,0.98,,142.1,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,0.97,,140.65,Percent of total billed charges,,,0.97,,140.65,Percent of total billed charges,,,0.96,,139.2,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,137.75,Percent of total billed charges,,137.75,142.1,
HC Susceptiblty Stdy Antimicrbial Micro/Agar Dilutj #,PX-30610504,CDM,87186,CPT,300,RC,,outpatient,,,145,130.5,,0.95,,137.75,Percent of total billed charges,,,0.98,,142.1,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,0.97,,140.65,Percent of total billed charges,,,0.96,,139.2,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,137.75,Percent of total billed charges,,137.75,142.1,
Evaluate antimicrobial drug,PX-30610551,CDM,87185,CPT,306,RC,,inpatient,,,14,12.6,,0.95,,13.3,Percent of total billed charges,,,0.98,,13.72,Percent of total billed charges,,,0.95,,13.3,Percent of total billed charges,,,0.97,,13.58,Percent of total billed charges,,,0.97,,13.58,Percent of total billed charges,,,0.96,,13.44,Percent of total billed charges,,,0.95,,13.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,13.3,Percent of total billed charges,,13.3,13.72,
Evaluate antimicrobial drug,PX-30610551,CDM,87185,CPT,306,RC,,outpatient,,,14,12.6,,0.95,,13.3,Percent of total billed charges,,,0.98,,13.72,Percent of total billed charges,,,0.95,,13.3,Percent of total billed charges,,,0.95,,13.3,Percent of total billed charges,,,0.97,,13.58,Percent of total billed charges,,,0.96,,13.44,Percent of total billed charges,,,0.95,,13.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,13.3,Percent of total billed charges,,13.3,13.72,
Special Gram or Giemsa stain for microorganism,PX-30610563,CDM,87205,CPT,300,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Special Gram or Giemsa stain for microorganism,PX-30610563,CDM,87205,CPT,300,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Tissue fungi or parasites,PX-30610575,CDM,87220,CPT,300,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Tissue fungi or parasites,PX-30610575,CDM,87220,CPT,300,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
HC Clostridium Ag Eia,PX-30610581,CDM,87324,CPT,306,RC,,inpatient,,,31,27.9,,0.95,,29.45,Percent of total billed charges,,,0.98,,30.38,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.96,,29.76,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,29.45,Percent of total billed charges,,29.45,30.38,
HC Clostridium Ag Eia,PX-30610581,CDM,87324,CPT,306,RC,,outpatient,,,31,27.9,,0.95,,29.45,Percent of total billed charges,,,0.98,,30.38,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.96,,29.76,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,29.45,Percent of total billed charges,,29.45,30.38,
Test byimmunoassay for Giardia (intestinal parasite),PX-30610583,CDM,87329,CPT,306,RC,,inpatient,,,121,108.9,,0.95,,114.95,Percent of total billed charges,,,0.98,,118.58,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.96,,116.16,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114.95,Percent of total billed charges,,114.95,118.58,
Test byimmunoassay for Giardia (intestinal parasite),PX-30610583,CDM,87329,CPT,306,RC,,outpatient,,,121,108.9,,0.95,,114.95,Percent of total billed charges,,,0.98,,118.58,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.96,,116.16,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114.95,Percent of total billed charges,,114.95,118.58,
Concentration of specimen for infectious agents,PX-30610599,CDM,87015,CPT,306,RC,,inpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
Concentration of specimen for infectious agents,PX-30610599,CDM,87015,CPT,306,RC,,outpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
"Stool culture, additional pathogens",PX-30610606,CDM,87046,CPT,306,RC,,inpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
"Stool culture, additional pathogens",PX-30610606,CDM,87046,CPT,306,RC,,outpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
Bacterial urine culture,PX-30610636,CDM,87088,CPT,306,RC,,inpatient,,,21,18.9,,0.95,,19.95,Percent of total billed charges,,,0.98,,20.58,Percent of total billed charges,,,0.95,,19.95,Percent of total billed charges,,,0.97,,20.37,Percent of total billed charges,,,0.97,,20.37,Percent of total billed charges,,,0.96,,20.16,Percent of total billed charges,,,0.95,,19.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19.95,Percent of total billed charges,,19.95,20.58,
Bacterial urine culture,PX-30610636,CDM,87088,CPT,306,RC,,outpatient,,,21,18.9,,0.95,,19.95,Percent of total billed charges,,,0.98,,20.58,Percent of total billed charges,,,0.95,,19.95,Percent of total billed charges,,,0.95,,19.95,Percent of total billed charges,,,0.97,,20.37,Percent of total billed charges,,,0.96,,20.16,Percent of total billed charges,,,0.95,,19.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19.95,Percent of total billed charges,,19.95,20.58,
HC H Pylori Antigen Stool,PX-30610663,CDM,87338,CPT,306,RC,,inpatient,,,134,120.6,,0.95,,127.3,Percent of total billed charges,,,0.98,,131.32,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,0.97,,129.98,Percent of total billed charges,,,0.97,,129.98,Percent of total billed charges,,,0.96,,128.64,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,127.3,Percent of total billed charges,,127.3,131.32,
HC H Pylori Antigen Stool,PX-30610663,CDM,87338,CPT,306,RC,,outpatient,,,134,120.6,,0.95,,127.3,Percent of total billed charges,,,0.98,,131.32,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,0.97,,129.98,Percent of total billed charges,,,0.96,,128.64,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,127.3,Percent of total billed charges,,127.3,131.32,
Special fluorescent/acid fast stain for microorganism,PX-30610665,CDM,87206,CPT,306,RC,,inpatient,,,31,27.9,,0.95,,29.45,Percent of total billed charges,,,0.98,,30.38,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.96,,29.76,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,29.45,Percent of total billed charges,,29.45,30.38,
Special fluorescent/acid fast stain for microorganism,PX-30610665,CDM,87206,CPT,306,RC,,outpatient,,,31,27.9,,0.95,,29.45,Percent of total billed charges,,,0.98,,30.38,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.96,,29.76,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,29.45,Percent of total billed charges,,29.45,30.38,
"Test by nucleic acid for clostridium difficile, amplified",PX-30610668,CDM,87493,CPT,306,RC,,inpatient,,,166,149.4,,0.95,,157.7,Percent of total billed charges,,,0.98,,162.68,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.96,,159.36,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,157.7,Percent of total billed charges,,157.7,162.68,
"Test by nucleic acid for clostridium difficile, amplified",PX-30610668,CDM,87493,CPT,306,RC,,outpatient,,,166,149.4,,0.95,,157.7,Percent of total billed charges,,,0.98,,162.68,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.96,,159.36,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,157.7,Percent of total billed charges,,157.7,162.68,
"White blood cell measure, stool specimen",PX-30010281,CDM,89055,CPT,300,RC,,inpatient,,,28,25.2,,0.95,,26.6,Percent of total billed charges,,,0.98,,27.44,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.96,,26.88,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,26.6,Percent of total billed charges,,26.6,27.44,
"White blood cell measure, stool specimen",PX-30010281,CDM,89055,CPT,300,RC,,outpatient,,,28,25.2,,0.95,,26.6,Percent of total billed charges,,,0.98,,27.44,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.96,,26.88,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,26.6,Percent of total billed charges,,26.6,27.44,
"Test by nucleic acid for Hepatitis B virus, quantification",PX-30610698,CDM,87517,CPT,306,RC,,inpatient,,,218,196.2,,0.95,,207.1,Percent of total billed charges,,,0.98,,213.64,Percent of total billed charges,,,0.95,,207.1,Percent of total billed charges,,,0.97,,211.46,Percent of total billed charges,,,0.97,,211.46,Percent of total billed charges,,,0.96,,209.28,Percent of total billed charges,,,0.95,,207.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,207.1,Percent of total billed charges,,207.1,213.64,
"Test by nucleic acid for Hepatitis B virus, quantification",PX-30610698,CDM,87517,CPT,306,RC,,outpatient,,,218,196.2,,0.95,,207.1,Percent of total billed charges,,,0.98,,213.64,Percent of total billed charges,,,0.95,,207.1,Percent of total billed charges,,,0.95,,207.1,Percent of total billed charges,,,0.97,,211.46,Percent of total billed charges,,,0.96,,209.28,Percent of total billed charges,,,0.95,,207.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,207.1,Percent of total billed charges,,207.1,213.64,
HC Iadna Bartonella Amplified Probe Technique,PX-30610966,CDM,87471,CPT,306,RC,,inpatient,,,126,113.4,,0.95,,119.7,Percent of total billed charges,,,0.98,,123.48,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.96,,120.96,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,119.7,Percent of total billed charges,,119.7,123.48,
HC Iadna Bartonella Amplified Probe Technique,PX-30610966,CDM,87471,CPT,306,RC,,outpatient,,,126,113.4,,0.95,,119.7,Percent of total billed charges,,,0.98,,123.48,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.96,,120.96,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,119.7,Percent of total billed charges,,119.7,123.48,
Automated urinalysis test,PX-30710008,CDM,81003,CPT,307,RC,,inpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
Automated urinalysis test,PX-30710008,CDM,81003,CPT,307,RC,,outpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
"Manual urinalysis test w/exam using microscope, automated",PX-30710009,CDM,81001,CPT,307,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
"Manual urinalysis test w/exam using microscope, automated",PX-30710009,CDM,81001,CPT,307,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Urinalysis using microscope,PX-30710010,CDM,81015,CPT,307,RC,,inpatient,,,17,15.3,,0.95,,16.15,Percent of total billed charges,,,0.98,,16.66,Percent of total billed charges,,,0.95,,16.15,Percent of total billed charges,,,0.97,,16.49,Percent of total billed charges,,,0.97,,16.49,Percent of total billed charges,,,0.96,,16.32,Percent of total billed charges,,,0.95,,16.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,16.15,Percent of total billed charges,,16.15,16.66,
Urinalysis using microscope,PX-30710010,CDM,81015,CPT,307,RC,,outpatient,,,17,15.3,,0.95,,16.15,Percent of total billed charges,,,0.98,,16.66,Percent of total billed charges,,,0.95,,16.15,Percent of total billed charges,,,0.95,,16.15,Percent of total billed charges,,,0.97,,16.49,Percent of total billed charges,,,0.96,,16.32,Percent of total billed charges,,,0.95,,16.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,16.15,Percent of total billed charges,,16.15,16.66,
"Stool fat or lipids analysis, qualitative",PX-30710011,CDM,82705,CPT,300,RC,,inpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
"Stool fat or lipids analysis, qualitative",PX-30710011,CDM,82705,CPT,300,RC,,outpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
"Semen evaluation volume, sperm count, motility and analysis",PX-30710102,CDM,89320,CPT,307,RC,,inpatient,,,204,183.6,,0.95,,193.8,Percent of total billed charges,,,0.98,,199.92,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.96,,195.84,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,193.8,Percent of total billed charges,,193.8,199.92,
"Semen evaluation volume, sperm count, motility and analysis",PX-30710102,CDM,89320,CPT,307,RC,,outpatient,,,204,183.6,,0.95,,193.8,Percent of total billed charges,,,0.98,,199.92,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.96,,195.84,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,193.8,Percent of total billed charges,,193.8,199.92,
"Bone marrow, smear interpretation",PX-31010027,CDM,85097,CPT,300,RC,,inpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
"Bone marrow, smear interpretation",PX-31010027,CDM,85097,CPT,300,RC,,outpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
"Microscopic genetic analysis of tissue, manual, initial",PX-31010217,CDM,88368,CPT,310,RC,,inpatient,,,364,327.6,,0.95,,345.8,Percent of total billed charges,,,0.98,,356.72,Percent of total billed charges,,,0.95,,345.8,Percent of total billed charges,,,0.97,,353.08,Percent of total billed charges,,,0.97,,353.08,Percent of total billed charges,,,0.96,,349.44,Percent of total billed charges,,,0.95,,345.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,345.8,Percent of total billed charges,,345.8,356.72,
"Microscopic genetic analysis of tissue, manual, initial",PX-31010217,CDM,88368,CPT,310,RC,,outpatient,,,364,327.6,,0.95,,345.8,Percent of total billed charges,,,0.98,,356.72,Percent of total billed charges,,,0.95,,345.8,Percent of total billed charges,,,0.95,,345.8,Percent of total billed charges,,,0.97,,353.08,Percent of total billed charges,,,0.96,,349.44,Percent of total billed charges,,,0.95,,345.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,345.8,Percent of total billed charges,,345.8,356.72,
"Pathology examination of tissue using a microscope, limited",PX-31010232,CDM,88300,CPT,310,RC,,inpatient,,,60,54,,0.95,,57,Percent of total billed charges,,,0.98,,58.8,Percent of total billed charges,,,0.95,,57,Percent of total billed charges,,,0.97,,58.2,Percent of total billed charges,,,0.97,,58.2,Percent of total billed charges,,,0.96,,57.6,Percent of total billed charges,,,0.95,,57,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57,Percent of total billed charges,,57,58.8,
"Pathology examination of tissue using a microscope, limited",PX-31010232,CDM,88300,CPT,310,RC,,outpatient,,,60,54,,0.95,,57,Percent of total billed charges,,,0.98,,58.8,Percent of total billed charges,,,0.95,,57,Percent of total billed charges,,,0.95,,57,Percent of total billed charges,,,0.97,,58.2,Percent of total billed charges,,,0.96,,57.6,Percent of total billed charges,,,0.95,,57,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57,Percent of total billed charges,,57,58.8,
"Chromosome analysis for genetic defects, count 15-20 cells",PX-31010281,CDM,88262,CPT,311,RC,,inpatient,,,203,182.7,,0.95,,192.85,Percent of total billed charges,,,0.98,,198.94,Percent of total billed charges,,,0.95,,192.85,Percent of total billed charges,,,0.97,,196.91,Percent of total billed charges,,,0.97,,196.91,Percent of total billed charges,,,0.96,,194.88,Percent of total billed charges,,,0.95,,192.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,192.85,Percent of total billed charges,,192.85,198.94,
"Chromosome analysis for genetic defects, count 15-20 cells",PX-31010281,CDM,88262,CPT,311,RC,,outpatient,,,203,182.7,,0.95,,192.85,Percent of total billed charges,,,0.98,,198.94,Percent of total billed charges,,,0.95,,192.85,Percent of total billed charges,,,0.95,,192.85,Percent of total billed charges,,,0.97,,196.91,Percent of total billed charges,,,0.96,,194.88,Percent of total billed charges,,,0.95,,192.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,192.85,Percent of total billed charges,,192.85,198.94,
Interpretation and report of genetic testing,PX-31010318,CDM,88291,CPT,311,RC,,inpatient,,,203,182.7,,0.95,,192.85,Percent of total billed charges,,,0.98,,198.94,Percent of total billed charges,,,0.95,,192.85,Percent of total billed charges,,,0.97,,196.91,Percent of total billed charges,,,0.97,,196.91,Percent of total billed charges,,,0.96,,194.88,Percent of total billed charges,,,0.95,,192.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,192.85,Percent of total billed charges,,192.85,198.94,
Interpretation and report of genetic testing,PX-31010318,CDM,88291,CPT,311,RC,,outpatient,,,203,182.7,,0.95,,192.85,Percent of total billed charges,,,0.98,,198.94,Percent of total billed charges,,,0.95,,192.85,Percent of total billed charges,,,0.95,,192.85,Percent of total billed charges,,,0.97,,196.91,Percent of total billed charges,,,0.96,,194.88,Percent of total billed charges,,,0.95,,192.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,192.85,Percent of total billed charges,,192.85,198.94,
Cell exam specimen selective cellular enhancement,PX-31010325,CDM,88112,CPT,311,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
Cell exam specimen selective cellular enhancement,PX-31010325,CDM,88112,CPT,311,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
Evaluation of fine needle aspirate,PX-31010330,CDM,88173,CPT,311,RC,,inpatient,,,145,130.5,,0.95,,137.75,Percent of total billed charges,,,0.98,,142.1,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,0.97,,140.65,Percent of total billed charges,,,0.97,,140.65,Percent of total billed charges,,,0.96,,139.2,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,137.75,Percent of total billed charges,,137.75,142.1,
Evaluation of fine needle aspirate,PX-31010330,CDM,88173,CPT,311,RC,,outpatient,,,145,130.5,,0.95,,137.75,Percent of total billed charges,,,0.98,,142.1,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,0.97,,140.65,Percent of total billed charges,,,0.96,,139.2,Percent of total billed charges,,,0.95,,137.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,137.75,Percent of total billed charges,,137.75,142.1,
"Cell examination of specimen, concentration technique",PX-31010339,CDM,88108,CPT,311,RC,,inpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
"Cell examination of specimen, concentration technique",PX-31010339,CDM,88108,CPT,311,RC,,outpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
Prep tissue for examination by removing any calcium present,PX-31010341,CDM,88311,CPT,310,RC,,inpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
Prep tissue for examination by removing any calcium present,PX-31010341,CDM,88311,CPT,310,RC,,outpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
"Antibody evaluation, initial single antibody stain",PX-31010379,CDM,88346,CPT,310,RC,,inpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
"Antibody evaluation, initial single antibody stain",PX-31010379,CDM,88346,CPT,310,RC,,outpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Special stained specimen slides to examine tissue initial,PX-31010386,CDM,88342,CPT,310,RC,,inpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
Special stained specimen slides to examine tissue initial,PX-31010386,CDM,88342,CPT,310,RC,,outpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
Genetic sequencing localization initial procedure,PX-31010391,CDM,88365,CPT,310,RC,,inpatient,,,249,224.1,,0.95,,236.55,Percent of total billed charges,,,0.98,,244.02,Percent of total billed charges,,,0.95,,236.55,Percent of total billed charges,,,0.97,,241.53,Percent of total billed charges,,,0.97,,241.53,Percent of total billed charges,,,0.96,,239.04,Percent of total billed charges,,,0.95,,236.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,236.55,Percent of total billed charges,,236.55,244.02,
Genetic sequencing localization initial procedure,PX-31010391,CDM,88365,CPT,310,RC,,outpatient,,,249,224.1,,0.95,,236.55,Percent of total billed charges,,,0.98,,244.02,Percent of total billed charges,,,0.95,,236.55,Percent of total billed charges,,,0.95,,236.55,Percent of total billed charges,,,0.97,,241.53,Percent of total billed charges,,,0.96,,239.04,Percent of total billed charges,,,0.95,,236.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,236.55,Percent of total billed charges,,236.55,244.02,
"Chromosome analysis for genetic defects, 100-300 cells",PX-31010403,CDM,88275,CPT,311,RC,,inpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
"Chromosome analysis for genetic defects, 100-300 cells",PX-31010403,CDM,88275,CPT,311,RC,,outpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
Surgical pathology consult/report on referred material,PX-31010429,CDM,88323,CPT,310,RC,,inpatient,,,412,370.8,,0.95,,391.4,Percent of total billed charges,,,0.98,,403.76,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.96,,395.52,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,391.4,Percent of total billed charges,,391.4,403.76,
Surgical pathology consult/report on referred material,PX-31010429,CDM,88323,CPT,310,RC,,outpatient,,,412,370.8,,0.95,,391.4,Percent of total billed charges,,,0.98,,403.76,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.96,,395.52,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,391.4,Percent of total billed charges,,391.4,403.76,
DNA testing for genetic defects,PX-31010443,CDM,88271,CPT,311,RC,,inpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
DNA testing for genetic defects,PX-31010443,CDM,88271,CPT,311,RC,,outpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
Special stained specimen slides to identify organisms,PX-31010498,CDM,88312,CPT,310,RC,,inpatient,,,181,162.9,,0.95,,171.95,Percent of total billed charges,,,0.98,,177.38,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,0.97,,175.57,Percent of total billed charges,,,0.97,,175.57,Percent of total billed charges,,,0.96,,173.76,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,171.95,Percent of total billed charges,,171.95,177.38,
Special stained specimen slides to identify organisms,PX-31010498,CDM,88312,CPT,310,RC,,outpatient,,,181,162.9,,0.95,,171.95,Percent of total billed charges,,,0.98,,177.38,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,0.97,,175.57,Percent of total billed charges,,,0.96,,173.76,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,171.95,Percent of total billed charges,,171.95,177.38,
Special stained specimen slides to examine tissue,PX-31010500,CDM,88313,CPT,310,RC,,inpatient,,,155,139.5,,0.95,,147.25,Percent of total billed charges,,,0.98,,151.9,Percent of total billed charges,,,0.95,,147.25,Percent of total billed charges,,,0.97,,150.35,Percent of total billed charges,,,0.97,,150.35,Percent of total billed charges,,,0.96,,148.8,Percent of total billed charges,,,0.95,,147.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,147.25,Percent of total billed charges,,147.25,151.9,
Special stained specimen slides to examine tissue,PX-31010500,CDM,88313,CPT,310,RC,,outpatient,,,155,139.5,,0.95,,147.25,Percent of total billed charges,,,0.98,,151.9,Percent of total billed charges,,,0.95,,147.25,Percent of total billed charges,,,0.95,,147.25,Percent of total billed charges,,,0.97,,150.35,Percent of total billed charges,,,0.96,,148.8,Percent of total billed charges,,,0.95,,147.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,147.25,Percent of total billed charges,,147.25,151.9,
Pathology examination of tissue using a microscope,PX-31010520,CDM,88302,CPT,310,RC,,inpatient,,,150,135,,0.95,,142.5,Percent of total billed charges,,,0.98,,147,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,0.97,,145.5,Percent of total billed charges,,,0.97,,145.5,Percent of total billed charges,,,0.96,,144,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,142.5,Percent of total billed charges,,142.5,147,
Pathology examination of tissue using a microscope,PX-31010520,CDM,88302,CPT,310,RC,,outpatient,,,150,135,,0.95,,142.5,Percent of total billed charges,,,0.98,,147,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,0.97,,145.5,Percent of total billed charges,,,0.96,,144,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,142.5,Percent of total billed charges,,142.5,147,
Pathology exam tissue moderately low complexity,PX-31010522,CDM,88304,CPT,310,RC,,inpatient,,,181,162.9,,0.95,,171.95,Percent of total billed charges,,,0.98,,177.38,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,0.97,,175.57,Percent of total billed charges,,,0.97,,175.57,Percent of total billed charges,,,0.96,,173.76,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,171.95,Percent of total billed charges,,171.95,177.38,
Pathology exam tissue moderately low complexity,PX-31010522,CDM,88304,CPT,310,RC,,outpatient,,,181,162.9,,0.95,,171.95,Percent of total billed charges,,,0.98,,177.38,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,0.97,,175.57,Percent of total billed charges,,,0.96,,173.76,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,171.95,Percent of total billed charges,,171.95,177.38,
Pathology exam tissue w/microscope intermediate complexity,PX-31010524,CDM,88305,CPT,310,RC,,inpatient,,,177,159.3,,0.95,,168.15,Percent of total billed charges,,,0.98,,173.46,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.96,,169.92,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,168.15,Percent of total billed charges,,168.15,173.46,
Pathology exam tissue w/microscope intermediate complexity,PX-31010524,CDM,88305,CPT,310,RC,,outpatient,,,177,159.3,,0.95,,168.15,Percent of total billed charges,,,0.98,,173.46,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.96,,169.92,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,168.15,Percent of total billed charges,,168.15,173.46,
Pathology examination of tissue using a microscope,PX-31010531,CDM,88307,CPT,310,RC,,inpatient,,,438,394.2,,0.95,,416.1,Percent of total billed charges,,,0.98,,429.24,Percent of total billed charges,,,0.95,,416.1,Percent of total billed charges,,,0.97,,424.86,Percent of total billed charges,,,0.97,,424.86,Percent of total billed charges,,,0.96,,420.48,Percent of total billed charges,,,0.95,,416.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,416.1,Percent of total billed charges,,416.1,429.24,
Pathology examination of tissue using a microscope,PX-31010531,CDM,88307,CPT,310,RC,,outpatient,,,438,394.2,,0.95,,416.1,Percent of total billed charges,,,0.98,,429.24,Percent of total billed charges,,,0.95,,416.1,Percent of total billed charges,,,0.95,,416.1,Percent of total billed charges,,,0.97,,424.86,Percent of total billed charges,,,0.96,,420.48,Percent of total billed charges,,,0.95,,416.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,416.1,Percent of total billed charges,,416.1,429.24,
Pathology examination of tissue using a microscope,PX-31010536,CDM,88309,CPT,310,RC,,inpatient,,,515,463.5,,0.95,,489.25,Percent of total billed charges,,,0.98,,504.7,Percent of total billed charges,,,0.95,,489.25,Percent of total billed charges,,,0.97,,499.55,Percent of total billed charges,,,0.97,,499.55,Percent of total billed charges,,,0.96,,494.4,Percent of total billed charges,,,0.95,,489.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,489.25,Percent of total billed charges,,489.25,504.7,
Pathology examination of tissue using a microscope,PX-31010536,CDM,88309,CPT,310,RC,,outpatient,,,515,463.5,,0.95,,489.25,Percent of total billed charges,,,0.98,,504.7,Percent of total billed charges,,,0.95,,489.25,Percent of total billed charges,,,0.95,,489.25,Percent of total billed charges,,,0.97,,499.55,Percent of total billed charges,,,0.96,,494.4,Percent of total billed charges,,,0.95,,489.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,489.25,Percent of total billed charges,,489.25,504.7,
Tissue culture to identify white blood cell disorders,PX-31010546,CDM,88230,CPT,311,RC,,inpatient,,,203,182.7,,0.95,,192.85,Percent of total billed charges,,,0.98,,198.94,Percent of total billed charges,,,0.95,,192.85,Percent of total billed charges,,,0.97,,196.91,Percent of total billed charges,,,0.97,,196.91,Percent of total billed charges,,,0.96,,194.88,Percent of total billed charges,,,0.95,,192.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,192.85,Percent of total billed charges,,192.85,198.94,
Tissue culture to identify white blood cell disorders,PX-31010546,CDM,88230,CPT,311,RC,,outpatient,,,203,182.7,,0.95,,192.85,Percent of total billed charges,,,0.98,,198.94,Percent of total billed charges,,,0.95,,192.85,Percent of total billed charges,,,0.95,,192.85,Percent of total billed charges,,,0.97,,196.91,Percent of total billed charges,,,0.96,,194.88,Percent of total billed charges,,,0.95,,192.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,192.85,Percent of total billed charges,,192.85,198.94,
Microscopic genetic analysis of tumor manual,PX-31010566,CDM,88360,CPT,310,RC,,inpatient,,,164,147.6,,0.95,,155.8,Percent of total billed charges,,,0.98,,160.72,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.96,,157.44,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,155.8,Percent of total billed charges,,155.8,160.72,
Microscopic genetic analysis of tumor manual,PX-31010566,CDM,88360,CPT,310,RC,,outpatient,,,164,147.6,,0.95,,155.8,Percent of total billed charges,,,0.98,,160.72,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.96,,157.44,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,155.8,Percent of total billed charges,,155.8,160.72,
"Pap test, manual screening",PX-31110033,CDM,88142,CPT,311,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"Pap test, manual screening",PX-31110033,CDM,88142,CPT,311,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"Test by nucleic acid for Staphylococcus aureus , amplified",PX-30610185,CDM,87640,CPT,306,RC,,inpatient,,,115,103.5,,0.95,,109.25,Percent of total billed charges,,,0.98,,112.7,Percent of total billed charges,,,0.95,,109.25,Percent of total billed charges,,,0.97,,111.55,Percent of total billed charges,,,0.97,,111.55,Percent of total billed charges,,,0.96,,110.4,Percent of total billed charges,,,0.95,,109.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,109.25,Percent of total billed charges,,109.25,112.7,
"Test by nucleic acid for Staphylococcus aureus , amplified",PX-30610185,CDM,87640,CPT,306,RC,,outpatient,,,115,103.5,,0.95,,109.25,Percent of total billed charges,,,0.98,,112.7,Percent of total billed charges,,,0.95,,109.25,Percent of total billed charges,,,0.95,,109.25,Percent of total billed charges,,,0.97,,111.55,Percent of total billed charges,,,0.96,,110.4,Percent of total billed charges,,,0.95,,109.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,109.25,Percent of total billed charges,,109.25,112.7,
HC PR 81025 Urine Pregnancy Test,PX-96910019,CDM,81025,CPT,983,RC,,inpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
HC PR 81025 Urine Pregnancy Test,PX-96910019,CDM,81025,CPT,983,RC,,outpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
HC PR 82962 Glucose Blood Test,PX-96910020,CDM,82962,CPT,983,RC,,inpatient,,,21,18.9,,0.95,,19.95,Percent of total billed charges,,,0.98,,20.58,Percent of total billed charges,,,0.95,,19.95,Percent of total billed charges,,,0.97,,20.37,Percent of total billed charges,,,0.97,,20.37,Percent of total billed charges,,,0.96,,20.16,Percent of total billed charges,,,0.95,,19.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19.95,Percent of total billed charges,,19.95,20.58,
HC PR 82962 Glucose Blood Test,PX-96910020,CDM,82962,CPT,983,RC,,outpatient,,,21,18.9,,0.95,,19.95,Percent of total billed charges,,,0.98,,20.58,Percent of total billed charges,,,0.95,,19.95,Percent of total billed charges,,,0.95,,19.95,Percent of total billed charges,,,0.97,,20.37,Percent of total billed charges,,,0.96,,20.16,Percent of total billed charges,,,0.95,,19.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19.95,Percent of total billed charges,,19.95,20.58,
Skin Test Tuberculosis Intradermal,PX-96910026,CDM,86580,CPT,983,RC,,inpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
Skin Test Tuberculosis Intradermal,PX-96910026,CDM,86580,CPT,983,RC,,outpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
HC Bougie Introducer #9-0212-70,PX-3254184WWM,CDM,3254184WWM,LOCAL,270,RC,,inpatient,,,40,36,,0.95,,38,Percent of total billed charges,,,0.98,,39.2,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.96,,38.4,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38,Percent of total billed charges,,38,39.2,
HC Bougie Introducer #9-0212-70,PX-3254184WWM,CDM,3254184WWM,LOCAL,270,RC,,outpatient,,,40,36,,0.95,,38,Percent of total billed charges,,,0.98,,39.2,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.96,,38.4,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38,Percent of total billed charges,,38,39.2,
HC Abd Binder Xxl #79-89210,PX-3254185WWM,CDM,3254185WWM,LOCAL,270,RC,,inpatient,,,40,36,,0.95,,38,Percent of total billed charges,,,0.98,,39.2,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.96,,38.4,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38,Percent of total billed charges,,38,39.2,
HC Abd Binder Xxl #79-89210,PX-3254185WWM,CDM,3254185WWM,LOCAL,270,RC,,outpatient,,,40,36,,0.95,,38,Percent of total billed charges,,,0.98,,39.2,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.96,,38.4,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38,Percent of total billed charges,,38,39.2,
HC PR 19000 Drainage of Breast Lesion,PX-97210303,CDM,19000,CPT,972,RC,,inpatient,,,247,222.3,,0.95,,234.65,Percent of total billed charges,,,0.98,,242.06,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.96,,237.12,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,234.65,Percent of total billed charges,,234.65,242.06,
HC PR 19000 Drainage of Breast Lesion,PX-97210303,CDM,19000,CPT,972,RC,,outpatient,,,247,222.3,,0.95,,234.65,Percent of total billed charges,,,0.98,,242.06,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.96,,237.12,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,234.65,Percent of total billed charges,,234.65,242.06,
HC PR 12002 Repair Superficial Wound(S) 2.6 to 7.5cm Slp Nk Ax Exgen T,PX-98310360,CDM,12002,CPT,983,RC,,inpatient,,,282,253.8,,0.95,,267.9,Percent of total billed charges,,,0.98,,276.36,Percent of total billed charges,,,0.95,,267.9,Percent of total billed charges,,,0.97,,273.54,Percent of total billed charges,,,0.97,,273.54,Percent of total billed charges,,,0.96,,270.72,Percent of total billed charges,,,0.95,,267.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,267.9,Percent of total billed charges,,267.9,276.36,
HC PR 12002 Repair Superficial Wound(S) 2.6 to 7.5cm Slp Nk Ax Exgen T,PX-98310360,CDM,12002,CPT,983,RC,,outpatient,,,282,253.8,,0.95,,267.9,Percent of total billed charges,,,0.98,,276.36,Percent of total billed charges,,,0.95,,267.9,Percent of total billed charges,,,0.95,,267.9,Percent of total billed charges,,,0.97,,273.54,Percent of total billed charges,,,0.96,,270.72,Percent of total billed charges,,,0.95,,267.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,267.9,Percent of total billed charges,,267.9,276.36,
HC PR 30901 Control of Nosebleed Simple,PX-98311005,CDM,30901,CPT,983,RC,,inpatient,,,385,346.5,,0.95,,365.75,Percent of total billed charges,,,0.98,,377.3,Percent of total billed charges,,,0.95,,365.75,Percent of total billed charges,,,0.97,,373.45,Percent of total billed charges,,,0.97,,373.45,Percent of total billed charges,,,0.96,,369.6,Percent of total billed charges,,,0.95,,365.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,365.75,Percent of total billed charges,,365.75,377.3,
HC PR 30901 Control of Nosebleed Simple,PX-98311005,CDM,30901,CPT,983,RC,,outpatient,,,385,346.5,,0.95,,365.75,Percent of total billed charges,,,0.98,,377.3,Percent of total billed charges,,,0.95,,365.75,Percent of total billed charges,,,0.95,,365.75,Percent of total billed charges,,,0.97,,373.45,Percent of total billed charges,,,0.96,,369.6,Percent of total billed charges,,,0.95,,365.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,365.75,Percent of total billed charges,,365.75,377.3,
HC PR 27788 Closed Treatment of Ankle Fracture W/Manip,PX-98311017,CDM,27788,CPT,983,RC,,inpatient,,,1552,1396.8,,0.95,,1474.4,Percent of total billed charges,,,0.98,,1520.96,Percent of total billed charges,,,0.95,,1474.4,Percent of total billed charges,,,0.97,,1505.44,Percent of total billed charges,,,0.97,,1505.44,Percent of total billed charges,,,0.96,,1489.92,Percent of total billed charges,,,0.95,,1474.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1474.4,Percent of total billed charges,,1474.4,1520.96,
HC PR 27788 Closed Treatment of Ankle Fracture W/Manip,PX-98311017,CDM,27788,CPT,983,RC,,outpatient,,,1552,1396.8,,0.95,,1474.4,Percent of total billed charges,,,0.98,,1520.96,Percent of total billed charges,,,0.95,,1474.4,Percent of total billed charges,,,0.95,,1474.4,Percent of total billed charges,,,0.97,,1505.44,Percent of total billed charges,,,0.96,,1489.92,Percent of total billed charges,,,0.95,,1474.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1474.4,Percent of total billed charges,,1474.4,1520.96,
HC PR 20551 Injection Single Tendon Origin/Insertion,PX-98311030,CDM,20551,CPT,983,RC,,inpatient,,,142,127.8,,0.95,,134.9,Percent of total billed charges,,,0.98,,139.16,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,0.97,,137.74,Percent of total billed charges,,,0.97,,137.74,Percent of total billed charges,,,0.96,,136.32,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,134.9,Percent of total billed charges,,134.9,139.16,
HC PR 20551 Injection Single Tendon Origin/Insertion,PX-98311030,CDM,20551,CPT,983,RC,,outpatient,,,142,127.8,,0.95,,134.9,Percent of total billed charges,,,0.98,,139.16,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,0.97,,137.74,Percent of total billed charges,,,0.96,,136.32,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,134.9,Percent of total billed charges,,134.9,139.16,
HC PR 37609 Temporal Artery Procedure,PX-98311035,CDM,37609,CPT,983,RC,,inpatient,,,764,687.6,,0.95,,725.8,Percent of total billed charges,,,0.98,,748.72,Percent of total billed charges,,,0.95,,725.8,Percent of total billed charges,,,0.97,,741.08,Percent of total billed charges,,,0.97,,741.08,Percent of total billed charges,,,0.96,,733.44,Percent of total billed charges,,,0.95,,725.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,725.8,Percent of total billed charges,,725.8,748.72,
HC PR 37609 Temporal Artery Procedure,PX-98311035,CDM,37609,CPT,983,RC,,outpatient,,,764,687.6,,0.95,,725.8,Percent of total billed charges,,,0.98,,748.72,Percent of total billed charges,,,0.95,,725.8,Percent of total billed charges,,,0.95,,725.8,Percent of total billed charges,,,0.97,,741.08,Percent of total billed charges,,,0.96,,733.44,Percent of total billed charges,,,0.95,,725.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,725.8,Percent of total billed charges,,725.8,748.72,
HC PR Admin Vaccine Initial,PX-77110225,CDM,90471,CPT,771,RC,,inpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
HC PR Admin Vaccine Initial,PX-77110225,CDM,90471,CPT,771,RC,,outpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
"Administration of vaccine, each additional",PX-77110226,CDM,90472,CPT,771,RC,,inpatient,,,37,33.3,,0.95,,35.15,Percent of total billed charges,,,0.98,,36.26,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.96,,35.52,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,35.15,Percent of total billed charges,,35.15,36.26,
"Administration of vaccine, each additional",PX-77110226,CDM,90472,CPT,771,RC,,outpatient,,,37,33.3,,0.95,,35.15,Percent of total billed charges,,,0.98,,36.26,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.96,,35.52,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,35.15,Percent of total billed charges,,35.15,36.26,
HC PR Admin Vaccine Initial Intranasal/Oral,PX-77110227,CDM,90473,CPT,771,RC,,inpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
HC PR Admin Vaccine Initial Intranasal/Oral,PX-77110227,CDM,90473,CPT,771,RC,,outpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
HC PR Admin Vaccine Initial Intranasal/Oral Ea Addl,PX-77110228,CDM,90474,CPT,771,RC,,inpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
HC PR Admin Vaccine Initial Intranasal/Oral Ea Addl,PX-77110228,CDM,90474,CPT,771,RC,,outpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
HC PR Admin Vaccine Initial Vfc,PX-77110229,CDM,90471,CPT,771,RC,,inpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,0.01,Percent of total billed charges,,0.01,0.01,
HC PR Admin Vaccine Initial Vfc,PX-77110229,CDM,90471,CPT,771,RC,,outpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,0.01,Percent of total billed charges,,0.01,0.01,
HC PR Admin Vaccine Ea Addl Vfc,PX-77110230,CDM,90472,CPT,771,RC,,inpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,0.01,Percent of total billed charges,,0.01,0.01,
HC PR Admin Vaccine Ea Addl Vfc,PX-77110230,CDM,90472,CPT,771,RC,,outpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,0.01,Percent of total billed charges,,0.01,0.01,
HC PR Admin Vaccine Initial Intranasal/Oral Vfc,PX-77110231,CDM,90473,CPT,771,RC,,inpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,0.01,Percent of total billed charges,,0.01,0.01,
HC PR Admin Vaccine Initial Intranasal/Oral Vfc,PX-77110231,CDM,90473,CPT,771,RC,,outpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,0.01,Percent of total billed charges,,0.01,0.01,
HC PR Admin Vaccine Initial Intranasal/Oral Ea Addl Vfc,PX-77110232,CDM,90474,CPT,771,RC,,inpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,0.01,Percent of total billed charges,,0.01,0.01,
HC PR Admin Vaccine Initial Intranasal/Oral Ea Addl Vfc,PX-77110232,CDM,90474,CPT,771,RC,,outpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,0.01,Percent of total billed charges,,0.01,0.01,
HC PR Admin Vaccine Influenza,PX-77110233,CDM,90471,CPT,771,RC,,inpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
HC PR Admin Vaccine Influenza,PX-77110233,CDM,90471,CPT,771,RC,,outpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
HC PR Admin Vaccine Hepatitis B,PX-77110235,CDM,90471,CPT,771,RC,,inpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
HC PR Admin Vaccine Hepatitis B,PX-77110235,CDM,90471,CPT,771,RC,,outpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
"IVinto tissue for therapy, 1 hour or less",PX-45010739,CDM,96369,CPT,450,RC,,inpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
"IVinto tissue for therapy, 1 hour or less",PX-45010739,CDM,96369,CPT,450,RC,,outpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
"Inhalation for acute airway obstruction, each additional hr",PX-41210044,CDM,94645,CPT,410,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
"Inhalation for acute airway obstruction, each additional hr",PX-41210044,CDM,94645,CPT,410,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
HC Ted Sox Knee Sm Long Mds160628h,PX-3254187WWM,CDM,3254187WWM,LOCAL,270,RC,,inpatient,,,49,44.1,,0.95,,46.55,Percent of total billed charges,,,0.98,,48.02,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.96,,47.04,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,46.55,Percent of total billed charges,,46.55,48.02,
HC Ted Sox Knee Sm Long Mds160628h,PX-3254187WWM,CDM,3254187WWM,LOCAL,270,RC,,outpatient,,,49,44.1,,0.95,,46.55,Percent of total billed charges,,,0.98,,48.02,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.96,,47.04,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,46.55,Percent of total billed charges,,46.55,48.02,
HC Ted Sox Knee MD Long Mds160648h,PX-3254188WWM,CDM,3254188WWM,LOCAL,270,RC,,inpatient,,,48,43.2,,0.95,,45.6,Percent of total billed charges,,,0.98,,47.04,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.96,,46.08,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,45.6,Percent of total billed charges,,45.6,47.04,
HC Ted Sox Knee MD Long Mds160648h,PX-3254188WWM,CDM,3254188WWM,LOCAL,270,RC,,outpatient,,,48,43.2,,0.95,,45.6,Percent of total billed charges,,,0.98,,47.04,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.96,,46.08,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,45.6,Percent of total billed charges,,45.6,47.04,
HC Urinary Drain Bag Kdl3057h,PX-3254189WWM,CDM,3254189WWM,LOCAL,270,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC Urinary Drain Bag Kdl3057h,PX-3254189WWM,CDM,3254189WWM,LOCAL,270,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC Electrode Zoll Ped 8900 000220 01,PX-3254190WWM,CDM,3254190WWM,LOCAL,270,RC,,inpatient,,,265,238.5,,0.95,,251.75,Percent of total billed charges,,,0.98,,259.7,Percent of total billed charges,,,0.95,,251.75,Percent of total billed charges,,,0.97,,257.05,Percent of total billed charges,,,0.97,,257.05,Percent of total billed charges,,,0.96,,254.4,Percent of total billed charges,,,0.95,,251.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,251.75,Percent of total billed charges,,251.75,259.7,
HC Electrode Zoll Ped 8900 000220 01,PX-3254190WWM,CDM,3254190WWM,LOCAL,270,RC,,outpatient,,,265,238.5,,0.95,,251.75,Percent of total billed charges,,,0.98,,259.7,Percent of total billed charges,,,0.95,,251.75,Percent of total billed charges,,,0.95,,251.75,Percent of total billed charges,,,0.97,,257.05,Percent of total billed charges,,,0.96,,254.4,Percent of total billed charges,,,0.95,,251.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,251.75,Percent of total billed charges,,251.75,259.7,
HC Electrode Zoll Adt 8900 0214 01,PX-3254191WWM,CDM,3254191WWM,LOCAL,270,RC,,inpatient,,,279,251.1,,0.95,,265.05,Percent of total billed charges,,,0.98,,273.42,Percent of total billed charges,,,0.95,,265.05,Percent of total billed charges,,,0.97,,270.63,Percent of total billed charges,,,0.97,,270.63,Percent of total billed charges,,,0.96,,267.84,Percent of total billed charges,,,0.95,,265.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,265.05,Percent of total billed charges,,265.05,273.42,
HC Electrode Zoll Adt 8900 0214 01,PX-3254191WWM,CDM,3254191WWM,LOCAL,270,RC,,outpatient,,,279,251.1,,0.95,,265.05,Percent of total billed charges,,,0.98,,273.42,Percent of total billed charges,,,0.95,,265.05,Percent of total billed charges,,,0.95,,265.05,Percent of total billed charges,,,0.97,,270.63,Percent of total billed charges,,,0.96,,267.84,Percent of total billed charges,,,0.95,,265.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,265.05,Percent of total billed charges,,265.05,273.42,
HC PR Rx Intrauterine Copper Contraceptive Iud 1 Ea,PX-63610524,CDM,J7300,HCPCS,636,RC,,inpatient,,,1933,1739.7,,0.95,,1836.35,Percent of total billed charges,,,0.98,,1894.34,Percent of total billed charges,,,0.95,,1836.35,Percent of total billed charges,,,0.97,,1875.01,Percent of total billed charges,,,0.97,,1875.01,Percent of total billed charges,,,0.96,,1855.68,Percent of total billed charges,,,0.95,,1836.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1836.35,Percent of total billed charges,,1836.35,1894.34,
HC PR Rx Intrauterine Copper Contraceptive Iud 1 Ea,PX-63610524,CDM,J7300,HCPCS,636,RC,,outpatient,,,1933,1739.7,,0.95,,1836.35,Percent of total billed charges,,,0.98,,1894.34,Percent of total billed charges,,,0.95,,1836.35,Percent of total billed charges,,,0.95,,1836.35,Percent of total billed charges,,,0.97,,1875.01,Percent of total billed charges,,,0.96,,1855.68,Percent of total billed charges,,,0.95,,1836.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1836.35,Percent of total billed charges,,1836.35,1894.34,
HC PR Rx Morphine Sulfate Inj 10 Mg,PX-63610534,CDM,J2270,HCPCS,636,RC,,inpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
HC PR Rx Morphine Sulfate Inj 10 Mg,PX-63610534,CDM,J2270,HCPCS,636,RC,,outpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
HC PR Rx Promethazine Hcl Inj 50 Mg,PX-63610536,CDM,J2550,HCPCS,636,RC,,inpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
HC PR Rx Promethazine Hcl Inj 50 Mg,PX-63610536,CDM,J2550,HCPCS,636,RC,,outpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
HC PR Rx Diphenhydramine Hcl Inj 50 Mg,PX-63610545,CDM,J1200,HCPCS,636,RC,,inpatient,,,51,45.9,,0.95,,48.45,Percent of total billed charges,,,0.98,,49.98,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.96,,48.96,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,48.45,Percent of total billed charges,,48.45,49.98,
HC PR Rx Diphenhydramine Hcl Inj 50 Mg,PX-63610545,CDM,J1200,HCPCS,636,RC,,outpatient,,,51,45.9,,0.95,,48.45,Percent of total billed charges,,,0.98,,49.98,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.96,,48.96,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,48.45,Percent of total billed charges,,48.45,49.98,
HC PR 71110 X-Ray Ribs 3 Vw Bilat,PX-97210569,CDM,71110,CPT,972,RC,,inpatient,,,324,291.6,,0.95,,307.8,Percent of total billed charges,,,0.98,,317.52,Percent of total billed charges,,,0.95,,307.8,Percent of total billed charges,,,0.97,,314.28,Percent of total billed charges,,,0.97,,314.28,Percent of total billed charges,,,0.96,,311.04,Percent of total billed charges,,,0.95,,307.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,307.8,Percent of total billed charges,,307.8,317.52,
HC PR 71110 X-Ray Ribs 3 Vw Bilat,PX-97210569,CDM,71110,CPT,972,RC,,outpatient,,,324,291.6,,0.95,,307.8,Percent of total billed charges,,,0.98,,317.52,Percent of total billed charges,,,0.95,,307.8,Percent of total billed charges,,,0.95,,307.8,Percent of total billed charges,,,0.97,,314.28,Percent of total billed charges,,,0.96,,311.04,Percent of total billed charges,,,0.95,,307.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,307.8,Percent of total billed charges,,307.8,317.52,
"Gene analysis, full sequence analysis",PX-31010809,CDM,81321,CPT,310,RC,,inpatient,,,1854,1668.6,,0.95,,1761.3,Percent of total billed charges,,,0.98,,1816.92,Percent of total billed charges,,,0.95,,1761.3,Percent of total billed charges,,,0.97,,1798.38,Percent of total billed charges,,,0.97,,1798.38,Percent of total billed charges,,,0.96,,1779.84,Percent of total billed charges,,,0.95,,1761.3,Percent of total billed charges,,,,,,,,,0.95,,1761.3,Percent of total billed charges,,1761.3,1816.92,
"Gene analysis, full sequence analysis",PX-31010809,CDM,81321,CPT,310,RC,,outpatient,,,1854,1668.6,,0.95,,1761.3,Percent of total billed charges,,,0.98,,1816.92,Percent of total billed charges,,,0.95,,1761.3,Percent of total billed charges,,,0.95,,1761.3,Percent of total billed charges,,,0.97,,1798.38,Percent of total billed charges,,,0.96,,1779.84,Percent of total billed charges,,,0.95,,1761.3,Percent of total billed charges,,,,,,,,,0.95,,1761.3,Percent of total billed charges,,1761.3,1816.92,
"Gene analysis, duplication or deletion variant",PX-31010810,CDM,81323,CPT,310,RC,,inpatient,,,927,834.3,,0.95,,880.65,Percent of total billed charges,,,0.98,,908.46,Percent of total billed charges,,,0.95,,880.65,Percent of total billed charges,,,0.97,,899.19,Percent of total billed charges,,,0.97,,899.19,Percent of total billed charges,,,0.96,,889.92,Percent of total billed charges,,,0.95,,880.65,Percent of total billed charges,,,,,,,,,0.95,,880.65,Percent of total billed charges,,880.65,908.46,
"Gene analysis, duplication or deletion variant",PX-31010810,CDM,81323,CPT,310,RC,,outpatient,,,927,834.3,,0.95,,880.65,Percent of total billed charges,,,0.98,,908.46,Percent of total billed charges,,,0.95,,880.65,Percent of total billed charges,,,0.95,,880.65,Percent of total billed charges,,,0.97,,899.19,Percent of total billed charges,,,0.96,,889.92,Percent of total billed charges,,,0.95,,880.65,Percent of total billed charges,,,,,,,,,0.95,,880.65,Percent of total billed charges,,880.65,908.46,
Other procedure on nervous system,PX-45010010,CDM,64999,CPT,450,RC,,inpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,440.8,Percent of total billed charges,,440.8,3950,
Other procedure on nervous system,PX-45010010,CDM,64999,CPT,450,RC,,outpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,440.8,Percent of total billed charges,,440.8,3950,
HC PR ED 64999 Nerve Block Inj Facial Cdm,PX-98110034,CDM,64999,CPT,981,RC,,inpatient,,,358,322.2,,0.95,,340.1,Percent of total billed charges,,,0.98,,350.84,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,0.97,,347.26,Percent of total billed charges,,,0.97,,347.26,Percent of total billed charges,,,0.96,,343.68,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,340.1,Percent of total billed charges,,340.1,350.84,
HC PR ED 64999 Nerve Block Inj Facial Cdm,PX-98110034,CDM,64999,CPT,981,RC,,outpatient,,,358,322.2,,0.95,,340.1,Percent of total billed charges,,,0.98,,350.84,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,0.97,,347.26,Percent of total billed charges,,,0.96,,343.68,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,340.1,Percent of total billed charges,,340.1,350.84,
Inject anesthetic agent/steroid into spine and pelvis nerve,PX-36110578,CDM,64451,CPT,361,RC,,inpatient,,,3128,2815.2,,0.95,,2971.6,Percent of total billed charges,,,0.98,,3065.44,Percent of total billed charges,,,0.95,,2971.6,Percent of total billed charges,,,0.97,,3034.16,Percent of total billed charges,,,0.97,,3034.16,Percent of total billed charges,,,0.96,,3002.88,Percent of total billed charges,,,0.95,,2971.6,Percent of total billed charges,,,,,,,,,0.95,,2971.6,Percent of total billed charges,,2971.6,3065.44,
Inject anesthetic agent/steroid into spine and pelvis nerve,PX-36110578,CDM,64451,CPT,361,RC,,outpatient,,,3128,2815.2,,0.95,,2971.6,Percent of total billed charges,,,0.98,,3065.44,Percent of total billed charges,,,0.95,,2971.6,Percent of total billed charges,,,0.95,,2971.6,Percent of total billed charges,,,0.97,,3034.16,Percent of total billed charges,,,0.96,,3002.88,Percent of total billed charges,,,0.95,,2971.6,Percent of total billed charges,,,,,,,,,0.95,,2971.6,Percent of total billed charges,,2971.6,3065.44,
"Therapy for mental processes, each additional 15 m",PX-42010010,CDM,97130,CPT,420,RC,,inpatient,,,161,144.9,,0.95,,152.95,Percent of total billed charges,,,0.98,,157.78,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.96,,154.56,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,152.95,Percent of total billed charges,,152.95,157.78,
"Therapy for mental processes, each additional 15 m",PX-42010010,CDM,97130,CPT,420,RC,,outpatient,,,161,144.9,,0.95,,152.95,Percent of total billed charges,,,0.98,,157.78,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.96,,154.56,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,152.95,Percent of total billed charges,,152.95,157.78,
"Therapy for a range of mental processes, initial 15 m",PX-42010011,CDM,97129,CPT,420,RC,,inpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
"Therapy for a range of mental processes, initial 15 m",PX-42010011,CDM,97129,CPT,420,RC,,outpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
Measurement of lacosamide,PX-30110241,CDM,80235,CPT,301,RC,,inpatient,,,94,84.6,,0.95,,89.3,Percent of total billed charges,,,0.98,,92.12,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.96,,90.24,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,89.3,Percent of total billed charges,,89.3,92.12,
Measurement of lacosamide,PX-30110241,CDM,80235,CPT,301,RC,,outpatient,,,94,84.6,,0.95,,89.3,Percent of total billed charges,,,0.98,,92.12,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.96,,90.24,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,89.3,Percent of total billed charges,,89.3,92.12,
HC PR 99421 Online Digital E/M Svc Est Pt <7 D 5-10 Minutes Cdm,PX-98311066,CDM,99421,CPT,983,RC,,inpatient,,,37,33.3,,0.95,,35.15,Percent of total billed charges,,,0.98,,36.26,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.96,,35.52,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,35.15,Percent of total billed charges,,35.15,36.26,
HC PR 99421 Online Digital E/M Svc Est Pt <7 D 5-10 Minutes Cdm,PX-98311066,CDM,99421,CPT,983,RC,,outpatient,,,37,33.3,,0.95,,35.15,Percent of total billed charges,,,0.98,,36.26,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.96,,35.52,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,35.15,Percent of total billed charges,,35.15,36.26,
Ultrasound measurement of bladder capacity after voiding,PX-36110646,CDM,51798,CPT,361,RC,,inpatient,,,60,54,,0.95,,57,Percent of total billed charges,,,0.98,,58.8,Percent of total billed charges,,,0.95,,57,Percent of total billed charges,,,0.97,,58.2,Percent of total billed charges,,,0.97,,58.2,Percent of total billed charges,,,0.96,,57.6,Percent of total billed charges,,,0.95,,57,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57,Percent of total billed charges,,57,58.8,
Ultrasound measurement of bladder capacity after voiding,PX-36110646,CDM,51798,CPT,361,RC,,outpatient,,,60,54,,0.95,,57,Percent of total billed charges,,,0.98,,58.8,Percent of total billed charges,,,0.95,,57,Percent of total billed charges,,,0.95,,57,Percent of total billed charges,,,0.97,,58.2,Percent of total billed charges,,,0.96,,57.6,Percent of total billed charges,,,0.95,,57,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57,Percent of total billed charges,,57,58.8,
Heart muscle strain imaging,PX-48310004,CDM,93356,CPT,483,RC,,inpatient,,,109,98.1,,0.95,,103.55,Percent of total billed charges,,,0.98,,106.82,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,0.97,,105.73,Percent of total billed charges,,,0.97,,105.73,Percent of total billed charges,,,0.96,,104.64,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,103.55,Percent of total billed charges,,103.55,106.82,
Heart muscle strain imaging,PX-48310004,CDM,93356,CPT,483,RC,,outpatient,,,109,98.1,,0.95,,103.55,Percent of total billed charges,,,0.98,,106.82,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,0.97,,105.73,Percent of total billed charges,,,0.96,,104.64,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,103.55,Percent of total billed charges,,103.55,106.82,
"Aspiration of abscess, blood, or cyst",PX-36010110,CDM,10160,CPT,361,RC,,inpatient,,,272,244.8,,0.95,,258.4,Percent of total billed charges,,,0.98,,266.56,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,0.97,,263.84,Percent of total billed charges,,,0.97,,263.84,Percent of total billed charges,,,0.96,,261.12,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,258.4,Percent of total billed charges,,258.4,266.56,
"Aspiration of abscess, blood, or cyst",PX-36010110,CDM,10160,CPT,361,RC,,outpatient,,,272,244.8,,0.95,,258.4,Percent of total billed charges,,,0.98,,266.56,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,0.97,,263.84,Percent of total billed charges,,,0.96,,261.12,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,258.4,Percent of total billed charges,,258.4,266.56,
"Aspiration of cyst of breast, first cyst",PX-36010111,CDM,19000,CPT,361,RC,,inpatient,,,450,405,,0.95,,427.5,Percent of total billed charges,,,0.98,,441,Percent of total billed charges,,,0.95,,427.5,Percent of total billed charges,,,0.97,,436.5,Percent of total billed charges,,,0.97,,436.5,Percent of total billed charges,,,0.96,,432,Percent of total billed charges,,,0.95,,427.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,427.5,Percent of total billed charges,,427.5,441,
"Aspiration of cyst of breast, first cyst",PX-36010111,CDM,19000,CPT,361,RC,,outpatient,,,450,405,,0.95,,427.5,Percent of total billed charges,,,0.98,,441,Percent of total billed charges,,,0.95,,427.5,Percent of total billed charges,,,0.95,,427.5,Percent of total billed charges,,,0.97,,436.5,Percent of total billed charges,,,0.96,,432,Percent of total billed charges,,,0.95,,427.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,427.5,Percent of total billed charges,,427.5,441,
Biopsy of muscle,PX-36010122,CDM,20205,CPT,361,RC,,inpatient,,,3420,3078,,0.95,,3249,Percent of total billed charges,,,0.98,,3351.6,Percent of total billed charges,,,0.95,,3249,Percent of total billed charges,,,0.97,,3317.4,Percent of total billed charges,,,0.97,,3317.4,Percent of total billed charges,,,0.96,,3283.2,Percent of total billed charges,,,0.95,,3249,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3249,Percent of total billed charges,,3249,3351.6,
Biopsy of muscle,PX-36010122,CDM,20205,CPT,361,RC,,outpatient,,,3420,3078,,0.95,,3249,Percent of total billed charges,,,0.98,,3351.6,Percent of total billed charges,,,0.95,,3249,Percent of total billed charges,,,0.95,,3249,Percent of total billed charges,,,0.97,,3317.4,Percent of total billed charges,,,0.96,,3283.2,Percent of total billed charges,,,0.95,,3249,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3249,Percent of total billed charges,,3249,3351.6,
Aspiration and/or injection of fluid from small joint,PX-36010130,CDM,20600,CPT,361,RC,,inpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
Aspiration and/or injection of fluid from small joint,PX-36010130,CDM,20600,CPT,361,RC,,outpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
Aspiration and/or injection of fluid from medium joint,PX-36010131,CDM,20605,CPT,361,RC,,inpatient,,,229,206.1,,0.95,,217.55,Percent of total billed charges,,,0.98,,224.42,Percent of total billed charges,,,0.95,,217.55,Percent of total billed charges,,,0.97,,222.13,Percent of total billed charges,,,0.97,,222.13,Percent of total billed charges,,,0.96,,219.84,Percent of total billed charges,,,0.95,,217.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,217.55,Percent of total billed charges,,217.55,224.42,
Aspiration and/or injection of fluid from medium joint,PX-36010131,CDM,20605,CPT,361,RC,,outpatient,,,229,206.1,,0.95,,217.55,Percent of total billed charges,,,0.98,,224.42,Percent of total billed charges,,,0.95,,217.55,Percent of total billed charges,,,0.95,,217.55,Percent of total billed charges,,,0.97,,222.13,Percent of total billed charges,,,0.96,,219.84,Percent of total billed charges,,,0.95,,217.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,217.55,Percent of total billed charges,,217.55,224.42,
Biopsy of bone using needle or trocar,PX-36110558,CDM,20220,CPT,361,RC,,inpatient,,,1368,1231.2,,0.95,,1299.6,Percent of total billed charges,,,0.98,,1340.64,Percent of total billed charges,,,0.95,,1299.6,Percent of total billed charges,,,0.97,,1326.96,Percent of total billed charges,,,0.97,,1326.96,Percent of total billed charges,,,0.96,,1313.28,Percent of total billed charges,,,0.95,,1299.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1299.6,Percent of total billed charges,,1299.6,1340.64,
Biopsy of bone using needle or trocar,PX-36110558,CDM,20220,CPT,361,RC,,outpatient,,,1368,1231.2,,0.95,,1299.6,Percent of total billed charges,,,0.98,,1340.64,Percent of total billed charges,,,0.95,,1299.6,Percent of total billed charges,,,0.95,,1299.6,Percent of total billed charges,,,0.97,,1326.96,Percent of total billed charges,,,0.96,,1313.28,Percent of total billed charges,,,0.95,,1299.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1299.6,Percent of total billed charges,,1299.6,1340.64,
Aspiration and/or injection of fluid from large joint,PX-36110562,CDM,20610,CPT,361,RC,,inpatient,,,319,287.1,,0.95,,303.05,Percent of total billed charges,,,0.98,,312.62,Percent of total billed charges,,,0.95,,303.05,Percent of total billed charges,,,0.97,,309.43,Percent of total billed charges,,,0.97,,309.43,Percent of total billed charges,,,0.96,,306.24,Percent of total billed charges,,,0.95,,303.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,303.05,Percent of total billed charges,,303.05,312.62,
Aspiration and/or injection of fluid from large joint,PX-36110562,CDM,20610,CPT,361,RC,,outpatient,,,319,287.1,,0.95,,303.05,Percent of total billed charges,,,0.98,,312.62,Percent of total billed charges,,,0.95,,303.05,Percent of total billed charges,,,0.95,,303.05,Percent of total billed charges,,,0.97,,309.43,Percent of total billed charges,,,0.96,,306.24,Percent of total billed charges,,,0.95,,303.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,303.05,Percent of total billed charges,,303.05,312.62,
Simple or single drainage of skin abscess,PX-45010309,CDM,10060,CPT,450,RC,,inpatient,,,315,283.5,,0.95,,299.25,Percent of total billed charges,,,0.98,,308.7,Percent of total billed charges,,,0.95,,299.25,Percent of total billed charges,,,0.97,,305.55,Percent of total billed charges,,,0.97,,305.55,Percent of total billed charges,,,0.96,,302.4,Percent of total billed charges,,,0.95,,299.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,299.25,Percent of total billed charges,,299.25,3950,
Simple or single drainage of skin abscess,PX-45010309,CDM,10060,CPT,450,RC,,outpatient,,,315,283.5,,0.95,,299.25,Percent of total billed charges,,,0.98,,308.7,Percent of total billed charges,,,0.95,,299.25,Percent of total billed charges,,,0.95,,299.25,Percent of total billed charges,,,0.97,,305.55,Percent of total billed charges,,,0.96,,302.4,Percent of total billed charges,,,0.95,,299.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,299.25,Percent of total billed charges,,299.25,3950,
Complicated or multiple drainage of skin abscess,PX-45010310,CDM,10061,CPT,450,RC,,inpatient,,,526,473.4,,0.95,,499.7,Percent of total billed charges,,,0.98,,515.48,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,,0.97,,510.22,Percent of total billed charges,,,0.97,,510.22,Percent of total billed charges,,,0.96,,504.96,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,499.7,Percent of total billed charges,,499.7,3950,
Complicated or multiple drainage of skin abscess,PX-45010310,CDM,10061,CPT,450,RC,,outpatient,,,526,473.4,,0.95,,499.7,Percent of total billed charges,,,0.98,,515.48,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,,0.97,,510.22,Percent of total billed charges,,,0.96,,504.96,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,499.7,Percent of total billed charges,,499.7,3950,
Simple drainage of cyst of tailbone,PX-45010311,CDM,10080,CPT,450,RC,,inpatient,,,348,313.2,,0.95,,330.6,Percent of total billed charges,,,0.98,,341.04,Percent of total billed charges,,,0.95,,330.6,Percent of total billed charges,,,0.97,,337.56,Percent of total billed charges,,,0.97,,337.56,Percent of total billed charges,,,0.96,,334.08,Percent of total billed charges,,,0.95,,330.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,330.6,Percent of total billed charges,,330.6,3950,
Simple drainage of cyst of tailbone,PX-45010311,CDM,10080,CPT,450,RC,,outpatient,,,348,313.2,,0.95,,330.6,Percent of total billed charges,,,0.98,,341.04,Percent of total billed charges,,,0.95,,330.6,Percent of total billed charges,,,0.95,,330.6,Percent of total billed charges,,,0.97,,337.56,Percent of total billed charges,,,0.96,,334.08,Percent of total billed charges,,,0.95,,330.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,330.6,Percent of total billed charges,,330.6,3950,
"Remove foreign body from tissue under skin, simple",PX-45010313,CDM,10120,CPT,450,RC,,inpatient,,,341,306.9,,0.95,,323.95,Percent of total billed charges,,,0.98,,334.18,Percent of total billed charges,,,0.95,,323.95,Percent of total billed charges,,,0.97,,330.77,Percent of total billed charges,,,0.97,,330.77,Percent of total billed charges,,,0.96,,327.36,Percent of total billed charges,,,0.95,,323.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,323.95,Percent of total billed charges,,323.95,3950,
"Remove foreign body from tissue under skin, simple",PX-45010313,CDM,10120,CPT,450,RC,,outpatient,,,341,306.9,,0.95,,323.95,Percent of total billed charges,,,0.98,,334.18,Percent of total billed charges,,,0.95,,323.95,Percent of total billed charges,,,0.95,,323.95,Percent of total billed charges,,,0.97,,330.77,Percent of total billed charges,,,0.96,,327.36,Percent of total billed charges,,,0.95,,323.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,323.95,Percent of total billed charges,,323.95,3950,
Remove foreign body from tissue under skn complex,PX-45010314,CDM,10121,CPT,450,RC,,inpatient,,,710,639,,0.95,,674.5,Percent of total billed charges,,,0.98,,695.8,Percent of total billed charges,,,0.95,,674.5,Percent of total billed charges,,,0.97,,688.7,Percent of total billed charges,,,0.97,,688.7,Percent of total billed charges,,,0.96,,681.6,Percent of total billed charges,,,0.95,,674.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,674.5,Percent of total billed charges,,674.5,3950,
Remove foreign body from tissue under skn complex,PX-45010314,CDM,10121,CPT,450,RC,,outpatient,,,710,639,,0.95,,674.5,Percent of total billed charges,,,0.98,,695.8,Percent of total billed charges,,,0.95,,674.5,Percent of total billed charges,,,0.95,,674.5,Percent of total billed charges,,,0.97,,688.7,Percent of total billed charges,,,0.96,,681.6,Percent of total billed charges,,,0.95,,674.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,674.5,Percent of total billed charges,,674.5,3950,
Drainage of blood or fluid accumulation,PX-45010316,CDM,10140,CPT,450,RC,,inpatient,,,325,292.5,,0.95,,308.75,Percent of total billed charges,,,0.98,,318.5,Percent of total billed charges,,,0.95,,308.75,Percent of total billed charges,,,0.97,,315.25,Percent of total billed charges,,,0.97,,315.25,Percent of total billed charges,,,0.96,,312,Percent of total billed charges,,,0.95,,308.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,308.75,Percent of total billed charges,,308.75,3950,
Drainage of blood or fluid accumulation,PX-45010316,CDM,10140,CPT,450,RC,,outpatient,,,325,292.5,,0.95,,308.75,Percent of total billed charges,,,0.98,,318.5,Percent of total billed charges,,,0.95,,308.75,Percent of total billed charges,,,0.95,,308.75,Percent of total billed charges,,,0.97,,315.25,Percent of total billed charges,,,0.96,,312,Percent of total billed charges,,,0.95,,308.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,308.75,Percent of total billed charges,,308.75,3950,
Complex drainage of wound infection after surgery,PX-45010317,CDM,10180,CPT,450,RC,,inpatient,,,935,841.5,,0.95,,888.25,Percent of total billed charges,,,0.98,,916.3,Percent of total billed charges,,,0.95,,888.25,Percent of total billed charges,,,0.97,,906.95,Percent of total billed charges,,,0.97,,906.95,Percent of total billed charges,,,0.96,,897.6,Percent of total billed charges,,,0.95,,888.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,888.25,Percent of total billed charges,,888.25,3950,
Complex drainage of wound infection after surgery,PX-45010317,CDM,10180,CPT,450,RC,,outpatient,,,935,841.5,,0.95,,888.25,Percent of total billed charges,,,0.98,,916.3,Percent of total billed charges,,,0.95,,888.25,Percent of total billed charges,,,0.95,,888.25,Percent of total billed charges,,,0.97,,906.95,Percent of total billed charges,,,0.96,,897.6,Percent of total billed charges,,,0.95,,888.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,888.25,Percent of total billed charges,,888.25,3950,
"Remove inflamed or infected skin, up to 10% of body surface",PX-45010318,CDM,11000,CPT,450,RC,,inpatient,,,188,169.2,,0.95,,178.6,Percent of total billed charges,,,0.98,,184.24,Percent of total billed charges,,,0.95,,178.6,Percent of total billed charges,,,0.97,,182.36,Percent of total billed charges,,,0.97,,182.36,Percent of total billed charges,,,0.96,,180.48,Percent of total billed charges,,,0.95,,178.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,178.6,Percent of total billed charges,,178.6,3950,
"Remove inflamed or infected skin, up to 10% of body surface",PX-45010318,CDM,11000,CPT,450,RC,,outpatient,,,188,169.2,,0.95,,178.6,Percent of total billed charges,,,0.98,,184.24,Percent of total billed charges,,,0.95,,178.6,Percent of total billed charges,,,0.95,,178.6,Percent of total billed charges,,,0.97,,182.36,Percent of total billed charges,,,0.96,,180.48,Percent of total billed charges,,,0.95,,178.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,178.6,Percent of total billed charges,,178.6,3950,
Remove foreign material from skin and tissue,PX-45010320,CDM,11010,CPT,450,RC,,inpatient,,,766,689.4,,0.95,,727.7,Percent of total billed charges,,,0.98,,750.68,Percent of total billed charges,,,0.95,,727.7,Percent of total billed charges,,,0.97,,743.02,Percent of total billed charges,,,0.97,,743.02,Percent of total billed charges,,,0.96,,735.36,Percent of total billed charges,,,0.95,,727.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,727.7,Percent of total billed charges,,727.7,3950,
Remove foreign material from skin and tissue,PX-45010320,CDM,11010,CPT,450,RC,,outpatient,,,766,689.4,,0.95,,727.7,Percent of total billed charges,,,0.98,,750.68,Percent of total billed charges,,,0.95,,727.7,Percent of total billed charges,,,0.95,,727.7,Percent of total billed charges,,,0.97,,743.02,Percent of total billed charges,,,0.96,,735.36,Percent of total billed charges,,,0.95,,727.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,727.7,Percent of total billed charges,,727.7,3950,
"Remove foreign material from skin, tissue, muscle",PX-45010321,CDM,11012,CPT,450,RC,,inpatient,,,2562,2305.8,,0.95,,2433.9,Percent of total billed charges,,,0.98,,2510.76,Percent of total billed charges,,,0.95,,2433.9,Percent of total billed charges,,,0.97,,2485.14,Percent of total billed charges,,,0.97,,2485.14,Percent of total billed charges,,,0.96,,2459.52,Percent of total billed charges,,,0.95,,2433.9,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2433.9,Percent of total billed charges,,2433.9,3950,
"Remove foreign material from skin, tissue, muscle",PX-45010321,CDM,11012,CPT,450,RC,,outpatient,,,2562,2305.8,,0.95,,2433.9,Percent of total billed charges,,,0.98,,2510.76,Percent of total billed charges,,,0.95,,2433.9,Percent of total billed charges,,,0.95,,2433.9,Percent of total billed charges,,,0.97,,2485.14,Percent of total billed charges,,,0.96,,2459.52,Percent of total billed charges,,,0.95,,2433.9,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2433.9,Percent of total billed charges,,2433.9,3950,
"Removal of skin and tissue, 20.0 sq cm or less",PX-45010324,CDM,11042,CPT,450,RC,,inpatient,,,946,851.4,,0.95,,898.7,Percent of total billed charges,,,0.98,,927.08,Percent of total billed charges,,,0.95,,898.7,Percent of total billed charges,,,0.97,,917.62,Percent of total billed charges,,,0.97,,917.62,Percent of total billed charges,,,0.96,,908.16,Percent of total billed charges,,,0.95,,898.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,898.7,Percent of total billed charges,,898.7,3950,
"Removal of skin and tissue, 20.0 sq cm or less",PX-45010324,CDM,11042,CPT,450,RC,,outpatient,,,946,851.4,,0.95,,898.7,Percent of total billed charges,,,0.98,,927.08,Percent of total billed charges,,,0.95,,898.7,Percent of total billed charges,,,0.95,,898.7,Percent of total billed charges,,,0.97,,917.62,Percent of total billed charges,,,0.96,,908.16,Percent of total billed charges,,,0.95,,898.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,898.7,Percent of total billed charges,,898.7,3950,
Removal of muscle and/or tissue <= 20.0 sq cm,PX-45010325,CDM,11043,CPT,450,RC,,inpatient,,,995,895.5,,0.95,,945.25,Percent of total billed charges,,,0.98,,975.1,Percent of total billed charges,,,0.95,,945.25,Percent of total billed charges,,,0.97,,965.15,Percent of total billed charges,,,0.97,,965.15,Percent of total billed charges,,,0.96,,955.2,Percent of total billed charges,,,0.95,,945.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,945.25,Percent of total billed charges,,945.25,3950,
Removal of muscle and/or tissue <= 20.0 sq cm,PX-45010325,CDM,11043,CPT,450,RC,,outpatient,,,995,895.5,,0.95,,945.25,Percent of total billed charges,,,0.98,,975.1,Percent of total billed charges,,,0.95,,945.25,Percent of total billed charges,,,0.95,,945.25,Percent of total billed charges,,,0.97,,965.15,Percent of total billed charges,,,0.96,,955.2,Percent of total billed charges,,,0.95,,945.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,945.25,Percent of total billed charges,,945.25,3950,
"Removal of bone, 20.0 sq cm or less",PX-45010327,CDM,11044,CPT,450,RC,,inpatient,,,1457,1311.3,,0.95,,1384.15,Percent of total billed charges,,,0.98,,1427.86,Percent of total billed charges,,,0.95,,1384.15,Percent of total billed charges,,,0.97,,1413.29,Percent of total billed charges,,,0.97,,1413.29,Percent of total billed charges,,,0.96,,1398.72,Percent of total billed charges,,,0.95,,1384.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1384.15,Percent of total billed charges,,1384.15,3950,
"Removal of bone, 20.0 sq cm or less",PX-45010327,CDM,11044,CPT,450,RC,,outpatient,,,1457,1311.3,,0.95,,1384.15,Percent of total billed charges,,,0.98,,1427.86,Percent of total billed charges,,,0.95,,1384.15,Percent of total billed charges,,,0.95,,1384.15,Percent of total billed charges,,,0.97,,1413.29,Percent of total billed charges,,,0.96,,1398.72,Percent of total billed charges,,,0.95,,1384.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1384.15,Percent of total billed charges,,1384.15,3950,
"Removal of skin tag, 1-15 skin tags",PX-45010331,CDM,11200,CPT,450,RC,,inpatient,,,196,176.4,,0.95,,186.2,Percent of total billed charges,,,0.98,,192.08,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,0.97,,190.12,Percent of total billed charges,,,0.97,,190.12,Percent of total billed charges,,,0.96,,188.16,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,186.2,Percent of total billed charges,,186.2,3950,
"Removal of skin tag, 1-15 skin tags",PX-45010331,CDM,11200,CPT,450,RC,,outpatient,,,196,176.4,,0.95,,186.2,Percent of total billed charges,,,0.98,,192.08,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,0.97,,190.12,Percent of total billed charges,,,0.96,,188.16,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,186.2,Percent of total billed charges,,186.2,3950,
"Remove noncancer skin growth of body, 2.1-3.0 cm",PX-45010344,CDM,11423,CPT,450,RC,,inpatient,,,670,603,,0.95,,636.5,Percent of total billed charges,,,0.98,,656.6,Percent of total billed charges,,,0.95,,636.5,Percent of total billed charges,,,0.97,,649.9,Percent of total billed charges,,,0.97,,649.9,Percent of total billed charges,,,0.96,,643.2,Percent of total billed charges,,,0.95,,636.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,636.5,Percent of total billed charges,,636.5,3950,
"Remove noncancer skin growth of body, 2.1-3.0 cm",PX-45010344,CDM,11423,CPT,450,RC,,outpatient,,,670,603,,0.95,,636.5,Percent of total billed charges,,,0.98,,656.6,Percent of total billed charges,,,0.95,,636.5,Percent of total billed charges,,,0.95,,636.5,Percent of total billed charges,,,0.97,,649.9,Percent of total billed charges,,,0.96,,643.2,Percent of total billed charges,,,0.95,,636.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,636.5,Percent of total billed charges,,636.5,3950,
"Removal of fingernails or toenails, 1-5 nails",PX-45010346,CDM,11720,CPT,450,RC,,inpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,105.45,Percent of total billed charges,,105.45,3950,
"Removal of fingernails or toenails, 1-5 nails",PX-45010346,CDM,11720,CPT,450,RC,,outpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,105.45,Percent of total billed charges,,105.45,3950,
"Simple separation fingernail or toenail, 1st nail",PX-45010348,CDM,11730,CPT,450,RC,,inpatient,,,246,221.4,,0.95,,233.7,Percent of total billed charges,,,0.98,,241.08,Percent of total billed charges,,,0.95,,233.7,Percent of total billed charges,,,0.97,,238.62,Percent of total billed charges,,,0.97,,238.62,Percent of total billed charges,,,0.96,,236.16,Percent of total billed charges,,,0.95,,233.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,233.7,Percent of total billed charges,,233.7,3950,
"Simple separation fingernail or toenail, 1st nail",PX-45010348,CDM,11730,CPT,450,RC,,outpatient,,,246,221.4,,0.95,,233.7,Percent of total billed charges,,,0.98,,241.08,Percent of total billed charges,,,0.95,,233.7,Percent of total billed charges,,,0.95,,233.7,Percent of total billed charges,,,0.97,,238.62,Percent of total billed charges,,,0.96,,236.16,Percent of total billed charges,,,0.95,,233.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,233.7,Percent of total billed charges,,233.7,3950,
Permanent removal fingernail or toenail,PX-45010351,CDM,11750,CPT,450,RC,,inpatient,,,750,675,,0.95,,712.5,Percent of total billed charges,,,0.98,,735,Percent of total billed charges,,,0.95,,712.5,Percent of total billed charges,,,0.97,,727.5,Percent of total billed charges,,,0.97,,727.5,Percent of total billed charges,,,0.96,,720,Percent of total billed charges,,,0.95,,712.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,712.5,Percent of total billed charges,,712.5,3950,
Permanent removal fingernail or toenail,PX-45010351,CDM,11750,CPT,450,RC,,outpatient,,,750,675,,0.95,,712.5,Percent of total billed charges,,,0.98,,735,Percent of total billed charges,,,0.95,,712.5,Percent of total billed charges,,,0.95,,712.5,Percent of total billed charges,,,0.97,,727.5,Percent of total billed charges,,,0.96,,720,Percent of total billed charges,,,0.95,,712.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,712.5,Percent of total billed charges,,712.5,3950,
Repair of fingernail or toenail bed,PX-45010353,CDM,11760,CPT,450,RC,,inpatient,,,720,648,,0.95,,684,Percent of total billed charges,,,0.98,,705.6,Percent of total billed charges,,,0.95,,684,Percent of total billed charges,,,0.97,,698.4,Percent of total billed charges,,,0.97,,698.4,Percent of total billed charges,,,0.96,,691.2,Percent of total billed charges,,,0.95,,684,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,684,Percent of total billed charges,,684,3950,
Repair of fingernail or toenail bed,PX-45010353,CDM,11760,CPT,450,RC,,outpatient,,,720,648,,0.95,,684,Percent of total billed charges,,,0.98,,705.6,Percent of total billed charges,,,0.95,,684,Percent of total billed charges,,,0.95,,684,Percent of total billed charges,,,0.97,,698.4,Percent of total billed charges,,,0.96,,691.2,Percent of total billed charges,,,0.95,,684,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,684,Percent of total billed charges,,684,3950,
Removal of skin of fingernail or toenail,PX-45010354,CDM,11765,CPT,450,RC,,inpatient,,,260,234,,0.95,,247,Percent of total billed charges,,,0.98,,254.8,Percent of total billed charges,,,0.95,,247,Percent of total billed charges,,,0.97,,252.2,Percent of total billed charges,,,0.97,,252.2,Percent of total billed charges,,,0.96,,249.6,Percent of total billed charges,,,0.95,,247,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,247,Percent of total billed charges,,247,3950,
Removal of skin of fingernail or toenail,PX-45010354,CDM,11765,CPT,450,RC,,outpatient,,,260,234,,0.95,,247,Percent of total billed charges,,,0.98,,254.8,Percent of total billed charges,,,0.95,,247,Percent of total billed charges,,,0.95,,247,Percent of total billed charges,,,0.97,,252.2,Percent of total billed charges,,,0.96,,249.6,Percent of total billed charges,,,0.95,,247,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,247,Percent of total billed charges,,247,3950,
"Simple repair of surface wound of body, 2.5 cm or less",PX-45010355,CDM,12001,CPT,450,RC,,inpatient,,,372,334.8,,0.95,,353.4,Percent of total billed charges,,,0.98,,364.56,Percent of total billed charges,,,0.95,,353.4,Percent of total billed charges,,,0.97,,360.84,Percent of total billed charges,,,0.97,,360.84,Percent of total billed charges,,,0.96,,357.12,Percent of total billed charges,,,0.95,,353.4,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,353.4,Percent of total billed charges,,353.4,3950,
"Simple repair of surface wound of body, 2.5 cm or less",PX-45010355,CDM,12001,CPT,450,RC,,outpatient,,,372,334.8,,0.95,,353.4,Percent of total billed charges,,,0.98,,364.56,Percent of total billed charges,,,0.95,,353.4,Percent of total billed charges,,,0.95,,353.4,Percent of total billed charges,,,0.97,,360.84,Percent of total billed charges,,,0.96,,357.12,Percent of total billed charges,,,0.95,,353.4,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,353.4,Percent of total billed charges,,353.4,3950,
"Simple repair of surface wound of body, 2.6-7.5 cm",PX-45010356,CDM,12002,CPT,450,RC,,inpatient,,,439,395.1,,0.95,,417.05,Percent of total billed charges,,,0.98,,430.22,Percent of total billed charges,,,0.95,,417.05,Percent of total billed charges,,,0.97,,425.83,Percent of total billed charges,,,0.97,,425.83,Percent of total billed charges,,,0.96,,421.44,Percent of total billed charges,,,0.95,,417.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,417.05,Percent of total billed charges,,417.05,3950,
"Simple repair of surface wound of body, 2.6-7.5 cm",PX-45010356,CDM,12002,CPT,450,RC,,outpatient,,,439,395.1,,0.95,,417.05,Percent of total billed charges,,,0.98,,430.22,Percent of total billed charges,,,0.95,,417.05,Percent of total billed charges,,,0.95,,417.05,Percent of total billed charges,,,0.97,,425.83,Percent of total billed charges,,,0.96,,421.44,Percent of total billed charges,,,0.95,,417.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,417.05,Percent of total billed charges,,417.05,3950,
Repair wound of body 7.6-12.5 cm,PX-45010357,CDM,12004,CPT,450,RC,,inpatient,,,525,472.5,,0.95,,498.75,Percent of total billed charges,,,0.98,,514.5,Percent of total billed charges,,,0.95,,498.75,Percent of total billed charges,,,0.97,,509.25,Percent of total billed charges,,,0.97,,509.25,Percent of total billed charges,,,0.96,,504,Percent of total billed charges,,,0.95,,498.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,498.75,Percent of total billed charges,,498.75,3950,
Repair wound of body 7.6-12.5 cm,PX-45010357,CDM,12004,CPT,450,RC,,outpatient,,,525,472.5,,0.95,,498.75,Percent of total billed charges,,,0.98,,514.5,Percent of total billed charges,,,0.95,,498.75,Percent of total billed charges,,,0.95,,498.75,Percent of total billed charges,,,0.97,,509.25,Percent of total billed charges,,,0.96,,504,Percent of total billed charges,,,0.95,,498.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,498.75,Percent of total billed charges,,498.75,3950,
"Simple repair surface wound of body, 12.6-20.0 cm",PX-45010358,CDM,12005,CPT,450,RC,,inpatient,,,708,637.2,,0.95,,672.6,Percent of total billed charges,,,0.98,,693.84,Percent of total billed charges,,,0.95,,672.6,Percent of total billed charges,,,0.97,,686.76,Percent of total billed charges,,,0.97,,686.76,Percent of total billed charges,,,0.96,,679.68,Percent of total billed charges,,,0.95,,672.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,672.6,Percent of total billed charges,,672.6,3950,
"Simple repair surface wound of body, 12.6-20.0 cm",PX-45010358,CDM,12005,CPT,450,RC,,outpatient,,,708,637.2,,0.95,,672.6,Percent of total billed charges,,,0.98,,693.84,Percent of total billed charges,,,0.95,,672.6,Percent of total billed charges,,,0.95,,672.6,Percent of total billed charges,,,0.97,,686.76,Percent of total billed charges,,,0.96,,679.68,Percent of total billed charges,,,0.95,,672.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,672.6,Percent of total billed charges,,672.6,3950,
"Simple repair surface wound of body, 20.1-30.0 cm",PX-45010359,CDM,12006,CPT,450,RC,,inpatient,,,830,747,,0.95,,788.5,Percent of total billed charges,,,0.98,,813.4,Percent of total billed charges,,,0.95,,788.5,Percent of total billed charges,,,0.97,,805.1,Percent of total billed charges,,,0.97,,805.1,Percent of total billed charges,,,0.96,,796.8,Percent of total billed charges,,,0.95,,788.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,788.5,Percent of total billed charges,,788.5,3950,
"Simple repair surface wound of body, 20.1-30.0 cm",PX-45010359,CDM,12006,CPT,450,RC,,outpatient,,,830,747,,0.95,,788.5,Percent of total billed charges,,,0.98,,813.4,Percent of total billed charges,,,0.95,,788.5,Percent of total billed charges,,,0.95,,788.5,Percent of total billed charges,,,0.97,,805.1,Percent of total billed charges,,,0.96,,796.8,Percent of total billed charges,,,0.95,,788.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,788.5,Percent of total billed charges,,788.5,3950,
"Simple repair of surface wound of head, 2.5 cm or less",PX-45010361,CDM,12011,CPT,450,RC,,inpatient,,,430,387,,0.95,,408.5,Percent of total billed charges,,,0.98,,421.4,Percent of total billed charges,,,0.95,,408.5,Percent of total billed charges,,,0.97,,417.1,Percent of total billed charges,,,0.97,,417.1,Percent of total billed charges,,,0.96,,412.8,Percent of total billed charges,,,0.95,,408.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,408.5,Percent of total billed charges,,408.5,3950,
"Simple repair of surface wound of head, 2.5 cm or less",PX-45010361,CDM,12011,CPT,450,RC,,outpatient,,,430,387,,0.95,,408.5,Percent of total billed charges,,,0.98,,421.4,Percent of total billed charges,,,0.95,,408.5,Percent of total billed charges,,,0.95,,408.5,Percent of total billed charges,,,0.97,,417.1,Percent of total billed charges,,,0.96,,412.8,Percent of total billed charges,,,0.95,,408.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,408.5,Percent of total billed charges,,408.5,3950,
"Simple repair of surface wound of head, 2.6-5.0 cm",PX-45010362,CDM,12013,CPT,450,RC,,inpatient,,,525,472.5,,0.95,,498.75,Percent of total billed charges,,,0.98,,514.5,Percent of total billed charges,,,0.95,,498.75,Percent of total billed charges,,,0.97,,509.25,Percent of total billed charges,,,0.97,,509.25,Percent of total billed charges,,,0.96,,504,Percent of total billed charges,,,0.95,,498.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,498.75,Percent of total billed charges,,498.75,3950,
"Simple repair of surface wound of head, 2.6-5.0 cm",PX-45010362,CDM,12013,CPT,450,RC,,outpatient,,,525,472.5,,0.95,,498.75,Percent of total billed charges,,,0.98,,514.5,Percent of total billed charges,,,0.95,,498.75,Percent of total billed charges,,,0.95,,498.75,Percent of total billed charges,,,0.97,,509.25,Percent of total billed charges,,,0.96,,504,Percent of total billed charges,,,0.95,,498.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,498.75,Percent of total billed charges,,498.75,3950,
"Simple repair surface wound of head, 5.1-7.5 cm",PX-45010363,CDM,12014,CPT,450,RC,,inpatient,,,644,579.6,,0.95,,611.8,Percent of total billed charges,,,0.98,,631.12,Percent of total billed charges,,,0.95,,611.8,Percent of total billed charges,,,0.97,,624.68,Percent of total billed charges,,,0.97,,624.68,Percent of total billed charges,,,0.96,,618.24,Percent of total billed charges,,,0.95,,611.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,611.8,Percent of total billed charges,,611.8,3950,
"Simple repair surface wound of head, 5.1-7.5 cm",PX-45010363,CDM,12014,CPT,450,RC,,outpatient,,,644,579.6,,0.95,,611.8,Percent of total billed charges,,,0.98,,631.12,Percent of total billed charges,,,0.95,,611.8,Percent of total billed charges,,,0.95,,611.8,Percent of total billed charges,,,0.97,,624.68,Percent of total billed charges,,,0.96,,618.24,Percent of total billed charges,,,0.95,,611.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,611.8,Percent of total billed charges,,611.8,3950,
"Simple repair surface wound of head, 7.6-12.5 cm",PX-45010364,CDM,12015,CPT,450,RC,,inpatient,,,775,697.5,,0.95,,736.25,Percent of total billed charges,,,0.98,,759.5,Percent of total billed charges,,,0.95,,736.25,Percent of total billed charges,,,0.97,,751.75,Percent of total billed charges,,,0.97,,751.75,Percent of total billed charges,,,0.96,,744,Percent of total billed charges,,,0.95,,736.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,736.25,Percent of total billed charges,,736.25,3950,
"Simple repair surface wound of head, 7.6-12.5 cm",PX-45010364,CDM,12015,CPT,450,RC,,outpatient,,,775,697.5,,0.95,,736.25,Percent of total billed charges,,,0.98,,759.5,Percent of total billed charges,,,0.95,,736.25,Percent of total billed charges,,,0.95,,736.25,Percent of total billed charges,,,0.97,,751.75,Percent of total billed charges,,,0.96,,744,Percent of total billed charges,,,0.95,,736.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,736.25,Percent of total billed charges,,736.25,3950,
"Simple repair of surface wound of head, 12.6-20.0 cm",PX-45010365,CDM,12016,CPT,450,RC,,inpatient,,,987,888.3,,0.95,,937.65,Percent of total billed charges,,,0.98,,967.26,Percent of total billed charges,,,0.95,,937.65,Percent of total billed charges,,,0.97,,957.39,Percent of total billed charges,,,0.97,,957.39,Percent of total billed charges,,,0.96,,947.52,Percent of total billed charges,,,0.95,,937.65,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,937.65,Percent of total billed charges,,937.65,3950,
"Simple repair of surface wound of head, 12.6-20.0 cm",PX-45010365,CDM,12016,CPT,450,RC,,outpatient,,,987,888.3,,0.95,,937.65,Percent of total billed charges,,,0.98,,967.26,Percent of total billed charges,,,0.95,,937.65,Percent of total billed charges,,,0.95,,937.65,Percent of total billed charges,,,0.97,,957.39,Percent of total billed charges,,,0.96,,947.52,Percent of total billed charges,,,0.95,,937.65,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,937.65,Percent of total billed charges,,937.65,3950,
Simple closure of surface wound reopening,PX-45010370,CDM,12020,CPT,450,RC,,inpatient,,,691,621.9,,0.95,,656.45,Percent of total billed charges,,,0.98,,677.18,Percent of total billed charges,,,0.95,,656.45,Percent of total billed charges,,,0.97,,670.27,Percent of total billed charges,,,0.97,,670.27,Percent of total billed charges,,,0.96,,663.36,Percent of total billed charges,,,0.95,,656.45,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,656.45,Percent of total billed charges,,656.45,3950,
Simple closure of surface wound reopening,PX-45010370,CDM,12020,CPT,450,RC,,outpatient,,,691,621.9,,0.95,,656.45,Percent of total billed charges,,,0.98,,677.18,Percent of total billed charges,,,0.95,,656.45,Percent of total billed charges,,,0.95,,656.45,Percent of total billed charges,,,0.97,,670.27,Percent of total billed charges,,,0.96,,663.36,Percent of total billed charges,,,0.95,,656.45,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,656.45,Percent of total billed charges,,656.45,3950,
"Repair wound of scalp, underarms, trunk, limbs, <2.5cm",PX-45010372,CDM,12031,CPT,450,RC,,inpatient,,,459,413.1,,0.95,,436.05,Percent of total billed charges,,,0.98,,449.82,Percent of total billed charges,,,0.95,,436.05,Percent of total billed charges,,,0.97,,445.23,Percent of total billed charges,,,0.97,,445.23,Percent of total billed charges,,,0.96,,440.64,Percent of total billed charges,,,0.95,,436.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,436.05,Percent of total billed charges,,436.05,3950,
"Repair wound of scalp, underarms, trunk, limbs, <2.5cm",PX-45010372,CDM,12031,CPT,450,RC,,outpatient,,,459,413.1,,0.95,,436.05,Percent of total billed charges,,,0.98,,449.82,Percent of total billed charges,,,0.95,,436.05,Percent of total billed charges,,,0.95,,436.05,Percent of total billed charges,,,0.97,,445.23,Percent of total billed charges,,,0.96,,440.64,Percent of total billed charges,,,0.95,,436.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,436.05,Percent of total billed charges,,436.05,3950,
"Repair wound of scalp, underarms, trunk, limbs, 2.6-7.5cm",PX-45010373,CDM,12032,CPT,450,RC,,inpatient,,,659,593.1,,0.95,,626.05,Percent of total billed charges,,,0.98,,645.82,Percent of total billed charges,,,0.95,,626.05,Percent of total billed charges,,,0.97,,639.23,Percent of total billed charges,,,0.97,,639.23,Percent of total billed charges,,,0.96,,632.64,Percent of total billed charges,,,0.95,,626.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,626.05,Percent of total billed charges,,626.05,3950,
"Repair wound of scalp, underarms, trunk, limbs, 2.6-7.5cm",PX-45010373,CDM,12032,CPT,450,RC,,outpatient,,,659,593.1,,0.95,,626.05,Percent of total billed charges,,,0.98,,645.82,Percent of total billed charges,,,0.95,,626.05,Percent of total billed charges,,,0.95,,626.05,Percent of total billed charges,,,0.97,,639.23,Percent of total billed charges,,,0.96,,632.64,Percent of total billed charges,,,0.95,,626.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,626.05,Percent of total billed charges,,626.05,3950,
"Repair wound of scalp, underarms, trunk, limbs, 7.6-12.5cm",PX-45010374,CDM,12034,CPT,450,RC,,inpatient,,,795,715.5,,0.95,,755.25,Percent of total billed charges,,,0.98,,779.1,Percent of total billed charges,,,0.95,,755.25,Percent of total billed charges,,,0.97,,771.15,Percent of total billed charges,,,0.97,,771.15,Percent of total billed charges,,,0.96,,763.2,Percent of total billed charges,,,0.95,,755.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,755.25,Percent of total billed charges,,755.25,3950,
"Repair wound of scalp, underarms, trunk, limbs, 7.6-12.5cm",PX-45010374,CDM,12034,CPT,450,RC,,outpatient,,,795,715.5,,0.95,,755.25,Percent of total billed charges,,,0.98,,779.1,Percent of total billed charges,,,0.95,,755.25,Percent of total billed charges,,,0.95,,755.25,Percent of total billed charges,,,0.97,,771.15,Percent of total billed charges,,,0.96,,763.2,Percent of total billed charges,,,0.95,,755.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,755.25,Percent of total billed charges,,755.25,3950,
"Repair wound of scalp,underarms, trunk, limbs, 12.6-20cm",PX-45010375,CDM,12035,CPT,450,RC,,inpatient,,,992,892.8,,0.95,,942.4,Percent of total billed charges,,,0.98,,972.16,Percent of total billed charges,,,0.95,,942.4,Percent of total billed charges,,,0.97,,962.24,Percent of total billed charges,,,0.97,,962.24,Percent of total billed charges,,,0.96,,952.32,Percent of total billed charges,,,0.95,,942.4,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,942.4,Percent of total billed charges,,942.4,3950,
"Repair wound of scalp,underarms, trunk, limbs, 12.6-20cm",PX-45010375,CDM,12035,CPT,450,RC,,outpatient,,,992,892.8,,0.95,,942.4,Percent of total billed charges,,,0.98,,972.16,Percent of total billed charges,,,0.95,,942.4,Percent of total billed charges,,,0.95,,942.4,Percent of total billed charges,,,0.97,,962.24,Percent of total billed charges,,,0.96,,952.32,Percent of total billed charges,,,0.95,,942.4,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,942.4,Percent of total billed charges,,942.4,3950,
"Repair wound of scalp, underarms, trunk, limbs, 20.1-30cm",PX-45010376,CDM,12036,CPT,450,RC,,inpatient,,,1190,1071,,0.95,,1130.5,Percent of total billed charges,,,0.98,,1166.2,Percent of total billed charges,,,0.95,,1130.5,Percent of total billed charges,,,0.97,,1154.3,Percent of total billed charges,,,0.97,,1154.3,Percent of total billed charges,,,0.96,,1142.4,Percent of total billed charges,,,0.95,,1130.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1130.5,Percent of total billed charges,,1130.5,3950,
"Repair wound of scalp, underarms, trunk, limbs, 20.1-30cm",PX-45010376,CDM,12036,CPT,450,RC,,outpatient,,,1190,1071,,0.95,,1130.5,Percent of total billed charges,,,0.98,,1166.2,Percent of total billed charges,,,0.95,,1130.5,Percent of total billed charges,,,0.95,,1130.5,Percent of total billed charges,,,0.97,,1154.3,Percent of total billed charges,,,0.96,,1142.4,Percent of total billed charges,,,0.95,,1130.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1130.5,Percent of total billed charges,,1130.5,3950,
"Intermediate repair wound of body, 2.5 cm or less",PX-45010378,CDM,12041,CPT,450,RC,,inpatient,,,455,409.5,,0.95,,432.25,Percent of total billed charges,,,0.98,,445.9,Percent of total billed charges,,,0.95,,432.25,Percent of total billed charges,,,0.97,,441.35,Percent of total billed charges,,,0.97,,441.35,Percent of total billed charges,,,0.96,,436.8,Percent of total billed charges,,,0.95,,432.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,432.25,Percent of total billed charges,,432.25,3950,
"Intermediate repair wound of body, 2.5 cm or less",PX-45010378,CDM,12041,CPT,450,RC,,outpatient,,,455,409.5,,0.95,,432.25,Percent of total billed charges,,,0.98,,445.9,Percent of total billed charges,,,0.95,,432.25,Percent of total billed charges,,,0.95,,432.25,Percent of total billed charges,,,0.97,,441.35,Percent of total billed charges,,,0.96,,436.8,Percent of total billed charges,,,0.95,,432.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,432.25,Percent of total billed charges,,432.25,3950,
"Intermediate repair wound of body, 2.6-7.5 cm",PX-45010380,CDM,12042,CPT,450,RC,,inpatient,,,679,611.1,,0.95,,645.05,Percent of total billed charges,,,0.98,,665.42,Percent of total billed charges,,,0.95,,645.05,Percent of total billed charges,,,0.97,,658.63,Percent of total billed charges,,,0.97,,658.63,Percent of total billed charges,,,0.96,,651.84,Percent of total billed charges,,,0.95,,645.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,645.05,Percent of total billed charges,,645.05,3950,
"Intermediate repair wound of body, 2.6-7.5 cm",PX-45010380,CDM,12042,CPT,450,RC,,outpatient,,,679,611.1,,0.95,,645.05,Percent of total billed charges,,,0.98,,665.42,Percent of total billed charges,,,0.95,,645.05,Percent of total billed charges,,,0.95,,645.05,Percent of total billed charges,,,0.97,,658.63,Percent of total billed charges,,,0.96,,651.84,Percent of total billed charges,,,0.95,,645.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,645.05,Percent of total billed charges,,645.05,3950,
"Intermediate repair wound of body, 7.6-12.5 cm",PX-45010381,CDM,12044,CPT,450,RC,,inpatient,,,841,756.9,,0.95,,798.95,Percent of total billed charges,,,0.98,,824.18,Percent of total billed charges,,,0.95,,798.95,Percent of total billed charges,,,0.97,,815.77,Percent of total billed charges,,,0.97,,815.77,Percent of total billed charges,,,0.96,,807.36,Percent of total billed charges,,,0.95,,798.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,798.95,Percent of total billed charges,,798.95,3950,
"Intermediate repair wound of body, 7.6-12.5 cm",PX-45010381,CDM,12044,CPT,450,RC,,outpatient,,,841,756.9,,0.95,,798.95,Percent of total billed charges,,,0.98,,824.18,Percent of total billed charges,,,0.95,,798.95,Percent of total billed charges,,,0.95,,798.95,Percent of total billed charges,,,0.97,,815.77,Percent of total billed charges,,,0.96,,807.36,Percent of total billed charges,,,0.95,,798.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,798.95,Percent of total billed charges,,798.95,3950,
"Intermediate repair wound of body, 12.6-20.0 cm",PX-45010382,CDM,12045,CPT,450,RC,,inpatient,,,1009,908.1,,0.95,,958.55,Percent of total billed charges,,,0.98,,988.82,Percent of total billed charges,,,0.95,,958.55,Percent of total billed charges,,,0.97,,978.73,Percent of total billed charges,,,0.97,,978.73,Percent of total billed charges,,,0.96,,968.64,Percent of total billed charges,,,0.95,,958.55,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,958.55,Percent of total billed charges,,958.55,3950,
"Intermediate repair wound of body, 12.6-20.0 cm",PX-45010382,CDM,12045,CPT,450,RC,,outpatient,,,1009,908.1,,0.95,,958.55,Percent of total billed charges,,,0.98,,988.82,Percent of total billed charges,,,0.95,,958.55,Percent of total billed charges,,,0.95,,958.55,Percent of total billed charges,,,0.97,,978.73,Percent of total billed charges,,,0.96,,968.64,Percent of total billed charges,,,0.95,,958.55,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,958.55,Percent of total billed charges,,958.55,3950,
"Intermediate repair wound of body, 20.1-30.0 cm",PX-45010383,CDM,12046,CPT,450,RC,,inpatient,,,1190,1071,,0.95,,1130.5,Percent of total billed charges,,,0.98,,1166.2,Percent of total billed charges,,,0.95,,1130.5,Percent of total billed charges,,,0.97,,1154.3,Percent of total billed charges,,,0.97,,1154.3,Percent of total billed charges,,,0.96,,1142.4,Percent of total billed charges,,,0.95,,1130.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1130.5,Percent of total billed charges,,1130.5,3950,
"Intermediate repair wound of body, 20.1-30.0 cm",PX-45010383,CDM,12046,CPT,450,RC,,outpatient,,,1190,1071,,0.95,,1130.5,Percent of total billed charges,,,0.98,,1166.2,Percent of total billed charges,,,0.95,,1130.5,Percent of total billed charges,,,0.95,,1130.5,Percent of total billed charges,,,0.97,,1154.3,Percent of total billed charges,,,0.96,,1142.4,Percent of total billed charges,,,0.95,,1130.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1130.5,Percent of total billed charges,,1130.5,3950,
"Intermediate repair wound of head, 2.5 cm or less",PX-45010385,CDM,12051,CPT,450,RC,,inpatient,,,594,534.6,,0.95,,564.3,Percent of total billed charges,,,0.98,,582.12,Percent of total billed charges,,,0.95,,564.3,Percent of total billed charges,,,0.97,,576.18,Percent of total billed charges,,,0.97,,576.18,Percent of total billed charges,,,0.96,,570.24,Percent of total billed charges,,,0.95,,564.3,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,564.3,Percent of total billed charges,,564.3,3950,
"Intermediate repair wound of head, 2.5 cm or less",PX-45010385,CDM,12051,CPT,450,RC,,outpatient,,,594,534.6,,0.95,,564.3,Percent of total billed charges,,,0.98,,582.12,Percent of total billed charges,,,0.95,,564.3,Percent of total billed charges,,,0.95,,564.3,Percent of total billed charges,,,0.97,,576.18,Percent of total billed charges,,,0.96,,570.24,Percent of total billed charges,,,0.95,,564.3,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,564.3,Percent of total billed charges,,564.3,3950,
"Intermediate repair wound of head, 2.6-5.0 cm",PX-45010386,CDM,12052,CPT,450,RC,,inpatient,,,778,700.2,,0.95,,739.1,Percent of total billed charges,,,0.98,,762.44,Percent of total billed charges,,,0.95,,739.1,Percent of total billed charges,,,0.97,,754.66,Percent of total billed charges,,,0.97,,754.66,Percent of total billed charges,,,0.96,,746.88,Percent of total billed charges,,,0.95,,739.1,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,739.1,Percent of total billed charges,,739.1,3950,
"Intermediate repair wound of head, 2.6-5.0 cm",PX-45010386,CDM,12052,CPT,450,RC,,outpatient,,,778,700.2,,0.95,,739.1,Percent of total billed charges,,,0.98,,762.44,Percent of total billed charges,,,0.95,,739.1,Percent of total billed charges,,,0.95,,739.1,Percent of total billed charges,,,0.97,,754.66,Percent of total billed charges,,,0.96,,746.88,Percent of total billed charges,,,0.95,,739.1,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,739.1,Percent of total billed charges,,739.1,3950,
"Intermediate repair wound of head, 5.1-7.5 cm",PX-45010387,CDM,12053,CPT,450,RC,,inpatient,,,926,833.4,,0.95,,879.7,Percent of total billed charges,,,0.98,,907.48,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,0.97,,898.22,Percent of total billed charges,,,0.97,,898.22,Percent of total billed charges,,,0.96,,888.96,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,879.7,Percent of total billed charges,,879.7,3950,
"Intermediate repair wound of head, 5.1-7.5 cm",PX-45010387,CDM,12053,CPT,450,RC,,outpatient,,,926,833.4,,0.95,,879.7,Percent of total billed charges,,,0.98,,907.48,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,0.97,,898.22,Percent of total billed charges,,,0.96,,888.96,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,879.7,Percent of total billed charges,,879.7,3950,
"Intermediate repair wound of head, 7.6-12.5 cm",PX-45010388,CDM,12054,CPT,450,RC,,inpatient,,,1129,1016.1,,0.95,,1072.55,Percent of total billed charges,,,0.98,,1106.42,Percent of total billed charges,,,0.95,,1072.55,Percent of total billed charges,,,0.97,,1095.13,Percent of total billed charges,,,0.97,,1095.13,Percent of total billed charges,,,0.96,,1083.84,Percent of total billed charges,,,0.95,,1072.55,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1072.55,Percent of total billed charges,,1072.55,3950,
"Intermediate repair wound of head, 7.6-12.5 cm",PX-45010388,CDM,12054,CPT,450,RC,,outpatient,,,1129,1016.1,,0.95,,1072.55,Percent of total billed charges,,,0.98,,1106.42,Percent of total billed charges,,,0.95,,1072.55,Percent of total billed charges,,,0.95,,1072.55,Percent of total billed charges,,,0.97,,1095.13,Percent of total billed charges,,,0.96,,1083.84,Percent of total billed charges,,,0.95,,1072.55,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1072.55,Percent of total billed charges,,1072.55,3950,
"Intermediate repair wound of head, 12.6-20.0 cm",PX-45010389,CDM,12055,CPT,450,RC,,inpatient,,,1408,1267.2,,0.95,,1337.6,Percent of total billed charges,,,0.98,,1379.84,Percent of total billed charges,,,0.95,,1337.6,Percent of total billed charges,,,0.97,,1365.76,Percent of total billed charges,,,0.97,,1365.76,Percent of total billed charges,,,0.96,,1351.68,Percent of total billed charges,,,0.95,,1337.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1337.6,Percent of total billed charges,,1337.6,3950,
"Intermediate repair wound of head, 12.6-20.0 cm",PX-45010389,CDM,12055,CPT,450,RC,,outpatient,,,1408,1267.2,,0.95,,1337.6,Percent of total billed charges,,,0.98,,1379.84,Percent of total billed charges,,,0.95,,1337.6,Percent of total billed charges,,,0.95,,1337.6,Percent of total billed charges,,,0.97,,1365.76,Percent of total billed charges,,,0.96,,1351.68,Percent of total billed charges,,,0.95,,1337.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1337.6,Percent of total billed charges,,1337.6,3950,
"Complicated repair wound of trunk, 1.1-2.5 cm",PX-45010392,CDM,13100,CPT,450,RC,,inpatient,,,724,651.6,,0.95,,687.8,Percent of total billed charges,,,0.98,,709.52,Percent of total billed charges,,,0.95,,687.8,Percent of total billed charges,,,0.97,,702.28,Percent of total billed charges,,,0.97,,702.28,Percent of total billed charges,,,0.96,,695.04,Percent of total billed charges,,,0.95,,687.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,687.8,Percent of total billed charges,,687.8,3950,
"Complicated repair wound of trunk, 1.1-2.5 cm",PX-45010392,CDM,13100,CPT,450,RC,,outpatient,,,724,651.6,,0.95,,687.8,Percent of total billed charges,,,0.98,,709.52,Percent of total billed charges,,,0.95,,687.8,Percent of total billed charges,,,0.95,,687.8,Percent of total billed charges,,,0.97,,702.28,Percent of total billed charges,,,0.96,,695.04,Percent of total billed charges,,,0.95,,687.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,687.8,Percent of total billed charges,,687.8,3950,
"Complicated repair wound of trunk, 2.6-7.5 cm",PX-45010393,CDM,13101,CPT,450,RC,,inpatient,,,995,895.5,,0.95,,945.25,Percent of total billed charges,,,0.98,,975.1,Percent of total billed charges,,,0.95,,945.25,Percent of total billed charges,,,0.97,,965.15,Percent of total billed charges,,,0.97,,965.15,Percent of total billed charges,,,0.96,,955.2,Percent of total billed charges,,,0.95,,945.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,945.25,Percent of total billed charges,,945.25,3950,
"Complicated repair wound of trunk, 2.6-7.5 cm",PX-45010393,CDM,13101,CPT,450,RC,,outpatient,,,995,895.5,,0.95,,945.25,Percent of total billed charges,,,0.98,,975.1,Percent of total billed charges,,,0.95,,945.25,Percent of total billed charges,,,0.95,,945.25,Percent of total billed charges,,,0.97,,965.15,Percent of total billed charges,,,0.96,,955.2,Percent of total billed charges,,,0.95,,945.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,945.25,Percent of total billed charges,,945.25,3950,
"Complicated repair wound of scalp, limbs, 1.1-2.5 cm",PX-45010395,CDM,13120,CPT,450,RC,,inpatient,,,848,763.2,,0.95,,805.6,Percent of total billed charges,,,0.98,,831.04,Percent of total billed charges,,,0.95,,805.6,Percent of total billed charges,,,0.97,,822.56,Percent of total billed charges,,,0.97,,822.56,Percent of total billed charges,,,0.96,,814.08,Percent of total billed charges,,,0.95,,805.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,805.6,Percent of total billed charges,,805.6,3950,
"Complicated repair wound of scalp, limbs, 1.1-2.5 cm",PX-45010395,CDM,13120,CPT,450,RC,,outpatient,,,848,763.2,,0.95,,805.6,Percent of total billed charges,,,0.98,,831.04,Percent of total billed charges,,,0.95,,805.6,Percent of total billed charges,,,0.95,,805.6,Percent of total billed charges,,,0.97,,822.56,Percent of total billed charges,,,0.96,,814.08,Percent of total billed charges,,,0.95,,805.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,805.6,Percent of total billed charges,,805.6,3950,
"Complicated repair wound of scalp, limbs, 2.6-7.5 cm",PX-45010396,CDM,13121,CPT,450,RC,,inpatient,,,1343,1208.7,,0.95,,1275.85,Percent of total billed charges,,,0.98,,1316.14,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,0.97,,1302.71,Percent of total billed charges,,,0.97,,1302.71,Percent of total billed charges,,,0.96,,1289.28,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1275.85,Percent of total billed charges,,1275.85,3950,
"Complicated repair wound of scalp, limbs, 2.6-7.5 cm",PX-45010396,CDM,13121,CPT,450,RC,,outpatient,,,1343,1208.7,,0.95,,1275.85,Percent of total billed charges,,,0.98,,1316.14,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,0.97,,1302.71,Percent of total billed charges,,,0.96,,1289.28,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1275.85,Percent of total billed charges,,1275.85,3950,
"Complicated repair wound of scalp, limbs, add <=5.0 cm",PX-45010398,CDM,13122,CPT,450,RC,,inpatient,,,320,288,,0.95,,304,Percent of total billed charges,,,0.98,,313.6,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,0.97,,310.4,Percent of total billed charges,,,0.97,,310.4,Percent of total billed charges,,,0.96,,307.2,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,,,,,,,0.95,,304,Percent of total billed charges,,304,313.6,
"Complicated repair wound of scalp, limbs, add <=5.0 cm",PX-45010398,CDM,13122,CPT,450,RC,,outpatient,,,320,288,,0.95,,304,Percent of total billed charges,,,0.98,,313.6,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,0.97,,310.4,Percent of total billed charges,,,0.96,,307.2,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,,,,,,,0.95,,304,Percent of total billed charges,,304,313.6,
"Complicated repair wound of body, 1.1-2.5 cm",PX-45010399,CDM,13131,CPT,450,RC,,inpatient,,,1068,961.2,,0.95,,1014.6,Percent of total billed charges,,,0.98,,1046.64,Percent of total billed charges,,,0.95,,1014.6,Percent of total billed charges,,,0.97,,1035.96,Percent of total billed charges,,,0.97,,1035.96,Percent of total billed charges,,,0.96,,1025.28,Percent of total billed charges,,,0.95,,1014.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1014.6,Percent of total billed charges,,1014.6,3950,
"Complicated repair wound of body, 1.1-2.5 cm",PX-45010399,CDM,13131,CPT,450,RC,,outpatient,,,1068,961.2,,0.95,,1014.6,Percent of total billed charges,,,0.98,,1046.64,Percent of total billed charges,,,0.95,,1014.6,Percent of total billed charges,,,0.95,,1014.6,Percent of total billed charges,,,0.97,,1035.96,Percent of total billed charges,,,0.96,,1025.28,Percent of total billed charges,,,0.95,,1014.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1014.6,Percent of total billed charges,,1014.6,3950,
"Complicated repair wound of body, 2.6-7.5 cm",PX-45010501,CDM,13132,CPT,450,RC,,inpatient,,,1821,1638.9,,0.95,,1729.95,Percent of total billed charges,,,0.98,,1784.58,Percent of total billed charges,,,0.95,,1729.95,Percent of total billed charges,,,0.97,,1766.37,Percent of total billed charges,,,0.97,,1766.37,Percent of total billed charges,,,0.96,,1748.16,Percent of total billed charges,,,0.95,,1729.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1729.95,Percent of total billed charges,,1729.95,3950,
"Complicated repair wound of body, 2.6-7.5 cm",PX-45010501,CDM,13132,CPT,450,RC,,outpatient,,,1821,1638.9,,0.95,,1729.95,Percent of total billed charges,,,0.98,,1784.58,Percent of total billed charges,,,0.95,,1729.95,Percent of total billed charges,,,0.95,,1729.95,Percent of total billed charges,,,0.97,,1766.37,Percent of total billed charges,,,0.96,,1748.16,Percent of total billed charges,,,0.95,,1729.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1729.95,Percent of total billed charges,,1729.95,3950,
"Simple repair surface wound of head, 1.1-2.5 cm",PX-45010504,CDM,13151,CPT,450,RC,,inpatient,,,1320,1188,,0.95,,1254,Percent of total billed charges,,,0.98,,1293.6,Percent of total billed charges,,,0.95,,1254,Percent of total billed charges,,,0.97,,1280.4,Percent of total billed charges,,,0.97,,1280.4,Percent of total billed charges,,,0.96,,1267.2,Percent of total billed charges,,,0.95,,1254,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1254,Percent of total billed charges,,1254,3950,
"Simple repair surface wound of head, 1.1-2.5 cm",PX-45010504,CDM,13151,CPT,450,RC,,outpatient,,,1320,1188,,0.95,,1254,Percent of total billed charges,,,0.98,,1293.6,Percent of total billed charges,,,0.95,,1254,Percent of total billed charges,,,0.95,,1254,Percent of total billed charges,,,0.97,,1280.4,Percent of total billed charges,,,0.96,,1267.2,Percent of total billed charges,,,0.95,,1254,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1254,Percent of total billed charges,,1254,3950,
"Complicated repair wound of head, 2.6-7.5 cm",PX-45010505,CDM,13152,CPT,450,RC,,inpatient,,,2286,2057.4,,0.95,,2171.7,Percent of total billed charges,,,0.98,,2240.28,Percent of total billed charges,,,0.95,,2171.7,Percent of total billed charges,,,0.97,,2217.42,Percent of total billed charges,,,0.97,,2217.42,Percent of total billed charges,,,0.96,,2194.56,Percent of total billed charges,,,0.95,,2171.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2171.7,Percent of total billed charges,,2171.7,3950,
"Complicated repair wound of head, 2.6-7.5 cm",PX-45010505,CDM,13152,CPT,450,RC,,outpatient,,,2286,2057.4,,0.95,,2171.7,Percent of total billed charges,,,0.98,,2240.28,Percent of total billed charges,,,0.95,,2171.7,Percent of total billed charges,,,0.95,,2171.7,Percent of total billed charges,,,0.97,,2217.42,Percent of total billed charges,,,0.96,,2194.56,Percent of total billed charges,,,0.95,,2171.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2171.7,Percent of total billed charges,,2171.7,3950,
Repair of tissue loss of finger or toe,PX-45010511,CDM,14350,CPT,450,RC,,inpatient,,,2633,2369.7,,0.95,,2501.35,Percent of total billed charges,,,0.98,,2580.34,Percent of total billed charges,,,0.95,,2501.35,Percent of total billed charges,,,0.97,,2554.01,Percent of total billed charges,,,0.97,,2554.01,Percent of total billed charges,,,0.96,,2527.68,Percent of total billed charges,,,0.95,,2501.35,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2501.35,Percent of total billed charges,,2501.35,3950,
Repair of tissue loss of finger or toe,PX-45010511,CDM,14350,CPT,450,RC,,outpatient,,,2633,2369.7,,0.95,,2501.35,Percent of total billed charges,,,0.98,,2580.34,Percent of total billed charges,,,0.95,,2501.35,Percent of total billed charges,,,0.95,,2501.35,Percent of total billed charges,,,0.97,,2554.01,Percent of total billed charges,,,0.96,,2527.68,Percent of total billed charges,,,0.95,,2501.35,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2501.35,Percent of total billed charges,,2501.35,3950,
"Skin graft to tip of finger or toe, 2.0 cm or less",PX-45010512,CDM,15050,CPT,450,RC,,inpatient,,,1299,1169.1,,0.95,,1234.05,Percent of total billed charges,,,0.98,,1273.02,Percent of total billed charges,,,0.95,,1234.05,Percent of total billed charges,,,0.97,,1260.03,Percent of total billed charges,,,0.97,,1260.03,Percent of total billed charges,,,0.96,,1247.04,Percent of total billed charges,,,0.95,,1234.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1234.05,Percent of total billed charges,,1234.05,3950,
"Skin graft to tip of finger or toe, 2.0 cm or less",PX-45010512,CDM,15050,CPT,450,RC,,outpatient,,,1299,1169.1,,0.95,,1234.05,Percent of total billed charges,,,0.98,,1273.02,Percent of total billed charges,,,0.95,,1234.05,Percent of total billed charges,,,0.95,,1234.05,Percent of total billed charges,,,0.97,,1260.03,Percent of total billed charges,,,0.96,,1247.04,Percent of total billed charges,,,0.95,,1234.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1234.05,Percent of total billed charges,,1234.05,3950,
First degree burn treatment,PX-45010518,CDM,16000,CPT,450,RC,,inpatient,,,196,176.4,,0.95,,186.2,Percent of total billed charges,,,0.98,,192.08,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,0.97,,190.12,Percent of total billed charges,,,0.97,,190.12,Percent of total billed charges,,,0.96,,188.16,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,186.2,Percent of total billed charges,,186.2,3950,
First degree burn treatment,PX-45010518,CDM,16000,CPT,450,RC,,outpatient,,,196,176.4,,0.95,,186.2,Percent of total billed charges,,,0.98,,192.08,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,0.97,,190.12,Percent of total billed charges,,,0.96,,188.16,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,186.2,Percent of total billed charges,,186.2,3950,
"Dressing change or remove burn tissue, <5% body surface",PX-45010519,CDM,16020,CPT,450,RC,,inpatient,,,216,194.4,,0.95,,205.2,Percent of total billed charges,,,0.98,,211.68,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,0.97,,209.52,Percent of total billed charges,,,0.97,,209.52,Percent of total billed charges,,,0.96,,207.36,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,205.2,Percent of total billed charges,,205.2,3950,
"Dressing change or remove burn tissue, <5% body surface",PX-45010519,CDM,16020,CPT,450,RC,,outpatient,,,216,194.4,,0.95,,205.2,Percent of total billed charges,,,0.98,,211.68,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,0.97,,209.52,Percent of total billed charges,,,0.96,,207.36,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,205.2,Percent of total billed charges,,205.2,3950,
"Dressing change or remove burn tissue, 5-10% body surface",PX-45010520,CDM,16025,CPT,450,RC,,inpatient,,,384,345.6,,0.95,,364.8,Percent of total billed charges,,,0.98,,376.32,Percent of total billed charges,,,0.95,,364.8,Percent of total billed charges,,,0.97,,372.48,Percent of total billed charges,,,0.97,,372.48,Percent of total billed charges,,,0.96,,368.64,Percent of total billed charges,,,0.95,,364.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,364.8,Percent of total billed charges,,364.8,3950,
"Dressing change or remove burn tissue, 5-10% body surface",PX-45010520,CDM,16025,CPT,450,RC,,outpatient,,,384,345.6,,0.95,,364.8,Percent of total billed charges,,,0.98,,376.32,Percent of total billed charges,,,0.95,,364.8,Percent of total billed charges,,,0.95,,364.8,Percent of total billed charges,,,0.97,,372.48,Percent of total billed charges,,,0.96,,368.64,Percent of total billed charges,,,0.95,,364.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,364.8,Percent of total billed charges,,364.8,3950,
HC ED Dress/Debrid P-Thick Burn L >10% Tbsa Cdm,PX-45010521,CDM,16030,CPT,450,RC,,inpatient,,,486,437.4,,0.95,,461.7,Percent of total billed charges,,,0.98,,476.28,Percent of total billed charges,,,0.95,,461.7,Percent of total billed charges,,,0.97,,471.42,Percent of total billed charges,,,0.97,,471.42,Percent of total billed charges,,,0.96,,466.56,Percent of total billed charges,,,0.95,,461.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,461.7,Percent of total billed charges,,461.7,3950,
HC ED Dress/Debrid P-Thick Burn L >10% Tbsa Cdm,PX-45010521,CDM,16030,CPT,450,RC,,outpatient,,,486,437.4,,0.95,,461.7,Percent of total billed charges,,,0.98,,476.28,Percent of total billed charges,,,0.95,,461.7,Percent of total billed charges,,,0.95,,461.7,Percent of total billed charges,,,0.97,,471.42,Percent of total billed charges,,,0.96,,466.56,Percent of total billed charges,,,0.95,,461.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,461.7,Percent of total billed charges,,461.7,3950,
"Exploration of wound of abdomen, back, or flank",PX-45010532,CDM,20102,CPT,450,RC,,inpatient,,,2604,2343.6,,0.95,,2473.8,Percent of total billed charges,,,0.98,,2551.92,Percent of total billed charges,,,0.95,,2473.8,Percent of total billed charges,,,0.97,,2525.88,Percent of total billed charges,,,0.97,,2525.88,Percent of total billed charges,,,0.96,,2499.84,Percent of total billed charges,,,0.95,,2473.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2473.8,Percent of total billed charges,,2473.8,3950,
"Exploration of wound of abdomen, back, or flank",PX-45010532,CDM,20102,CPT,450,RC,,outpatient,,,2604,2343.6,,0.95,,2473.8,Percent of total billed charges,,,0.98,,2551.92,Percent of total billed charges,,,0.95,,2473.8,Percent of total billed charges,,,0.95,,2473.8,Percent of total billed charges,,,0.97,,2525.88,Percent of total billed charges,,,0.96,,2499.84,Percent of total billed charges,,,0.95,,2473.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2473.8,Percent of total billed charges,,2473.8,3950,
Exploration of wound of arm or leg,PX-45010533,CDM,20103,CPT,450,RC,,inpatient,,,1935,1741.5,,0.95,,1838.25,Percent of total billed charges,,,0.98,,1896.3,Percent of total billed charges,,,0.95,,1838.25,Percent of total billed charges,,,0.97,,1876.95,Percent of total billed charges,,,0.97,,1876.95,Percent of total billed charges,,,0.96,,1857.6,Percent of total billed charges,,,0.95,,1838.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1838.25,Percent of total billed charges,,1838.25,3950,
Exploration of wound of arm or leg,PX-45010533,CDM,20103,CPT,450,RC,,outpatient,,,1935,1741.5,,0.95,,1838.25,Percent of total billed charges,,,0.98,,1896.3,Percent of total billed charges,,,0.95,,1838.25,Percent of total billed charges,,,0.95,,1838.25,Percent of total billed charges,,,0.97,,1876.95,Percent of total billed charges,,,0.96,,1857.6,Percent of total billed charges,,,0.95,,1838.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1838.25,Percent of total billed charges,,1838.25,3950,
Removal of foreign body in muscle or tendon,PX-45010534,CDM,20520,CPT,450,RC,,inpatient,,,624,561.6,,0.95,,592.8,Percent of total billed charges,,,0.98,,611.52,Percent of total billed charges,,,0.95,,592.8,Percent of total billed charges,,,0.97,,605.28,Percent of total billed charges,,,0.97,,605.28,Percent of total billed charges,,,0.96,,599.04,Percent of total billed charges,,,0.95,,592.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,592.8,Percent of total billed charges,,592.8,3950,
Removal of foreign body in muscle or tendon,PX-45010534,CDM,20520,CPT,450,RC,,outpatient,,,624,561.6,,0.95,,592.8,Percent of total billed charges,,,0.98,,611.52,Percent of total billed charges,,,0.95,,592.8,Percent of total billed charges,,,0.95,,592.8,Percent of total billed charges,,,0.97,,605.28,Percent of total billed charges,,,0.96,,599.04,Percent of total billed charges,,,0.95,,592.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,592.8,Percent of total billed charges,,592.8,3950,
Complicated remove foreign body in deep muscle/tendon,PX-45010535,CDM,20525,CPT,450,RC,,inpatient,,,1426,1283.4,,0.95,,1354.7,Percent of total billed charges,,,0.98,,1397.48,Percent of total billed charges,,,0.95,,1354.7,Percent of total billed charges,,,0.97,,1383.22,Percent of total billed charges,,,0.97,,1383.22,Percent of total billed charges,,,0.96,,1368.96,Percent of total billed charges,,,0.95,,1354.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1354.7,Percent of total billed charges,,1354.7,3950,
Complicated remove foreign body in deep muscle/tendon,PX-45010535,CDM,20525,CPT,450,RC,,outpatient,,,1426,1283.4,,0.95,,1354.7,Percent of total billed charges,,,0.98,,1397.48,Percent of total billed charges,,,0.95,,1354.7,Percent of total billed charges,,,0.95,,1354.7,Percent of total billed charges,,,0.97,,1383.22,Percent of total billed charges,,,0.96,,1368.96,Percent of total billed charges,,,0.95,,1354.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1354.7,Percent of total billed charges,,1354.7,3950,
Injection of carpal tunnel,PX-45010536,CDM,20526,CPT,450,RC,,inpatient,,,338,304.2,,0.95,,321.1,Percent of total billed charges,,,0.98,,331.24,Percent of total billed charges,,,0.95,,321.1,Percent of total billed charges,,,0.97,,327.86,Percent of total billed charges,,,0.97,,327.86,Percent of total billed charges,,,0.96,,324.48,Percent of total billed charges,,,0.95,,321.1,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,321.1,Percent of total billed charges,,321.1,3950,
Injection of carpal tunnel,PX-45010536,CDM,20526,CPT,450,RC,,outpatient,,,338,304.2,,0.95,,321.1,Percent of total billed charges,,,0.98,,331.24,Percent of total billed charges,,,0.95,,321.1,Percent of total billed charges,,,0.95,,321.1,Percent of total billed charges,,,0.97,,327.86,Percent of total billed charges,,,0.96,,324.48,Percent of total billed charges,,,0.95,,321.1,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,321.1,Percent of total billed charges,,321.1,3950,
Injection into tendon or ligament,PX-45010538,CDM,20550,CPT,450,RC,,inpatient,,,262,235.8,,0.95,,248.9,Percent of total billed charges,,,0.98,,256.76,Percent of total billed charges,,,0.95,,248.9,Percent of total billed charges,,,0.97,,254.14,Percent of total billed charges,,,0.97,,254.14,Percent of total billed charges,,,0.96,,251.52,Percent of total billed charges,,,0.95,,248.9,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,248.9,Percent of total billed charges,,248.9,3950,
Injection into tendon or ligament,PX-45010538,CDM,20550,CPT,450,RC,,outpatient,,,262,235.8,,0.95,,248.9,Percent of total billed charges,,,0.98,,256.76,Percent of total billed charges,,,0.95,,248.9,Percent of total billed charges,,,0.95,,248.9,Percent of total billed charges,,,0.97,,254.14,Percent of total billed charges,,,0.96,,251.52,Percent of total billed charges,,,0.95,,248.9,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,248.9,Percent of total billed charges,,248.9,3950,
"Injection of trigger points, 1-2 muscles",PX-45010539,CDM,20552,CPT,450,RC,,inpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,286.9,Percent of total billed charges,,286.9,3950,
"Injection of trigger points, 1-2 muscles",PX-45010539,CDM,20552,CPT,450,RC,,outpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,286.9,Percent of total billed charges,,286.9,3950,
"Injection of trigger points, 3 or more muscles",PX-45010540,CDM,20553,CPT,450,RC,,inpatient,,,579,521.1,,0.95,,550.05,Percent of total billed charges,,,0.98,,567.42,Percent of total billed charges,,,0.95,,550.05,Percent of total billed charges,,,0.97,,561.63,Percent of total billed charges,,,0.97,,561.63,Percent of total billed charges,,,0.96,,555.84,Percent of total billed charges,,,0.95,,550.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,550.05,Percent of total billed charges,,550.05,3950,
"Injection of trigger points, 3 or more muscles",PX-45010540,CDM,20553,CPT,450,RC,,outpatient,,,579,521.1,,0.95,,550.05,Percent of total billed charges,,,0.98,,567.42,Percent of total billed charges,,,0.95,,550.05,Percent of total billed charges,,,0.95,,550.05,Percent of total billed charges,,,0.97,,561.63,Percent of total billed charges,,,0.96,,555.84,Percent of total billed charges,,,0.95,,550.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,550.05,Percent of total billed charges,,550.05,3950,
Remove foreign body of shoulder joint,PX-45010546,CDM,23330,CPT,450,RC,,inpatient,,,594,534.6,,0.95,,564.3,Percent of total billed charges,,,0.98,,582.12,Percent of total billed charges,,,0.95,,564.3,Percent of total billed charges,,,0.97,,576.18,Percent of total billed charges,,,0.97,,576.18,Percent of total billed charges,,,0.96,,570.24,Percent of total billed charges,,,0.95,,564.3,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,564.3,Percent of total billed charges,,564.3,3950,
Remove foreign body of shoulder joint,PX-45010546,CDM,23330,CPT,450,RC,,outpatient,,,594,534.6,,0.95,,564.3,Percent of total billed charges,,,0.98,,582.12,Percent of total billed charges,,,0.95,,564.3,Percent of total billed charges,,,0.95,,564.3,Percent of total billed charges,,,0.97,,576.18,Percent of total billed charges,,,0.96,,570.24,Percent of total billed charges,,,0.95,,564.3,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,564.3,Percent of total billed charges,,564.3,3950,
Closed treatment of dislocated jaw joint,PX-45010556,CDM,21480,CPT,450,RC,,inpatient,,,520,468,,0.95,,494,Percent of total billed charges,,,0.98,,509.6,Percent of total billed charges,,,0.95,,494,Percent of total billed charges,,,0.97,,504.4,Percent of total billed charges,,,0.97,,504.4,Percent of total billed charges,,,0.96,,499.2,Percent of total billed charges,,,0.95,,494,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,494,Percent of total billed charges,,494,3950,
Closed treatment of dislocated jaw joint,PX-45010556,CDM,21480,CPT,450,RC,,outpatient,,,520,468,,0.95,,494,Percent of total billed charges,,,0.98,,509.6,Percent of total billed charges,,,0.95,,494,Percent of total billed charges,,,0.95,,494,Percent of total billed charges,,,0.97,,504.4,Percent of total billed charges,,,0.96,,499.2,Percent of total billed charges,,,0.95,,494,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,494,Percent of total billed charges,,494,3950,
Drain abscess in soft tissue of neck or chest,PX-45010557,CDM,21501,CPT,450,RC,,inpatient,,,1256,1130.4,,0.95,,1193.2,Percent of total billed charges,,,0.98,,1230.88,Percent of total billed charges,,,0.95,,1193.2,Percent of total billed charges,,,0.97,,1218.32,Percent of total billed charges,,,0.97,,1218.32,Percent of total billed charges,,,0.96,,1205.76,Percent of total billed charges,,,0.95,,1193.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1193.2,Percent of total billed charges,,1193.2,3950,
Drain abscess in soft tissue of neck or chest,PX-45010557,CDM,21501,CPT,450,RC,,outpatient,,,1256,1130.4,,0.95,,1193.2,Percent of total billed charges,,,0.98,,1230.88,Percent of total billed charges,,,0.95,,1193.2,Percent of total billed charges,,,0.95,,1193.2,Percent of total billed charges,,,0.97,,1218.32,Percent of total billed charges,,,0.96,,1205.76,Percent of total billed charges,,,0.95,,1193.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1193.2,Percent of total billed charges,,1193.2,3950,
Closed treatment of broken chest bone,PX-45010560,CDM,21820,CPT,450,RC,,inpatient,,,767,690.3,,0.95,,728.65,Percent of total billed charges,,,0.98,,751.66,Percent of total billed charges,,,0.95,,728.65,Percent of total billed charges,,,0.97,,743.99,Percent of total billed charges,,,0.97,,743.99,Percent of total billed charges,,,0.96,,736.32,Percent of total billed charges,,,0.95,,728.65,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,728.65,Percent of total billed charges,,728.65,3950,
Closed treatment of broken chest bone,PX-45010560,CDM,21820,CPT,450,RC,,outpatient,,,767,690.3,,0.95,,728.65,Percent of total billed charges,,,0.98,,751.66,Percent of total billed charges,,,0.95,,728.65,Percent of total billed charges,,,0.95,,728.65,Percent of total billed charges,,,0.97,,743.99,Percent of total billed charges,,,0.96,,736.32,Percent of total billed charges,,,0.95,,728.65,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,728.65,Percent of total billed charges,,728.65,3950,
Closed treatment of broken spine bone with cast or brace,PX-45010562,CDM,22310,CPT,450,RC,,inpatient,,,2176,1958.4,,0.95,,2067.2,Percent of total billed charges,,,0.98,,2132.48,Percent of total billed charges,,,0.95,,2067.2,Percent of total billed charges,,,0.97,,2110.72,Percent of total billed charges,,,0.97,,2110.72,Percent of total billed charges,,,0.96,,2088.96,Percent of total billed charges,,,0.95,,2067.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2067.2,Percent of total billed charges,,2067.2,3950,
Closed treatment of broken spine bone with cast or brace,PX-45010562,CDM,22310,CPT,450,RC,,outpatient,,,2176,1958.4,,0.95,,2067.2,Percent of total billed charges,,,0.98,,2132.48,Percent of total billed charges,,,0.95,,2067.2,Percent of total billed charges,,,0.95,,2067.2,Percent of total billed charges,,,0.97,,2110.72,Percent of total billed charges,,,0.96,,2088.96,Percent of total billed charges,,,0.95,,2067.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2067.2,Percent of total billed charges,,2067.2,3950,
Closed treatment of broken collar bone,PX-45010566,CDM,23500,CPT,450,RC,,inpatient,,,760,684,,0.95,,722,Percent of total billed charges,,,0.98,,744.8,Percent of total billed charges,,,0.95,,722,Percent of total billed charges,,,0.97,,737.2,Percent of total billed charges,,,0.97,,737.2,Percent of total billed charges,,,0.96,,729.6,Percent of total billed charges,,,0.95,,722,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,722,Percent of total billed charges,,722,3950,
Closed treatment of broken collar bone,PX-45010566,CDM,23500,CPT,450,RC,,outpatient,,,760,684,,0.95,,722,Percent of total billed charges,,,0.98,,744.8,Percent of total billed charges,,,0.95,,722,Percent of total billed charges,,,0.95,,722,Percent of total billed charges,,,0.97,,737.2,Percent of total billed charges,,,0.96,,729.6,Percent of total billed charges,,,0.95,,722,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,722,Percent of total billed charges,,722,3950,
Closed treatment of broken collar bone with manipulation,PX-45010569,CDM,23505,CPT,450,RC,,inpatient,,,1217,1095.3,,0.95,,1156.15,Percent of total billed charges,,,0.98,,1192.66,Percent of total billed charges,,,0.95,,1156.15,Percent of total billed charges,,,0.97,,1180.49,Percent of total billed charges,,,0.97,,1180.49,Percent of total billed charges,,,0.96,,1168.32,Percent of total billed charges,,,0.95,,1156.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1156.15,Percent of total billed charges,,1156.15,3950,
Closed treatment of broken collar bone with manipulation,PX-45010569,CDM,23505,CPT,450,RC,,outpatient,,,1217,1095.3,,0.95,,1156.15,Percent of total billed charges,,,0.98,,1192.66,Percent of total billed charges,,,0.95,,1156.15,Percent of total billed charges,,,0.95,,1156.15,Percent of total billed charges,,,0.97,,1180.49,Percent of total billed charges,,,0.96,,1168.32,Percent of total billed charges,,,0.95,,1156.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1156.15,Percent of total billed charges,,1156.15,3950,
Closed treat dislocated joint b/w collar bone and shoulder,PX-45010579,CDM,23545,CPT,450,RC,,inpatient,,,1041,936.9,,0.95,,988.95,Percent of total billed charges,,,0.98,,1020.18,Percent of total billed charges,,,0.95,,988.95,Percent of total billed charges,,,0.97,,1009.77,Percent of total billed charges,,,0.97,,1009.77,Percent of total billed charges,,,0.96,,999.36,Percent of total billed charges,,,0.95,,988.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,988.95,Percent of total billed charges,,988.95,3950,
Closed treat dislocated joint b/w collar bone and shoulder,PX-45010579,CDM,23545,CPT,450,RC,,outpatient,,,1041,936.9,,0.95,,988.95,Percent of total billed charges,,,0.98,,1020.18,Percent of total billed charges,,,0.95,,988.95,Percent of total billed charges,,,0.95,,988.95,Percent of total billed charges,,,0.97,,1009.77,Percent of total billed charges,,,0.96,,999.36,Percent of total billed charges,,,0.95,,988.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,988.95,Percent of total billed charges,,988.95,3950,
Closed treatment of broken top of upper arm bone,PX-45010585,CDM,23600,CPT,450,RC,,inpatient,,,1166,1049.4,,0.95,,1107.7,Percent of total billed charges,,,0.98,,1142.68,Percent of total billed charges,,,0.95,,1107.7,Percent of total billed charges,,,0.97,,1131.02,Percent of total billed charges,,,0.97,,1131.02,Percent of total billed charges,,,0.96,,1119.36,Percent of total billed charges,,,0.95,,1107.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1107.7,Percent of total billed charges,,1107.7,3950,
Closed treatment of broken top of upper arm bone,PX-45010585,CDM,23600,CPT,450,RC,,outpatient,,,1166,1049.4,,0.95,,1107.7,Percent of total billed charges,,,0.98,,1142.68,Percent of total billed charges,,,0.95,,1107.7,Percent of total billed charges,,,0.95,,1107.7,Percent of total billed charges,,,0.97,,1131.02,Percent of total billed charges,,,0.96,,1119.36,Percent of total billed charges,,,0.95,,1107.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1107.7,Percent of total billed charges,,1107.7,3950,
Closed treatment of broken top of upper arm bone,PX-45010588,CDM,23605,CPT,450,RC,,inpatient,,,528,475.2,,0.95,,501.6,Percent of total billed charges,,,0.98,,517.44,Percent of total billed charges,,,0.95,,501.6,Percent of total billed charges,,,0.97,,512.16,Percent of total billed charges,,,0.97,,512.16,Percent of total billed charges,,,0.96,,506.88,Percent of total billed charges,,,0.95,,501.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,501.6,Percent of total billed charges,,501.6,3950,
Closed treatment of broken top of upper arm bone,PX-45010588,CDM,23605,CPT,450,RC,,outpatient,,,528,475.2,,0.95,,501.6,Percent of total billed charges,,,0.98,,517.44,Percent of total billed charges,,,0.95,,501.6,Percent of total billed charges,,,0.95,,501.6,Percent of total billed charges,,,0.97,,512.16,Percent of total billed charges,,,0.96,,506.88,Percent of total billed charges,,,0.95,,501.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,501.6,Percent of total billed charges,,501.6,3950,
Closed treatment of dislocated shoulder,PX-45010594,CDM,23650,CPT,450,RC,,inpatient,,,1108,997.2,,0.95,,1052.6,Percent of total billed charges,,,0.98,,1085.84,Percent of total billed charges,,,0.95,,1052.6,Percent of total billed charges,,,0.97,,1074.76,Percent of total billed charges,,,0.97,,1074.76,Percent of total billed charges,,,0.96,,1063.68,Percent of total billed charges,,,0.95,,1052.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1052.6,Percent of total billed charges,,1052.6,3950,
Closed treatment of dislocated shoulder,PX-45010594,CDM,23650,CPT,450,RC,,outpatient,,,1108,997.2,,0.95,,1052.6,Percent of total billed charges,,,0.98,,1085.84,Percent of total billed charges,,,0.95,,1052.6,Percent of total billed charges,,,0.95,,1052.6,Percent of total billed charges,,,0.97,,1074.76,Percent of total billed charges,,,0.96,,1063.68,Percent of total billed charges,,,0.95,,1052.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1052.6,Percent of total billed charges,,1052.6,3950,
Closed treatment of dislocated shoulder,PX-45010596,CDM,23655,CPT,450,RC,,inpatient,,,1482,1333.8,,0.95,,1407.9,Percent of total billed charges,,,0.98,,1452.36,Percent of total billed charges,,,0.95,,1407.9,Percent of total billed charges,,,0.97,,1437.54,Percent of total billed charges,,,0.97,,1437.54,Percent of total billed charges,,,0.96,,1422.72,Percent of total billed charges,,,0.95,,1407.9,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1407.9,Percent of total billed charges,,1407.9,3950,
Closed treatment of dislocated shoulder,PX-45010596,CDM,23655,CPT,450,RC,,outpatient,,,1482,1333.8,,0.95,,1407.9,Percent of total billed charges,,,0.98,,1452.36,Percent of total billed charges,,,0.95,,1407.9,Percent of total billed charges,,,0.95,,1407.9,Percent of total billed charges,,,0.97,,1437.54,Percent of total billed charges,,,0.96,,1422.72,Percent of total billed charges,,,0.95,,1407.9,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1407.9,Percent of total billed charges,,1407.9,3950,
Closed treatment dislocated shoulder/broken upper arm bone,PX-45010598,CDM,23665,CPT,450,RC,,inpatient,,,1204,1083.6,,0.95,,1143.8,Percent of total billed charges,,,0.98,,1179.92,Percent of total billed charges,,,0.95,,1143.8,Percent of total billed charges,,,0.97,,1167.88,Percent of total billed charges,,,0.97,,1167.88,Percent of total billed charges,,,0.96,,1155.84,Percent of total billed charges,,,0.95,,1143.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1143.8,Percent of total billed charges,,1143.8,3950,
Closed treatment dislocated shoulder/broken upper arm bone,PX-45010598,CDM,23665,CPT,450,RC,,outpatient,,,1204,1083.6,,0.95,,1143.8,Percent of total billed charges,,,0.98,,1179.92,Percent of total billed charges,,,0.95,,1143.8,Percent of total billed charges,,,0.95,,1143.8,Percent of total billed charges,,,0.97,,1167.88,Percent of total billed charges,,,0.96,,1155.84,Percent of total billed charges,,,0.95,,1143.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1143.8,Percent of total billed charges,,1143.8,3950,
Drainage of fluid filled sac in elbow joint,PX-45010604,CDM,23931,CPT,450,RC,,inpatient,,,1067,960.3,,0.95,,1013.65,Percent of total billed charges,,,0.98,,1045.66,Percent of total billed charges,,,0.95,,1013.65,Percent of total billed charges,,,0.97,,1034.99,Percent of total billed charges,,,0.97,,1034.99,Percent of total billed charges,,,0.96,,1024.32,Percent of total billed charges,,,0.95,,1013.65,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1013.65,Percent of total billed charges,,1013.65,3950,
Drainage of fluid filled sac in elbow joint,PX-45010604,CDM,23931,CPT,450,RC,,outpatient,,,1067,960.3,,0.95,,1013.65,Percent of total billed charges,,,0.98,,1045.66,Percent of total billed charges,,,0.95,,1013.65,Percent of total billed charges,,,0.95,,1013.65,Percent of total billed charges,,,0.97,,1034.99,Percent of total billed charges,,,0.96,,1024.32,Percent of total billed charges,,,0.95,,1013.65,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1013.65,Percent of total billed charges,,1013.65,3950,
Remove foreign body of upper arm or elbow area,PX-45010606,CDM,24200,CPT,450,RC,,inpatient,,,643,578.7,,0.95,,610.85,Percent of total billed charges,,,0.98,,630.14,Percent of total billed charges,,,0.95,,610.85,Percent of total billed charges,,,0.97,,623.71,Percent of total billed charges,,,0.97,,623.71,Percent of total billed charges,,,0.96,,617.28,Percent of total billed charges,,,0.95,,610.85,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,610.85,Percent of total billed charges,,610.85,3950,
Remove foreign body of upper arm or elbow area,PX-45010606,CDM,24200,CPT,450,RC,,outpatient,,,643,578.7,,0.95,,610.85,Percent of total billed charges,,,0.98,,630.14,Percent of total billed charges,,,0.95,,610.85,Percent of total billed charges,,,0.95,,610.85,Percent of total billed charges,,,0.97,,623.71,Percent of total billed charges,,,0.96,,617.28,Percent of total billed charges,,,0.95,,610.85,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,610.85,Percent of total billed charges,,610.85,3950,
"Removal blood accumulation, fingernail or toenail",PX-45010609,CDM,11740,CPT,450,RC,,inpatient,,,150,135,,0.95,,142.5,Percent of total billed charges,,,0.98,,147,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,0.97,,145.5,Percent of total billed charges,,,0.97,,145.5,Percent of total billed charges,,,0.96,,144,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,142.5,Percent of total billed charges,,142.5,3950,
"Removal blood accumulation, fingernail or toenail",PX-45010609,CDM,11740,CPT,450,RC,,outpatient,,,150,135,,0.95,,142.5,Percent of total billed charges,,,0.98,,147,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,0.97,,145.5,Percent of total billed charges,,,0.96,,144,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,142.5,Percent of total billed charges,,142.5,3950,
Closed treatment of broken nose bone w/manipulation,PX-45010612,CDM,21315,CPT,450,RC,,inpatient,,,714,642.6,,0.95,,678.3,Percent of total billed charges,,,0.98,,699.72,Percent of total billed charges,,,0.95,,678.3,Percent of total billed charges,,,0.97,,692.58,Percent of total billed charges,,,0.97,,692.58,Percent of total billed charges,,,0.96,,685.44,Percent of total billed charges,,,0.95,,678.3,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,678.3,Percent of total billed charges,,678.3,3950,
Closed treatment of broken nose bone w/manipulation,PX-45010612,CDM,21315,CPT,450,RC,,outpatient,,,714,642.6,,0.95,,678.3,Percent of total billed charges,,,0.98,,699.72,Percent of total billed charges,,,0.95,,678.3,Percent of total billed charges,,,0.95,,678.3,Percent of total billed charges,,,0.97,,692.58,Percent of total billed charges,,,0.96,,685.44,Percent of total billed charges,,,0.95,,678.3,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,678.3,Percent of total billed charges,,678.3,3950,
"Remove cancer skin growth of head, > 4.0 cm",PX-51010344,CDM,11646,CPT,510,RC,,inpatient,,,2072,1864.8,,0.95,,1968.4,Percent of total billed charges,,,0.98,,2030.56,Percent of total billed charges,,,0.95,,1968.4,Percent of total billed charges,,,0.97,,2009.84,Percent of total billed charges,,,0.97,,2009.84,Percent of total billed charges,,,0.96,,1989.12,Percent of total billed charges,,,0.95,,1968.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1968.4,Percent of total billed charges,,1968.4,2030.56,
"Remove cancer skin growth of head, > 4.0 cm",PX-51010344,CDM,11646,CPT,510,RC,,outpatient,,,2072,1864.8,,0.95,,1968.4,Percent of total billed charges,,,0.98,,2030.56,Percent of total billed charges,,,0.95,,1968.4,Percent of total billed charges,,,0.95,,1968.4,Percent of total billed charges,,,0.97,,2009.84,Percent of total billed charges,,,0.96,,1989.12,Percent of total billed charges,,,0.95,,1968.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1968.4,Percent of total billed charges,,1968.4,2030.56,
"Fine needle aspiration biopsy, first growth",PX-51010401,CDM,10021,CPT,510,RC,,inpatient,,,492,442.8,,0.95,,467.4,Percent of total billed charges,,,0.98,,482.16,Percent of total billed charges,,,0.95,,467.4,Percent of total billed charges,,,0.97,,477.24,Percent of total billed charges,,,0.97,,477.24,Percent of total billed charges,,,0.96,,472.32,Percent of total billed charges,,,0.95,,467.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,467.4,Percent of total billed charges,,467.4,482.16,
"Fine needle aspiration biopsy, first growth",PX-51010401,CDM,10021,CPT,510,RC,,outpatient,,,492,442.8,,0.95,,467.4,Percent of total billed charges,,,0.98,,482.16,Percent of total billed charges,,,0.95,,467.4,Percent of total billed charges,,,0.95,,467.4,Percent of total billed charges,,,0.97,,477.24,Percent of total billed charges,,,0.96,,472.32,Percent of total billed charges,,,0.95,,467.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,467.4,Percent of total billed charges,,467.4,482.16,
"Shaving of skin growth of body, 0.5 cm or less",PX-51010410,CDM,11305,CPT,510,RC,,inpatient,,,204,183.6,,0.95,,193.8,Percent of total billed charges,,,0.98,,199.92,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.96,,195.84,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,193.8,Percent of total billed charges,,193.8,199.92,
"Shaving of skin growth of body, 0.5 cm or less",PX-51010410,CDM,11305,CPT,510,RC,,outpatient,,,204,183.6,,0.95,,193.8,Percent of total billed charges,,,0.98,,199.92,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.96,,195.84,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,193.8,Percent of total billed charges,,193.8,199.92,
"Remove skin growth body, arms, or legs, <= 0.5 cm",PX-51010417,CDM,11400,CPT,761,RC,,inpatient,,,434,390.6,,0.95,,412.3,Percent of total billed charges,,,0.98,,425.32,Percent of total billed charges,,,0.95,,412.3,Percent of total billed charges,,,0.97,,420.98,Percent of total billed charges,,,0.97,,420.98,Percent of total billed charges,,,0.96,,416.64,Percent of total billed charges,,,0.95,,412.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,412.3,Percent of total billed charges,,412.3,425.32,
"Remove skin growth body, arms, or legs, <= 0.5 cm",PX-51010417,CDM,11400,CPT,761,RC,,outpatient,,,434,390.6,,0.95,,412.3,Percent of total billed charges,,,0.98,,425.32,Percent of total billed charges,,,0.95,,412.3,Percent of total billed charges,,,0.95,,412.3,Percent of total billed charges,,,0.97,,420.98,Percent of total billed charges,,,0.96,,416.64,Percent of total billed charges,,,0.95,,412.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,412.3,Percent of total billed charges,,412.3,425.32,
"Remove skin growth body, arms, or legs, 1.1-2.0 cm",PX-51010418,CDM,11402,CPT,510,RC,,inpatient,,,621,558.9,,0.95,,589.95,Percent of total billed charges,,,0.98,,608.58,Percent of total billed charges,,,0.95,,589.95,Percent of total billed charges,,,0.97,,602.37,Percent of total billed charges,,,0.97,,602.37,Percent of total billed charges,,,0.96,,596.16,Percent of total billed charges,,,0.95,,589.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,589.95,Percent of total billed charges,,589.95,608.58,
"Remove skin growth body, arms, or legs, 1.1-2.0 cm",PX-51010418,CDM,11402,CPT,510,RC,,outpatient,,,621,558.9,,0.95,,589.95,Percent of total billed charges,,,0.98,,608.58,Percent of total billed charges,,,0.95,,589.95,Percent of total billed charges,,,0.95,,589.95,Percent of total billed charges,,,0.97,,602.37,Percent of total billed charges,,,0.96,,596.16,Percent of total billed charges,,,0.95,,589.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,589.95,Percent of total billed charges,,589.95,608.58,
"Remove noncancer skin growth of body, > 4.0 cm",PX-51010421,CDM,11406,CPT,510,RC,,inpatient,,,936,842.4,,0.95,,889.2,Percent of total billed charges,,,0.98,,917.28,Percent of total billed charges,,,0.95,,889.2,Percent of total billed charges,,,0.97,,907.92,Percent of total billed charges,,,0.97,,907.92,Percent of total billed charges,,,0.96,,898.56,Percent of total billed charges,,,0.95,,889.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,889.2,Percent of total billed charges,,889.2,917.28,
"Remove noncancer skin growth of body, > 4.0 cm",PX-51010421,CDM,11406,CPT,510,RC,,outpatient,,,936,842.4,,0.95,,889.2,Percent of total billed charges,,,0.98,,917.28,Percent of total billed charges,,,0.95,,889.2,Percent of total billed charges,,,0.95,,889.2,Percent of total billed charges,,,0.97,,907.92,Percent of total billed charges,,,0.96,,898.56,Percent of total billed charges,,,0.95,,889.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,889.2,Percent of total billed charges,,889.2,917.28,
"Remove cancer skin growth of body, 0.6-1.0 cm",PX-51010433,CDM,11621,CPT,510,RC,,inpatient,,,726,653.4,,0.95,,689.7,Percent of total billed charges,,,0.98,,711.48,Percent of total billed charges,,,0.95,,689.7,Percent of total billed charges,,,0.97,,704.22,Percent of total billed charges,,,0.97,,704.22,Percent of total billed charges,,,0.96,,696.96,Percent of total billed charges,,,0.95,,689.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,689.7,Percent of total billed charges,,689.7,711.48,
"Remove cancer skin growth of body, 0.6-1.0 cm",PX-51010433,CDM,11621,CPT,510,RC,,outpatient,,,726,653.4,,0.95,,689.7,Percent of total billed charges,,,0.98,,711.48,Percent of total billed charges,,,0.95,,689.7,Percent of total billed charges,,,0.95,,689.7,Percent of total billed charges,,,0.97,,704.22,Percent of total billed charges,,,0.96,,696.96,Percent of total billed charges,,,0.95,,689.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,689.7,Percent of total billed charges,,689.7,711.48,
"Remove cancer skin growth of head, 0.6-1.0 cm",PX-51010437,CDM,11641,CPT,510,RC,,inpatient,,,824,741.6,,0.95,,782.8,Percent of total billed charges,,,0.98,,807.52,Percent of total billed charges,,,0.95,,782.8,Percent of total billed charges,,,0.97,,799.28,Percent of total billed charges,,,0.97,,799.28,Percent of total billed charges,,,0.96,,791.04,Percent of total billed charges,,,0.95,,782.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,782.8,Percent of total billed charges,,782.8,807.52,
"Remove cancer skin growth of head, 0.6-1.0 cm",PX-51010437,CDM,11641,CPT,510,RC,,outpatient,,,824,741.6,,0.95,,782.8,Percent of total billed charges,,,0.98,,807.52,Percent of total billed charges,,,0.95,,782.8,Percent of total billed charges,,,0.95,,782.8,Percent of total billed charges,,,0.97,,799.28,Percent of total billed charges,,,0.96,,791.04,Percent of total billed charges,,,0.95,,782.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,782.8,Percent of total billed charges,,782.8,807.52,
"Remove cancer skin growth of head, 1.1-2.0 cm",PX-51010438,CDM,11642,CPT,510,RC,,inpatient,,,1024,921.6,,0.95,,972.8,Percent of total billed charges,,,0.98,,1003.52,Percent of total billed charges,,,0.95,,972.8,Percent of total billed charges,,,0.97,,993.28,Percent of total billed charges,,,0.97,,993.28,Percent of total billed charges,,,0.96,,983.04,Percent of total billed charges,,,0.95,,972.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,972.8,Percent of total billed charges,,972.8,1003.52,
"Remove cancer skin growth of head, 1.1-2.0 cm",PX-51010438,CDM,11642,CPT,510,RC,,outpatient,,,1024,921.6,,0.95,,972.8,Percent of total billed charges,,,0.98,,1003.52,Percent of total billed charges,,,0.95,,972.8,Percent of total billed charges,,,0.95,,972.8,Percent of total billed charges,,,0.97,,993.28,Percent of total billed charges,,,0.96,,983.04,Percent of total billed charges,,,0.95,,972.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,972.8,Percent of total billed charges,,972.8,1003.52,
Trimming of fingernails or toenails,PX-51010440,CDM,11719,CPT,510,RC,,inpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
Trimming of fingernails or toenails,PX-51010440,CDM,11719,CPT,510,RC,,outpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
"Shaving of skin growth of head, 0.5 cm or less",PX-51010414,CDM,11310,CPT,510,RC,,inpatient,,,260,234,,0.95,,247,Percent of total billed charges,,,0.98,,254.8,Percent of total billed charges,,,0.95,,247,Percent of total billed charges,,,0.97,,252.2,Percent of total billed charges,,,0.97,,252.2,Percent of total billed charges,,,0.96,,249.6,Percent of total billed charges,,,0.95,,247,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,247,Percent of total billed charges,,247,254.8,
"Shaving of skin growth of head, 0.5 cm or less",PX-51010414,CDM,11310,CPT,510,RC,,outpatient,,,260,234,,0.95,,247,Percent of total billed charges,,,0.98,,254.8,Percent of total billed charges,,,0.95,,247,Percent of total billed charges,,,0.95,,247,Percent of total billed charges,,,0.97,,252.2,Percent of total billed charges,,,0.96,,249.6,Percent of total billed charges,,,0.95,,247,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,247,Percent of total billed charges,,247,254.8,
"Remove cancer skin growth of body, limbs, 0.6-1.0 cm",PX-51010428,CDM,11601,CPT,510,RC,,inpatient,,,925,832.5,,0.95,,878.75,Percent of total billed charges,,,0.98,,906.5,Percent of total billed charges,,,0.95,,878.75,Percent of total billed charges,,,0.97,,897.25,Percent of total billed charges,,,0.97,,897.25,Percent of total billed charges,,,0.96,,888,Percent of total billed charges,,,0.95,,878.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,878.75,Percent of total billed charges,,878.75,906.5,
"Remove cancer skin growth of body, limbs, 0.6-1.0 cm",PX-51010428,CDM,11601,CPT,510,RC,,outpatient,,,925,832.5,,0.95,,878.75,Percent of total billed charges,,,0.98,,906.5,Percent of total billed charges,,,0.95,,878.75,Percent of total billed charges,,,0.95,,878.75,Percent of total billed charges,,,0.97,,897.25,Percent of total billed charges,,,0.96,,888,Percent of total billed charges,,,0.95,,878.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,878.75,Percent of total billed charges,,878.75,906.5,
HC PR 11404 Exc Tr-Ext B9+Marg 3.1-4 Cm,PX-96910485,CDM,11404,CPT,983,RC,,inpatient,,,555,499.5,,0.95,,527.25,Percent of total billed charges,,,0.98,,543.9,Percent of total billed charges,,,0.95,,527.25,Percent of total billed charges,,,0.97,,538.35,Percent of total billed charges,,,0.97,,538.35,Percent of total billed charges,,,0.96,,532.8,Percent of total billed charges,,,0.95,,527.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,527.25,Percent of total billed charges,,527.25,543.9,
HC PR 11404 Exc Tr-Ext B9+Marg 3.1-4 Cm,PX-96910485,CDM,11404,CPT,983,RC,,outpatient,,,555,499.5,,0.95,,527.25,Percent of total billed charges,,,0.98,,543.9,Percent of total billed charges,,,0.95,,527.25,Percent of total billed charges,,,0.95,,527.25,Percent of total billed charges,,,0.97,,538.35,Percent of total billed charges,,,0.96,,532.8,Percent of total billed charges,,,0.95,,527.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,527.25,Percent of total billed charges,,527.25,543.9,
HC PR 11421 Exc H-F-Nk-Sp B9+Marg 0.6-1,PX-96910489,CDM,11421,CPT,983,RC,,inpatient,,,419,377.1,,0.95,,398.05,Percent of total billed charges,,,0.98,,410.62,Percent of total billed charges,,,0.95,,398.05,Percent of total billed charges,,,0.97,,406.43,Percent of total billed charges,,,0.97,,406.43,Percent of total billed charges,,,0.96,,402.24,Percent of total billed charges,,,0.95,,398.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,398.05,Percent of total billed charges,,398.05,410.62,
HC PR 11421 Exc H-F-Nk-Sp B9+Marg 0.6-1,PX-96910489,CDM,11421,CPT,983,RC,,outpatient,,,419,377.1,,0.95,,398.05,Percent of total billed charges,,,0.98,,410.62,Percent of total billed charges,,,0.95,,398.05,Percent of total billed charges,,,0.95,,398.05,Percent of total billed charges,,,0.97,,406.43,Percent of total billed charges,,,0.96,,402.24,Percent of total billed charges,,,0.95,,398.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,398.05,Percent of total billed charges,,398.05,410.62,
HC PR 11441 Exc Face-Mm B9+Marg 0.6-1 Cm,PX-96910492,CDM,11441,CPT,983,RC,,inpatient,,,450,405,,0.95,,427.5,Percent of total billed charges,,,0.98,,441,Percent of total billed charges,,,0.95,,427.5,Percent of total billed charges,,,0.97,,436.5,Percent of total billed charges,,,0.97,,436.5,Percent of total billed charges,,,0.96,,432,Percent of total billed charges,,,0.95,,427.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,427.5,Percent of total billed charges,,427.5,441,
HC PR 11441 Exc Face-Mm B9+Marg 0.6-1 Cm,PX-96910492,CDM,11441,CPT,983,RC,,outpatient,,,450,405,,0.95,,427.5,Percent of total billed charges,,,0.98,,441,Percent of total billed charges,,,0.95,,427.5,Percent of total billed charges,,,0.95,,427.5,Percent of total billed charges,,,0.97,,436.5,Percent of total billed charges,,,0.96,,432,Percent of total billed charges,,,0.95,,427.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,427.5,Percent of total billed charges,,427.5,441,
HC PR 11450 Removal Sweat Gland Lesion Axil,PX-96910493,CDM,11450,CPT,983,RC,,inpatient,,,1063,956.7,,0.95,,1009.85,Percent of total billed charges,,,0.98,,1041.74,Percent of total billed charges,,,0.95,,1009.85,Percent of total billed charges,,,0.97,,1031.11,Percent of total billed charges,,,0.97,,1031.11,Percent of total billed charges,,,0.96,,1020.48,Percent of total billed charges,,,0.95,,1009.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1009.85,Percent of total billed charges,,1009.85,1041.74,
HC PR 11450 Removal Sweat Gland Lesion Axil,PX-96910493,CDM,11450,CPT,983,RC,,outpatient,,,1063,956.7,,0.95,,1009.85,Percent of total billed charges,,,0.98,,1041.74,Percent of total billed charges,,,0.95,,1009.85,Percent of total billed charges,,,0.95,,1009.85,Percent of total billed charges,,,0.97,,1031.11,Percent of total billed charges,,,0.96,,1020.48,Percent of total billed charges,,,0.95,,1009.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1009.85,Percent of total billed charges,,1009.85,1041.74,
HC PR 11600 Exc Tr-Ext Mlg+Marg 0.5 < Cm,PX-96910494,CDM,11600,CPT,983,RC,,inpatient,,,514,462.6,,0.95,,488.3,Percent of total billed charges,,,0.98,,503.72,Percent of total billed charges,,,0.95,,488.3,Percent of total billed charges,,,0.97,,498.58,Percent of total billed charges,,,0.97,,498.58,Percent of total billed charges,,,0.96,,493.44,Percent of total billed charges,,,0.95,,488.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,488.3,Percent of total billed charges,,488.3,503.72,
HC PR 11600 Exc Tr-Ext Mlg+Marg 0.5 < Cm,PX-96910494,CDM,11600,CPT,983,RC,,outpatient,,,514,462.6,,0.95,,488.3,Percent of total billed charges,,,0.98,,503.72,Percent of total billed charges,,,0.95,,488.3,Percent of total billed charges,,,0.95,,488.3,Percent of total billed charges,,,0.97,,498.58,Percent of total billed charges,,,0.96,,493.44,Percent of total billed charges,,,0.95,,488.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,488.3,Percent of total billed charges,,488.3,503.72,
HC PR 11601 Exc Tr-Ext Mlg+Marg 0.6-1 Cm,PX-96910495,CDM,11601,CPT,983,RC,,inpatient,,,607,546.3,,0.95,,576.65,Percent of total billed charges,,,0.98,,594.86,Percent of total billed charges,,,0.95,,576.65,Percent of total billed charges,,,0.97,,588.79,Percent of total billed charges,,,0.97,,588.79,Percent of total billed charges,,,0.96,,582.72,Percent of total billed charges,,,0.95,,576.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,576.65,Percent of total billed charges,,576.65,594.86,
HC PR 11601 Exc Tr-Ext Mlg+Marg 0.6-1 Cm,PX-96910495,CDM,11601,CPT,983,RC,,outpatient,,,607,546.3,,0.95,,576.65,Percent of total billed charges,,,0.98,,594.86,Percent of total billed charges,,,0.95,,576.65,Percent of total billed charges,,,0.95,,576.65,Percent of total billed charges,,,0.97,,588.79,Percent of total billed charges,,,0.96,,582.72,Percent of total billed charges,,,0.95,,576.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,576.65,Percent of total billed charges,,576.65,594.86,
Exc Tr-Ext Mlg+Marg 1.1-2 Cm,PX-96910496,CDM,11602,CPT,983,RC,,inpatient,,,690,621,,0.95,,655.5,Percent of total billed charges,,,0.98,,676.2,Percent of total billed charges,,,0.95,,655.5,Percent of total billed charges,,,0.97,,669.3,Percent of total billed charges,,,0.97,,669.3,Percent of total billed charges,,,0.96,,662.4,Percent of total billed charges,,,0.95,,655.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,655.5,Percent of total billed charges,,655.5,676.2,
Exc Tr-Ext Mlg+Marg 1.1-2 Cm,PX-96910496,CDM,11602,CPT,983,RC,,outpatient,,,690,621,,0.95,,655.5,Percent of total billed charges,,,0.98,,676.2,Percent of total billed charges,,,0.95,,655.5,Percent of total billed charges,,,0.95,,655.5,Percent of total billed charges,,,0.97,,669.3,Percent of total billed charges,,,0.96,,662.4,Percent of total billed charges,,,0.95,,655.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,655.5,Percent of total billed charges,,655.5,676.2,
HC PR 11721 Debride Nail 6 or More,PX-96910498,CDM,11721,CPT,983,RC,,inpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC PR 11721 Debride Nail 6 or More,PX-96910498,CDM,11721,CPT,983,RC,,outpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC PR 11900 Injection Into Skin Lesions,PX-96910501,CDM,11900,CPT,983,RC,,inpatient,,,142,127.8,,0.95,,134.9,Percent of total billed charges,,,0.98,,139.16,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,0.97,,137.74,Percent of total billed charges,,,0.97,,137.74,Percent of total billed charges,,,0.96,,136.32,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,134.9,Percent of total billed charges,,134.9,139.16,
HC PR 11900 Injection Into Skin Lesions,PX-96910501,CDM,11900,CPT,983,RC,,outpatient,,,142,127.8,,0.95,,134.9,Percent of total billed charges,,,0.98,,139.16,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,0.97,,137.74,Percent of total billed charges,,,0.96,,136.32,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,134.9,Percent of total billed charges,,134.9,139.16,
HC PR 17110 Destruct B9 Lesion 1-14,PX-96910506,CDM,17110,CPT,983,RC,,inpatient,,,295,265.5,,0.95,,280.25,Percent of total billed charges,,,0.98,,289.1,Percent of total billed charges,,,0.95,,280.25,Percent of total billed charges,,,0.97,,286.15,Percent of total billed charges,,,0.97,,286.15,Percent of total billed charges,,,0.96,,283.2,Percent of total billed charges,,,0.95,,280.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,280.25,Percent of total billed charges,,280.25,289.1,
HC PR 17110 Destruct B9 Lesion 1-14,PX-96910506,CDM,17110,CPT,983,RC,,outpatient,,,295,265.5,,0.95,,280.25,Percent of total billed charges,,,0.98,,289.1,Percent of total billed charges,,,0.95,,280.25,Percent of total billed charges,,,0.95,,280.25,Percent of total billed charges,,,0.97,,286.15,Percent of total billed charges,,,0.96,,283.2,Percent of total billed charges,,,0.95,,280.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,280.25,Percent of total billed charges,,280.25,289.1,
HC PR 17261 Destruction of Skin Lesions Tnk/Arm/Lg M 0.6-1,PX-96910507,CDM,17261,CPT,983,RC,,inpatient,,,367,330.3,,0.95,,348.65,Percent of total billed charges,,,0.98,,359.66,Percent of total billed charges,,,0.95,,348.65,Percent of total billed charges,,,0.97,,355.99,Percent of total billed charges,,,0.97,,355.99,Percent of total billed charges,,,0.96,,352.32,Percent of total billed charges,,,0.95,,348.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,348.65,Percent of total billed charges,,348.65,359.66,
HC PR 17261 Destruction of Skin Lesions Tnk/Arm/Lg M 0.6-1,PX-96910507,CDM,17261,CPT,983,RC,,outpatient,,,367,330.3,,0.95,,348.65,Percent of total billed charges,,,0.98,,359.66,Percent of total billed charges,,,0.95,,348.65,Percent of total billed charges,,,0.95,,348.65,Percent of total billed charges,,,0.97,,355.99,Percent of total billed charges,,,0.96,,352.32,Percent of total billed charges,,,0.95,,348.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,348.65,Percent of total billed charges,,348.65,359.66,
HC PR 19120 Removal of Breast Lesion 1 or More Lesions,PX-96910513,CDM,19120,CPT,983,RC,,inpatient,,,1288,1159.2,,0.95,,1223.6,Percent of total billed charges,,,0.98,,1262.24,Percent of total billed charges,,,0.95,,1223.6,Percent of total billed charges,,,0.97,,1249.36,Percent of total billed charges,,,0.97,,1249.36,Percent of total billed charges,,,0.96,,1236.48,Percent of total billed charges,,,0.95,,1223.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1223.6,Percent of total billed charges,,1223.6,1262.24,
HC PR 19120 Removal of Breast Lesion 1 or More Lesions,PX-96910513,CDM,19120,CPT,983,RC,,outpatient,,,1288,1159.2,,0.95,,1223.6,Percent of total billed charges,,,0.98,,1262.24,Percent of total billed charges,,,0.95,,1223.6,Percent of total billed charges,,,0.95,,1223.6,Percent of total billed charges,,,0.97,,1249.36,Percent of total billed charges,,,0.96,,1236.48,Percent of total billed charges,,,0.95,,1223.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1223.6,Percent of total billed charges,,1223.6,1262.24,
HC PR 19125 Exc Breast Les Preop Plmt Rad Marker Open 1 Les,PX-96910514,CDM,19125,CPT,975,RC,,inpatient,,,1419,1277.1,,0.95,,1348.05,Percent of total billed charges,,,0.98,,1390.62,Percent of total billed charges,,,0.95,,1348.05,Percent of total billed charges,,,0.97,,1376.43,Percent of total billed charges,,,0.97,,1376.43,Percent of total billed charges,,,0.96,,1362.24,Percent of total billed charges,,,0.95,,1348.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1348.05,Percent of total billed charges,,1348.05,1390.62,
HC PR 19125 Exc Breast Les Preop Plmt Rad Marker Open 1 Les,PX-96910514,CDM,19125,CPT,975,RC,,outpatient,,,1419,1277.1,,0.95,,1348.05,Percent of total billed charges,,,0.98,,1390.62,Percent of total billed charges,,,0.95,,1348.05,Percent of total billed charges,,,0.95,,1348.05,Percent of total billed charges,,,0.97,,1376.43,Percent of total billed charges,,,0.96,,1362.24,Percent of total billed charges,,,0.95,,1348.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1348.05,Percent of total billed charges,,1348.05,1390.62,
HC PR 19301 Partial Mastectomy,PX-96910516,CDM,19301,CPT,983,RC,,inpatient,,,1632,1468.8,,0.95,,1550.4,Percent of total billed charges,,,0.98,,1599.36,Percent of total billed charges,,,0.95,,1550.4,Percent of total billed charges,,,0.97,,1583.04,Percent of total billed charges,,,0.97,,1583.04,Percent of total billed charges,,,0.96,,1566.72,Percent of total billed charges,,,0.95,,1550.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1550.4,Percent of total billed charges,,1550.4,1599.36,
HC PR 19301 Partial Mastectomy,PX-96910516,CDM,19301,CPT,983,RC,,outpatient,,,1632,1468.8,,0.95,,1550.4,Percent of total billed charges,,,0.98,,1599.36,Percent of total billed charges,,,0.95,,1550.4,Percent of total billed charges,,,0.95,,1550.4,Percent of total billed charges,,,0.97,,1583.04,Percent of total billed charges,,,0.96,,1566.72,Percent of total billed charges,,,0.95,,1550.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1550.4,Percent of total billed charges,,1550.4,1599.36,
HC PR 19303 Mast Simple Complete,PX-96910518,CDM,19303,CPT,975,RC,,inpatient,,,2731,2457.9,,0.95,,2594.45,Percent of total billed charges,,,0.98,,2676.38,Percent of total billed charges,,,0.95,,2594.45,Percent of total billed charges,,,0.97,,2649.07,Percent of total billed charges,,,0.97,,2649.07,Percent of total billed charges,,,0.96,,2621.76,Percent of total billed charges,,,0.95,,2594.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2594.45,Percent of total billed charges,,2594.45,2676.38,
HC PR 19303 Mast Simple Complete,PX-96910518,CDM,19303,CPT,975,RC,,outpatient,,,2731,2457.9,,0.95,,2594.45,Percent of total billed charges,,,0.98,,2676.38,Percent of total billed charges,,,0.95,,2594.45,Percent of total billed charges,,,0.95,,2594.45,Percent of total billed charges,,,0.97,,2649.07,Percent of total billed charges,,,0.96,,2621.76,Percent of total billed charges,,,0.95,,2594.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2594.45,Percent of total billed charges,,2594.45,2676.38,
HC PR 20526 Ther Injection Carp Tunnel,PX-96910519,CDM,20526,CPT,983,RC,,inpatient,,,312,280.8,,0.95,,296.4,Percent of total billed charges,,,0.98,,305.76,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,0.97,,302.64,Percent of total billed charges,,,0.97,,302.64,Percent of total billed charges,,,0.96,,299.52,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,296.4,Percent of total billed charges,,296.4,305.76,
HC PR 20526 Ther Injection Carp Tunnel,PX-96910519,CDM,20526,CPT,983,RC,,outpatient,,,312,280.8,,0.95,,296.4,Percent of total billed charges,,,0.98,,305.76,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,0.97,,302.64,Percent of total billed charges,,,0.96,,299.52,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,296.4,Percent of total billed charges,,296.4,305.76,
HC PR 24071 Exc Arm/Elbow Les Sc 3+ Cm,PX-96910531,CDM,24071,CPT,983,RC,,inpatient,,,1009,908.1,,0.95,,958.55,Percent of total billed charges,,,0.98,,988.82,Percent of total billed charges,,,0.95,,958.55,Percent of total billed charges,,,0.97,,978.73,Percent of total billed charges,,,0.97,,978.73,Percent of total billed charges,,,0.96,,968.64,Percent of total billed charges,,,0.95,,958.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,958.55,Percent of total billed charges,,958.55,988.82,
HC PR 24071 Exc Arm/Elbow Les Sc 3+ Cm,PX-96910531,CDM,24071,CPT,983,RC,,outpatient,,,1009,908.1,,0.95,,958.55,Percent of total billed charges,,,0.98,,988.82,Percent of total billed charges,,,0.95,,958.55,Percent of total billed charges,,,0.95,,958.55,Percent of total billed charges,,,0.97,,978.73,Percent of total billed charges,,,0.96,,968.64,Percent of total billed charges,,,0.95,,958.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,958.55,Percent of total billed charges,,958.55,988.82,
HC PR 11603 Exc Tr-Ext Mlg+Marg 2.1-3 Cm,PX-96910535,CDM,11603,CPT,983,RC,,inpatient,,,752,676.8,,0.95,,714.4,Percent of total billed charges,,,0.98,,736.96,Percent of total billed charges,,,0.95,,714.4,Percent of total billed charges,,,0.97,,729.44,Percent of total billed charges,,,0.97,,729.44,Percent of total billed charges,,,0.96,,721.92,Percent of total billed charges,,,0.95,,714.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,714.4,Percent of total billed charges,,714.4,736.96,
HC PR 11603 Exc Tr-Ext Mlg+Marg 2.1-3 Cm,PX-96910535,CDM,11603,CPT,983,RC,,outpatient,,,752,676.8,,0.95,,714.4,Percent of total billed charges,,,0.98,,736.96,Percent of total billed charges,,,0.95,,714.4,Percent of total billed charges,,,0.95,,714.4,Percent of total billed charges,,,0.97,,729.44,Percent of total billed charges,,,0.96,,721.92,Percent of total billed charges,,,0.95,,714.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,714.4,Percent of total billed charges,,714.4,736.96,
HC PR 20665 Removal of Fixation Device,PX-96910536,CDM,20665,CPT,969,RC,,inpatient,,,570,513,,0.95,,541.5,Percent of total billed charges,,,0.98,,558.6,Percent of total billed charges,,,0.95,,541.5,Percent of total billed charges,,,0.97,,552.9,Percent of total billed charges,,,0.97,,552.9,Percent of total billed charges,,,0.96,,547.2,Percent of total billed charges,,,0.95,,541.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,541.5,Percent of total billed charges,,541.5,558.6,
HC PR 20665 Removal of Fixation Device,PX-96910536,CDM,20665,CPT,969,RC,,outpatient,,,570,513,,0.95,,541.5,Percent of total billed charges,,,0.98,,558.6,Percent of total billed charges,,,0.95,,541.5,Percent of total billed charges,,,0.95,,541.5,Percent of total billed charges,,,0.97,,552.9,Percent of total billed charges,,,0.96,,547.2,Percent of total billed charges,,,0.95,,541.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,541.5,Percent of total billed charges,,541.5,558.6,
HC PR 20680 Removal of Implant,PX-96910538,CDM,20680,CPT,983,RC,,inpatient,,,1483,1334.7,,0.95,,1408.85,Percent of total billed charges,,,0.98,,1453.34,Percent of total billed charges,,,0.95,,1408.85,Percent of total billed charges,,,0.97,,1438.51,Percent of total billed charges,,,0.97,,1438.51,Percent of total billed charges,,,0.96,,1423.68,Percent of total billed charges,,,0.95,,1408.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1408.85,Percent of total billed charges,,1408.85,1453.34,
HC PR 20680 Removal of Implant,PX-96910538,CDM,20680,CPT,983,RC,,outpatient,,,1483,1334.7,,0.95,,1408.85,Percent of total billed charges,,,0.98,,1453.34,Percent of total billed charges,,,0.95,,1408.85,Percent of total billed charges,,,0.95,,1408.85,Percent of total billed charges,,,0.97,,1438.51,Percent of total billed charges,,,0.96,,1423.68,Percent of total billed charges,,,0.95,,1408.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1408.85,Percent of total billed charges,,1408.85,1453.34,
HC PR 11010 Debride Skin at Fx Site,PX-97510032,CDM,11010,CPT,975,RC,,inpatient,,,1101,990.9,,0.95,,1045.95,Percent of total billed charges,,,0.98,,1078.98,Percent of total billed charges,,,0.95,,1045.95,Percent of total billed charges,,,0.97,,1067.97,Percent of total billed charges,,,0.97,,1067.97,Percent of total billed charges,,,0.96,,1056.96,Percent of total billed charges,,,0.95,,1045.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1045.95,Percent of total billed charges,,1045.95,1078.98,
HC PR 11010 Debride Skin at Fx Site,PX-97510032,CDM,11010,CPT,975,RC,,outpatient,,,1101,990.9,,0.95,,1045.95,Percent of total billed charges,,,0.98,,1078.98,Percent of total billed charges,,,0.95,,1045.95,Percent of total billed charges,,,0.95,,1045.95,Percent of total billed charges,,,0.97,,1067.97,Percent of total billed charges,,,0.96,,1056.96,Percent of total billed charges,,,0.95,,1045.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1045.95,Percent of total billed charges,,1045.95,1078.98,
HC PR 11012 Deb Skin Bone at Fx Site,PX-97510036,CDM,11012,CPT,975,RC,,inpatient,,,2619,2357.1,,0.95,,2488.05,Percent of total billed charges,,,0.98,,2566.62,Percent of total billed charges,,,0.95,,2488.05,Percent of total billed charges,,,0.97,,2540.43,Percent of total billed charges,,,0.97,,2540.43,Percent of total billed charges,,,0.96,,2514.24,Percent of total billed charges,,,0.95,,2488.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2488.05,Percent of total billed charges,,2488.05,2566.62,
HC PR 11012 Deb Skin Bone at Fx Site,PX-97510036,CDM,11012,CPT,975,RC,,outpatient,,,2619,2357.1,,0.95,,2488.05,Percent of total billed charges,,,0.98,,2566.62,Percent of total billed charges,,,0.95,,2488.05,Percent of total billed charges,,,0.95,,2488.05,Percent of total billed charges,,,0.97,,2540.43,Percent of total billed charges,,,0.96,,2514.24,Percent of total billed charges,,,0.95,,2488.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2488.05,Percent of total billed charges,,2488.05,2566.62,
HC PR 11200 Removal of Skin Tags,PX-97510044,CDM,11200,CPT,975,RC,,inpatient,,,229,206.1,,0.95,,217.55,Percent of total billed charges,,,0.98,,224.42,Percent of total billed charges,,,0.95,,217.55,Percent of total billed charges,,,0.97,,222.13,Percent of total billed charges,,,0.97,,222.13,Percent of total billed charges,,,0.96,,219.84,Percent of total billed charges,,,0.95,,217.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,217.55,Percent of total billed charges,,217.55,224.42,
HC PR 11200 Removal of Skin Tags,PX-97510044,CDM,11200,CPT,975,RC,,outpatient,,,229,206.1,,0.95,,217.55,Percent of total billed charges,,,0.98,,224.42,Percent of total billed charges,,,0.95,,217.55,Percent of total billed charges,,,0.95,,217.55,Percent of total billed charges,,,0.97,,222.13,Percent of total billed charges,,,0.96,,219.84,Percent of total billed charges,,,0.95,,217.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,217.55,Percent of total billed charges,,217.55,224.42,
HC PR 11300 Shave Skin Lesion 0.5 Cm or Less Trnk Arm Leg,PX-97510046,CDM,11300,CPT,975,RC,,inpatient,,,259,233.1,,0.95,,246.05,Percent of total billed charges,,,0.98,,253.82,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,0.97,,251.23,Percent of total billed charges,,,0.97,,251.23,Percent of total billed charges,,,0.96,,248.64,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,246.05,Percent of total billed charges,,246.05,253.82,
HC PR 11300 Shave Skin Lesion 0.5 Cm or Less Trnk Arm Leg,PX-97510046,CDM,11300,CPT,975,RC,,outpatient,,,259,233.1,,0.95,,246.05,Percent of total billed charges,,,0.98,,253.82,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,0.97,,251.23,Percent of total billed charges,,,0.96,,248.64,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,246.05,Percent of total billed charges,,246.05,253.82,
HC PR 11302 Shave Skin Lesion 1.1 to 2.0 Cm Trnk Arm Leg,PX-97510050,CDM,11302,CPT,975,RC,,inpatient,,,338,304.2,,0.95,,321.1,Percent of total billed charges,,,0.98,,331.24,Percent of total billed charges,,,0.95,,321.1,Percent of total billed charges,,,0.97,,327.86,Percent of total billed charges,,,0.97,,327.86,Percent of total billed charges,,,0.96,,324.48,Percent of total billed charges,,,0.95,,321.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,321.1,Percent of total billed charges,,321.1,331.24,
HC PR 11302 Shave Skin Lesion 1.1 to 2.0 Cm Trnk Arm Leg,PX-97510050,CDM,11302,CPT,975,RC,,outpatient,,,338,304.2,,0.95,,321.1,Percent of total billed charges,,,0.98,,331.24,Percent of total billed charges,,,0.95,,321.1,Percent of total billed charges,,,0.95,,321.1,Percent of total billed charges,,,0.97,,327.86,Percent of total billed charges,,,0.96,,324.48,Percent of total billed charges,,,0.95,,321.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,321.1,Percent of total billed charges,,321.1,331.24,
HC PR 11303 Shave Skin Lesion Over 2.0 Cm Trnk Arm Leg,PX-97510053,CDM,11303,CPT,975,RC,,inpatient,,,374,336.6,,0.95,,355.3,Percent of total billed charges,,,0.98,,366.52,Percent of total billed charges,,,0.95,,355.3,Percent of total billed charges,,,0.97,,362.78,Percent of total billed charges,,,0.97,,362.78,Percent of total billed charges,,,0.96,,359.04,Percent of total billed charges,,,0.95,,355.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,355.3,Percent of total billed charges,,355.3,366.52,
HC PR 11303 Shave Skin Lesion Over 2.0 Cm Trnk Arm Leg,PX-97510053,CDM,11303,CPT,975,RC,,outpatient,,,374,336.6,,0.95,,355.3,Percent of total billed charges,,,0.98,,366.52,Percent of total billed charges,,,0.95,,355.3,Percent of total billed charges,,,0.95,,355.3,Percent of total billed charges,,,0.97,,362.78,Percent of total billed charges,,,0.96,,359.04,Percent of total billed charges,,,0.95,,355.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,355.3,Percent of total billed charges,,355.3,366.52,
HC PR 11310 Shave Skin Lesion 0.5 Cm or Less Face Ers Eyld Nse Lps Muc,PX-97510060,CDM,11310,CPT,975,RC,,inpatient,,,285,256.5,,0.95,,270.75,Percent of total billed charges,,,0.98,,279.3,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.96,,273.6,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,270.75,Percent of total billed charges,,270.75,279.3,
HC PR 11310 Shave Skin Lesion 0.5 Cm or Less Face Ers Eyld Nse Lps Muc,PX-97510060,CDM,11310,CPT,975,RC,,outpatient,,,285,256.5,,0.95,,270.75,Percent of total billed charges,,,0.98,,279.3,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.96,,273.6,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,270.75,Percent of total billed charges,,270.75,279.3,
HC PR 11311 Shave Skin Lesion 0.6 to 1.0 Cm Face Ers Eyld Nse Lps Muc,PX-97510063,CDM,11311,CPT,975,RC,,inpatient,,,340,306,,0.95,,323,Percent of total billed charges,,,0.98,,333.2,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.96,,326.4,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,323,Percent of total billed charges,,323,333.2,
HC PR 11311 Shave Skin Lesion 0.6 to 1.0 Cm Face Ers Eyld Nse Lps Muc,PX-97510063,CDM,11311,CPT,975,RC,,outpatient,,,340,306,,0.95,,323,Percent of total billed charges,,,0.98,,333.2,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.96,,326.4,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,323,Percent of total billed charges,,323,333.2,
HC PR 11400 Exc Tr-Ext B9+Marg 0.5 < Cm,PX-97510066,CDM,11400,CPT,975,RC,,inpatient,,,348,313.2,,0.95,,330.6,Percent of total billed charges,,,0.98,,341.04,Percent of total billed charges,,,0.95,,330.6,Percent of total billed charges,,,0.97,,337.56,Percent of total billed charges,,,0.97,,337.56,Percent of total billed charges,,,0.96,,334.08,Percent of total billed charges,,,0.95,,330.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,330.6,Percent of total billed charges,,330.6,341.04,
HC PR 11400 Exc Tr-Ext B9+Marg 0.5 < Cm,PX-97510066,CDM,11400,CPT,975,RC,,outpatient,,,348,313.2,,0.95,,330.6,Percent of total billed charges,,,0.98,,341.04,Percent of total billed charges,,,0.95,,330.6,Percent of total billed charges,,,0.95,,330.6,Percent of total billed charges,,,0.97,,337.56,Percent of total billed charges,,,0.96,,334.08,Percent of total billed charges,,,0.95,,330.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,330.6,Percent of total billed charges,,330.6,341.04,
Exc Tr-Ext B9+Marg 1.1-2 Cm,PX-97510068,CDM,11402,CPT,975,RC,,inpatient,,,441,396.9,,0.95,,418.95,Percent of total billed charges,,,0.98,,432.18,Percent of total billed charges,,,0.95,,418.95,Percent of total billed charges,,,0.97,,427.77,Percent of total billed charges,,,0.97,,427.77,Percent of total billed charges,,,0.96,,423.36,Percent of total billed charges,,,0.95,,418.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,418.95,Percent of total billed charges,,418.95,432.18,
Exc Tr-Ext B9+Marg 1.1-2 Cm,PX-97510068,CDM,11402,CPT,975,RC,,outpatient,,,441,396.9,,0.95,,418.95,Percent of total billed charges,,,0.98,,432.18,Percent of total billed charges,,,0.95,,418.95,Percent of total billed charges,,,0.95,,418.95,Percent of total billed charges,,,0.97,,427.77,Percent of total billed charges,,,0.96,,423.36,Percent of total billed charges,,,0.95,,418.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,418.95,Percent of total billed charges,,418.95,432.18,
"HC PR 11403 Exc Skin Benig 2.1-3cm Trunk, Arm, Leg",PX-97510070,CDM,11403,CPT,975,RC,,inpatient,,,510,459,,0.95,,484.5,Percent of total billed charges,,,0.98,,499.8,Percent of total billed charges,,,0.95,,484.5,Percent of total billed charges,,,0.97,,494.7,Percent of total billed charges,,,0.97,,494.7,Percent of total billed charges,,,0.96,,489.6,Percent of total billed charges,,,0.95,,484.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,484.5,Percent of total billed charges,,484.5,499.8,
"HC PR 11403 Exc Skin Benig 2.1-3cm Trunk, Arm, Leg",PX-97510070,CDM,11403,CPT,975,RC,,outpatient,,,510,459,,0.95,,484.5,Percent of total billed charges,,,0.98,,499.8,Percent of total billed charges,,,0.95,,484.5,Percent of total billed charges,,,0.95,,484.5,Percent of total billed charges,,,0.97,,494.7,Percent of total billed charges,,,0.96,,489.6,Percent of total billed charges,,,0.95,,484.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,484.5,Percent of total billed charges,,484.5,499.8,
HC PR 11420 Exc H-F-Nk-Sp B9+Marg 0.5 <,PX-97510074,CDM,11420,CPT,975,RC,,inpatient,,,327,294.3,,0.95,,310.65,Percent of total billed charges,,,0.98,,320.46,Percent of total billed charges,,,0.95,,310.65,Percent of total billed charges,,,0.97,,317.19,Percent of total billed charges,,,0.97,,317.19,Percent of total billed charges,,,0.96,,313.92,Percent of total billed charges,,,0.95,,310.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,310.65,Percent of total billed charges,,310.65,320.46,
HC PR 11420 Exc H-F-Nk-Sp B9+Marg 0.5 <,PX-97510074,CDM,11420,CPT,975,RC,,outpatient,,,327,294.3,,0.95,,310.65,Percent of total billed charges,,,0.98,,320.46,Percent of total billed charges,,,0.95,,310.65,Percent of total billed charges,,,0.95,,310.65,Percent of total billed charges,,,0.97,,317.19,Percent of total billed charges,,,0.96,,313.92,Percent of total billed charges,,,0.95,,310.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,310.65,Percent of total billed charges,,310.65,320.46,
HC PR 11422 Exc H-F-Nk-Sp B9+Marg 1.1-2,PX-97510075,CDM,11422,CPT,975,RC,,inpatient,,,468,421.2,,0.95,,444.6,Percent of total billed charges,,,0.98,,458.64,Percent of total billed charges,,,0.95,,444.6,Percent of total billed charges,,,0.97,,453.96,Percent of total billed charges,,,0.97,,453.96,Percent of total billed charges,,,0.96,,449.28,Percent of total billed charges,,,0.95,,444.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,444.6,Percent of total billed charges,,444.6,458.64,
HC PR 11422 Exc H-F-Nk-Sp B9+Marg 1.1-2,PX-97510075,CDM,11422,CPT,975,RC,,outpatient,,,468,421.2,,0.95,,444.6,Percent of total billed charges,,,0.98,,458.64,Percent of total billed charges,,,0.95,,444.6,Percent of total billed charges,,,0.95,,444.6,Percent of total billed charges,,,0.97,,453.96,Percent of total billed charges,,,0.96,,449.28,Percent of total billed charges,,,0.95,,444.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,444.6,Percent of total billed charges,,444.6,458.64,
HC PR 11423 Exc H-F-Nk-Sp B9+Marg 2.1-3,PX-97510076,CDM,11423,CPT,975,RC,,inpatient,,,508,457.2,,0.95,,482.6,Percent of total billed charges,,,0.98,,497.84,Percent of total billed charges,,,0.95,,482.6,Percent of total billed charges,,,0.97,,492.76,Percent of total billed charges,,,0.97,,492.76,Percent of total billed charges,,,0.96,,487.68,Percent of total billed charges,,,0.95,,482.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,482.6,Percent of total billed charges,,482.6,497.84,
HC PR 11423 Exc H-F-Nk-Sp B9+Marg 2.1-3,PX-97510076,CDM,11423,CPT,975,RC,,outpatient,,,508,457.2,,0.95,,482.6,Percent of total billed charges,,,0.98,,497.84,Percent of total billed charges,,,0.95,,482.6,Percent of total billed charges,,,0.95,,482.6,Percent of total billed charges,,,0.97,,492.76,Percent of total billed charges,,,0.96,,487.68,Percent of total billed charges,,,0.95,,482.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,482.6,Percent of total billed charges,,482.6,497.84,
HC PR 11426 Exc H-F-Nk-Sp B9+Marg > 4 Cm,PX-97510077,CDM,11426,CPT,975,RC,,inpatient,,,810,729,,0.95,,769.5,Percent of total billed charges,,,0.98,,793.8,Percent of total billed charges,,,0.95,,769.5,Percent of total billed charges,,,0.97,,785.7,Percent of total billed charges,,,0.97,,785.7,Percent of total billed charges,,,0.96,,777.6,Percent of total billed charges,,,0.95,,769.5,Percent of total billed charges,,,,,,,,,0.95,,769.5,Percent of total billed charges,,769.5,793.8,
HC PR 11426 Exc H-F-Nk-Sp B9+Marg > 4 Cm,PX-97510077,CDM,11426,CPT,975,RC,,outpatient,,,810,729,,0.95,,769.5,Percent of total billed charges,,,0.98,,793.8,Percent of total billed charges,,,0.95,,769.5,Percent of total billed charges,,,0.95,,769.5,Percent of total billed charges,,,0.97,,785.7,Percent of total billed charges,,,0.96,,777.6,Percent of total billed charges,,,0.95,,769.5,Percent of total billed charges,,,,,,,,,0.95,,769.5,Percent of total billed charges,,769.5,793.8,
Excision-other benign lesions face/ears/eyelids/nose/lips,PX-97510078,CDM,11440,CPT,975,RC,,inpatient,,,355,319.5,,0.95,,337.25,Percent of total billed charges,,,0.98,,347.9,Percent of total billed charges,,,0.95,,337.25,Percent of total billed charges,,,0.97,,344.35,Percent of total billed charges,,,0.97,,344.35,Percent of total billed charges,,,0.96,,340.8,Percent of total billed charges,,,0.95,,337.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,337.25,Percent of total billed charges,,337.25,347.9,
Excision-other benign lesions face/ears/eyelids/nose/lips,PX-97510078,CDM,11440,CPT,975,RC,,outpatient,,,355,319.5,,0.95,,337.25,Percent of total billed charges,,,0.98,,347.9,Percent of total billed charges,,,0.95,,337.25,Percent of total billed charges,,,0.95,,337.25,Percent of total billed charges,,,0.97,,344.35,Percent of total billed charges,,,0.96,,340.8,Percent of total billed charges,,,0.95,,337.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,337.25,Percent of total billed charges,,337.25,347.9,
HC PR 11442 Exc Face-Mm B9+Marg 1.1-2 Cm,PX-97510079,CDM,11442,CPT,975,RC,,inpatient,,,479,431.1,,0.95,,455.05,Percent of total billed charges,,,0.98,,469.42,Percent of total billed charges,,,0.95,,455.05,Percent of total billed charges,,,0.97,,464.63,Percent of total billed charges,,,0.97,,464.63,Percent of total billed charges,,,0.96,,459.84,Percent of total billed charges,,,0.95,,455.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,455.05,Percent of total billed charges,,455.05,469.42,
HC PR 11442 Exc Face-Mm B9+Marg 1.1-2 Cm,PX-97510079,CDM,11442,CPT,975,RC,,outpatient,,,479,431.1,,0.95,,455.05,Percent of total billed charges,,,0.98,,469.42,Percent of total billed charges,,,0.95,,455.05,Percent of total billed charges,,,0.95,,455.05,Percent of total billed charges,,,0.97,,464.63,Percent of total billed charges,,,0.96,,459.84,Percent of total billed charges,,,0.95,,455.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,455.05,Percent of total billed charges,,455.05,469.42,
HC PR 11443 Exc Face-Mm B9+Marg 2.1-3 Cm,PX-97510080,CDM,11443,CPT,975,RC,,inpatient,,,564,507.6,,0.95,,535.8,Percent of total billed charges,,,0.98,,552.72,Percent of total billed charges,,,0.95,,535.8,Percent of total billed charges,,,0.97,,547.08,Percent of total billed charges,,,0.97,,547.08,Percent of total billed charges,,,0.96,,541.44,Percent of total billed charges,,,0.95,,535.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,535.8,Percent of total billed charges,,535.8,552.72,
HC PR 11443 Exc Face-Mm B9+Marg 2.1-3 Cm,PX-97510080,CDM,11443,CPT,975,RC,,outpatient,,,564,507.6,,0.95,,535.8,Percent of total billed charges,,,0.98,,552.72,Percent of total billed charges,,,0.95,,535.8,Percent of total billed charges,,,0.95,,535.8,Percent of total billed charges,,,0.97,,547.08,Percent of total billed charges,,,0.96,,541.44,Percent of total billed charges,,,0.95,,535.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,535.8,Percent of total billed charges,,535.8,552.72,
HC PR 11621 Exc H-F-Nk-Sp Mlg+Marg 0.6-1,PX-97510082,CDM,11621,CPT,975,RC,,inpatient,,,613,551.7,,0.95,,582.35,Percent of total billed charges,,,0.98,,600.74,Percent of total billed charges,,,0.95,,582.35,Percent of total billed charges,,,0.97,,594.61,Percent of total billed charges,,,0.97,,594.61,Percent of total billed charges,,,0.96,,588.48,Percent of total billed charges,,,0.95,,582.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,582.35,Percent of total billed charges,,582.35,600.74,
HC PR 11621 Exc H-F-Nk-Sp Mlg+Marg 0.6-1,PX-97510082,CDM,11621,CPT,975,RC,,outpatient,,,613,551.7,,0.95,,582.35,Percent of total billed charges,,,0.98,,600.74,Percent of total billed charges,,,0.95,,582.35,Percent of total billed charges,,,0.95,,582.35,Percent of total billed charges,,,0.97,,594.61,Percent of total billed charges,,,0.96,,588.48,Percent of total billed charges,,,0.95,,582.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,582.35,Percent of total billed charges,,582.35,600.74,
HC PR 11622 Exc H-F-Nk-Sp Mlg+Marg 1.1-2,PX-97510083,CDM,11622,CPT,975,RC,,inpatient,,,680,612,,0.95,,646,Percent of total billed charges,,,0.98,,666.4,Percent of total billed charges,,,0.95,,646,Percent of total billed charges,,,0.97,,659.6,Percent of total billed charges,,,0.97,,659.6,Percent of total billed charges,,,0.96,,652.8,Percent of total billed charges,,,0.95,,646,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,646,Percent of total billed charges,,646,666.4,
HC PR 11622 Exc H-F-Nk-Sp Mlg+Marg 1.1-2,PX-97510083,CDM,11622,CPT,975,RC,,outpatient,,,680,612,,0.95,,646,Percent of total billed charges,,,0.98,,666.4,Percent of total billed charges,,,0.95,,646,Percent of total billed charges,,,0.95,,646,Percent of total billed charges,,,0.97,,659.6,Percent of total billed charges,,,0.96,,652.8,Percent of total billed charges,,,0.95,,646,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,646,Percent of total billed charges,,646,666.4,
HC PR 11623 Exc H-F-Nk-Sp Mlg+Marg 2.1-3,PX-97510084,CDM,11623,CPT,975,RC,,inpatient,,,800,720,,0.95,,760,Percent of total billed charges,,,0.98,,784,Percent of total billed charges,,,0.95,,760,Percent of total billed charges,,,0.97,,776,Percent of total billed charges,,,0.97,,776,Percent of total billed charges,,,0.96,,768,Percent of total billed charges,,,0.95,,760,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,760,Percent of total billed charges,,760,784,
HC PR 11623 Exc H-F-Nk-Sp Mlg+Marg 2.1-3,PX-97510084,CDM,11623,CPT,975,RC,,outpatient,,,800,720,,0.95,,760,Percent of total billed charges,,,0.98,,784,Percent of total billed charges,,,0.95,,760,Percent of total billed charges,,,0.95,,760,Percent of total billed charges,,,0.97,,776,Percent of total billed charges,,,0.96,,768,Percent of total billed charges,,,0.95,,760,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,760,Percent of total billed charges,,760,784,
HC PR 11624 Exc H-F-Nk-Sp Mlg+Marg 3.1-4,PX-97510085,CDM,11624,CPT,975,RC,,inpatient,,,831,747.9,,0.95,,789.45,Percent of total billed charges,,,0.98,,814.38,Percent of total billed charges,,,0.95,,789.45,Percent of total billed charges,,,0.97,,806.07,Percent of total billed charges,,,0.97,,806.07,Percent of total billed charges,,,0.96,,797.76,Percent of total billed charges,,,0.95,,789.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,789.45,Percent of total billed charges,,789.45,814.38,
HC PR 11624 Exc H-F-Nk-Sp Mlg+Marg 3.1-4,PX-97510085,CDM,11624,CPT,975,RC,,outpatient,,,831,747.9,,0.95,,789.45,Percent of total billed charges,,,0.98,,814.38,Percent of total billed charges,,,0.95,,789.45,Percent of total billed charges,,,0.95,,789.45,Percent of total billed charges,,,0.97,,806.07,Percent of total billed charges,,,0.96,,797.76,Percent of total billed charges,,,0.95,,789.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,789.45,Percent of total billed charges,,789.45,814.38,
HC PR 11640 Exc Face-Mm Malig+Marg 0.5 <,PX-97510087,CDM,11640,CPT,975,RC,,inpatient,,,536,482.4,,0.95,,509.2,Percent of total billed charges,,,0.98,,525.28,Percent of total billed charges,,,0.95,,509.2,Percent of total billed charges,,,0.97,,519.92,Percent of total billed charges,,,0.97,,519.92,Percent of total billed charges,,,0.96,,514.56,Percent of total billed charges,,,0.95,,509.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,509.2,Percent of total billed charges,,509.2,525.28,
HC PR 11640 Exc Face-Mm Malig+Marg 0.5 <,PX-97510087,CDM,11640,CPT,975,RC,,outpatient,,,536,482.4,,0.95,,509.2,Percent of total billed charges,,,0.98,,525.28,Percent of total billed charges,,,0.95,,509.2,Percent of total billed charges,,,0.95,,509.2,Percent of total billed charges,,,0.97,,519.92,Percent of total billed charges,,,0.96,,514.56,Percent of total billed charges,,,0.95,,509.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,509.2,Percent of total billed charges,,509.2,525.28,
HC PR 11641 Exc Face-Mm Malig+Marg 0.6-1,PX-97510088,CDM,11641,CPT,975,RC,,inpatient,,,632,568.8,,0.95,,600.4,Percent of total billed charges,,,0.98,,619.36,Percent of total billed charges,,,0.95,,600.4,Percent of total billed charges,,,0.97,,613.04,Percent of total billed charges,,,0.97,,613.04,Percent of total billed charges,,,0.96,,606.72,Percent of total billed charges,,,0.95,,600.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,600.4,Percent of total billed charges,,600.4,619.36,
HC PR 11641 Exc Face-Mm Malig+Marg 0.6-1,PX-97510088,CDM,11641,CPT,975,RC,,outpatient,,,632,568.8,,0.95,,600.4,Percent of total billed charges,,,0.98,,619.36,Percent of total billed charges,,,0.95,,600.4,Percent of total billed charges,,,0.95,,600.4,Percent of total billed charges,,,0.97,,613.04,Percent of total billed charges,,,0.96,,606.72,Percent of total billed charges,,,0.95,,600.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,600.4,Percent of total billed charges,,600.4,619.36,
HC PR 11642 Exc Face-Mm Malig+Marg 1.1-2,PX-97510089,CDM,11642,CPT,975,RC,,inpatient,,,757,681.3,,0.95,,719.15,Percent of total billed charges,,,0.98,,741.86,Percent of total billed charges,,,0.95,,719.15,Percent of total billed charges,,,0.97,,734.29,Percent of total billed charges,,,0.97,,734.29,Percent of total billed charges,,,0.96,,726.72,Percent of total billed charges,,,0.95,,719.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,719.15,Percent of total billed charges,,719.15,741.86,
HC PR 11642 Exc Face-Mm Malig+Marg 1.1-2,PX-97510089,CDM,11642,CPT,975,RC,,outpatient,,,757,681.3,,0.95,,719.15,Percent of total billed charges,,,0.98,,741.86,Percent of total billed charges,,,0.95,,719.15,Percent of total billed charges,,,0.95,,719.15,Percent of total billed charges,,,0.97,,734.29,Percent of total billed charges,,,0.96,,726.72,Percent of total billed charges,,,0.95,,719.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,719.15,Percent of total billed charges,,719.15,741.86,
HC PR 11643 Exc Face-Mm Malig+Marg 2.1-3,PX-97510090,CDM,11643,CPT,975,RC,,inpatient,,,851,765.9,,0.95,,808.45,Percent of total billed charges,,,0.98,,833.98,Percent of total billed charges,,,0.95,,808.45,Percent of total billed charges,,,0.97,,825.47,Percent of total billed charges,,,0.97,,825.47,Percent of total billed charges,,,0.96,,816.96,Percent of total billed charges,,,0.95,,808.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,808.45,Percent of total billed charges,,808.45,833.98,
HC PR 11643 Exc Face-Mm Malig+Marg 2.1-3,PX-97510090,CDM,11643,CPT,975,RC,,outpatient,,,851,765.9,,0.95,,808.45,Percent of total billed charges,,,0.98,,833.98,Percent of total billed charges,,,0.95,,808.45,Percent of total billed charges,,,0.95,,808.45,Percent of total billed charges,,,0.97,,825.47,Percent of total billed charges,,,0.96,,816.96,Percent of total billed charges,,,0.95,,808.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,808.45,Percent of total billed charges,,808.45,833.98,
HC PR 11646 Exc Face-Mm Mlg+Marg > 4 Cm,PX-97510092,CDM,11646,CPT,975,RC,,inpatient,,,1242,1117.8,,0.95,,1179.9,Percent of total billed charges,,,0.98,,1217.16,Percent of total billed charges,,,0.95,,1179.9,Percent of total billed charges,,,0.97,,1204.74,Percent of total billed charges,,,0.97,,1204.74,Percent of total billed charges,,,0.96,,1192.32,Percent of total billed charges,,,0.95,,1179.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1179.9,Percent of total billed charges,,1179.9,1217.16,
HC PR 11646 Exc Face-Mm Mlg+Marg > 4 Cm,PX-97510092,CDM,11646,CPT,975,RC,,outpatient,,,1242,1117.8,,0.95,,1179.9,Percent of total billed charges,,,0.98,,1217.16,Percent of total billed charges,,,0.95,,1179.9,Percent of total billed charges,,,0.95,,1179.9,Percent of total billed charges,,,0.97,,1204.74,Percent of total billed charges,,,0.96,,1192.32,Percent of total billed charges,,,0.95,,1179.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1179.9,Percent of total billed charges,,1179.9,1217.16,
HC PR 11770 Removal of Pilonidal Lesion Simple,PX-97510093,CDM,11770,CPT,975,RC,,inpatient,,,677,609.3,,0.95,,643.15,Percent of total billed charges,,,0.98,,663.46,Percent of total billed charges,,,0.95,,643.15,Percent of total billed charges,,,0.97,,656.69,Percent of total billed charges,,,0.97,,656.69,Percent of total billed charges,,,0.96,,649.92,Percent of total billed charges,,,0.95,,643.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,643.15,Percent of total billed charges,,643.15,663.46,
HC PR 11770 Removal of Pilonidal Lesion Simple,PX-97510093,CDM,11770,CPT,975,RC,,outpatient,,,677,609.3,,0.95,,643.15,Percent of total billed charges,,,0.98,,663.46,Percent of total billed charges,,,0.95,,643.15,Percent of total billed charges,,,0.95,,643.15,Percent of total billed charges,,,0.97,,656.69,Percent of total billed charges,,,0.96,,649.92,Percent of total billed charges,,,0.95,,643.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,643.15,Percent of total billed charges,,643.15,663.46,
HC PR 11981 Insert Drug Implant Device,PX-97510097,CDM,11981,CPT,975,RC,,inpatient,,,312,280.8,,0.95,,296.4,Percent of total billed charges,,,0.98,,305.76,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,0.97,,302.64,Percent of total billed charges,,,0.97,,302.64,Percent of total billed charges,,,0.96,,299.52,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,296.4,Percent of total billed charges,,296.4,305.76,
HC PR 11981 Insert Drug Implant Device,PX-97510097,CDM,11981,CPT,975,RC,,outpatient,,,312,280.8,,0.95,,296.4,Percent of total billed charges,,,0.98,,305.76,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,0.97,,302.64,Percent of total billed charges,,,0.96,,299.52,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,296.4,Percent of total billed charges,,296.4,305.76,
HC PR 11982 Remove Drug Implant Device,PX-97510098,CDM,11982,CPT,975,RC,,inpatient,,,389,350.1,,0.95,,369.55,Percent of total billed charges,,,0.98,,381.22,Percent of total billed charges,,,0.95,,369.55,Percent of total billed charges,,,0.97,,377.33,Percent of total billed charges,,,0.97,,377.33,Percent of total billed charges,,,0.96,,373.44,Percent of total billed charges,,,0.95,,369.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,369.55,Percent of total billed charges,,369.55,381.22,
HC PR 11982 Remove Drug Implant Device,PX-97510098,CDM,11982,CPT,975,RC,,outpatient,,,389,350.1,,0.95,,369.55,Percent of total billed charges,,,0.98,,381.22,Percent of total billed charges,,,0.95,,369.55,Percent of total billed charges,,,0.95,,369.55,Percent of total billed charges,,,0.97,,377.33,Percent of total billed charges,,,0.96,,373.44,Percent of total billed charges,,,0.95,,369.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,369.55,Percent of total billed charges,,369.55,381.22,
HC PR 11983 Remove/Insert Drug Implant,PX-97510099,CDM,11983,CPT,975,RC,,inpatient,,,539,485.1,,0.95,,512.05,Percent of total billed charges,,,0.98,,528.22,Percent of total billed charges,,,0.95,,512.05,Percent of total billed charges,,,0.97,,522.83,Percent of total billed charges,,,0.97,,522.83,Percent of total billed charges,,,0.96,,517.44,Percent of total billed charges,,,0.95,,512.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,512.05,Percent of total billed charges,,512.05,528.22,
HC PR 11983 Remove/Insert Drug Implant,PX-97510099,CDM,11983,CPT,975,RC,,outpatient,,,539,485.1,,0.95,,512.05,Percent of total billed charges,,,0.98,,528.22,Percent of total billed charges,,,0.95,,512.05,Percent of total billed charges,,,0.95,,512.05,Percent of total billed charges,,,0.97,,522.83,Percent of total billed charges,,,0.96,,517.44,Percent of total billed charges,,,0.95,,512.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,512.05,Percent of total billed charges,,512.05,528.22,
"HC PR 14020 Skin Tissue Rearrangement 10 Sq Cm or Less Scalp,Arm Leg",PX-97510302,CDM,14020,CPT,975,RC,,inpatient,,,1739,1565.1,,0.95,,1652.05,Percent of total billed charges,,,0.98,,1704.22,Percent of total billed charges,,,0.95,,1652.05,Percent of total billed charges,,,0.97,,1686.83,Percent of total billed charges,,,0.97,,1686.83,Percent of total billed charges,,,0.96,,1669.44,Percent of total billed charges,,,0.95,,1652.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1652.05,Percent of total billed charges,,1652.05,1704.22,
"HC PR 14020 Skin Tissue Rearrangement 10 Sq Cm or Less Scalp,Arm Leg",PX-97510302,CDM,14020,CPT,975,RC,,outpatient,,,1739,1565.1,,0.95,,1652.05,Percent of total billed charges,,,0.98,,1704.22,Percent of total billed charges,,,0.95,,1652.05,Percent of total billed charges,,,0.95,,1652.05,Percent of total billed charges,,,0.97,,1686.83,Percent of total billed charges,,,0.96,,1669.44,Percent of total billed charges,,,0.95,,1652.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1652.05,Percent of total billed charges,,1652.05,1704.22,
HC PR 15839 Excise Excessive Skin Tissue Other Area,PX-97510330,CDM,15839,CPT,975,RC,,inpatient,,,2203,1982.7,,0.95,,2092.85,Percent of total billed charges,,,0.98,,2158.94,Percent of total billed charges,,,0.95,,2092.85,Percent of total billed charges,,,0.97,,2136.91,Percent of total billed charges,,,0.97,,2136.91,Percent of total billed charges,,,0.96,,2114.88,Percent of total billed charges,,,0.95,,2092.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2092.85,Percent of total billed charges,,2092.85,2158.94,
HC PR 15839 Excise Excessive Skin Tissue Other Area,PX-97510330,CDM,15839,CPT,975,RC,,outpatient,,,2203,1982.7,,0.95,,2092.85,Percent of total billed charges,,,0.98,,2158.94,Percent of total billed charges,,,0.95,,2092.85,Percent of total billed charges,,,0.95,,2092.85,Percent of total billed charges,,,0.97,,2136.91,Percent of total billed charges,,,0.96,,2114.88,Percent of total billed charges,,,0.95,,2092.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2092.85,Percent of total billed charges,,2092.85,2158.94,
HC PR 15852 Dressing Change Not for Burn Under Anesthesia,PX-97510333,CDM,15852,CPT,975,RC,,inpatient,,,109,98.1,,0.95,,103.55,Percent of total billed charges,,,0.98,,106.82,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,0.97,,105.73,Percent of total billed charges,,,0.97,,105.73,Percent of total billed charges,,,0.96,,104.64,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,103.55,Percent of total billed charges,,103.55,106.82,
HC PR 15852 Dressing Change Not for Burn Under Anesthesia,PX-97510333,CDM,15852,CPT,975,RC,,outpatient,,,109,98.1,,0.95,,103.55,Percent of total billed charges,,,0.98,,106.82,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,0.97,,105.73,Percent of total billed charges,,,0.96,,104.64,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,103.55,Percent of total billed charges,,103.55,106.82,
HC PR 17000 Destruct Premalg Lesion First Lesion,PX-97510334,CDM,17000,CPT,975,RC,,inpatient,,,177,159.3,,0.95,,168.15,Percent of total billed charges,,,0.98,,173.46,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.96,,169.92,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,168.15,Percent of total billed charges,,168.15,173.46,
HC PR 17000 Destruct Premalg Lesion First Lesion,PX-97510334,CDM,17000,CPT,975,RC,,outpatient,,,177,159.3,,0.95,,168.15,Percent of total billed charges,,,0.98,,173.46,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.96,,169.92,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,168.15,Percent of total billed charges,,168.15,173.46,
HC PR 17003 Destruct Premalg Les 2-14,PX-97510335,CDM,17003,CPT,975,RC,,inpatient,,,17,15.3,,0.95,,16.15,Percent of total billed charges,,,0.98,,16.66,Percent of total billed charges,,,0.95,,16.15,Percent of total billed charges,,,0.97,,16.49,Percent of total billed charges,,,0.97,,16.49,Percent of total billed charges,,,0.96,,16.32,Percent of total billed charges,,,0.95,,16.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,16.15,Percent of total billed charges,,16.15,16.66,
HC PR 17003 Destruct Premalg Les 2-14,PX-97510335,CDM,17003,CPT,975,RC,,outpatient,,,17,15.3,,0.95,,16.15,Percent of total billed charges,,,0.98,,16.66,Percent of total billed charges,,,0.95,,16.15,Percent of total billed charges,,,0.95,,16.15,Percent of total billed charges,,,0.97,,16.49,Percent of total billed charges,,,0.96,,16.32,Percent of total billed charges,,,0.95,,16.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,16.15,Percent of total billed charges,,16.15,16.66,
HC PR 17260 Destruction of Skin Lesions Tnk/Arm/Lg M<=0.5,PX-97510338,CDM,17260,CPT,975,RC,,inpatient,,,247,222.3,,0.95,,234.65,Percent of total billed charges,,,0.98,,242.06,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.96,,237.12,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,234.65,Percent of total billed charges,,234.65,242.06,
HC PR 17260 Destruction of Skin Lesions Tnk/Arm/Lg M<=0.5,PX-97510338,CDM,17260,CPT,975,RC,,outpatient,,,247,222.3,,0.95,,234.65,Percent of total billed charges,,,0.98,,242.06,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.96,,237.12,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,234.65,Percent of total billed charges,,234.65,242.06,
HC PR 17270 Destruction of Skin Lesions Other M <=0.5,PX-97510340,CDM,17270,CPT,975,RC,,inpatient,,,629,566.1,,0.95,,597.55,Percent of total billed charges,,,0.98,,616.42,Percent of total billed charges,,,0.95,,597.55,Percent of total billed charges,,,0.97,,610.13,Percent of total billed charges,,,0.97,,610.13,Percent of total billed charges,,,0.96,,603.84,Percent of total billed charges,,,0.95,,597.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,597.55,Percent of total billed charges,,597.55,616.42,
HC PR 17270 Destruction of Skin Lesions Other M <=0.5,PX-97510340,CDM,17270,CPT,975,RC,,outpatient,,,629,566.1,,0.95,,597.55,Percent of total billed charges,,,0.98,,616.42,Percent of total billed charges,,,0.95,,597.55,Percent of total billed charges,,,0.95,,597.55,Percent of total billed charges,,,0.97,,610.13,Percent of total billed charges,,,0.96,,603.84,Percent of total billed charges,,,0.95,,597.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,597.55,Percent of total billed charges,,597.55,616.42,
HC PR 17272 Destruction of Skin Lesions Other M 1.1-2,PX-97510342,CDM,17272,CPT,975,RC,,inpatient,,,466,419.4,,0.95,,442.7,Percent of total billed charges,,,0.98,,456.68,Percent of total billed charges,,,0.95,,442.7,Percent of total billed charges,,,0.97,,452.02,Percent of total billed charges,,,0.97,,452.02,Percent of total billed charges,,,0.96,,447.36,Percent of total billed charges,,,0.95,,442.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,442.7,Percent of total billed charges,,442.7,456.68,
HC PR 17272 Destruction of Skin Lesions Other M 1.1-2,PX-97510342,CDM,17272,CPT,975,RC,,outpatient,,,466,419.4,,0.95,,442.7,Percent of total billed charges,,,0.98,,456.68,Percent of total billed charges,,,0.95,,442.7,Percent of total billed charges,,,0.95,,442.7,Percent of total billed charges,,,0.97,,452.02,Percent of total billed charges,,,0.96,,447.36,Percent of total billed charges,,,0.95,,442.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,442.7,Percent of total billed charges,,442.7,456.68,
HC PR 17276 Destruction of Skin Lesions Other M >4,PX-97510345,CDM,17276,CPT,975,RC,,inpatient,,,700,630,,0.95,,665,Percent of total billed charges,,,0.98,,686,Percent of total billed charges,,,0.95,,665,Percent of total billed charges,,,0.97,,679,Percent of total billed charges,,,0.97,,679,Percent of total billed charges,,,0.96,,672,Percent of total billed charges,,,0.95,,665,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,665,Percent of total billed charges,,665,686,
HC PR 17276 Destruction of Skin Lesions Other M >4,PX-97510345,CDM,17276,CPT,975,RC,,outpatient,,,700,630,,0.95,,665,Percent of total billed charges,,,0.98,,686,Percent of total billed charges,,,0.95,,665,Percent of total billed charges,,,0.95,,665,Percent of total billed charges,,,0.97,,679,Percent of total billed charges,,,0.96,,672,Percent of total billed charges,,,0.95,,665,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,665,Percent of total billed charges,,665,686,
HC PR 17280 Destruction of Skin Lesions Fc Ear Eylds Ns Lip Muc 0.5 Cm,PX-97510346,CDM,17280,CPT,975,RC,,inpatient,,,348,313.2,,0.95,,330.6,Percent of total billed charges,,,0.98,,341.04,Percent of total billed charges,,,0.95,,330.6,Percent of total billed charges,,,0.97,,337.56,Percent of total billed charges,,,0.97,,337.56,Percent of total billed charges,,,0.96,,334.08,Percent of total billed charges,,,0.95,,330.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,330.6,Percent of total billed charges,,330.6,341.04,
HC PR 17280 Destruction of Skin Lesions Fc Ear Eylds Ns Lip Muc 0.5 Cm,PX-97510346,CDM,17280,CPT,975,RC,,outpatient,,,348,313.2,,0.95,,330.6,Percent of total billed charges,,,0.98,,341.04,Percent of total billed charges,,,0.95,,330.6,Percent of total billed charges,,,0.95,,330.6,Percent of total billed charges,,,0.97,,337.56,Percent of total billed charges,,,0.96,,334.08,Percent of total billed charges,,,0.95,,330.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,330.6,Percent of total billed charges,,330.6,341.04,
HC PR 19001 Drain Breast Lesion Add-On,PX-97510352,CDM,19001,CPT,975,RC,,inpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
HC PR 19001 Drain Breast Lesion Add-On,PX-97510352,CDM,19001,CPT,975,RC,,outpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
HC PR 19101 Biopsy of Breast Open,PX-97510356,CDM,19101,CPT,975,RC,,inpatient,,,831,747.9,,0.95,,789.45,Percent of total billed charges,,,0.98,,814.38,Percent of total billed charges,,,0.95,,789.45,Percent of total billed charges,,,0.97,,806.07,Percent of total billed charges,,,0.97,,806.07,Percent of total billed charges,,,0.96,,797.76,Percent of total billed charges,,,0.95,,789.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,789.45,Percent of total billed charges,,789.45,814.38,
HC PR 19101 Biopsy of Breast Open,PX-97510356,CDM,19101,CPT,975,RC,,outpatient,,,831,747.9,,0.95,,789.45,Percent of total billed charges,,,0.98,,814.38,Percent of total billed charges,,,0.95,,789.45,Percent of total billed charges,,,0.95,,789.45,Percent of total billed charges,,,0.97,,806.07,Percent of total billed charges,,,0.96,,797.76,Percent of total billed charges,,,0.95,,789.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,789.45,Percent of total billed charges,,789.45,814.38,
HC PR 19305 Mast Radical,PX-97510370,CDM,19305,CPT,975,RC,,inpatient,,,2835,2551.5,,0.95,,2693.25,Percent of total billed charges,,,0.98,,2778.3,Percent of total billed charges,,,0.95,,2693.25,Percent of total billed charges,,,0.97,,2749.95,Percent of total billed charges,,,0.97,,2749.95,Percent of total billed charges,,,0.96,,2721.6,Percent of total billed charges,,,0.95,,2693.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2693.25,Percent of total billed charges,,2693.25,2778.3,
HC PR 19305 Mast Radical,PX-97510370,CDM,19305,CPT,975,RC,,outpatient,,,2835,2551.5,,0.95,,2693.25,Percent of total billed charges,,,0.98,,2778.3,Percent of total billed charges,,,0.95,,2693.25,Percent of total billed charges,,,0.95,,2693.25,Percent of total billed charges,,,0.97,,2749.95,Percent of total billed charges,,,0.96,,2721.6,Percent of total billed charges,,,0.95,,2693.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2693.25,Percent of total billed charges,,2693.25,2778.3,
HC PR 19307 Mast Mod Rad,PX-97510373,CDM,19307,CPT,975,RC,,inpatient,,,2911,2619.9,,0.95,,2765.45,Percent of total billed charges,,,0.98,,2852.78,Percent of total billed charges,,,0.95,,2765.45,Percent of total billed charges,,,0.97,,2823.67,Percent of total billed charges,,,0.97,,2823.67,Percent of total billed charges,,,0.96,,2794.56,Percent of total billed charges,,,0.95,,2765.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2765.45,Percent of total billed charges,,2765.45,2852.78,
HC PR 19307 Mast Mod Rad,PX-97510373,CDM,19307,CPT,975,RC,,outpatient,,,2911,2619.9,,0.95,,2765.45,Percent of total billed charges,,,0.98,,2852.78,Percent of total billed charges,,,0.95,,2765.45,Percent of total billed charges,,,0.95,,2765.45,Percent of total billed charges,,,0.97,,2823.67,Percent of total billed charges,,,0.96,,2794.56,Percent of total billed charges,,,0.95,,2765.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2765.45,Percent of total billed charges,,2765.45,2852.78,
HC PR 19318 Reduction of Large Breast,PX-97510374,CDM,19318,CPT,975,RC,,inpatient,,,2688,2419.2,,0.95,,2553.6,Percent of total billed charges,,,0.98,,2634.24,Percent of total billed charges,,,0.95,,2553.6,Percent of total billed charges,,,0.97,,2607.36,Percent of total billed charges,,,0.97,,2607.36,Percent of total billed charges,,,0.96,,2580.48,Percent of total billed charges,,,0.95,,2553.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2553.6,Percent of total billed charges,,2553.6,2634.24,
HC PR 19318 Reduction of Large Breast,PX-97510374,CDM,19318,CPT,975,RC,,outpatient,,,2688,2419.2,,0.95,,2553.6,Percent of total billed charges,,,0.98,,2634.24,Percent of total billed charges,,,0.95,,2553.6,Percent of total billed charges,,,0.95,,2553.6,Percent of total billed charges,,,0.97,,2607.36,Percent of total billed charges,,,0.96,,2580.48,Percent of total billed charges,,,0.95,,2553.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2553.6,Percent of total billed charges,,2553.6,2634.24,
HC PR 20205 Deep Muscle Biopsy,PX-97510378,CDM,20205,CPT,975,RC,,inpatient,,,3162,2845.8,,0.95,,3003.9,Percent of total billed charges,,,0.98,,3098.76,Percent of total billed charges,,,0.95,,3003.9,Percent of total billed charges,,,0.97,,3067.14,Percent of total billed charges,,,0.97,,3067.14,Percent of total billed charges,,,0.96,,3035.52,Percent of total billed charges,,,0.95,,3003.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3003.9,Percent of total billed charges,,3003.9,3098.76,
HC PR 20205 Deep Muscle Biopsy,PX-97510378,CDM,20205,CPT,975,RC,,outpatient,,,3162,2845.8,,0.95,,3003.9,Percent of total billed charges,,,0.98,,3098.76,Percent of total billed charges,,,0.95,,3003.9,Percent of total billed charges,,,0.95,,3003.9,Percent of total billed charges,,,0.97,,3067.14,Percent of total billed charges,,,0.96,,3035.52,Percent of total billed charges,,,0.95,,3003.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3003.9,Percent of total billed charges,,3003.9,3098.76,
HC PR 20612 Aspirate/Inj Ganglion Cyst,PX-97510383,CDM,20612,CPT,975,RC,,inpatient,,,161,144.9,,0.95,,152.95,Percent of total billed charges,,,0.98,,157.78,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.96,,154.56,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,152.95,Percent of total billed charges,,152.95,157.78,
HC PR 20612 Aspirate/Inj Ganglion Cyst,PX-97510383,CDM,20612,CPT,975,RC,,outpatient,,,161,144.9,,0.95,,152.95,Percent of total billed charges,,,0.98,,157.78,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.96,,154.56,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,152.95,Percent of total billed charges,,152.95,157.78,
HC PR 21011 Exc Face Les Sc < 2 Cm,PX-97510391,CDM,21011,CPT,975,RC,,inpatient,,,926,833.4,,0.95,,879.7,Percent of total billed charges,,,0.98,,907.48,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,0.97,,898.22,Percent of total billed charges,,,0.97,,898.22,Percent of total billed charges,,,0.96,,888.96,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,879.7,Percent of total billed charges,,879.7,907.48,
HC PR 21011 Exc Face Les Sc < 2 Cm,PX-97510391,CDM,21011,CPT,975,RC,,outpatient,,,926,833.4,,0.95,,879.7,Percent of total billed charges,,,0.98,,907.48,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,0.97,,898.22,Percent of total billed charges,,,0.96,,888.96,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,879.7,Percent of total billed charges,,879.7,907.48,
HC PR 21012 Exc Face Les Sbq 2+ Cm,PX-97510392,CDM,21012,CPT,975,RC,,inpatient,,,843,758.7,,0.95,,800.85,Percent of total billed charges,,,0.98,,826.14,Percent of total billed charges,,,0.95,,800.85,Percent of total billed charges,,,0.97,,817.71,Percent of total billed charges,,,0.97,,817.71,Percent of total billed charges,,,0.96,,809.28,Percent of total billed charges,,,0.95,,800.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,800.85,Percent of total billed charges,,800.85,826.14,
HC PR 21012 Exc Face Les Sbq 2+ Cm,PX-97510392,CDM,21012,CPT,975,RC,,outpatient,,,843,758.7,,0.95,,800.85,Percent of total billed charges,,,0.98,,826.14,Percent of total billed charges,,,0.95,,800.85,Percent of total billed charges,,,0.95,,800.85,Percent of total billed charges,,,0.97,,817.71,Percent of total billed charges,,,0.96,,809.28,Percent of total billed charges,,,0.95,,800.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,800.85,Percent of total billed charges,,800.85,826.14,
HC PR 21552 Exc Neck Les Sc 3+ Cm,PX-97510403,CDM,21552,CPT,975,RC,,inpatient,,,1111,999.9,,0.95,,1055.45,Percent of total billed charges,,,0.98,,1088.78,Percent of total billed charges,,,0.95,,1055.45,Percent of total billed charges,,,0.97,,1077.67,Percent of total billed charges,,,0.97,,1077.67,Percent of total billed charges,,,0.96,,1066.56,Percent of total billed charges,,,0.95,,1055.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1055.45,Percent of total billed charges,,1055.45,1088.78,
HC PR 21552 Exc Neck Les Sc 3+ Cm,PX-97510403,CDM,21552,CPT,975,RC,,outpatient,,,1111,999.9,,0.95,,1055.45,Percent of total billed charges,,,0.98,,1088.78,Percent of total billed charges,,,0.95,,1055.45,Percent of total billed charges,,,0.95,,1055.45,Percent of total billed charges,,,0.97,,1077.67,Percent of total billed charges,,,0.96,,1066.56,Percent of total billed charges,,,0.95,,1055.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1055.45,Percent of total billed charges,,1055.45,1088.78,
HC PR 21555 Exc Neck Les Sc < 3 Cm,PX-97510405,CDM,21555,CPT,975,RC,,inpatient,,,1075,967.5,,0.95,,1021.25,Percent of total billed charges,,,0.98,,1053.5,Percent of total billed charges,,,0.95,,1021.25,Percent of total billed charges,,,0.97,,1042.75,Percent of total billed charges,,,0.97,,1042.75,Percent of total billed charges,,,0.96,,1032,Percent of total billed charges,,,0.95,,1021.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1021.25,Percent of total billed charges,,1021.25,1053.5,
HC PR 21555 Exc Neck Les Sc < 3 Cm,PX-97510405,CDM,21555,CPT,975,RC,,outpatient,,,1075,967.5,,0.95,,1021.25,Percent of total billed charges,,,0.98,,1053.5,Percent of total billed charges,,,0.95,,1021.25,Percent of total billed charges,,,0.95,,1021.25,Percent of total billed charges,,,0.97,,1042.75,Percent of total billed charges,,,0.96,,1032,Percent of total billed charges,,,0.95,,1021.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1021.25,Percent of total billed charges,,1021.25,1053.5,
HC PR 21556 Exc Neck Tum Deep < 5 Cm,PX-97510406,CDM,21556,CPT,975,RC,,inpatient,,,1316,1184.4,,0.95,,1250.2,Percent of total billed charges,,,0.98,,1289.68,Percent of total billed charges,,,0.95,,1250.2,Percent of total billed charges,,,0.97,,1276.52,Percent of total billed charges,,,0.97,,1276.52,Percent of total billed charges,,,0.96,,1263.36,Percent of total billed charges,,,0.95,,1250.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1250.2,Percent of total billed charges,,1250.2,1289.68,
HC PR 21556 Exc Neck Tum Deep < 5 Cm,PX-97510406,CDM,21556,CPT,975,RC,,outpatient,,,1316,1184.4,,0.95,,1250.2,Percent of total billed charges,,,0.98,,1289.68,Percent of total billed charges,,,0.95,,1250.2,Percent of total billed charges,,,0.95,,1250.2,Percent of total billed charges,,,0.97,,1276.52,Percent of total billed charges,,,0.96,,1263.36,Percent of total billed charges,,,0.95,,1250.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1250.2,Percent of total billed charges,,1250.2,1289.68,
HC PR 21930 Exc Back Les Sc < 3 Cm,PX-97510410,CDM,21930,CPT,975,RC,,inpatient,,,589,530.1,,0.95,,559.55,Percent of total billed charges,,,0.98,,577.22,Percent of total billed charges,,,0.95,,559.55,Percent of total billed charges,,,0.97,,571.33,Percent of total billed charges,,,0.97,,571.33,Percent of total billed charges,,,0.96,,565.44,Percent of total billed charges,,,0.95,,559.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,559.55,Percent of total billed charges,,559.55,577.22,
HC PR 21930 Exc Back Les Sc < 3 Cm,PX-97510410,CDM,21930,CPT,975,RC,,outpatient,,,589,530.1,,0.95,,559.55,Percent of total billed charges,,,0.98,,577.22,Percent of total billed charges,,,0.95,,559.55,Percent of total billed charges,,,0.95,,559.55,Percent of total billed charges,,,0.97,,571.33,Percent of total billed charges,,,0.96,,565.44,Percent of total billed charges,,,0.95,,559.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,559.55,Percent of total billed charges,,559.55,577.22,
HC PR 21931 Exc Back Les Sc 3+ Cm,PX-97510411,CDM,21931,CPT,975,RC,,inpatient,,,1166,1049.4,,0.95,,1107.7,Percent of total billed charges,,,0.98,,1142.68,Percent of total billed charges,,,0.95,,1107.7,Percent of total billed charges,,,0.97,,1131.02,Percent of total billed charges,,,0.97,,1131.02,Percent of total billed charges,,,0.96,,1119.36,Percent of total billed charges,,,0.95,,1107.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1107.7,Percent of total billed charges,,1107.7,1142.68,
HC PR 21931 Exc Back Les Sc 3+ Cm,PX-97510411,CDM,21931,CPT,975,RC,,outpatient,,,1166,1049.4,,0.95,,1107.7,Percent of total billed charges,,,0.98,,1142.68,Percent of total billed charges,,,0.95,,1107.7,Percent of total billed charges,,,0.95,,1107.7,Percent of total billed charges,,,0.97,,1131.02,Percent of total billed charges,,,0.96,,1119.36,Percent of total billed charges,,,0.95,,1107.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1107.7,Percent of total billed charges,,1107.7,1142.68,
HC PR 22903 Exc Abd Les Sc > 3 Cm,PX-97510431,CDM,22903,CPT,975,RC,,inpatient,,,953,857.7,,0.95,,905.35,Percent of total billed charges,,,0.98,,933.94,Percent of total billed charges,,,0.95,,905.35,Percent of total billed charges,,,0.97,,924.41,Percent of total billed charges,,,0.97,,924.41,Percent of total billed charges,,,0.96,,914.88,Percent of total billed charges,,,0.95,,905.35,Percent of total billed charges,,,,,,,,,0.95,,905.35,Percent of total billed charges,,905.35,933.94,
HC PR 22903 Exc Abd Les Sc > 3 Cm,PX-97510431,CDM,22903,CPT,975,RC,,outpatient,,,953,857.7,,0.95,,905.35,Percent of total billed charges,,,0.98,,933.94,Percent of total billed charges,,,0.95,,905.35,Percent of total billed charges,,,0.95,,905.35,Percent of total billed charges,,,0.97,,924.41,Percent of total billed charges,,,0.96,,914.88,Percent of total billed charges,,,0.95,,905.35,Percent of total billed charges,,,,,,,,,0.95,,905.35,Percent of total billed charges,,905.35,933.94,
HC PR 23615 Treat Humerus Fracture Open,PX-97510445,CDM,23615,CPT,975,RC,,inpatient,,,2194,1974.6,,0.95,,2084.3,Percent of total billed charges,,,0.98,,2150.12,Percent of total billed charges,,,0.95,,2084.3,Percent of total billed charges,,,0.97,,2128.18,Percent of total billed charges,,,0.97,,2128.18,Percent of total billed charges,,,0.96,,2106.24,Percent of total billed charges,,,0.95,,2084.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2084.3,Percent of total billed charges,,2084.3,2150.12,
HC PR 23615 Treat Humerus Fracture Open,PX-97510445,CDM,23615,CPT,975,RC,,outpatient,,,2194,1974.6,,0.95,,2084.3,Percent of total billed charges,,,0.98,,2150.12,Percent of total billed charges,,,0.95,,2084.3,Percent of total billed charges,,,0.95,,2084.3,Percent of total billed charges,,,0.97,,2128.18,Percent of total billed charges,,,0.96,,2106.24,Percent of total billed charges,,,0.95,,2084.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2084.3,Percent of total billed charges,,2084.3,2150.12,
HC PR 11606 Exc Tr-Ext Mlg+Marg > 4 Cm,PX-97510458,CDM,11606,CPT,975,RC,,inpatient,,,1105,994.5,,0.95,,1049.75,Percent of total billed charges,,,0.98,,1082.9,Percent of total billed charges,,,0.95,,1049.75,Percent of total billed charges,,,0.97,,1071.85,Percent of total billed charges,,,0.97,,1071.85,Percent of total billed charges,,,0.96,,1060.8,Percent of total billed charges,,,0.95,,1049.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1049.75,Percent of total billed charges,,1049.75,1082.9,
HC PR 11606 Exc Tr-Ext Mlg+Marg > 4 Cm,PX-97510458,CDM,11606,CPT,975,RC,,outpatient,,,1105,994.5,,0.95,,1049.75,Percent of total billed charges,,,0.98,,1082.9,Percent of total billed charges,,,0.95,,1049.75,Percent of total billed charges,,,0.95,,1049.75,Percent of total billed charges,,,0.97,,1071.85,Percent of total billed charges,,,0.96,,1060.8,Percent of total billed charges,,,0.95,,1049.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1049.75,Percent of total billed charges,,1049.75,1082.9,
HC PR 11771 Removal of Pilonidal Lesion Exten,PX-97510462,CDM,11771,CPT,975,RC,,inpatient,,,1556,1400.4,,0.95,,1478.2,Percent of total billed charges,,,0.98,,1524.88,Percent of total billed charges,,,0.95,,1478.2,Percent of total billed charges,,,0.97,,1509.32,Percent of total billed charges,,,0.97,,1509.32,Percent of total billed charges,,,0.96,,1493.76,Percent of total billed charges,,,0.95,,1478.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1478.2,Percent of total billed charges,,1478.2,1524.88,
HC PR 11771 Removal of Pilonidal Lesion Exten,PX-97510462,CDM,11771,CPT,975,RC,,outpatient,,,1556,1400.4,,0.95,,1478.2,Percent of total billed charges,,,0.98,,1524.88,Percent of total billed charges,,,0.95,,1478.2,Percent of total billed charges,,,0.95,,1478.2,Percent of total billed charges,,,0.97,,1509.32,Percent of total billed charges,,,0.96,,1493.76,Percent of total billed charges,,,0.95,,1478.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1478.2,Percent of total billed charges,,1478.2,1524.88,
HC PR ED 10060 Drainage of Skin Abscess Simple or Single Cdm,PX-98110229,CDM,10060,CPT,981,RC,,inpatient,,,355,319.5,,0.95,,337.25,Percent of total billed charges,,,0.98,,347.9,Percent of total billed charges,,,0.95,,337.25,Percent of total billed charges,,,0.97,,344.35,Percent of total billed charges,,,0.97,,344.35,Percent of total billed charges,,,0.96,,340.8,Percent of total billed charges,,,0.95,,337.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,337.25,Percent of total billed charges,,337.25,347.9,
HC PR ED 10060 Drainage of Skin Abscess Simple or Single Cdm,PX-98110229,CDM,10060,CPT,981,RC,,outpatient,,,355,319.5,,0.95,,337.25,Percent of total billed charges,,,0.98,,347.9,Percent of total billed charges,,,0.95,,337.25,Percent of total billed charges,,,0.95,,337.25,Percent of total billed charges,,,0.97,,344.35,Percent of total billed charges,,,0.96,,340.8,Percent of total billed charges,,,0.95,,337.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,337.25,Percent of total billed charges,,337.25,347.9,
HC PR ED 10061 Drainage of Skin Abscess Complicated or Multiple Cdm,PX-98110231,CDM,10061,CPT,981,RC,,inpatient,,,626,563.4,,0.95,,594.7,Percent of total billed charges,,,0.98,,613.48,Percent of total billed charges,,,0.95,,594.7,Percent of total billed charges,,,0.97,,607.22,Percent of total billed charges,,,0.97,,607.22,Percent of total billed charges,,,0.96,,600.96,Percent of total billed charges,,,0.95,,594.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,594.7,Percent of total billed charges,,594.7,613.48,
HC PR ED 10061 Drainage of Skin Abscess Complicated or Multiple Cdm,PX-98110231,CDM,10061,CPT,981,RC,,outpatient,,,626,563.4,,0.95,,594.7,Percent of total billed charges,,,0.98,,613.48,Percent of total billed charges,,,0.95,,594.7,Percent of total billed charges,,,0.95,,594.7,Percent of total billed charges,,,0.97,,607.22,Percent of total billed charges,,,0.96,,600.96,Percent of total billed charges,,,0.95,,594.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,594.7,Percent of total billed charges,,594.7,613.48,
HC PR ED 10080 Drainage of Pilonidal Cyst Simple Cdm,PX-98110232,CDM,10080,CPT,981,RC,,inpatient,,,348,313.2,,0.95,,330.6,Percent of total billed charges,,,0.98,,341.04,Percent of total billed charges,,,0.95,,330.6,Percent of total billed charges,,,0.97,,337.56,Percent of total billed charges,,,0.97,,337.56,Percent of total billed charges,,,0.96,,334.08,Percent of total billed charges,,,0.95,,330.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,330.6,Percent of total billed charges,,330.6,341.04,
HC PR ED 10080 Drainage of Pilonidal Cyst Simple Cdm,PX-98110232,CDM,10080,CPT,981,RC,,outpatient,,,348,313.2,,0.95,,330.6,Percent of total billed charges,,,0.98,,341.04,Percent of total billed charges,,,0.95,,330.6,Percent of total billed charges,,,0.95,,330.6,Percent of total billed charges,,,0.97,,337.56,Percent of total billed charges,,,0.96,,334.08,Percent of total billed charges,,,0.95,,330.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,330.6,Percent of total billed charges,,330.6,341.04,
HC PR ED 10081 Drainage of Pilonidal Cyst Complicated Cdm,PX-98110233,CDM,10081,CPT,981,RC,,inpatient,,,669,602.1,,0.95,,635.55,Percent of total billed charges,,,0.98,,655.62,Percent of total billed charges,,,0.95,,635.55,Percent of total billed charges,,,0.97,,648.93,Percent of total billed charges,,,0.97,,648.93,Percent of total billed charges,,,0.96,,642.24,Percent of total billed charges,,,0.95,,635.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,635.55,Percent of total billed charges,,635.55,655.62,
HC PR ED 10081 Drainage of Pilonidal Cyst Complicated Cdm,PX-98110233,CDM,10081,CPT,981,RC,,outpatient,,,669,602.1,,0.95,,635.55,Percent of total billed charges,,,0.98,,655.62,Percent of total billed charges,,,0.95,,635.55,Percent of total billed charges,,,0.95,,635.55,Percent of total billed charges,,,0.97,,648.93,Percent of total billed charges,,,0.96,,642.24,Percent of total billed charges,,,0.95,,635.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,635.55,Percent of total billed charges,,635.55,655.62,
HC PR ED 10120 Remove Foreign Body Simple Cdm,PX-98110234,CDM,10120,CPT,981,RC,,inpatient,,,463,416.7,,0.95,,439.85,Percent of total billed charges,,,0.98,,453.74,Percent of total billed charges,,,0.95,,439.85,Percent of total billed charges,,,0.97,,449.11,Percent of total billed charges,,,0.97,,449.11,Percent of total billed charges,,,0.96,,444.48,Percent of total billed charges,,,0.95,,439.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,439.85,Percent of total billed charges,,439.85,453.74,
HC PR ED 10120 Remove Foreign Body Simple Cdm,PX-98110234,CDM,10120,CPT,981,RC,,outpatient,,,463,416.7,,0.95,,439.85,Percent of total billed charges,,,0.98,,453.74,Percent of total billed charges,,,0.95,,439.85,Percent of total billed charges,,,0.95,,439.85,Percent of total billed charges,,,0.97,,449.11,Percent of total billed charges,,,0.96,,444.48,Percent of total billed charges,,,0.95,,439.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,439.85,Percent of total billed charges,,439.85,453.74,
HC PR ED 10121 Remove Foreign Body Complicated Cdm,PX-98110235,CDM,10121,CPT,981,RC,,inpatient,,,741,666.9,,0.95,,703.95,Percent of total billed charges,,,0.98,,726.18,Percent of total billed charges,,,0.95,,703.95,Percent of total billed charges,,,0.97,,718.77,Percent of total billed charges,,,0.97,,718.77,Percent of total billed charges,,,0.96,,711.36,Percent of total billed charges,,,0.95,,703.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,703.95,Percent of total billed charges,,703.95,726.18,
HC PR ED 10121 Remove Foreign Body Complicated Cdm,PX-98110235,CDM,10121,CPT,981,RC,,outpatient,,,741,666.9,,0.95,,703.95,Percent of total billed charges,,,0.98,,726.18,Percent of total billed charges,,,0.95,,703.95,Percent of total billed charges,,,0.95,,703.95,Percent of total billed charges,,,0.97,,718.77,Percent of total billed charges,,,0.96,,711.36,Percent of total billed charges,,,0.95,,703.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,703.95,Percent of total billed charges,,703.95,726.18,
HC PR ED 10140 Drainage of Hematoma/Fluid Cdm,PX-98110236,CDM,10140,CPT,981,RC,,inpatient,,,520,468,,0.95,,494,Percent of total billed charges,,,0.98,,509.6,Percent of total billed charges,,,0.95,,494,Percent of total billed charges,,,0.97,,504.4,Percent of total billed charges,,,0.97,,504.4,Percent of total billed charges,,,0.96,,499.2,Percent of total billed charges,,,0.95,,494,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,494,Percent of total billed charges,,494,509.6,
HC PR ED 10140 Drainage of Hematoma/Fluid Cdm,PX-98110236,CDM,10140,CPT,981,RC,,outpatient,,,520,468,,0.95,,494,Percent of total billed charges,,,0.98,,509.6,Percent of total billed charges,,,0.95,,494,Percent of total billed charges,,,0.95,,494,Percent of total billed charges,,,0.97,,504.4,Percent of total billed charges,,,0.96,,499.2,Percent of total billed charges,,,0.95,,494,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,494,Percent of total billed charges,,494,509.6,
HC PR ED 10160 Puncture Aspiration Abscess Hematoma Bulla/Cyst Cdm,PX-98110238,CDM,10160,CPT,981,RC,,inpatient,,,395,355.5,,0.95,,375.25,Percent of total billed charges,,,0.98,,387.1,Percent of total billed charges,,,0.95,,375.25,Percent of total billed charges,,,0.97,,383.15,Percent of total billed charges,,,0.97,,383.15,Percent of total billed charges,,,0.96,,379.2,Percent of total billed charges,,,0.95,,375.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,375.25,Percent of total billed charges,,375.25,387.1,
HC PR ED 10160 Puncture Aspiration Abscess Hematoma Bulla/Cyst Cdm,PX-98110238,CDM,10160,CPT,981,RC,,outpatient,,,395,355.5,,0.95,,375.25,Percent of total billed charges,,,0.98,,387.1,Percent of total billed charges,,,0.95,,375.25,Percent of total billed charges,,,0.95,,375.25,Percent of total billed charges,,,0.97,,383.15,Percent of total billed charges,,,0.96,,379.2,Percent of total billed charges,,,0.95,,375.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,375.25,Percent of total billed charges,,375.25,387.1,
HC PR ED 11000 Debride Infected Skin Cdm,PX-98110240,CDM,11000,CPT,981,RC,,inpatient,,,153,137.7,,0.95,,145.35,Percent of total billed charges,,,0.98,,149.94,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.96,,146.88,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,145.35,Percent of total billed charges,,145.35,149.94,
HC PR ED 11000 Debride Infected Skin Cdm,PX-98110240,CDM,11000,CPT,981,RC,,outpatient,,,153,137.7,,0.95,,145.35,Percent of total billed charges,,,0.98,,149.94,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.96,,146.88,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,145.35,Percent of total billed charges,,145.35,149.94,
HC PR ED 11042 Deb Subq Tissue 20 Sq Cm/< Cdm,PX-98110242,CDM,11042,CPT,981,RC,,inpatient,,,320,288,,0.95,,304,Percent of total billed charges,,,0.98,,313.6,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,0.97,,310.4,Percent of total billed charges,,,0.97,,310.4,Percent of total billed charges,,,0.96,,307.2,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,304,Percent of total billed charges,,304,313.6,
HC PR ED 11042 Deb Subq Tissue 20 Sq Cm/< Cdm,PX-98110242,CDM,11042,CPT,981,RC,,outpatient,,,320,288,,0.95,,304,Percent of total billed charges,,,0.98,,313.6,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,0.97,,310.4,Percent of total billed charges,,,0.96,,307.2,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,304,Percent of total billed charges,,304,313.6,
HC PR ED 11401 Exc Tr-Ext B9+Marg 0.6-1 Cm Cdm,PX-98110249,CDM,11401,CPT,981,RC,,inpatient,,,450,405,,0.95,,427.5,Percent of total billed charges,,,0.98,,441,Percent of total billed charges,,,0.95,,427.5,Percent of total billed charges,,,0.97,,436.5,Percent of total billed charges,,,0.97,,436.5,Percent of total billed charges,,,0.96,,432,Percent of total billed charges,,,0.95,,427.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,427.5,Percent of total billed charges,,427.5,441,
HC PR ED 11401 Exc Tr-Ext B9+Marg 0.6-1 Cm Cdm,PX-98110249,CDM,11401,CPT,981,RC,,outpatient,,,450,405,,0.95,,427.5,Percent of total billed charges,,,0.98,,441,Percent of total billed charges,,,0.95,,427.5,Percent of total billed charges,,,0.95,,427.5,Percent of total billed charges,,,0.97,,436.5,Percent of total billed charges,,,0.96,,432,Percent of total billed charges,,,0.95,,427.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,427.5,Percent of total billed charges,,427.5,441,
HC PR ED 11720 Debride Nail 1-5 Cdm,PX-98110250,CDM,11720,CPT,981,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
HC PR ED 11720 Debride Nail 1-5 Cdm,PX-98110250,CDM,11720,CPT,981,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
HC PR ED 11730 Removal of Nail Plate Cdm,PX-98110251,CDM,11730,CPT,981,RC,,inpatient,,,335,301.5,,0.95,,318.25,Percent of total billed charges,,,0.98,,328.3,Percent of total billed charges,,,0.95,,318.25,Percent of total billed charges,,,0.97,,324.95,Percent of total billed charges,,,0.97,,324.95,Percent of total billed charges,,,0.96,,321.6,Percent of total billed charges,,,0.95,,318.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,318.25,Percent of total billed charges,,318.25,328.3,
HC PR ED 11730 Removal of Nail Plate Cdm,PX-98110251,CDM,11730,CPT,981,RC,,outpatient,,,335,301.5,,0.95,,318.25,Percent of total billed charges,,,0.98,,328.3,Percent of total billed charges,,,0.95,,318.25,Percent of total billed charges,,,0.95,,318.25,Percent of total billed charges,,,0.97,,324.95,Percent of total billed charges,,,0.96,,321.6,Percent of total billed charges,,,0.95,,318.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,318.25,Percent of total billed charges,,318.25,328.3,
HC PR ED 11740 Drain Blood From Under Nail Cdm,PX-98110253,CDM,11740,CPT,981,RC,,inpatient,,,162,145.8,,0.95,,153.9,Percent of total billed charges,,,0.98,,158.76,Percent of total billed charges,,,0.95,,153.9,Percent of total billed charges,,,0.97,,157.14,Percent of total billed charges,,,0.97,,157.14,Percent of total billed charges,,,0.96,,155.52,Percent of total billed charges,,,0.95,,153.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,153.9,Percent of total billed charges,,153.9,158.76,
HC PR ED 11740 Drain Blood From Under Nail Cdm,PX-98110253,CDM,11740,CPT,981,RC,,outpatient,,,162,145.8,,0.95,,153.9,Percent of total billed charges,,,0.98,,158.76,Percent of total billed charges,,,0.95,,153.9,Percent of total billed charges,,,0.95,,153.9,Percent of total billed charges,,,0.97,,157.14,Percent of total billed charges,,,0.96,,155.52,Percent of total billed charges,,,0.95,,153.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,153.9,Percent of total billed charges,,153.9,158.76,
HC PR ED 11750 Removal of Nail Bed Cdm,PX-98110254,CDM,11750,CPT,981,RC,,inpatient,,,626,563.4,,0.95,,594.7,Percent of total billed charges,,,0.98,,613.48,Percent of total billed charges,,,0.95,,594.7,Percent of total billed charges,,,0.97,,607.22,Percent of total billed charges,,,0.97,,607.22,Percent of total billed charges,,,0.96,,600.96,Percent of total billed charges,,,0.95,,594.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,594.7,Percent of total billed charges,,594.7,613.48,
HC PR ED 11750 Removal of Nail Bed Cdm,PX-98110254,CDM,11750,CPT,981,RC,,outpatient,,,626,563.4,,0.95,,594.7,Percent of total billed charges,,,0.98,,613.48,Percent of total billed charges,,,0.95,,594.7,Percent of total billed charges,,,0.95,,594.7,Percent of total billed charges,,,0.97,,607.22,Percent of total billed charges,,,0.96,,600.96,Percent of total billed charges,,,0.95,,594.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,594.7,Percent of total billed charges,,594.7,613.48,
HC PR ED 11760 Repair of Nail Bed Cdm,PX-98110256,CDM,11760,CPT,981,RC,,inpatient,,,499,449.1,,0.95,,474.05,Percent of total billed charges,,,0.98,,489.02,Percent of total billed charges,,,0.95,,474.05,Percent of total billed charges,,,0.97,,484.03,Percent of total billed charges,,,0.97,,484.03,Percent of total billed charges,,,0.96,,479.04,Percent of total billed charges,,,0.95,,474.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,474.05,Percent of total billed charges,,474.05,489.02,
HC PR ED 11760 Repair of Nail Bed Cdm,PX-98110256,CDM,11760,CPT,981,RC,,outpatient,,,499,449.1,,0.95,,474.05,Percent of total billed charges,,,0.98,,489.02,Percent of total billed charges,,,0.95,,474.05,Percent of total billed charges,,,0.95,,474.05,Percent of total billed charges,,,0.97,,484.03,Percent of total billed charges,,,0.96,,479.04,Percent of total billed charges,,,0.95,,474.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,474.05,Percent of total billed charges,,474.05,489.02,
HC PR ED 11765 Excision of Nail Fold Toe Cdm,PX-98110258,CDM,11765,CPT,981,RC,,inpatient,,,532,478.8,,0.95,,505.4,Percent of total billed charges,,,0.98,,521.36,Percent of total billed charges,,,0.95,,505.4,Percent of total billed charges,,,0.97,,516.04,Percent of total billed charges,,,0.97,,516.04,Percent of total billed charges,,,0.96,,510.72,Percent of total billed charges,,,0.95,,505.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,505.4,Percent of total billed charges,,505.4,521.36,
HC PR ED 11765 Excision of Nail Fold Toe Cdm,PX-98110258,CDM,11765,CPT,981,RC,,outpatient,,,532,478.8,,0.95,,505.4,Percent of total billed charges,,,0.98,,521.36,Percent of total billed charges,,,0.95,,505.4,Percent of total billed charges,,,0.95,,505.4,Percent of total billed charges,,,0.97,,516.04,Percent of total billed charges,,,0.96,,510.72,Percent of total billed charges,,,0.95,,505.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,505.4,Percent of total billed charges,,505.4,521.36,
HC PR ED 12001 Repair Superfic Wound(S)< 2.5cm Slp Nk Ax Exgen Trnk Ex Cdm,PX-98110259,CDM,12001,CPT,981,RC,,inpatient,,,327,294.3,,0.95,,310.65,Percent of total billed charges,,,0.98,,320.46,Percent of total billed charges,,,0.95,,310.65,Percent of total billed charges,,,0.97,,317.19,Percent of total billed charges,,,0.97,,317.19,Percent of total billed charges,,,0.96,,313.92,Percent of total billed charges,,,0.95,,310.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,310.65,Percent of total billed charges,,310.65,320.46,
HC PR ED 12001 Repair Superfic Wound(S)< 2.5cm Slp Nk Ax Exgen Trnk Ex Cdm,PX-98110259,CDM,12001,CPT,981,RC,,outpatient,,,327,294.3,,0.95,,310.65,Percent of total billed charges,,,0.98,,320.46,Percent of total billed charges,,,0.95,,310.65,Percent of total billed charges,,,0.95,,310.65,Percent of total billed charges,,,0.97,,317.19,Percent of total billed charges,,,0.96,,313.92,Percent of total billed charges,,,0.95,,310.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,310.65,Percent of total billed charges,,310.65,320.46,
HC PR ED 12002 Repair Superfic Wound(S) 2.6 to 7.5cm Slp Nk Ax Exgen T Cdm,PX-98110260,CDM,12002,CPT,981,RC,,inpatient,,,432,388.8,,0.95,,410.4,Percent of total billed charges,,,0.98,,423.36,Percent of total billed charges,,,0.95,,410.4,Percent of total billed charges,,,0.97,,419.04,Percent of total billed charges,,,0.97,,419.04,Percent of total billed charges,,,0.96,,414.72,Percent of total billed charges,,,0.95,,410.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,410.4,Percent of total billed charges,,410.4,423.36,
HC PR ED 12002 Repair Superfic Wound(S) 2.6 to 7.5cm Slp Nk Ax Exgen T Cdm,PX-98110260,CDM,12002,CPT,981,RC,,outpatient,,,432,388.8,,0.95,,410.4,Percent of total billed charges,,,0.98,,423.36,Percent of total billed charges,,,0.95,,410.4,Percent of total billed charges,,,0.95,,410.4,Percent of total billed charges,,,0.97,,419.04,Percent of total billed charges,,,0.96,,414.72,Percent of total billed charges,,,0.95,,410.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,410.4,Percent of total billed charges,,410.4,423.36,
HC PR ED 12004 Repair Superfic Wound(S)7.6 to 12.5cm Slp Nk Ax Exgen T Cdm,PX-98110261,CDM,12004,CPT,981,RC,,inpatient,,,535,481.5,,0.95,,508.25,Percent of total billed charges,,,0.98,,524.3,Percent of total billed charges,,,0.95,,508.25,Percent of total billed charges,,,0.97,,518.95,Percent of total billed charges,,,0.97,,518.95,Percent of total billed charges,,,0.96,,513.6,Percent of total billed charges,,,0.95,,508.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,508.25,Percent of total billed charges,,508.25,524.3,
HC PR ED 12004 Repair Superfic Wound(S)7.6 to 12.5cm Slp Nk Ax Exgen T Cdm,PX-98110261,CDM,12004,CPT,981,RC,,outpatient,,,535,481.5,,0.95,,508.25,Percent of total billed charges,,,0.98,,524.3,Percent of total billed charges,,,0.95,,508.25,Percent of total billed charges,,,0.95,,508.25,Percent of total billed charges,,,0.97,,518.95,Percent of total billed charges,,,0.96,,513.6,Percent of total billed charges,,,0.95,,508.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,508.25,Percent of total billed charges,,508.25,524.3,
HC PR ED 12005 Repair Superfic Wound(S)12.6 to 20.0cm Slp Nk Ax Exgen Cdm,PX-98110262,CDM,12005,CPT,981,RC,,inpatient,,,787,708.3,,0.95,,747.65,Percent of total billed charges,,,0.98,,771.26,Percent of total billed charges,,,0.95,,747.65,Percent of total billed charges,,,0.97,,763.39,Percent of total billed charges,,,0.97,,763.39,Percent of total billed charges,,,0.96,,755.52,Percent of total billed charges,,,0.95,,747.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,747.65,Percent of total billed charges,,747.65,771.26,
HC PR ED 12005 Repair Superfic Wound(S)12.6 to 20.0cm Slp Nk Ax Exgen Cdm,PX-98110262,CDM,12005,CPT,981,RC,,outpatient,,,787,708.3,,0.95,,747.65,Percent of total billed charges,,,0.98,,771.26,Percent of total billed charges,,,0.95,,747.65,Percent of total billed charges,,,0.95,,747.65,Percent of total billed charges,,,0.97,,763.39,Percent of total billed charges,,,0.96,,755.52,Percent of total billed charges,,,0.95,,747.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,747.65,Percent of total billed charges,,747.65,771.26,
HC PR ED 12006 Repair Superfic Wound(S) 20.1-30.0cm Slp Nk Ax Exgen Tr Cdm,PX-98110263,CDM,12006,CPT,981,RC,,inpatient,,,855,769.5,,0.95,,812.25,Percent of total billed charges,,,0.98,,837.9,Percent of total billed charges,,,0.95,,812.25,Percent of total billed charges,,,0.97,,829.35,Percent of total billed charges,,,0.97,,829.35,Percent of total billed charges,,,0.96,,820.8,Percent of total billed charges,,,0.95,,812.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,812.25,Percent of total billed charges,,812.25,837.9,
HC PR ED 12006 Repair Superfic Wound(S) 20.1-30.0cm Slp Nk Ax Exgen Tr Cdm,PX-98110263,CDM,12006,CPT,981,RC,,outpatient,,,855,769.5,,0.95,,812.25,Percent of total billed charges,,,0.98,,837.9,Percent of total billed charges,,,0.95,,812.25,Percent of total billed charges,,,0.95,,812.25,Percent of total billed charges,,,0.97,,829.35,Percent of total billed charges,,,0.96,,820.8,Percent of total billed charges,,,0.95,,812.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,812.25,Percent of total billed charges,,812.25,837.9,
HC PR ED 12011 Repair Superfic Wound(S) <2.5 Face Ers Eyld Nse Lps Muc Cdm,PX-98110265,CDM,12011,CPT,981,RC,,inpatient,,,390,351,,0.95,,370.5,Percent of total billed charges,,,0.98,,382.2,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,0.97,,378.3,Percent of total billed charges,,,0.97,,378.3,Percent of total billed charges,,,0.96,,374.4,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,370.5,Percent of total billed charges,,370.5,382.2,
HC PR ED 12011 Repair Superfic Wound(S) <2.5 Face Ers Eyld Nse Lps Muc Cdm,PX-98110265,CDM,12011,CPT,981,RC,,outpatient,,,390,351,,0.95,,370.5,Percent of total billed charges,,,0.98,,382.2,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,0.97,,378.3,Percent of total billed charges,,,0.96,,374.4,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,370.5,Percent of total billed charges,,370.5,382.2,
HC PR ED 12013 Repair Superfic Wound(S) 2.6 to 5.0cm Face Ers Eyld Nse Cdm,PX-98110266,CDM,12013,CPT,981,RC,,inpatient,,,532,478.8,,0.95,,505.4,Percent of total billed charges,,,0.98,,521.36,Percent of total billed charges,,,0.95,,505.4,Percent of total billed charges,,,0.97,,516.04,Percent of total billed charges,,,0.97,,516.04,Percent of total billed charges,,,0.96,,510.72,Percent of total billed charges,,,0.95,,505.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,505.4,Percent of total billed charges,,505.4,521.36,
HC PR ED 12013 Repair Superfic Wound(S) 2.6 to 5.0cm Face Ers Eyld Nse Cdm,PX-98110266,CDM,12013,CPT,981,RC,,outpatient,,,532,478.8,,0.95,,505.4,Percent of total billed charges,,,0.98,,521.36,Percent of total billed charges,,,0.95,,505.4,Percent of total billed charges,,,0.95,,505.4,Percent of total billed charges,,,0.97,,516.04,Percent of total billed charges,,,0.96,,510.72,Percent of total billed charges,,,0.95,,505.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,505.4,Percent of total billed charges,,505.4,521.36,
HC PR ED 12014 Repair Superfic Wound(S) 5.1 to 7.5cm Face Ers Eyld Nse Cdm,PX-98110267,CDM,12014,CPT,981,RC,,inpatient,,,603,542.7,,0.95,,572.85,Percent of total billed charges,,,0.98,,590.94,Percent of total billed charges,,,0.95,,572.85,Percent of total billed charges,,,0.97,,584.91,Percent of total billed charges,,,0.97,,584.91,Percent of total billed charges,,,0.96,,578.88,Percent of total billed charges,,,0.95,,572.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,572.85,Percent of total billed charges,,572.85,590.94,
HC PR ED 12014 Repair Superfic Wound(S) 5.1 to 7.5cm Face Ers Eyld Nse Cdm,PX-98110267,CDM,12014,CPT,981,RC,,outpatient,,,603,542.7,,0.95,,572.85,Percent of total billed charges,,,0.98,,590.94,Percent of total billed charges,,,0.95,,572.85,Percent of total billed charges,,,0.95,,572.85,Percent of total billed charges,,,0.97,,584.91,Percent of total billed charges,,,0.96,,578.88,Percent of total billed charges,,,0.95,,572.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,572.85,Percent of total billed charges,,572.85,590.94,
HC PR ED 12015 Repair Superfic Wound(S) 7.6 to 12.5cm Face Ers Eyld Ns Cdm,PX-98110268,CDM,12015,CPT,981,RC,,inpatient,,,741,666.9,,0.95,,703.95,Percent of total billed charges,,,0.98,,726.18,Percent of total billed charges,,,0.95,,703.95,Percent of total billed charges,,,0.97,,718.77,Percent of total billed charges,,,0.97,,718.77,Percent of total billed charges,,,0.96,,711.36,Percent of total billed charges,,,0.95,,703.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,703.95,Percent of total billed charges,,703.95,726.18,
HC PR ED 12015 Repair Superfic Wound(S) 7.6 to 12.5cm Face Ers Eyld Ns Cdm,PX-98110268,CDM,12015,CPT,981,RC,,outpatient,,,741,666.9,,0.95,,703.95,Percent of total billed charges,,,0.98,,726.18,Percent of total billed charges,,,0.95,,703.95,Percent of total billed charges,,,0.95,,703.95,Percent of total billed charges,,,0.97,,718.77,Percent of total billed charges,,,0.96,,711.36,Percent of total billed charges,,,0.95,,703.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,703.95,Percent of total billed charges,,703.95,726.18,
HC PR ED 12016 Repair Superfic Wound(S) 12.6 to 20.0cm Face Ers Eyld N Cdm,PX-98110269,CDM,12016,CPT,981,RC,,inpatient,,,988,889.2,,0.95,,938.6,Percent of total billed charges,,,0.98,,968.24,Percent of total billed charges,,,0.95,,938.6,Percent of total billed charges,,,0.97,,958.36,Percent of total billed charges,,,0.97,,958.36,Percent of total billed charges,,,0.96,,948.48,Percent of total billed charges,,,0.95,,938.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,938.6,Percent of total billed charges,,938.6,968.24,
HC PR ED 12016 Repair Superfic Wound(S) 12.6 to 20.0cm Face Ers Eyld N Cdm,PX-98110269,CDM,12016,CPT,981,RC,,outpatient,,,988,889.2,,0.95,,938.6,Percent of total billed charges,,,0.98,,968.24,Percent of total billed charges,,,0.95,,938.6,Percent of total billed charges,,,0.95,,938.6,Percent of total billed charges,,,0.97,,958.36,Percent of total billed charges,,,0.96,,948.48,Percent of total billed charges,,,0.95,,938.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,938.6,Percent of total billed charges,,938.6,968.24,
HC PR ED 12020 Closure of Split Wound Simple Closure Cdm,PX-98110272,CDM,12020,CPT,981,RC,,inpatient,,,635,571.5,,0.95,,603.25,Percent of total billed charges,,,0.98,,622.3,Percent of total billed charges,,,0.95,,603.25,Percent of total billed charges,,,0.97,,615.95,Percent of total billed charges,,,0.97,,615.95,Percent of total billed charges,,,0.96,,609.6,Percent of total billed charges,,,0.95,,603.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,603.25,Percent of total billed charges,,603.25,622.3,
HC PR ED 12020 Closure of Split Wound Simple Closure Cdm,PX-98110272,CDM,12020,CPT,981,RC,,outpatient,,,635,571.5,,0.95,,603.25,Percent of total billed charges,,,0.98,,622.3,Percent of total billed charges,,,0.95,,603.25,Percent of total billed charges,,,0.95,,603.25,Percent of total billed charges,,,0.97,,615.95,Percent of total billed charges,,,0.96,,609.6,Percent of total billed charges,,,0.95,,603.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,603.25,Percent of total billed charges,,603.25,622.3,
HC PR ED 12031 Intmd Wnd Repair S/Tr/Ext Up to 2.5cm Cdm,PX-98110274,CDM,12031,CPT,981,RC,,inpatient,,,470,423,,0.95,,446.5,Percent of total billed charges,,,0.98,,460.6,Percent of total billed charges,,,0.95,,446.5,Percent of total billed charges,,,0.97,,455.9,Percent of total billed charges,,,0.97,,455.9,Percent of total billed charges,,,0.96,,451.2,Percent of total billed charges,,,0.95,,446.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,446.5,Percent of total billed charges,,446.5,460.6,
HC PR ED 12031 Intmd Wnd Repair S/Tr/Ext Up to 2.5cm Cdm,PX-98110274,CDM,12031,CPT,981,RC,,outpatient,,,470,423,,0.95,,446.5,Percent of total billed charges,,,0.98,,460.6,Percent of total billed charges,,,0.95,,446.5,Percent of total billed charges,,,0.95,,446.5,Percent of total billed charges,,,0.97,,455.9,Percent of total billed charges,,,0.96,,451.2,Percent of total billed charges,,,0.95,,446.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,446.5,Percent of total billed charges,,446.5,460.6,
HC PR ED 12032 Intmd Wnd Repair S/Tr/Ext 2.6 to 7.5cm Cdm,PX-98110275,CDM,12032,CPT,981,RC,,inpatient,,,749,674.1,,0.95,,711.55,Percent of total billed charges,,,0.98,,734.02,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,0.97,,726.53,Percent of total billed charges,,,0.97,,726.53,Percent of total billed charges,,,0.96,,719.04,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,711.55,Percent of total billed charges,,711.55,734.02,
HC PR ED 12032 Intmd Wnd Repair S/Tr/Ext 2.6 to 7.5cm Cdm,PX-98110275,CDM,12032,CPT,981,RC,,outpatient,,,749,674.1,,0.95,,711.55,Percent of total billed charges,,,0.98,,734.02,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,0.97,,726.53,Percent of total billed charges,,,0.96,,719.04,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,711.55,Percent of total billed charges,,711.55,734.02,
HC PR ED 12034 Intmd Wnd Repair S/Tr/Ext 7.6 to 12.5cm Cdm,PX-98110276,CDM,12034,CPT,981,RC,,inpatient,,,825,742.5,,0.95,,783.75,Percent of total billed charges,,,0.98,,808.5,Percent of total billed charges,,,0.95,,783.75,Percent of total billed charges,,,0.97,,800.25,Percent of total billed charges,,,0.97,,800.25,Percent of total billed charges,,,0.96,,792,Percent of total billed charges,,,0.95,,783.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,783.75,Percent of total billed charges,,783.75,808.5,
HC PR ED 12034 Intmd Wnd Repair S/Tr/Ext 7.6 to 12.5cm Cdm,PX-98110276,CDM,12034,CPT,981,RC,,outpatient,,,825,742.5,,0.95,,783.75,Percent of total billed charges,,,0.98,,808.5,Percent of total billed charges,,,0.95,,783.75,Percent of total billed charges,,,0.95,,783.75,Percent of total billed charges,,,0.97,,800.25,Percent of total billed charges,,,0.96,,792,Percent of total billed charges,,,0.95,,783.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,783.75,Percent of total billed charges,,783.75,808.5,
HC PR ED 12035 Intmd Wnd Repair S/Tr/Ext 12.6 to 20.0cm Cdm,PX-98110277,CDM,12035,CPT,981,RC,,inpatient,,,959,863.1,,0.95,,911.05,Percent of total billed charges,,,0.98,,939.82,Percent of total billed charges,,,0.95,,911.05,Percent of total billed charges,,,0.97,,930.23,Percent of total billed charges,,,0.97,,930.23,Percent of total billed charges,,,0.96,,920.64,Percent of total billed charges,,,0.95,,911.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,911.05,Percent of total billed charges,,911.05,939.82,
HC PR ED 12035 Intmd Wnd Repair S/Tr/Ext 12.6 to 20.0cm Cdm,PX-98110277,CDM,12035,CPT,981,RC,,outpatient,,,959,863.1,,0.95,,911.05,Percent of total billed charges,,,0.98,,939.82,Percent of total billed charges,,,0.95,,911.05,Percent of total billed charges,,,0.95,,911.05,Percent of total billed charges,,,0.97,,930.23,Percent of total billed charges,,,0.96,,920.64,Percent of total billed charges,,,0.95,,911.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,911.05,Percent of total billed charges,,911.05,939.82,
HC PR ED 12036 Intmd Wnd Repair S/Tr/Ext 20.1 to 30.0cm Cdm,PX-98110278,CDM,12036,CPT,981,RC,,inpatient,,,1080,972,,0.95,,1026,Percent of total billed charges,,,0.98,,1058.4,Percent of total billed charges,,,0.95,,1026,Percent of total billed charges,,,0.97,,1047.6,Percent of total billed charges,,,0.97,,1047.6,Percent of total billed charges,,,0.96,,1036.8,Percent of total billed charges,,,0.95,,1026,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1026,Percent of total billed charges,,1026,1058.4,
HC PR ED 12036 Intmd Wnd Repair S/Tr/Ext 20.1 to 30.0cm Cdm,PX-98110278,CDM,12036,CPT,981,RC,,outpatient,,,1080,972,,0.95,,1026,Percent of total billed charges,,,0.98,,1058.4,Percent of total billed charges,,,0.95,,1026,Percent of total billed charges,,,0.95,,1026,Percent of total billed charges,,,0.97,,1047.6,Percent of total billed charges,,,0.96,,1036.8,Percent of total billed charges,,,0.95,,1026,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1026,Percent of total billed charges,,1026,1058.4,
HC PR ED 12041 Intmd Wnd Repair N-Hf/Genit Up to 2.5cm Cdm,PX-98110280,CDM,12041,CPT,981,RC,,inpatient,,,730,657,,0.95,,693.5,Percent of total billed charges,,,0.98,,715.4,Percent of total billed charges,,,0.95,,693.5,Percent of total billed charges,,,0.97,,708.1,Percent of total billed charges,,,0.97,,708.1,Percent of total billed charges,,,0.96,,700.8,Percent of total billed charges,,,0.95,,693.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,693.5,Percent of total billed charges,,693.5,715.4,
HC PR ED 12041 Intmd Wnd Repair N-Hf/Genit Up to 2.5cm Cdm,PX-98110280,CDM,12041,CPT,981,RC,,outpatient,,,730,657,,0.95,,693.5,Percent of total billed charges,,,0.98,,715.4,Percent of total billed charges,,,0.95,,693.5,Percent of total billed charges,,,0.95,,693.5,Percent of total billed charges,,,0.97,,708.1,Percent of total billed charges,,,0.96,,700.8,Percent of total billed charges,,,0.95,,693.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,693.5,Percent of total billed charges,,693.5,715.4,
HC PR ED 12042 Intmd Wnd Repair N-Hg/Genit 2.6 to 7.5cm Cdm,PX-98110281,CDM,12042,CPT,981,RC,,inpatient,,,764,687.6,,0.95,,725.8,Percent of total billed charges,,,0.98,,748.72,Percent of total billed charges,,,0.95,,725.8,Percent of total billed charges,,,0.97,,741.08,Percent of total billed charges,,,0.97,,741.08,Percent of total billed charges,,,0.96,,733.44,Percent of total billed charges,,,0.95,,725.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,725.8,Percent of total billed charges,,725.8,748.72,
HC PR ED 12042 Intmd Wnd Repair N-Hg/Genit 2.6 to 7.5cm Cdm,PX-98110281,CDM,12042,CPT,981,RC,,outpatient,,,764,687.6,,0.95,,725.8,Percent of total billed charges,,,0.98,,748.72,Percent of total billed charges,,,0.95,,725.8,Percent of total billed charges,,,0.95,,725.8,Percent of total billed charges,,,0.97,,741.08,Percent of total billed charges,,,0.96,,733.44,Percent of total billed charges,,,0.95,,725.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,725.8,Percent of total billed charges,,725.8,748.72,
HC PR ED 12044 Intmd Wnd Repair N-Hg/Genit 7.6 to 12.5cm Cdm,PX-98110282,CDM,12044,CPT,981,RC,,inpatient,,,943,848.7,,0.95,,895.85,Percent of total billed charges,,,0.98,,924.14,Percent of total billed charges,,,0.95,,895.85,Percent of total billed charges,,,0.97,,914.71,Percent of total billed charges,,,0.97,,914.71,Percent of total billed charges,,,0.96,,905.28,Percent of total billed charges,,,0.95,,895.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,895.85,Percent of total billed charges,,895.85,924.14,
HC PR ED 12044 Intmd Wnd Repair N-Hg/Genit 7.6 to 12.5cm Cdm,PX-98110282,CDM,12044,CPT,981,RC,,outpatient,,,943,848.7,,0.95,,895.85,Percent of total billed charges,,,0.98,,924.14,Percent of total billed charges,,,0.95,,895.85,Percent of total billed charges,,,0.95,,895.85,Percent of total billed charges,,,0.97,,914.71,Percent of total billed charges,,,0.96,,905.28,Percent of total billed charges,,,0.95,,895.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,895.85,Percent of total billed charges,,895.85,924.14,
HC PR ED 12045 Intmd Wnd Repair N-Hg/Genit 12.6 to 20.0cm Cdm,PX-98110284,CDM,12045,CPT,981,RC,,inpatient,,,1019,917.1,,0.95,,968.05,Percent of total billed charges,,,0.98,,998.62,Percent of total billed charges,,,0.95,,968.05,Percent of total billed charges,,,0.97,,988.43,Percent of total billed charges,,,0.97,,988.43,Percent of total billed charges,,,0.96,,978.24,Percent of total billed charges,,,0.95,,968.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,968.05,Percent of total billed charges,,968.05,998.62,
HC PR ED 12045 Intmd Wnd Repair N-Hg/Genit 12.6 to 20.0cm Cdm,PX-98110284,CDM,12045,CPT,981,RC,,outpatient,,,1019,917.1,,0.95,,968.05,Percent of total billed charges,,,0.98,,998.62,Percent of total billed charges,,,0.95,,968.05,Percent of total billed charges,,,0.95,,968.05,Percent of total billed charges,,,0.97,,988.43,Percent of total billed charges,,,0.96,,978.24,Percent of total billed charges,,,0.95,,968.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,968.05,Percent of total billed charges,,968.05,998.62,
HC PR ED 12046 Intmd Wnd Repair N-Hg/Genit 20.1-30.0cm Cdm,PX-98110285,CDM,12046,CPT,981,RC,,inpatient,,,1326,1193.4,,0.95,,1259.7,Percent of total billed charges,,,0.98,,1299.48,Percent of total billed charges,,,0.95,,1259.7,Percent of total billed charges,,,0.97,,1286.22,Percent of total billed charges,,,0.97,,1286.22,Percent of total billed charges,,,0.96,,1272.96,Percent of total billed charges,,,0.95,,1259.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1259.7,Percent of total billed charges,,1259.7,1299.48,
HC PR ED 12046 Intmd Wnd Repair N-Hg/Genit 20.1-30.0cm Cdm,PX-98110285,CDM,12046,CPT,981,RC,,outpatient,,,1326,1193.4,,0.95,,1259.7,Percent of total billed charges,,,0.98,,1299.48,Percent of total billed charges,,,0.95,,1259.7,Percent of total billed charges,,,0.95,,1259.7,Percent of total billed charges,,,0.97,,1286.22,Percent of total billed charges,,,0.96,,1272.96,Percent of total billed charges,,,0.95,,1259.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1259.7,Percent of total billed charges,,1259.7,1299.48,
HC PR ED 12051 Intmd Wnd Repair Face/Mm <2.5 Cm Cdm,PX-98110287,CDM,12051,CPT,981,RC,,inpatient,,,699,629.1,,0.95,,664.05,Percent of total billed charges,,,0.98,,685.02,Percent of total billed charges,,,0.95,,664.05,Percent of total billed charges,,,0.97,,678.03,Percent of total billed charges,,,0.97,,678.03,Percent of total billed charges,,,0.96,,671.04,Percent of total billed charges,,,0.95,,664.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,664.05,Percent of total billed charges,,664.05,685.02,
HC PR ED 12051 Intmd Wnd Repair Face/Mm <2.5 Cm Cdm,PX-98110287,CDM,12051,CPT,981,RC,,outpatient,,,699,629.1,,0.95,,664.05,Percent of total billed charges,,,0.98,,685.02,Percent of total billed charges,,,0.95,,664.05,Percent of total billed charges,,,0.95,,664.05,Percent of total billed charges,,,0.97,,678.03,Percent of total billed charges,,,0.96,,671.04,Percent of total billed charges,,,0.95,,664.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,664.05,Percent of total billed charges,,664.05,685.02,
HC PR ED 12052 Intmd Wnd Repair Face/Mm 2.6 to 5.0cm Cdm,PX-98110288,CDM,12052,CPT,981,RC,,inpatient,,,886,797.4,,0.95,,841.7,Percent of total billed charges,,,0.98,,868.28,Percent of total billed charges,,,0.95,,841.7,Percent of total billed charges,,,0.97,,859.42,Percent of total billed charges,,,0.97,,859.42,Percent of total billed charges,,,0.96,,850.56,Percent of total billed charges,,,0.95,,841.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,841.7,Percent of total billed charges,,841.7,868.28,
HC PR ED 12052 Intmd Wnd Repair Face/Mm 2.6 to 5.0cm Cdm,PX-98110288,CDM,12052,CPT,981,RC,,outpatient,,,886,797.4,,0.95,,841.7,Percent of total billed charges,,,0.98,,868.28,Percent of total billed charges,,,0.95,,841.7,Percent of total billed charges,,,0.95,,841.7,Percent of total billed charges,,,0.97,,859.42,Percent of total billed charges,,,0.96,,850.56,Percent of total billed charges,,,0.95,,841.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,841.7,Percent of total billed charges,,841.7,868.28,
HC PR ED 12053 Intmd Wnd Repair Face/Mm 5.1 to 7.5cm Cdm,PX-98110289,CDM,12053,CPT,981,RC,,inpatient,,,895,805.5,,0.95,,850.25,Percent of total billed charges,,,0.98,,877.1,Percent of total billed charges,,,0.95,,850.25,Percent of total billed charges,,,0.97,,868.15,Percent of total billed charges,,,0.97,,868.15,Percent of total billed charges,,,0.96,,859.2,Percent of total billed charges,,,0.95,,850.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,850.25,Percent of total billed charges,,850.25,877.1,
HC PR ED 12053 Intmd Wnd Repair Face/Mm 5.1 to 7.5cm Cdm,PX-98110289,CDM,12053,CPT,981,RC,,outpatient,,,895,805.5,,0.95,,850.25,Percent of total billed charges,,,0.98,,877.1,Percent of total billed charges,,,0.95,,850.25,Percent of total billed charges,,,0.95,,850.25,Percent of total billed charges,,,0.97,,868.15,Percent of total billed charges,,,0.96,,859.2,Percent of total billed charges,,,0.95,,850.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,850.25,Percent of total billed charges,,850.25,877.1,
HC PR ED 12054 Intmd Wnd Repair Face/Mm 7.5 to 12.5cm Cdm,PX-98110290,CDM,12054,CPT,981,RC,,inpatient,,,1129,1016.1,,0.95,,1072.55,Percent of total billed charges,,,0.98,,1106.42,Percent of total billed charges,,,0.95,,1072.55,Percent of total billed charges,,,0.97,,1095.13,Percent of total billed charges,,,0.97,,1095.13,Percent of total billed charges,,,0.96,,1083.84,Percent of total billed charges,,,0.95,,1072.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1072.55,Percent of total billed charges,,1072.55,1106.42,
HC PR ED 12054 Intmd Wnd Repair Face/Mm 7.5 to 12.5cm Cdm,PX-98110290,CDM,12054,CPT,981,RC,,outpatient,,,1129,1016.1,,0.95,,1072.55,Percent of total billed charges,,,0.98,,1106.42,Percent of total billed charges,,,0.95,,1072.55,Percent of total billed charges,,,0.95,,1072.55,Percent of total billed charges,,,0.97,,1095.13,Percent of total billed charges,,,0.96,,1083.84,Percent of total billed charges,,,0.95,,1072.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1072.55,Percent of total billed charges,,1072.55,1106.42,
"HC PR ED 13100 Repair of Wound or Lesion 1.1 to 2.5cm Complex, Trunk Cdm",PX-98110294,CDM,13100,CPT,981,RC,,inpatient,,,838,754.2,,0.95,,796.1,Percent of total billed charges,,,0.98,,821.24,Percent of total billed charges,,,0.95,,796.1,Percent of total billed charges,,,0.97,,812.86,Percent of total billed charges,,,0.97,,812.86,Percent of total billed charges,,,0.96,,804.48,Percent of total billed charges,,,0.95,,796.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,796.1,Percent of total billed charges,,796.1,821.24,
"HC PR ED 13100 Repair of Wound or Lesion 1.1 to 2.5cm Complex, Trunk Cdm",PX-98110294,CDM,13100,CPT,981,RC,,outpatient,,,838,754.2,,0.95,,796.1,Percent of total billed charges,,,0.98,,821.24,Percent of total billed charges,,,0.95,,796.1,Percent of total billed charges,,,0.95,,796.1,Percent of total billed charges,,,0.97,,812.86,Percent of total billed charges,,,0.96,,804.48,Percent of total billed charges,,,0.95,,796.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,796.1,Percent of total billed charges,,796.1,821.24,
"HC PR ED 13101 Repair of Wound or Lesion 2.6 to 7.5cm Complex, Trunk Cdm",PX-98110295,CDM,13101,CPT,981,RC,,inpatient,,,1159,1043.1,,0.95,,1101.05,Percent of total billed charges,,,0.98,,1135.82,Percent of total billed charges,,,0.95,,1101.05,Percent of total billed charges,,,0.97,,1124.23,Percent of total billed charges,,,0.97,,1124.23,Percent of total billed charges,,,0.96,,1112.64,Percent of total billed charges,,,0.95,,1101.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1101.05,Percent of total billed charges,,1101.05,1135.82,
"HC PR ED 13101 Repair of Wound or Lesion 2.6 to 7.5cm Complex, Trunk Cdm",PX-98110295,CDM,13101,CPT,981,RC,,outpatient,,,1159,1043.1,,0.95,,1101.05,Percent of total billed charges,,,0.98,,1135.82,Percent of total billed charges,,,0.95,,1101.05,Percent of total billed charges,,,0.95,,1101.05,Percent of total billed charges,,,0.97,,1124.23,Percent of total billed charges,,,0.96,,1112.64,Percent of total billed charges,,,0.95,,1101.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1101.05,Percent of total billed charges,,1101.05,1135.82,
HC PR ED 13120 Repair of Wound or Lesion 1.1 to 2.5cm Cplx Sclp Arm L Cdm,PX-98110297,CDM,13120,CPT,981,RC,,inpatient,,,873,785.7,,0.95,,829.35,Percent of total billed charges,,,0.98,,855.54,Percent of total billed charges,,,0.95,,829.35,Percent of total billed charges,,,0.97,,846.81,Percent of total billed charges,,,0.97,,846.81,Percent of total billed charges,,,0.96,,838.08,Percent of total billed charges,,,0.95,,829.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,829.35,Percent of total billed charges,,829.35,855.54,
HC PR ED 13120 Repair of Wound or Lesion 1.1 to 2.5cm Cplx Sclp Arm L Cdm,PX-98110297,CDM,13120,CPT,981,RC,,outpatient,,,873,785.7,,0.95,,829.35,Percent of total billed charges,,,0.98,,855.54,Percent of total billed charges,,,0.95,,829.35,Percent of total billed charges,,,0.95,,829.35,Percent of total billed charges,,,0.97,,846.81,Percent of total billed charges,,,0.96,,838.08,Percent of total billed charges,,,0.95,,829.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,829.35,Percent of total billed charges,,829.35,855.54,
HC PR ED 13121 Repair of Wound or Lesion 2.6 to 7.5cm Cplx Sclp Arm L Cdm,PX-98110298,CDM,13121,CPT,981,RC,,inpatient,,,1425,1282.5,,0.95,,1353.75,Percent of total billed charges,,,0.98,,1396.5,Percent of total billed charges,,,0.95,,1353.75,Percent of total billed charges,,,0.97,,1382.25,Percent of total billed charges,,,0.97,,1382.25,Percent of total billed charges,,,0.96,,1368,Percent of total billed charges,,,0.95,,1353.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1353.75,Percent of total billed charges,,1353.75,1396.5,
HC PR ED 13121 Repair of Wound or Lesion 2.6 to 7.5cm Cplx Sclp Arm L Cdm,PX-98110298,CDM,13121,CPT,981,RC,,outpatient,,,1425,1282.5,,0.95,,1353.75,Percent of total billed charges,,,0.98,,1396.5,Percent of total billed charges,,,0.95,,1353.75,Percent of total billed charges,,,0.95,,1353.75,Percent of total billed charges,,,0.97,,1382.25,Percent of total billed charges,,,0.96,,1368,Percent of total billed charges,,,0.95,,1353.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1353.75,Percent of total billed charges,,1353.75,1396.5,
HC PR ED 13122 Repair Complex Scalp/Arm/Leg Ea Addl 5 Cm/< Cdm,PX-98110299,CDM,13122,CPT,981,RC,,inpatient,,,324,291.6,,0.95,,307.8,Percent of total billed charges,,,0.98,,317.52,Percent of total billed charges,,,0.95,,307.8,Percent of total billed charges,,,0.97,,314.28,Percent of total billed charges,,,0.97,,314.28,Percent of total billed charges,,,0.96,,311.04,Percent of total billed charges,,,0.95,,307.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,307.8,Percent of total billed charges,,307.8,317.52,
HC PR ED 13122 Repair Complex Scalp/Arm/Leg Ea Addl 5 Cm/< Cdm,PX-98110299,CDM,13122,CPT,981,RC,,outpatient,,,324,291.6,,0.95,,307.8,Percent of total billed charges,,,0.98,,317.52,Percent of total billed charges,,,0.95,,307.8,Percent of total billed charges,,,0.95,,307.8,Percent of total billed charges,,,0.97,,314.28,Percent of total billed charges,,,0.96,,311.04,Percent of total billed charges,,,0.95,,307.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,307.8,Percent of total billed charges,,307.8,317.52,
HC PR ED 13131 Repair of Wound or Lesion 1.1 to 2.5cm Cplx Frhd Cks Shn Cdm,PX-98110501,CDM,13131,CPT,981,RC,,inpatient,,,1097,987.3,,0.95,,1042.15,Percent of total billed charges,,,0.98,,1075.06,Percent of total billed charges,,,0.95,,1042.15,Percent of total billed charges,,,0.97,,1064.09,Percent of total billed charges,,,0.97,,1064.09,Percent of total billed charges,,,0.96,,1053.12,Percent of total billed charges,,,0.95,,1042.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1042.15,Percent of total billed charges,,1042.15,1075.06,
HC PR ED 13131 Repair of Wound or Lesion 1.1 to 2.5cm Cplx Frhd Cks Shn Cdm,PX-98110501,CDM,13131,CPT,981,RC,,outpatient,,,1097,987.3,,0.95,,1042.15,Percent of total billed charges,,,0.98,,1075.06,Percent of total billed charges,,,0.95,,1042.15,Percent of total billed charges,,,0.95,,1042.15,Percent of total billed charges,,,0.97,,1064.09,Percent of total billed charges,,,0.96,,1053.12,Percent of total billed charges,,,0.95,,1042.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1042.15,Percent of total billed charges,,1042.15,1075.06,
HC PR ED 13132 Repair of Wound or Lesion 2.6 to 7.5cm Cplx Frhd Cks Shn Cdm,PX-98110502,CDM,13132,CPT,981,RC,,inpatient,,,1877,1689.3,,0.95,,1783.15,Percent of total billed charges,,,0.98,,1839.46,Percent of total billed charges,,,0.95,,1783.15,Percent of total billed charges,,,0.97,,1820.69,Percent of total billed charges,,,0.97,,1820.69,Percent of total billed charges,,,0.96,,1801.92,Percent of total billed charges,,,0.95,,1783.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1783.15,Percent of total billed charges,,1783.15,1839.46,
HC PR ED 13132 Repair of Wound or Lesion 2.6 to 7.5cm Cplx Frhd Cks Shn Cdm,PX-98110502,CDM,13132,CPT,981,RC,,outpatient,,,1877,1689.3,,0.95,,1783.15,Percent of total billed charges,,,0.98,,1839.46,Percent of total billed charges,,,0.95,,1783.15,Percent of total billed charges,,,0.95,,1783.15,Percent of total billed charges,,,0.97,,1820.69,Percent of total billed charges,,,0.96,,1801.92,Percent of total billed charges,,,0.95,,1783.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1783.15,Percent of total billed charges,,1783.15,1839.46,
HC PR ED 13151 Repair of Wnd or Lesn 1.1 to 2.5cm Cmplx Eyld Ns Ers Lps Cdm,PX-98110505,CDM,13151,CPT,981,RC,,inpatient,,,1360,1224,,0.95,,1292,Percent of total billed charges,,,0.98,,1332.8,Percent of total billed charges,,,0.95,,1292,Percent of total billed charges,,,0.97,,1319.2,Percent of total billed charges,,,0.97,,1319.2,Percent of total billed charges,,,0.96,,1305.6,Percent of total billed charges,,,0.95,,1292,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1292,Percent of total billed charges,,1292,1332.8,
HC PR ED 13151 Repair of Wnd or Lesn 1.1 to 2.5cm Cmplx Eyld Ns Ers Lps Cdm,PX-98110505,CDM,13151,CPT,981,RC,,outpatient,,,1360,1224,,0.95,,1292,Percent of total billed charges,,,0.98,,1332.8,Percent of total billed charges,,,0.95,,1292,Percent of total billed charges,,,0.95,,1292,Percent of total billed charges,,,0.97,,1319.2,Percent of total billed charges,,,0.96,,1305.6,Percent of total billed charges,,,0.95,,1292,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1292,Percent of total billed charges,,1292,1332.8,
HC PR ED 13152 Repair of Wnd or Les 2.6 to 7.5cm Cmplx Eyld Ns Ers Lps Cdm,PX-98110506,CDM,13152,CPT,981,RC,,inpatient,,,2344,2109.6,,0.95,,2226.8,Percent of total billed charges,,,0.98,,2297.12,Percent of total billed charges,,,0.95,,2226.8,Percent of total billed charges,,,0.97,,2273.68,Percent of total billed charges,,,0.97,,2273.68,Percent of total billed charges,,,0.96,,2250.24,Percent of total billed charges,,,0.95,,2226.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2226.8,Percent of total billed charges,,2226.8,2297.12,
HC PR ED 13152 Repair of Wnd or Les 2.6 to 7.5cm Cmplx Eyld Ns Ers Lps Cdm,PX-98110506,CDM,13152,CPT,981,RC,,outpatient,,,2344,2109.6,,0.95,,2226.8,Percent of total billed charges,,,0.98,,2297.12,Percent of total billed charges,,,0.95,,2226.8,Percent of total billed charges,,,0.95,,2226.8,Percent of total billed charges,,,0.97,,2273.68,Percent of total billed charges,,,0.96,,2250.24,Percent of total billed charges,,,0.95,,2226.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2226.8,Percent of total billed charges,,2226.8,2297.12,
HC PR ED 16000 Initial Treatment of Burn(S) 1st Deg Local Tx Cdm,PX-98110509,CDM,16000,CPT,981,RC,,inpatient,,,197,177.3,,0.95,,187.15,Percent of total billed charges,,,0.98,,193.06,Percent of total billed charges,,,0.95,,187.15,Percent of total billed charges,,,0.97,,191.09,Percent of total billed charges,,,0.97,,191.09,Percent of total billed charges,,,0.96,,189.12,Percent of total billed charges,,,0.95,,187.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,187.15,Percent of total billed charges,,187.15,193.06,
HC PR ED 16000 Initial Treatment of Burn(S) 1st Deg Local Tx Cdm,PX-98110509,CDM,16000,CPT,981,RC,,outpatient,,,197,177.3,,0.95,,187.15,Percent of total billed charges,,,0.98,,193.06,Percent of total billed charges,,,0.95,,187.15,Percent of total billed charges,,,0.95,,187.15,Percent of total billed charges,,,0.97,,191.09,Percent of total billed charges,,,0.96,,189.12,Percent of total billed charges,,,0.95,,187.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,187.15,Percent of total billed charges,,187.15,193.06,
HC PR ED 16020 Dress/Debrid P-Thick Burn S <5% Tbsa Cdm,PX-98110510,CDM,16020,CPT,981,RC,,inpatient,,,290,261,,0.95,,275.5,Percent of total billed charges,,,0.98,,284.2,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.96,,278.4,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,275.5,Percent of total billed charges,,275.5,284.2,
HC PR ED 16020 Dress/Debrid P-Thick Burn S <5% Tbsa Cdm,PX-98110510,CDM,16020,CPT,981,RC,,outpatient,,,290,261,,0.95,,275.5,Percent of total billed charges,,,0.98,,284.2,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.96,,278.4,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,275.5,Percent of total billed charges,,275.5,284.2,
HC PR ED 16025 Dress/Debrid P-Thick Burn M 5-10% Tbsa Cdm,PX-98110511,CDM,16025,CPT,981,RC,,inpatient,,,389,350.1,,0.95,,369.55,Percent of total billed charges,,,0.98,,381.22,Percent of total billed charges,,,0.95,,369.55,Percent of total billed charges,,,0.97,,377.33,Percent of total billed charges,,,0.97,,377.33,Percent of total billed charges,,,0.96,,373.44,Percent of total billed charges,,,0.95,,369.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,369.55,Percent of total billed charges,,369.55,381.22,
HC PR ED 16025 Dress/Debrid P-Thick Burn M 5-10% Tbsa Cdm,PX-98110511,CDM,16025,CPT,981,RC,,outpatient,,,389,350.1,,0.95,,369.55,Percent of total billed charges,,,0.98,,381.22,Percent of total billed charges,,,0.95,,369.55,Percent of total billed charges,,,0.95,,369.55,Percent of total billed charges,,,0.97,,377.33,Percent of total billed charges,,,0.96,,373.44,Percent of total billed charges,,,0.95,,369.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,369.55,Percent of total billed charges,,369.55,381.22,
HC PR ED 16030 Dress/Debrid P-Thick Burn L >10% Tbsa Cdm,PX-98110512,CDM,16030,CPT,981,RC,,inpatient,,,487,438.3,,0.95,,462.65,Percent of total billed charges,,,0.98,,477.26,Percent of total billed charges,,,0.95,,462.65,Percent of total billed charges,,,0.97,,472.39,Percent of total billed charges,,,0.97,,472.39,Percent of total billed charges,,,0.96,,467.52,Percent of total billed charges,,,0.95,,462.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,462.65,Percent of total billed charges,,462.65,477.26,
HC PR ED 16030 Dress/Debrid P-Thick Burn L >10% Tbsa Cdm,PX-98110512,CDM,16030,CPT,981,RC,,outpatient,,,487,438.3,,0.95,,462.65,Percent of total billed charges,,,0.98,,477.26,Percent of total billed charges,,,0.95,,462.65,Percent of total billed charges,,,0.95,,462.65,Percent of total billed charges,,,0.97,,472.39,Percent of total billed charges,,,0.96,,467.52,Percent of total billed charges,,,0.95,,462.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,462.65,Percent of total billed charges,,462.65,477.26,
HC PR ED 19000 Drainage of Breast Lesion Cdm,PX-98110514,CDM,19000,CPT,981,RC,,inpatient,,,282,253.8,,0.95,,267.9,Percent of total billed charges,,,0.98,,276.36,Percent of total billed charges,,,0.95,,267.9,Percent of total billed charges,,,0.97,,273.54,Percent of total billed charges,,,0.97,,273.54,Percent of total billed charges,,,0.96,,270.72,Percent of total billed charges,,,0.95,,267.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,267.9,Percent of total billed charges,,267.9,276.36,
HC PR ED 19000 Drainage of Breast Lesion Cdm,PX-98110514,CDM,19000,CPT,981,RC,,outpatient,,,282,253.8,,0.95,,267.9,Percent of total billed charges,,,0.98,,276.36,Percent of total billed charges,,,0.95,,267.9,Percent of total billed charges,,,0.95,,267.9,Percent of total billed charges,,,0.97,,273.54,Percent of total billed charges,,,0.96,,270.72,Percent of total billed charges,,,0.95,,267.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,267.9,Percent of total billed charges,,267.9,276.36,
HC PR ED 20102 Explore Wound Abdomen Cdm,PX-98110519,CDM,20102,CPT,981,RC,,inpatient,,,2410,2169,,0.95,,2289.5,Percent of total billed charges,,,0.98,,2361.8,Percent of total billed charges,,,0.95,,2289.5,Percent of total billed charges,,,0.97,,2337.7,Percent of total billed charges,,,0.97,,2337.7,Percent of total billed charges,,,0.96,,2313.6,Percent of total billed charges,,,0.95,,2289.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2289.5,Percent of total billed charges,,2289.5,2361.8,
HC PR ED 20102 Explore Wound Abdomen Cdm,PX-98110519,CDM,20102,CPT,981,RC,,outpatient,,,2410,2169,,0.95,,2289.5,Percent of total billed charges,,,0.98,,2361.8,Percent of total billed charges,,,0.95,,2289.5,Percent of total billed charges,,,0.95,,2289.5,Percent of total billed charges,,,0.97,,2337.7,Percent of total billed charges,,,0.96,,2313.6,Percent of total billed charges,,,0.95,,2289.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2289.5,Percent of total billed charges,,2289.5,2361.8,
HC PR ED 20103 Explore Wound Extremity Cdm,PX-98110520,CDM,20103,CPT,981,RC,,inpatient,,,2185,1966.5,,0.95,,2075.75,Percent of total billed charges,,,0.98,,2141.3,Percent of total billed charges,,,0.95,,2075.75,Percent of total billed charges,,,0.97,,2119.45,Percent of total billed charges,,,0.97,,2119.45,Percent of total billed charges,,,0.96,,2097.6,Percent of total billed charges,,,0.95,,2075.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2075.75,Percent of total billed charges,,2075.75,2141.3,
HC PR ED 20103 Explore Wound Extremity Cdm,PX-98110520,CDM,20103,CPT,981,RC,,outpatient,,,2185,1966.5,,0.95,,2075.75,Percent of total billed charges,,,0.98,,2141.3,Percent of total billed charges,,,0.95,,2075.75,Percent of total billed charges,,,0.95,,2075.75,Percent of total billed charges,,,0.97,,2119.45,Percent of total billed charges,,,0.96,,2097.6,Percent of total billed charges,,,0.95,,2075.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2075.75,Percent of total billed charges,,2075.75,2141.3,
"HC PR ED 20520 Removal of Foreign Body Musc, Simp Cdm",PX-98110521,CDM,20520,CPT,981,RC,,inpatient,,,594,534.6,,0.95,,564.3,Percent of total billed charges,,,0.98,,582.12,Percent of total billed charges,,,0.95,,564.3,Percent of total billed charges,,,0.97,,576.18,Percent of total billed charges,,,0.97,,576.18,Percent of total billed charges,,,0.96,,570.24,Percent of total billed charges,,,0.95,,564.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,564.3,Percent of total billed charges,,564.3,582.12,
"HC PR ED 20520 Removal of Foreign Body Musc, Simp Cdm",PX-98110521,CDM,20520,CPT,981,RC,,outpatient,,,594,534.6,,0.95,,564.3,Percent of total billed charges,,,0.98,,582.12,Percent of total billed charges,,,0.95,,564.3,Percent of total billed charges,,,0.95,,564.3,Percent of total billed charges,,,0.97,,576.18,Percent of total billed charges,,,0.96,,570.24,Percent of total billed charges,,,0.95,,564.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,564.3,Percent of total billed charges,,564.3,582.12,
HC PR ED 20525 Removal of Foreign Body Complex Cdm,PX-98110522,CDM,20525,CPT,981,RC,,inpatient,,,1334,1200.6,,0.95,,1267.3,Percent of total billed charges,,,0.98,,1307.32,Percent of total billed charges,,,0.95,,1267.3,Percent of total billed charges,,,0.97,,1293.98,Percent of total billed charges,,,0.97,,1293.98,Percent of total billed charges,,,0.96,,1280.64,Percent of total billed charges,,,0.95,,1267.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1267.3,Percent of total billed charges,,1267.3,1307.32,
HC PR ED 20525 Removal of Foreign Body Complex Cdm,PX-98110522,CDM,20525,CPT,981,RC,,outpatient,,,1334,1200.6,,0.95,,1267.3,Percent of total billed charges,,,0.98,,1307.32,Percent of total billed charges,,,0.95,,1267.3,Percent of total billed charges,,,0.95,,1267.3,Percent of total billed charges,,,0.97,,1293.98,Percent of total billed charges,,,0.96,,1280.64,Percent of total billed charges,,,0.95,,1267.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1267.3,Percent of total billed charges,,1267.3,1307.32,
HC PR ED 20550 Inj Tendon Sheath/Ligament Cdm,PX-98110523,CDM,20550,CPT,981,RC,,inpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
HC PR ED 20550 Inj Tendon Sheath/Ligament Cdm,PX-98110523,CDM,20550,CPT,981,RC,,outpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
HC PR ED 20552 Inj Trigger Point 1/2 Muscl Cdm,PX-98110525,CDM,20552,CPT,981,RC,,inpatient,,,219,197.1,,0.95,,208.05,Percent of total billed charges,,,0.98,,214.62,Percent of total billed charges,,,0.95,,208.05,Percent of total billed charges,,,0.97,,212.43,Percent of total billed charges,,,0.97,,212.43,Percent of total billed charges,,,0.96,,210.24,Percent of total billed charges,,,0.95,,208.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,208.05,Percent of total billed charges,,208.05,214.62,
HC PR ED 20552 Inj Trigger Point 1/2 Muscl Cdm,PX-98110525,CDM,20552,CPT,981,RC,,outpatient,,,219,197.1,,0.95,,208.05,Percent of total billed charges,,,0.98,,214.62,Percent of total billed charges,,,0.95,,208.05,Percent of total billed charges,,,0.95,,208.05,Percent of total billed charges,,,0.97,,212.43,Percent of total billed charges,,,0.96,,210.24,Percent of total billed charges,,,0.95,,208.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,208.05,Percent of total billed charges,,208.05,214.62,
HC PR ED 20553 Inject Trigger Points =/> 3 Cdm,PX-98110526,CDM,20553,CPT,981,RC,,inpatient,,,149,134.1,,0.95,,141.55,Percent of total billed charges,,,0.98,,146.02,Percent of total billed charges,,,0.95,,141.55,Percent of total billed charges,,,0.97,,144.53,Percent of total billed charges,,,0.97,,144.53,Percent of total billed charges,,,0.96,,143.04,Percent of total billed charges,,,0.95,,141.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,141.55,Percent of total billed charges,,141.55,146.02,
HC PR ED 20553 Inject Trigger Points =/> 3 Cdm,PX-98110526,CDM,20553,CPT,981,RC,,outpatient,,,149,134.1,,0.95,,141.55,Percent of total billed charges,,,0.98,,146.02,Percent of total billed charges,,,0.95,,141.55,Percent of total billed charges,,,0.95,,141.55,Percent of total billed charges,,,0.97,,144.53,Percent of total billed charges,,,0.96,,143.04,Percent of total billed charges,,,0.95,,141.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,141.55,Percent of total billed charges,,141.55,146.02,
HC PR ED 20600 Drain/Inject Joint/Bursa Small W/O Ultrasound Guidance Cdm,PX-98110528,CDM,20600,CPT,981,RC,,inpatient,,,242,217.8,,0.95,,229.9,Percent of total billed charges,,,0.98,,237.16,Percent of total billed charges,,,0.95,,229.9,Percent of total billed charges,,,0.97,,234.74,Percent of total billed charges,,,0.97,,234.74,Percent of total billed charges,,,0.96,,232.32,Percent of total billed charges,,,0.95,,229.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,229.9,Percent of total billed charges,,229.9,237.16,
HC PR ED 20600 Drain/Inject Joint/Bursa Small W/O Ultrasound Guidance Cdm,PX-98110528,CDM,20600,CPT,981,RC,,outpatient,,,242,217.8,,0.95,,229.9,Percent of total billed charges,,,0.98,,237.16,Percent of total billed charges,,,0.95,,229.9,Percent of total billed charges,,,0.95,,229.9,Percent of total billed charges,,,0.97,,234.74,Percent of total billed charges,,,0.96,,232.32,Percent of total billed charges,,,0.95,,229.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,229.9,Percent of total billed charges,,229.9,237.16,
HC PR ED 20605 Drain/Inject Joint/Bursa Interm W/O Ultrasound Guidance Cdm,PX-98110529,CDM,20605,CPT,981,RC,,inpatient,,,179,161.1,,0.95,,170.05,Percent of total billed charges,,,0.98,,175.42,Percent of total billed charges,,,0.95,,170.05,Percent of total billed charges,,,0.97,,173.63,Percent of total billed charges,,,0.97,,173.63,Percent of total billed charges,,,0.96,,171.84,Percent of total billed charges,,,0.95,,170.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,170.05,Percent of total billed charges,,170.05,175.42,
HC PR ED 20605 Drain/Inject Joint/Bursa Interm W/O Ultrasound Guidance Cdm,PX-98110529,CDM,20605,CPT,981,RC,,outpatient,,,179,161.1,,0.95,,170.05,Percent of total billed charges,,,0.98,,175.42,Percent of total billed charges,,,0.95,,170.05,Percent of total billed charges,,,0.95,,170.05,Percent of total billed charges,,,0.97,,173.63,Percent of total billed charges,,,0.96,,171.84,Percent of total billed charges,,,0.95,,170.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,170.05,Percent of total billed charges,,170.05,175.42,
HC PR ED 20610 Drain/Inject Joint/Bursa Major Cdm,PX-98110531,CDM,20610,CPT,981,RC,,inpatient,,,185,166.5,,0.95,,175.75,Percent of total billed charges,,,0.98,,181.3,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,0.97,,179.45,Percent of total billed charges,,,0.97,,179.45,Percent of total billed charges,,,0.96,,177.6,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,175.75,Percent of total billed charges,,175.75,181.3,
HC PR ED 20610 Drain/Inject Joint/Bursa Major Cdm,PX-98110531,CDM,20610,CPT,981,RC,,outpatient,,,185,166.5,,0.95,,175.75,Percent of total billed charges,,,0.98,,181.3,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,0.97,,179.45,Percent of total billed charges,,,0.96,,177.6,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,175.75,Percent of total billed charges,,175.75,181.3,
HC PR ED 21480 Reset Dislocated Jaw Uncomplicated Cdm,PX-98110541,CDM,21480,CPT,981,RC,,inpatient,,,520,468,,0.95,,494,Percent of total billed charges,,,0.98,,509.6,Percent of total billed charges,,,0.95,,494,Percent of total billed charges,,,0.97,,504.4,Percent of total billed charges,,,0.97,,504.4,Percent of total billed charges,,,0.96,,499.2,Percent of total billed charges,,,0.95,,494,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,494,Percent of total billed charges,,494,509.6,
HC PR ED 21480 Reset Dislocated Jaw Uncomplicated Cdm,PX-98110541,CDM,21480,CPT,981,RC,,outpatient,,,520,468,,0.95,,494,Percent of total billed charges,,,0.98,,509.6,Percent of total billed charges,,,0.95,,494,Percent of total billed charges,,,0.95,,494,Percent of total billed charges,,,0.97,,504.4,Percent of total billed charges,,,0.96,,499.2,Percent of total billed charges,,,0.95,,494,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,494,Percent of total billed charges,,494,509.6,
HC PR ED 21820 Treat Sternum Fracture Cdm,PX-98110544,CDM,21820,CPT,981,RC,,inpatient,,,767,690.3,,0.95,,728.65,Percent of total billed charges,,,0.98,,751.66,Percent of total billed charges,,,0.95,,728.65,Percent of total billed charges,,,0.97,,743.99,Percent of total billed charges,,,0.97,,743.99,Percent of total billed charges,,,0.96,,736.32,Percent of total billed charges,,,0.95,,728.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,728.65,Percent of total billed charges,,728.65,751.66,
HC PR ED 21820 Treat Sternum Fracture Cdm,PX-98110544,CDM,21820,CPT,981,RC,,outpatient,,,767,690.3,,0.95,,728.65,Percent of total billed charges,,,0.98,,751.66,Percent of total billed charges,,,0.95,,728.65,Percent of total billed charges,,,0.95,,728.65,Percent of total billed charges,,,0.97,,743.99,Percent of total billed charges,,,0.96,,736.32,Percent of total billed charges,,,0.95,,728.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,728.65,Percent of total billed charges,,728.65,751.66,
HC PR ED 22310 Treat Spine Fracture Cdm,PX-98110547,CDM,22310,CPT,981,RC,,inpatient,,,2176,1958.4,,0.95,,2067.2,Percent of total billed charges,,,0.98,,2132.48,Percent of total billed charges,,,0.95,,2067.2,Percent of total billed charges,,,0.97,,2110.72,Percent of total billed charges,,,0.97,,2110.72,Percent of total billed charges,,,0.96,,2088.96,Percent of total billed charges,,,0.95,,2067.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2067.2,Percent of total billed charges,,2067.2,2132.48,
HC PR ED 22310 Treat Spine Fracture Cdm,PX-98110547,CDM,22310,CPT,981,RC,,outpatient,,,2176,1958.4,,0.95,,2067.2,Percent of total billed charges,,,0.98,,2132.48,Percent of total billed charges,,,0.95,,2067.2,Percent of total billed charges,,,0.95,,2067.2,Percent of total billed charges,,,0.97,,2110.72,Percent of total billed charges,,,0.96,,2088.96,Percent of total billed charges,,,0.95,,2067.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2067.2,Percent of total billed charges,,2067.2,2132.48,
HC PR ED 23330 Remove Shoulder Foreign Body Cdm,PX-98110550,CDM,23330,CPT,981,RC,,inpatient,,,597,537.3,,0.95,,567.15,Percent of total billed charges,,,0.98,,585.06,Percent of total billed charges,,,0.95,,567.15,Percent of total billed charges,,,0.97,,579.09,Percent of total billed charges,,,0.97,,579.09,Percent of total billed charges,,,0.96,,573.12,Percent of total billed charges,,,0.95,,567.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,567.15,Percent of total billed charges,,567.15,585.06,
HC PR ED 23330 Remove Shoulder Foreign Body Cdm,PX-98110550,CDM,23330,CPT,981,RC,,outpatient,,,597,537.3,,0.95,,567.15,Percent of total billed charges,,,0.98,,585.06,Percent of total billed charges,,,0.95,,567.15,Percent of total billed charges,,,0.95,,567.15,Percent of total billed charges,,,0.97,,579.09,Percent of total billed charges,,,0.96,,573.12,Percent of total billed charges,,,0.95,,567.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,567.15,Percent of total billed charges,,567.15,585.06,
HC PR ED 23500 Treat Clavicle Fracture W/O Manip Cdm,PX-98110551,CDM,23500,CPT,981,RC,,inpatient,,,762,685.8,,0.95,,723.9,Percent of total billed charges,,,0.98,,746.76,Percent of total billed charges,,,0.95,,723.9,Percent of total billed charges,,,0.97,,739.14,Percent of total billed charges,,,0.97,,739.14,Percent of total billed charges,,,0.96,,731.52,Percent of total billed charges,,,0.95,,723.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,723.9,Percent of total billed charges,,723.9,746.76,
HC PR ED 23500 Treat Clavicle Fracture W/O Manip Cdm,PX-98110551,CDM,23500,CPT,981,RC,,outpatient,,,762,685.8,,0.95,,723.9,Percent of total billed charges,,,0.98,,746.76,Percent of total billed charges,,,0.95,,723.9,Percent of total billed charges,,,0.95,,723.9,Percent of total billed charges,,,0.97,,739.14,Percent of total billed charges,,,0.96,,731.52,Percent of total billed charges,,,0.95,,723.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,723.9,Percent of total billed charges,,723.9,746.76,
HC PR ED 23505 Treat Clavicle Fracture W/Manip Cdm,PX-98110553,CDM,23505,CPT,981,RC,,inpatient,,,1278,1150.2,,0.95,,1214.1,Percent of total billed charges,,,0.98,,1252.44,Percent of total billed charges,,,0.95,,1214.1,Percent of total billed charges,,,0.97,,1239.66,Percent of total billed charges,,,0.97,,1239.66,Percent of total billed charges,,,0.96,,1226.88,Percent of total billed charges,,,0.95,,1214.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1214.1,Percent of total billed charges,,1214.1,1252.44,
HC PR ED 23505 Treat Clavicle Fracture W/Manip Cdm,PX-98110553,CDM,23505,CPT,981,RC,,outpatient,,,1278,1150.2,,0.95,,1214.1,Percent of total billed charges,,,0.98,,1252.44,Percent of total billed charges,,,0.95,,1214.1,Percent of total billed charges,,,0.95,,1214.1,Percent of total billed charges,,,0.97,,1239.66,Percent of total billed charges,,,0.96,,1226.88,Percent of total billed charges,,,0.95,,1214.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1214.1,Percent of total billed charges,,1214.1,1252.44,
HC PR ED 23545 Treat Clavicle Dislocation Ac Jt Dislo W/Man Cdm,PX-98110559,CDM,23545,CPT,981,RC,,inpatient,,,987,888.3,,0.95,,937.65,Percent of total billed charges,,,0.98,,967.26,Percent of total billed charges,,,0.95,,937.65,Percent of total billed charges,,,0.97,,957.39,Percent of total billed charges,,,0.97,,957.39,Percent of total billed charges,,,0.96,,947.52,Percent of total billed charges,,,0.95,,937.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,937.65,Percent of total billed charges,,937.65,967.26,
HC PR ED 23545 Treat Clavicle Dislocation Ac Jt Dislo W/Man Cdm,PX-98110559,CDM,23545,CPT,981,RC,,outpatient,,,987,888.3,,0.95,,937.65,Percent of total billed charges,,,0.98,,967.26,Percent of total billed charges,,,0.95,,937.65,Percent of total billed charges,,,0.95,,937.65,Percent of total billed charges,,,0.97,,957.39,Percent of total billed charges,,,0.96,,947.52,Percent of total billed charges,,,0.95,,937.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,937.65,Percent of total billed charges,,937.65,967.26,
HC PR ED 23600 Treat Humerus Fracture W/O Manip Cdm,PX-98110563,CDM,23600,CPT,981,RC,,inpatient,,,1170,1053,,0.95,,1111.5,Percent of total billed charges,,,0.98,,1146.6,Percent of total billed charges,,,0.95,,1111.5,Percent of total billed charges,,,0.97,,1134.9,Percent of total billed charges,,,0.97,,1134.9,Percent of total billed charges,,,0.96,,1123.2,Percent of total billed charges,,,0.95,,1111.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1111.5,Percent of total billed charges,,1111.5,1146.6,
HC PR ED 23600 Treat Humerus Fracture W/O Manip Cdm,PX-98110563,CDM,23600,CPT,981,RC,,outpatient,,,1170,1053,,0.95,,1111.5,Percent of total billed charges,,,0.98,,1146.6,Percent of total billed charges,,,0.95,,1111.5,Percent of total billed charges,,,0.95,,1111.5,Percent of total billed charges,,,0.97,,1134.9,Percent of total billed charges,,,0.96,,1123.2,Percent of total billed charges,,,0.95,,1111.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1111.5,Percent of total billed charges,,1111.5,1146.6,
HC PR ED 23650 Treat Shoulder Dislocation W/Manip Cdm,PX-98110570,CDM,23650,CPT,981,RC,,inpatient,,,1198,1078.2,,0.95,,1138.1,Percent of total billed charges,,,0.98,,1174.04,Percent of total billed charges,,,0.95,,1138.1,Percent of total billed charges,,,0.97,,1162.06,Percent of total billed charges,,,0.97,,1162.06,Percent of total billed charges,,,0.96,,1150.08,Percent of total billed charges,,,0.95,,1138.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1138.1,Percent of total billed charges,,1138.1,1174.04,
HC PR ED 23650 Treat Shoulder Dislocation W/Manip Cdm,PX-98110570,CDM,23650,CPT,981,RC,,outpatient,,,1198,1078.2,,0.95,,1138.1,Percent of total billed charges,,,0.98,,1174.04,Percent of total billed charges,,,0.95,,1138.1,Percent of total billed charges,,,0.95,,1138.1,Percent of total billed charges,,,0.97,,1162.06,Percent of total billed charges,,,0.96,,1150.08,Percent of total billed charges,,,0.95,,1138.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1138.1,Percent of total billed charges,,1138.1,1174.04,
HC PR ED 23655 Treat Shoulder Dislocation W/Manip & Annes Cdm,PX-98110572,CDM,23655,CPT,981,RC,,inpatient,,,1498,1348.2,,0.95,,1423.1,Percent of total billed charges,,,0.98,,1468.04,Percent of total billed charges,,,0.95,,1423.1,Percent of total billed charges,,,0.97,,1453.06,Percent of total billed charges,,,0.97,,1453.06,Percent of total billed charges,,,0.96,,1438.08,Percent of total billed charges,,,0.95,,1423.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1423.1,Percent of total billed charges,,1423.1,1468.04,
HC PR ED 23655 Treat Shoulder Dislocation W/Manip & Annes Cdm,PX-98110572,CDM,23655,CPT,981,RC,,outpatient,,,1498,1348.2,,0.95,,1423.1,Percent of total billed charges,,,0.98,,1468.04,Percent of total billed charges,,,0.95,,1423.1,Percent of total billed charges,,,0.95,,1423.1,Percent of total billed charges,,,0.97,,1453.06,Percent of total billed charges,,,0.96,,1438.08,Percent of total billed charges,,,0.95,,1423.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1423.1,Percent of total billed charges,,1423.1,1468.04,
HC PR ED 23665 Cltx Shoulder Dislc W/Fx Humeral Tubrst W/Manj Cdm,PX-98110574,CDM,23665,CPT,981,RC,,inpatient,,,1204,1083.6,,0.95,,1143.8,Percent of total billed charges,,,0.98,,1179.92,Percent of total billed charges,,,0.95,,1143.8,Percent of total billed charges,,,0.97,,1167.88,Percent of total billed charges,,,0.97,,1167.88,Percent of total billed charges,,,0.96,,1155.84,Percent of total billed charges,,,0.95,,1143.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1143.8,Percent of total billed charges,,1143.8,1179.92,
HC PR ED 23665 Cltx Shoulder Dislc W/Fx Humeral Tubrst W/Manj Cdm,PX-98110574,CDM,23665,CPT,981,RC,,outpatient,,,1204,1083.6,,0.95,,1143.8,Percent of total billed charges,,,0.98,,1179.92,Percent of total billed charges,,,0.95,,1143.8,Percent of total billed charges,,,0.95,,1143.8,Percent of total billed charges,,,0.97,,1167.88,Percent of total billed charges,,,0.96,,1155.84,Percent of total billed charges,,,0.95,,1143.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1143.8,Percent of total billed charges,,1143.8,1179.92,
HC PR ED 23931 Drainage of Arm Bursa Cdm,PX-98110578,CDM,23931,CPT,981,RC,,inpatient,,,1104,993.6,,0.95,,1048.8,Percent of total billed charges,,,0.98,,1081.92,Percent of total billed charges,,,0.95,,1048.8,Percent of total billed charges,,,0.97,,1070.88,Percent of total billed charges,,,0.97,,1070.88,Percent of total billed charges,,,0.96,,1059.84,Percent of total billed charges,,,0.95,,1048.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1048.8,Percent of total billed charges,,1048.8,1081.92,
HC PR ED 23931 Drainage of Arm Bursa Cdm,PX-98110578,CDM,23931,CPT,981,RC,,outpatient,,,1104,993.6,,0.95,,1048.8,Percent of total billed charges,,,0.98,,1081.92,Percent of total billed charges,,,0.95,,1048.8,Percent of total billed charges,,,0.95,,1048.8,Percent of total billed charges,,,0.97,,1070.88,Percent of total billed charges,,,0.96,,1059.84,Percent of total billed charges,,,0.95,,1048.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1048.8,Percent of total billed charges,,1048.8,1081.92,
HC PR ED 24200 Removal of Arm Foreign Body Cdm,PX-98110584,CDM,24200,CPT,981,RC,,inpatient,,,568,511.2,,0.95,,539.6,Percent of total billed charges,,,0.98,,556.64,Percent of total billed charges,,,0.95,,539.6,Percent of total billed charges,,,0.97,,550.96,Percent of total billed charges,,,0.97,,550.96,Percent of total billed charges,,,0.96,,545.28,Percent of total billed charges,,,0.95,,539.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,539.6,Percent of total billed charges,,539.6,556.64,
HC PR ED 24200 Removal of Arm Foreign Body Cdm,PX-98110584,CDM,24200,CPT,981,RC,,outpatient,,,568,511.2,,0.95,,539.6,Percent of total billed charges,,,0.98,,556.64,Percent of total billed charges,,,0.95,,539.6,Percent of total billed charges,,,0.95,,539.6,Percent of total billed charges,,,0.97,,550.96,Percent of total billed charges,,,0.96,,545.28,Percent of total billed charges,,,0.95,,539.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,539.6,Percent of total billed charges,,539.6,556.64,
HC PR 11305 Shave Skin Lesion 0.5 Cm or Less Sclp Nk Hnd Ft Gen,PX-98310345,CDM,11305,CPT,983,RC,,inpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
HC PR 11305 Shave Skin Lesion 0.5 Cm or Less Sclp Nk Hnd Ft Gen,PX-98310345,CDM,11305,CPT,983,RC,,outpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
HC PR 11470 Removal Sweat Gland Lesion,PX-98310349,CDM,11470,CPT,983,RC,,inpatient,,,1124,1011.6,,0.95,,1067.8,Percent of total billed charges,,,0.98,,1101.52,Percent of total billed charges,,,0.95,,1067.8,Percent of total billed charges,,,0.97,,1090.28,Percent of total billed charges,,,0.97,,1090.28,Percent of total billed charges,,,0.96,,1079.04,Percent of total billed charges,,,0.95,,1067.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1067.8,Percent of total billed charges,,1067.8,1101.52,
HC PR 11470 Removal Sweat Gland Lesion,PX-98310349,CDM,11470,CPT,983,RC,,outpatient,,,1124,1011.6,,0.95,,1067.8,Percent of total billed charges,,,0.98,,1101.52,Percent of total billed charges,,,0.95,,1067.8,Percent of total billed charges,,,0.95,,1067.8,Percent of total billed charges,,,0.97,,1090.28,Percent of total billed charges,,,0.96,,1079.04,Percent of total billed charges,,,0.95,,1067.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1067.8,Percent of total billed charges,,1067.8,1101.52,
Treat dislocated finger joint,PX-45010231,CDM,26785,CPT,450,RC,,inpatient,,,1385,1246.5,,0.95,,1315.75,Percent of total billed charges,,,0.98,,1357.3,Percent of total billed charges,,,0.95,,1315.75,Percent of total billed charges,,,0.97,,1343.45,Percent of total billed charges,,,0.97,,1343.45,Percent of total billed charges,,,0.96,,1329.6,Percent of total billed charges,,,0.95,,1315.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1315.75,Percent of total billed charges,,1315.75,3950,
Treat dislocated finger joint,PX-45010231,CDM,26785,CPT,450,RC,,outpatient,,,1385,1246.5,,0.95,,1315.75,Percent of total billed charges,,,0.98,,1357.3,Percent of total billed charges,,,0.95,,1315.75,Percent of total billed charges,,,0.95,,1315.75,Percent of total billed charges,,,0.97,,1343.45,Percent of total billed charges,,,0.96,,1329.6,Percent of total billed charges,,,0.95,,1315.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1315.75,Percent of total billed charges,,1315.75,3950,
Amputation of finger or thumb with direct closure,PX-45010239,CDM,26951,CPT,450,RC,,inpatient,,,999,899.1,,0.95,,949.05,Percent of total billed charges,,,0.98,,979.02,Percent of total billed charges,,,0.95,,949.05,Percent of total billed charges,,,0.97,,969.03,Percent of total billed charges,,,0.97,,969.03,Percent of total billed charges,,,0.96,,959.04,Percent of total billed charges,,,0.95,,949.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,949.05,Percent of total billed charges,,949.05,3950,
Amputation of finger or thumb with direct closure,PX-45010239,CDM,26951,CPT,450,RC,,outpatient,,,999,899.1,,0.95,,949.05,Percent of total billed charges,,,0.98,,979.02,Percent of total billed charges,,,0.95,,949.05,Percent of total billed charges,,,0.95,,949.05,Percent of total billed charges,,,0.97,,969.03,Percent of total billed charges,,,0.96,,959.04,Percent of total billed charges,,,0.95,,949.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,949.05,Percent of total billed charges,,949.05,3950,
Amputation of finger or thumb with tissue flap,PX-45010250,CDM,26952,CPT,450,RC,,inpatient,,,2474,2226.6,,0.95,,2350.3,Percent of total billed charges,,,0.98,,2424.52,Percent of total billed charges,,,0.95,,2350.3,Percent of total billed charges,,,0.97,,2399.78,Percent of total billed charges,,,0.97,,2399.78,Percent of total billed charges,,,0.96,,2375.04,Percent of total billed charges,,,0.95,,2350.3,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2350.3,Percent of total billed charges,,2350.3,3950,
Amputation of finger or thumb with tissue flap,PX-45010250,CDM,26952,CPT,450,RC,,outpatient,,,2474,2226.6,,0.95,,2350.3,Percent of total billed charges,,,0.98,,2424.52,Percent of total billed charges,,,0.95,,2350.3,Percent of total billed charges,,,0.95,,2350.3,Percent of total billed charges,,,0.97,,2399.78,Percent of total billed charges,,,0.96,,2375.04,Percent of total billed charges,,,0.95,,2350.3,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2350.3,Percent of total billed charges,,2350.3,3950,
Closed treatment of broken upper thigh bone,PX-45010257,CDM,27230,CPT,450,RC,,inpatient,,,1710,1539,,0.95,,1624.5,Percent of total billed charges,,,0.98,,1675.8,Percent of total billed charges,,,0.95,,1624.5,Percent of total billed charges,,,0.97,,1658.7,Percent of total billed charges,,,0.97,,1658.7,Percent of total billed charges,,,0.96,,1641.6,Percent of total billed charges,,,0.95,,1624.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1624.5,Percent of total billed charges,,1624.5,3950,
Closed treatment of broken upper thigh bone,PX-45010257,CDM,27230,CPT,450,RC,,outpatient,,,1710,1539,,0.95,,1624.5,Percent of total billed charges,,,0.98,,1675.8,Percent of total billed charges,,,0.95,,1624.5,Percent of total billed charges,,,0.95,,1624.5,Percent of total billed charges,,,0.97,,1658.7,Percent of total billed charges,,,0.96,,1641.6,Percent of total billed charges,,,0.95,,1624.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1624.5,Percent of total billed charges,,1624.5,3950,
Closed treatment of dislocated hip,PX-45010263,CDM,27250,CPT,450,RC,,inpatient,,,1846,1661.4,,0.95,,1753.7,Percent of total billed charges,,,0.98,,1809.08,Percent of total billed charges,,,0.95,,1753.7,Percent of total billed charges,,,0.97,,1790.62,Percent of total billed charges,,,0.97,,1790.62,Percent of total billed charges,,,0.96,,1772.16,Percent of total billed charges,,,0.95,,1753.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1753.7,Percent of total billed charges,,1753.7,3950,
Closed treatment of dislocated hip,PX-45010263,CDM,27250,CPT,450,RC,,outpatient,,,1846,1661.4,,0.95,,1753.7,Percent of total billed charges,,,0.98,,1809.08,Percent of total billed charges,,,0.95,,1753.7,Percent of total billed charges,,,0.95,,1753.7,Percent of total billed charges,,,0.97,,1790.62,Percent of total billed charges,,,0.96,,1772.16,Percent of total billed charges,,,0.95,,1753.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1753.7,Percent of total billed charges,,1753.7,3950,
Closed treatment of dislocated hip under anesthesia,PX-45010267,CDM,27252,CPT,450,RC,,inpatient,,,2854,2568.6,,0.95,,2711.3,Percent of total billed charges,,,0.98,,2796.92,Percent of total billed charges,,,0.95,,2711.3,Percent of total billed charges,,,0.97,,2768.38,Percent of total billed charges,,,0.97,,2768.38,Percent of total billed charges,,,0.96,,2739.84,Percent of total billed charges,,,0.95,,2711.3,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2711.3,Percent of total billed charges,,2711.3,3950,
Closed treatment of dislocated hip under anesthesia,PX-45010267,CDM,27252,CPT,450,RC,,outpatient,,,2854,2568.6,,0.95,,2711.3,Percent of total billed charges,,,0.98,,2796.92,Percent of total billed charges,,,0.95,,2711.3,Percent of total billed charges,,,0.95,,2711.3,Percent of total billed charges,,,0.97,,2768.38,Percent of total billed charges,,,0.96,,2739.84,Percent of total billed charges,,,0.95,,2711.3,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2711.3,Percent of total billed charges,,2711.3,3950,
Closed Treatment of spontaneous dislocated hip,PX-45010269,CDM,27256,CPT,450,RC,,inpatient,,,1582,1423.8,,0.95,,1502.9,Percent of total billed charges,,,0.98,,1550.36,Percent of total billed charges,,,0.95,,1502.9,Percent of total billed charges,,,0.97,,1534.54,Percent of total billed charges,,,0.97,,1534.54,Percent of total billed charges,,,0.96,,1518.72,Percent of total billed charges,,,0.95,,1502.9,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1502.9,Percent of total billed charges,,1502.9,3950,
Closed Treatment of spontaneous dislocated hip,PX-45010269,CDM,27256,CPT,450,RC,,outpatient,,,1582,1423.8,,0.95,,1502.9,Percent of total billed charges,,,0.98,,1550.36,Percent of total billed charges,,,0.95,,1502.9,Percent of total billed charges,,,0.95,,1502.9,Percent of total billed charges,,,0.97,,1534.54,Percent of total billed charges,,,0.96,,1518.72,Percent of total billed charges,,,0.95,,1502.9,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1502.9,Percent of total billed charges,,1502.9,3950,
Closed treatment of dislocated hip prosthesis,PX-45010271,CDM,27265,CPT,450,RC,,inpatient,,,457,411.3,,0.95,,434.15,Percent of total billed charges,,,0.98,,447.86,Percent of total billed charges,,,0.95,,434.15,Percent of total billed charges,,,0.97,,443.29,Percent of total billed charges,,,0.97,,443.29,Percent of total billed charges,,,0.96,,438.72,Percent of total billed charges,,,0.95,,434.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,434.15,Percent of total billed charges,,434.15,3950,
Closed treatment of dislocated hip prosthesis,PX-45010271,CDM,27265,CPT,450,RC,,outpatient,,,457,411.3,,0.95,,434.15,Percent of total billed charges,,,0.98,,447.86,Percent of total billed charges,,,0.95,,434.15,Percent of total billed charges,,,0.95,,434.15,Percent of total billed charges,,,0.97,,443.29,Percent of total billed charges,,,0.96,,438.72,Percent of total billed charges,,,0.95,,434.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,434.15,Percent of total billed charges,,434.15,3950,
Closed treat dislocated hip prosthesis under anesthesia,PX-45010275,CDM,27266,CPT,450,RC,,inpatient,,,1581,1422.9,,0.95,,1501.95,Percent of total billed charges,,,0.98,,1549.38,Percent of total billed charges,,,0.95,,1501.95,Percent of total billed charges,,,0.97,,1533.57,Percent of total billed charges,,,0.97,,1533.57,Percent of total billed charges,,,0.96,,1517.76,Percent of total billed charges,,,0.95,,1501.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1501.95,Percent of total billed charges,,1501.95,3950,
Closed treat dislocated hip prosthesis under anesthesia,PX-45010275,CDM,27266,CPT,450,RC,,outpatient,,,1581,1422.9,,0.95,,1501.95,Percent of total billed charges,,,0.98,,1549.38,Percent of total billed charges,,,0.95,,1501.95,Percent of total billed charges,,,0.95,,1501.95,Percent of total billed charges,,,0.97,,1533.57,Percent of total billed charges,,,0.96,,1517.76,Percent of total billed charges,,,0.95,,1501.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1501.95,Percent of total billed charges,,1501.95,3950,
Closed treatment of broken middle part of upper arm bone,PX-45010705,CDM,24500,CPT,450,RC,,inpatient,,,1242,1117.8,,0.95,,1179.9,Percent of total billed charges,,,0.98,,1217.16,Percent of total billed charges,,,0.95,,1179.9,Percent of total billed charges,,,0.97,,1204.74,Percent of total billed charges,,,0.97,,1204.74,Percent of total billed charges,,,0.96,,1192.32,Percent of total billed charges,,,0.95,,1179.9,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1179.9,Percent of total billed charges,,1179.9,3950,
Closed treatment of broken middle part of upper arm bone,PX-45010705,CDM,24500,CPT,450,RC,,outpatient,,,1242,1117.8,,0.95,,1179.9,Percent of total billed charges,,,0.98,,1217.16,Percent of total billed charges,,,0.95,,1179.9,Percent of total billed charges,,,0.95,,1179.9,Percent of total billed charges,,,0.97,,1204.74,Percent of total billed charges,,,0.96,,1192.32,Percent of total billed charges,,,0.95,,1179.9,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1179.9,Percent of total billed charges,,1179.9,3950,
Closed treatment of broken middle part of upper arm bone,PX-45010709,CDM,24505,CPT,450,RC,,inpatient,,,2573,2315.7,,0.95,,2444.35,Percent of total billed charges,,,0.98,,2521.54,Percent of total billed charges,,,0.95,,2444.35,Percent of total billed charges,,,0.97,,2495.81,Percent of total billed charges,,,0.97,,2495.81,Percent of total billed charges,,,0.96,,2470.08,Percent of total billed charges,,,0.95,,2444.35,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2444.35,Percent of total billed charges,,2444.35,3950,
Closed treatment of broken middle part of upper arm bone,PX-45010709,CDM,24505,CPT,450,RC,,outpatient,,,2573,2315.7,,0.95,,2444.35,Percent of total billed charges,,,0.98,,2521.54,Percent of total billed charges,,,0.95,,2444.35,Percent of total billed charges,,,0.95,,2444.35,Percent of total billed charges,,,0.97,,2495.81,Percent of total billed charges,,,0.96,,2470.08,Percent of total billed charges,,,0.95,,2444.35,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2444.35,Percent of total billed charges,,2444.35,3950,
HC ED Treat Humerus Fracture Cdm,PX-45010713,CDM,24530,CPT,450,RC,,inpatient,,,965,868.5,,0.95,,916.75,Percent of total billed charges,,,0.98,,945.7,Percent of total billed charges,,,0.95,,916.75,Percent of total billed charges,,,0.97,,936.05,Percent of total billed charges,,,0.97,,936.05,Percent of total billed charges,,,0.96,,926.4,Percent of total billed charges,,,0.95,,916.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,916.75,Percent of total billed charges,,916.75,3950,
HC ED Treat Humerus Fracture Cdm,PX-45010713,CDM,24530,CPT,450,RC,,outpatient,,,965,868.5,,0.95,,916.75,Percent of total billed charges,,,0.98,,945.7,Percent of total billed charges,,,0.95,,916.75,Percent of total billed charges,,,0.95,,916.75,Percent of total billed charges,,,0.97,,936.05,Percent of total billed charges,,,0.96,,926.4,Percent of total billed charges,,,0.95,,916.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,916.75,Percent of total billed charges,,916.75,3950,
Closed treat broken outer part of upper arm bone at elbow,PX-45010722,CDM,24560,CPT,450,RC,,inpatient,,,1097,987.3,,0.95,,1042.15,Percent of total billed charges,,,0.98,,1075.06,Percent of total billed charges,,,0.95,,1042.15,Percent of total billed charges,,,0.97,,1064.09,Percent of total billed charges,,,0.97,,1064.09,Percent of total billed charges,,,0.96,,1053.12,Percent of total billed charges,,,0.95,,1042.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1042.15,Percent of total billed charges,,1042.15,3950,
Closed treat broken outer part of upper arm bone at elbow,PX-45010722,CDM,24560,CPT,450,RC,,outpatient,,,1097,987.3,,0.95,,1042.15,Percent of total billed charges,,,0.98,,1075.06,Percent of total billed charges,,,0.95,,1042.15,Percent of total billed charges,,,0.95,,1042.15,Percent of total billed charges,,,0.97,,1064.09,Percent of total billed charges,,,0.96,,1053.12,Percent of total billed charges,,,0.95,,1042.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1042.15,Percent of total billed charges,,1042.15,3950,
Repair of dislocated elbow,PX-45010738,CDM,24600,CPT,450,RC,,inpatient,,,1275,1147.5,,0.95,,1211.25,Percent of total billed charges,,,0.98,,1249.5,Percent of total billed charges,,,0.95,,1211.25,Percent of total billed charges,,,0.97,,1236.75,Percent of total billed charges,,,0.97,,1236.75,Percent of total billed charges,,,0.96,,1224,Percent of total billed charges,,,0.95,,1211.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1211.25,Percent of total billed charges,,1211.25,3950,
Repair of dislocated elbow,PX-45010738,CDM,24600,CPT,450,RC,,outpatient,,,1275,1147.5,,0.95,,1211.25,Percent of total billed charges,,,0.98,,1249.5,Percent of total billed charges,,,0.95,,1211.25,Percent of total billed charges,,,0.95,,1211.25,Percent of total billed charges,,,0.97,,1236.75,Percent of total billed charges,,,0.96,,1224,Percent of total billed charges,,,0.95,,1211.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1211.25,Percent of total billed charges,,1211.25,3950,
Repair of dislocated elbow under anesthesia,PX-45010741,CDM,24605,CPT,450,RC,,inpatient,,,1409,1268.1,,0.95,,1338.55,Percent of total billed charges,,,0.98,,1380.82,Percent of total billed charges,,,0.95,,1338.55,Percent of total billed charges,,,0.97,,1366.73,Percent of total billed charges,,,0.97,,1366.73,Percent of total billed charges,,,0.96,,1352.64,Percent of total billed charges,,,0.95,,1338.55,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1338.55,Percent of total billed charges,,1338.55,3950,
Repair of dislocated elbow under anesthesia,PX-45010741,CDM,24605,CPT,450,RC,,outpatient,,,1409,1268.1,,0.95,,1338.55,Percent of total billed charges,,,0.98,,1380.82,Percent of total billed charges,,,0.95,,1338.55,Percent of total billed charges,,,0.95,,1338.55,Percent of total billed charges,,,0.97,,1366.73,Percent of total billed charges,,,0.96,,1352.64,Percent of total billed charges,,,0.95,,1338.55,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1338.55,Percent of total billed charges,,1338.55,3950,
Closed treatment of dislocated forearm bone on thumb side,PX-45010749,CDM,24640,CPT,450,RC,,inpatient,,,499,449.1,,0.95,,474.05,Percent of total billed charges,,,0.98,,489.02,Percent of total billed charges,,,0.95,,474.05,Percent of total billed charges,,,0.97,,484.03,Percent of total billed charges,,,0.97,,484.03,Percent of total billed charges,,,0.96,,479.04,Percent of total billed charges,,,0.95,,474.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,474.05,Percent of total billed charges,,474.05,3950,
Closed treatment of dislocated forearm bone on thumb side,PX-45010749,CDM,24640,CPT,450,RC,,outpatient,,,499,449.1,,0.95,,474.05,Percent of total billed charges,,,0.98,,489.02,Percent of total billed charges,,,0.95,,474.05,Percent of total billed charges,,,0.95,,474.05,Percent of total billed charges,,,0.97,,484.03,Percent of total billed charges,,,0.96,,479.04,Percent of total billed charges,,,0.95,,474.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,474.05,Percent of total billed charges,,474.05,3950,
Closed treat broken forearm bone on thumb side at elbow,PX-45010752,CDM,24650,CPT,450,RC,,inpatient,,,931,837.9,,0.95,,884.45,Percent of total billed charges,,,0.98,,912.38,Percent of total billed charges,,,0.95,,884.45,Percent of total billed charges,,,0.97,,903.07,Percent of total billed charges,,,0.97,,903.07,Percent of total billed charges,,,0.96,,893.76,Percent of total billed charges,,,0.95,,884.45,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,884.45,Percent of total billed charges,,884.45,3950,
Closed treat broken forearm bone on thumb side at elbow,PX-45010752,CDM,24650,CPT,450,RC,,outpatient,,,931,837.9,,0.95,,884.45,Percent of total billed charges,,,0.98,,912.38,Percent of total billed charges,,,0.95,,884.45,Percent of total billed charges,,,0.95,,884.45,Percent of total billed charges,,,0.97,,903.07,Percent of total billed charges,,,0.96,,893.76,Percent of total billed charges,,,0.95,,884.45,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,884.45,Percent of total billed charges,,884.45,3950,
Closed treat broken forearm bone on small finger side,PX-45010760,CDM,24670,CPT,450,RC,,inpatient,,,949,854.1,,0.95,,901.55,Percent of total billed charges,,,0.98,,930.02,Percent of total billed charges,,,0.95,,901.55,Percent of total billed charges,,,0.97,,920.53,Percent of total billed charges,,,0.97,,920.53,Percent of total billed charges,,,0.96,,911.04,Percent of total billed charges,,,0.95,,901.55,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,901.55,Percent of total billed charges,,901.55,3950,
Closed treat broken forearm bone on small finger side,PX-45010760,CDM,24670,CPT,450,RC,,outpatient,,,949,854.1,,0.95,,901.55,Percent of total billed charges,,,0.98,,930.02,Percent of total billed charges,,,0.95,,901.55,Percent of total billed charges,,,0.95,,901.55,Percent of total billed charges,,,0.97,,920.53,Percent of total billed charges,,,0.96,,911.04,Percent of total billed charges,,,0.95,,901.55,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,901.55,Percent of total billed charges,,901.55,3950,
Primary repair tendon/muscle of palm side of forearm/wrist,PX-45010770,CDM,25260,CPT,450,RC,,inpatient,,,2797,2517.3,,0.95,,2657.15,Percent of total billed charges,,,0.98,,2741.06,Percent of total billed charges,,,0.95,,2657.15,Percent of total billed charges,,,0.97,,2713.09,Percent of total billed charges,,,0.97,,2713.09,Percent of total billed charges,,,0.96,,2685.12,Percent of total billed charges,,,0.95,,2657.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2657.15,Percent of total billed charges,,2657.15,3950,
Primary repair tendon/muscle of palm side of forearm/wrist,PX-45010770,CDM,25260,CPT,450,RC,,outpatient,,,2797,2517.3,,0.95,,2657.15,Percent of total billed charges,,,0.98,,2741.06,Percent of total billed charges,,,0.95,,2657.15,Percent of total billed charges,,,0.95,,2657.15,Percent of total billed charges,,,0.97,,2713.09,Percent of total billed charges,,,0.96,,2685.12,Percent of total billed charges,,,0.95,,2657.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2657.15,Percent of total billed charges,,2657.15,3950,
Closed treat broken midpart of forearm bone on thumb side,PX-45010778,CDM,25500,CPT,450,RC,,inpatient,,,960,864,,0.95,,912,Percent of total billed charges,,,0.98,,940.8,Percent of total billed charges,,,0.95,,912,Percent of total billed charges,,,0.97,,931.2,Percent of total billed charges,,,0.97,,931.2,Percent of total billed charges,,,0.96,,921.6,Percent of total billed charges,,,0.95,,912,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,912,Percent of total billed charges,,912,3950,
Closed treat broken midpart of forearm bone on thumb side,PX-45010778,CDM,25500,CPT,450,RC,,outpatient,,,960,864,,0.95,,912,Percent of total billed charges,,,0.98,,940.8,Percent of total billed charges,,,0.95,,912,Percent of total billed charges,,,0.95,,912,Percent of total billed charges,,,0.97,,931.2,Percent of total billed charges,,,0.96,,921.6,Percent of total billed charges,,,0.95,,912,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,912,Percent of total billed charges,,912,3950,
Closed treat broken midpart of forearm bone on thumb side,PX-45010782,CDM,25505,CPT,450,RC,,inpatient,,,1840,1656,,0.95,,1748,Percent of total billed charges,,,0.98,,1803.2,Percent of total billed charges,,,0.95,,1748,Percent of total billed charges,,,0.97,,1784.8,Percent of total billed charges,,,0.97,,1784.8,Percent of total billed charges,,,0.96,,1766.4,Percent of total billed charges,,,0.95,,1748,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1748,Percent of total billed charges,,1748,3950,
Closed treat broken midpart of forearm bone on thumb side,PX-45010782,CDM,25505,CPT,450,RC,,outpatient,,,1840,1656,,0.95,,1748,Percent of total billed charges,,,0.98,,1803.2,Percent of total billed charges,,,0.95,,1748,Percent of total billed charges,,,0.95,,1748,Percent of total billed charges,,,0.97,,1784.8,Percent of total billed charges,,,0.96,,1766.4,Percent of total billed charges,,,0.95,,1748,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1748,Percent of total billed charges,,1748,3950,
Closed treatment of broken midpart of forearm bone,PX-45010790,CDM,25530,CPT,450,RC,,inpatient,,,944,849.6,,0.95,,896.8,Percent of total billed charges,,,0.98,,925.12,Percent of total billed charges,,,0.95,,896.8,Percent of total billed charges,,,0.97,,915.68,Percent of total billed charges,,,0.97,,915.68,Percent of total billed charges,,,0.96,,906.24,Percent of total billed charges,,,0.95,,896.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,896.8,Percent of total billed charges,,896.8,3950,
Closed treatment of broken midpart of forearm bone,PX-45010790,CDM,25530,CPT,450,RC,,outpatient,,,944,849.6,,0.95,,896.8,Percent of total billed charges,,,0.98,,925.12,Percent of total billed charges,,,0.95,,896.8,Percent of total billed charges,,,0.95,,896.8,Percent of total billed charges,,,0.97,,915.68,Percent of total billed charges,,,0.96,,906.24,Percent of total billed charges,,,0.95,,896.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,896.8,Percent of total billed charges,,896.8,3950,
Closed treatment of broken midpart of both forearm bones,PX-45010798,CDM,25560,CPT,450,RC,,inpatient,,,970,873,,0.95,,921.5,Percent of total billed charges,,,0.98,,950.6,Percent of total billed charges,,,0.95,,921.5,Percent of total billed charges,,,0.97,,940.9,Percent of total billed charges,,,0.97,,940.9,Percent of total billed charges,,,0.96,,931.2,Percent of total billed charges,,,0.95,,921.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,921.5,Percent of total billed charges,,921.5,3950,
Closed treatment of broken midpart of both forearm bones,PX-45010798,CDM,25560,CPT,450,RC,,outpatient,,,970,873,,0.95,,921.5,Percent of total billed charges,,,0.98,,950.6,Percent of total billed charges,,,0.95,,921.5,Percent of total billed charges,,,0.95,,921.5,Percent of total billed charges,,,0.97,,940.9,Percent of total billed charges,,,0.96,,931.2,Percent of total billed charges,,,0.95,,921.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,921.5,Percent of total billed charges,,921.5,3950,
Closed treatment of broken midpart of both forearm bones,PX-45010801,CDM,25565,CPT,450,RC,,inpatient,,,2055,1849.5,,0.95,,1952.25,Percent of total billed charges,,,0.98,,2013.9,Percent of total billed charges,,,0.95,,1952.25,Percent of total billed charges,,,0.97,,1993.35,Percent of total billed charges,,,0.97,,1993.35,Percent of total billed charges,,,0.96,,1972.8,Percent of total billed charges,,,0.95,,1952.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1952.25,Percent of total billed charges,,1952.25,3950,
Closed treatment of broken midpart of both forearm bones,PX-45010801,CDM,25565,CPT,450,RC,,outpatient,,,2055,1849.5,,0.95,,1952.25,Percent of total billed charges,,,0.98,,2013.9,Percent of total billed charges,,,0.95,,1952.25,Percent of total billed charges,,,0.95,,1952.25,Percent of total billed charges,,,0.97,,1993.35,Percent of total billed charges,,,0.96,,1972.8,Percent of total billed charges,,,0.95,,1952.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1952.25,Percent of total billed charges,,1952.25,3950,
HC ED Treat Distal Radial Fracture Radius/Ulna W/O Manip Cdm,PX-45010804,CDM,25600,CPT,450,RC,,inpatient,,,1148,1033.2,,0.95,,1090.6,Percent of total billed charges,,,0.98,,1125.04,Percent of total billed charges,,,0.95,,1090.6,Percent of total billed charges,,,0.97,,1113.56,Percent of total billed charges,,,0.97,,1113.56,Percent of total billed charges,,,0.96,,1102.08,Percent of total billed charges,,,0.95,,1090.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1090.6,Percent of total billed charges,,1090.6,3950,
HC ED Treat Distal Radial Fracture Radius/Ulna W/O Manip Cdm,PX-45010804,CDM,25600,CPT,450,RC,,outpatient,,,1148,1033.2,,0.95,,1090.6,Percent of total billed charges,,,0.98,,1125.04,Percent of total billed charges,,,0.95,,1090.6,Percent of total billed charges,,,0.95,,1090.6,Percent of total billed charges,,,0.97,,1113.56,Percent of total billed charges,,,0.96,,1102.08,Percent of total billed charges,,,0.95,,1090.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1090.6,Percent of total billed charges,,1090.6,3950,
Closed treatment of broken or growth plate forearm bone,PX-45010808,CDM,25605,CPT,450,RC,,inpatient,,,1945,1750.5,,0.95,,1847.75,Percent of total billed charges,,,0.98,,1906.1,Percent of total billed charges,,,0.95,,1847.75,Percent of total billed charges,,,0.97,,1886.65,Percent of total billed charges,,,0.97,,1886.65,Percent of total billed charges,,,0.96,,1867.2,Percent of total billed charges,,,0.95,,1847.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1847.75,Percent of total billed charges,,1847.75,3950,
Closed treatment of broken or growth plate forearm bone,PX-45010808,CDM,25605,CPT,450,RC,,outpatient,,,1945,1750.5,,0.95,,1847.75,Percent of total billed charges,,,0.98,,1906.1,Percent of total billed charges,,,0.95,,1847.75,Percent of total billed charges,,,0.95,,1847.75,Percent of total billed charges,,,0.97,,1886.65,Percent of total billed charges,,,0.96,,1867.2,Percent of total billed charges,,,0.95,,1847.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1847.75,Percent of total billed charges,,1847.75,3950,
Closed treatment of broken wrist bone near base of thumb,PX-45010812,CDM,25622,CPT,450,RC,,inpatient,,,1013,911.7,,0.95,,962.35,Percent of total billed charges,,,0.98,,992.74,Percent of total billed charges,,,0.95,,962.35,Percent of total billed charges,,,0.97,,982.61,Percent of total billed charges,,,0.97,,982.61,Percent of total billed charges,,,0.96,,972.48,Percent of total billed charges,,,0.95,,962.35,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,962.35,Percent of total billed charges,,962.35,3950,
Closed treatment of broken wrist bone near base of thumb,PX-45010812,CDM,25622,CPT,450,RC,,outpatient,,,1013,911.7,,0.95,,962.35,Percent of total billed charges,,,0.98,,992.74,Percent of total billed charges,,,0.95,,962.35,Percent of total billed charges,,,0.95,,962.35,Percent of total billed charges,,,0.97,,982.61,Percent of total billed charges,,,0.96,,972.48,Percent of total billed charges,,,0.95,,962.35,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,962.35,Percent of total billed charges,,962.35,3950,
Closed treatment of other broken wrist bone,PX-45010820,CDM,25630,CPT,450,RC,,inpatient,,,1024,921.6,,0.95,,972.8,Percent of total billed charges,,,0.98,,1003.52,Percent of total billed charges,,,0.95,,972.8,Percent of total billed charges,,,0.97,,993.28,Percent of total billed charges,,,0.97,,993.28,Percent of total billed charges,,,0.96,,983.04,Percent of total billed charges,,,0.95,,972.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,972.8,Percent of total billed charges,,972.8,3950,
Closed treatment of other broken wrist bone,PX-45010820,CDM,25630,CPT,450,RC,,outpatient,,,1024,921.6,,0.95,,972.8,Percent of total billed charges,,,0.98,,1003.52,Percent of total billed charges,,,0.95,,972.8,Percent of total billed charges,,,0.95,,972.8,Percent of total billed charges,,,0.97,,993.28,Percent of total billed charges,,,0.96,,983.04,Percent of total billed charges,,,0.95,,972.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,972.8,Percent of total billed charges,,972.8,3950,
Closed treat broken base of forearm bone on small finger,PX-45010828,CDM,25650,CPT,450,RC,,inpatient,,,1174,1056.6,,0.95,,1115.3,Percent of total billed charges,,,0.98,,1150.52,Percent of total billed charges,,,0.95,,1115.3,Percent of total billed charges,,,0.97,,1138.78,Percent of total billed charges,,,0.97,,1138.78,Percent of total billed charges,,,0.96,,1127.04,Percent of total billed charges,,,0.95,,1115.3,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1115.3,Percent of total billed charges,,1115.3,3950,
Closed treat broken base of forearm bone on small finger,PX-45010828,CDM,25650,CPT,450,RC,,outpatient,,,1174,1056.6,,0.95,,1115.3,Percent of total billed charges,,,0.98,,1150.52,Percent of total billed charges,,,0.95,,1115.3,Percent of total billed charges,,,0.95,,1115.3,Percent of total billed charges,,,0.97,,1138.78,Percent of total billed charges,,,0.96,,1127.04,Percent of total billed charges,,,0.95,,1115.3,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1115.3,Percent of total billed charges,,1115.3,3950,
Closed treatment of dislocated wrist bones,PX-45010832,CDM,25660,CPT,450,RC,,inpatient,,,1278,1150.2,,0.95,,1214.1,Percent of total billed charges,,,0.98,,1252.44,Percent of total billed charges,,,0.95,,1214.1,Percent of total billed charges,,,0.97,,1239.66,Percent of total billed charges,,,0.97,,1239.66,Percent of total billed charges,,,0.96,,1226.88,Percent of total billed charges,,,0.95,,1214.1,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1214.1,Percent of total billed charges,,1214.1,3950,
Closed treatment of dislocated wrist bones,PX-45010832,CDM,25660,CPT,450,RC,,outpatient,,,1278,1150.2,,0.95,,1214.1,Percent of total billed charges,,,0.98,,1252.44,Percent of total billed charges,,,0.95,,1214.1,Percent of total billed charges,,,0.95,,1214.1,Percent of total billed charges,,,0.97,,1239.66,Percent of total billed charges,,,0.96,,1226.88,Percent of total billed charges,,,0.95,,1214.1,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1214.1,Percent of total billed charges,,1214.1,3950,
HC ED Open Tx Distal Phalangeal Fracture Each Cdm,PX-45010849,CDM,26765,CPT,450,RC,,inpatient,,,1484,1335.6,,0.95,,1409.8,Percent of total billed charges,,,0.98,,1454.32,Percent of total billed charges,,,0.95,,1409.8,Percent of total billed charges,,,0.97,,1439.48,Percent of total billed charges,,,0.97,,1439.48,Percent of total billed charges,,,0.96,,1424.64,Percent of total billed charges,,,0.95,,1409.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1409.8,Percent of total billed charges,,1409.8,3950,
HC ED Open Tx Distal Phalangeal Fracture Each Cdm,PX-45010849,CDM,26765,CPT,450,RC,,outpatient,,,1484,1335.6,,0.95,,1409.8,Percent of total billed charges,,,0.98,,1454.32,Percent of total billed charges,,,0.95,,1409.8,Percent of total billed charges,,,0.95,,1409.8,Percent of total billed charges,,,0.97,,1439.48,Percent of total billed charges,,,0.96,,1424.64,Percent of total billed charges,,,0.95,,1409.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1409.8,Percent of total billed charges,,1409.8,3950,
Closed treatment of dislocated finger joint,PX-45010851,CDM,26770,CPT,450,RC,,inpatient,,,808,727.2,,0.95,,767.6,Percent of total billed charges,,,0.98,,791.84,Percent of total billed charges,,,0.95,,767.6,Percent of total billed charges,,,0.97,,783.76,Percent of total billed charges,,,0.97,,783.76,Percent of total billed charges,,,0.96,,775.68,Percent of total billed charges,,,0.95,,767.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,767.6,Percent of total billed charges,,767.6,3950,
Closed treatment of dislocated finger joint,PX-45010851,CDM,26770,CPT,450,RC,,outpatient,,,808,727.2,,0.95,,767.6,Percent of total billed charges,,,0.98,,791.84,Percent of total billed charges,,,0.95,,767.6,Percent of total billed charges,,,0.95,,767.6,Percent of total billed charges,,,0.97,,783.76,Percent of total billed charges,,,0.96,,775.68,Percent of total billed charges,,,0.95,,767.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,767.6,Percent of total billed charges,,767.6,3950,
Closed treatment of dislocated finger joint,PX-45010852,CDM,26775,CPT,450,RC,,inpatient,,,1000,900,,0.95,,950,Percent of total billed charges,,,0.98,,980,Percent of total billed charges,,,0.95,,950,Percent of total billed charges,,,0.97,,970,Percent of total billed charges,,,0.97,,970,Percent of total billed charges,,,0.96,,960,Percent of total billed charges,,,0.95,,950,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,950,Percent of total billed charges,,950,3950,
Closed treatment of dislocated finger joint,PX-45010852,CDM,26775,CPT,450,RC,,outpatient,,,1000,900,,0.95,,950,Percent of total billed charges,,,0.98,,980,Percent of total billed charges,,,0.95,,950,Percent of total billed charges,,,0.95,,950,Percent of total billed charges,,,0.97,,970,Percent of total billed charges,,,0.96,,960,Percent of total billed charges,,,0.95,,950,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,950,Percent of total billed charges,,950,3950,
Repair of tendon on top of hand,PX-45010872,CDM,26410,CPT,450,RC,,inpatient,,,2189,1970.1,,0.95,,2079.55,Percent of total billed charges,,,0.98,,2145.22,Percent of total billed charges,,,0.95,,2079.55,Percent of total billed charges,,,0.97,,2123.33,Percent of total billed charges,,,0.97,,2123.33,Percent of total billed charges,,,0.96,,2101.44,Percent of total billed charges,,,0.95,,2079.55,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2079.55,Percent of total billed charges,,2079.55,3950,
Repair of tendon on top of hand,PX-45010872,CDM,26410,CPT,450,RC,,outpatient,,,2189,1970.1,,0.95,,2079.55,Percent of total billed charges,,,0.98,,2145.22,Percent of total billed charges,,,0.95,,2079.55,Percent of total billed charges,,,0.95,,2079.55,Percent of total billed charges,,,0.97,,2123.33,Percent of total billed charges,,,0.96,,2101.44,Percent of total billed charges,,,0.95,,2079.55,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2079.55,Percent of total billed charges,,2079.55,3950,
Repair of tendon on top side of finger,PX-45010876,CDM,26418,CPT,450,RC,,inpatient,,,2144,1929.6,,0.95,,2036.8,Percent of total billed charges,,,0.98,,2101.12,Percent of total billed charges,,,0.95,,2036.8,Percent of total billed charges,,,0.97,,2079.68,Percent of total billed charges,,,0.97,,2079.68,Percent of total billed charges,,,0.96,,2058.24,Percent of total billed charges,,,0.95,,2036.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2036.8,Percent of total billed charges,,2036.8,3950,
Repair of tendon on top side of finger,PX-45010876,CDM,26418,CPT,450,RC,,outpatient,,,2144,1929.6,,0.95,,2036.8,Percent of total billed charges,,,0.98,,2101.12,Percent of total billed charges,,,0.95,,2036.8,Percent of total billed charges,,,0.95,,2036.8,Percent of total billed charges,,,0.97,,2079.68,Percent of total billed charges,,,0.96,,2058.24,Percent of total billed charges,,,0.95,,2036.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2036.8,Percent of total billed charges,,2036.8,3950,
Closed treatment of broken hand bone,PX-45010900,CDM,26600,CPT,450,RC,,inpatient,,,809,728.1,,0.95,,768.55,Percent of total billed charges,,,0.98,,792.82,Percent of total billed charges,,,0.95,,768.55,Percent of total billed charges,,,0.97,,784.73,Percent of total billed charges,,,0.97,,784.73,Percent of total billed charges,,,0.96,,776.64,Percent of total billed charges,,,0.95,,768.55,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,768.55,Percent of total billed charges,,768.55,3950,
Closed treatment of broken hand bone,PX-45010900,CDM,26600,CPT,450,RC,,outpatient,,,809,728.1,,0.95,,768.55,Percent of total billed charges,,,0.98,,792.82,Percent of total billed charges,,,0.95,,768.55,Percent of total billed charges,,,0.95,,768.55,Percent of total billed charges,,,0.97,,784.73,Percent of total billed charges,,,0.96,,776.64,Percent of total billed charges,,,0.95,,768.55,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,768.55,Percent of total billed charges,,768.55,3950,
Closed treatment of broken hand bone with manipulation,PX-45010904,CDM,26605,CPT,450,RC,,inpatient,,,1018,916.2,,0.95,,967.1,Percent of total billed charges,,,0.98,,997.64,Percent of total billed charges,,,0.95,,967.1,Percent of total billed charges,,,0.97,,987.46,Percent of total billed charges,,,0.97,,987.46,Percent of total billed charges,,,0.96,,977.28,Percent of total billed charges,,,0.95,,967.1,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,967.1,Percent of total billed charges,,967.1,3950,
Closed treatment of broken hand bone with manipulation,PX-45010904,CDM,26605,CPT,450,RC,,outpatient,,,1018,916.2,,0.95,,967.1,Percent of total billed charges,,,0.98,,997.64,Percent of total billed charges,,,0.95,,967.1,Percent of total billed charges,,,0.95,,967.1,Percent of total billed charges,,,0.97,,987.46,Percent of total billed charges,,,0.96,,977.28,Percent of total billed charges,,,0.95,,967.1,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,967.1,Percent of total billed charges,,967.1,3950,
Closed treatment of dislocated thumb at wrist,PX-45010909,CDM,26641,CPT,450,RC,,inpatient,,,1095,985.5,,0.95,,1040.25,Percent of total billed charges,,,0.98,,1073.1,Percent of total billed charges,,,0.95,,1040.25,Percent of total billed charges,,,0.97,,1062.15,Percent of total billed charges,,,0.97,,1062.15,Percent of total billed charges,,,0.96,,1051.2,Percent of total billed charges,,,0.95,,1040.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1040.25,Percent of total billed charges,,1040.25,3950,
Closed treatment of dislocated thumb at wrist,PX-45010909,CDM,26641,CPT,450,RC,,outpatient,,,1095,985.5,,0.95,,1040.25,Percent of total billed charges,,,0.98,,1073.1,Percent of total billed charges,,,0.95,,1040.25,Percent of total billed charges,,,0.95,,1040.25,Percent of total billed charges,,,0.97,,1062.15,Percent of total billed charges,,,0.96,,1051.2,Percent of total billed charges,,,0.95,,1040.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1040.25,Percent of total billed charges,,1040.25,3950,
Closed treatment of broken thumb at wrist with manipulation,PX-45010915,CDM,26645,CPT,450,RC,,inpatient,,,1245,1120.5,,0.95,,1182.75,Percent of total billed charges,,,0.98,,1220.1,Percent of total billed charges,,,0.95,,1182.75,Percent of total billed charges,,,0.97,,1207.65,Percent of total billed charges,,,0.97,,1207.65,Percent of total billed charges,,,0.96,,1195.2,Percent of total billed charges,,,0.95,,1182.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1182.75,Percent of total billed charges,,1182.75,3950,
Closed treatment of broken thumb at wrist with manipulation,PX-45010915,CDM,26645,CPT,450,RC,,outpatient,,,1245,1120.5,,0.95,,1182.75,Percent of total billed charges,,,0.98,,1220.1,Percent of total billed charges,,,0.95,,1182.75,Percent of total billed charges,,,0.95,,1182.75,Percent of total billed charges,,,0.97,,1207.65,Percent of total billed charges,,,0.96,,1195.2,Percent of total billed charges,,,0.95,,1182.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1182.75,Percent of total billed charges,,1182.75,3950,
Closed treatment of dislocated hand bone at wrist joint,PX-45010921,CDM,26670,CPT,450,RC,,inpatient,,,1056,950.4,,0.95,,1003.2,Percent of total billed charges,,,0.98,,1034.88,Percent of total billed charges,,,0.95,,1003.2,Percent of total billed charges,,,0.97,,1024.32,Percent of total billed charges,,,0.97,,1024.32,Percent of total billed charges,,,0.96,,1013.76,Percent of total billed charges,,,0.95,,1003.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1003.2,Percent of total billed charges,,1003.2,3950,
Closed treatment of dislocated hand bone at wrist joint,PX-45010921,CDM,26670,CPT,450,RC,,outpatient,,,1056,950.4,,0.95,,1003.2,Percent of total billed charges,,,0.98,,1034.88,Percent of total billed charges,,,0.95,,1003.2,Percent of total billed charges,,,0.95,,1003.2,Percent of total billed charges,,,0.97,,1024.32,Percent of total billed charges,,,0.96,,1013.76,Percent of total billed charges,,,0.95,,1003.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1003.2,Percent of total billed charges,,1003.2,3950,
Closed treatment of broken finger or thumb at midportion,PX-45010929,CDM,26720,CPT,450,RC,,inpatient,,,605,544.5,,0.95,,574.75,Percent of total billed charges,,,0.98,,592.9,Percent of total billed charges,,,0.95,,574.75,Percent of total billed charges,,,0.97,,586.85,Percent of total billed charges,,,0.97,,586.85,Percent of total billed charges,,,0.96,,580.8,Percent of total billed charges,,,0.95,,574.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,574.75,Percent of total billed charges,,574.75,3950,
Closed treatment of broken finger or thumb at midportion,PX-45010929,CDM,26720,CPT,450,RC,,outpatient,,,605,544.5,,0.95,,574.75,Percent of total billed charges,,,0.98,,592.9,Percent of total billed charges,,,0.95,,574.75,Percent of total billed charges,,,0.95,,574.75,Percent of total billed charges,,,0.97,,586.85,Percent of total billed charges,,,0.96,,580.8,Percent of total billed charges,,,0.95,,574.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,574.75,Percent of total billed charges,,574.75,3950,
Closed treatment of broken finger or thumb at midportion,PX-45010943,CDM,26725,CPT,450,RC,,inpatient,,,1034,930.6,,0.95,,982.3,Percent of total billed charges,,,0.98,,1013.32,Percent of total billed charges,,,0.95,,982.3,Percent of total billed charges,,,0.97,,1002.98,Percent of total billed charges,,,0.97,,1002.98,Percent of total billed charges,,,0.96,,992.64,Percent of total billed charges,,,0.95,,982.3,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,982.3,Percent of total billed charges,,982.3,3950,
Closed treatment of broken finger or thumb at midportion,PX-45010943,CDM,26725,CPT,450,RC,,outpatient,,,1034,930.6,,0.95,,982.3,Percent of total billed charges,,,0.98,,1013.32,Percent of total billed charges,,,0.95,,982.3,Percent of total billed charges,,,0.95,,982.3,Percent of total billed charges,,,0.97,,1002.98,Percent of total billed charges,,,0.96,,992.64,Percent of total billed charges,,,0.95,,982.3,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,982.3,Percent of total billed charges,,982.3,3950,
Closed treatment of broken finger or hand at base of finger,PX-45010963,CDM,26740,CPT,450,RC,,inpatient,,,857,771.3,,0.95,,814.15,Percent of total billed charges,,,0.98,,839.86,Percent of total billed charges,,,0.95,,814.15,Percent of total billed charges,,,0.97,,831.29,Percent of total billed charges,,,0.97,,831.29,Percent of total billed charges,,,0.96,,822.72,Percent of total billed charges,,,0.95,,814.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,814.15,Percent of total billed charges,,814.15,3950,
Closed treatment of broken finger or hand at base of finger,PX-45010963,CDM,26740,CPT,450,RC,,outpatient,,,857,771.3,,0.95,,814.15,Percent of total billed charges,,,0.98,,839.86,Percent of total billed charges,,,0.95,,814.15,Percent of total billed charges,,,0.95,,814.15,Percent of total billed charges,,,0.97,,831.29,Percent of total billed charges,,,0.96,,822.72,Percent of total billed charges,,,0.95,,814.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,814.15,Percent of total billed charges,,814.15,3950,
Closed treatment of broken finger or hand at base of finger,PX-45010974,CDM,26742,CPT,450,RC,,inpatient,,,1166,1049.4,,0.95,,1107.7,Percent of total billed charges,,,0.98,,1142.68,Percent of total billed charges,,,0.95,,1107.7,Percent of total billed charges,,,0.97,,1131.02,Percent of total billed charges,,,0.97,,1131.02,Percent of total billed charges,,,0.96,,1119.36,Percent of total billed charges,,,0.95,,1107.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1107.7,Percent of total billed charges,,1107.7,3950,
Closed treatment of broken finger or hand at base of finger,PX-45010974,CDM,26742,CPT,450,RC,,outpatient,,,1166,1049.4,,0.95,,1107.7,Percent of total billed charges,,,0.98,,1142.68,Percent of total billed charges,,,0.95,,1107.7,Percent of total billed charges,,,0.95,,1107.7,Percent of total billed charges,,,0.97,,1131.02,Percent of total billed charges,,,0.96,,1119.36,Percent of total billed charges,,,0.95,,1107.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1107.7,Percent of total billed charges,,1107.7,3950,
Closed treatment of broken end of finger or thumb,PX-45010986,CDM,26750,CPT,450,RC,,inpatient,,,605,544.5,,0.95,,574.75,Percent of total billed charges,,,0.98,,592.9,Percent of total billed charges,,,0.95,,574.75,Percent of total billed charges,,,0.97,,586.85,Percent of total billed charges,,,0.97,,586.85,Percent of total billed charges,,,0.96,,580.8,Percent of total billed charges,,,0.95,,574.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,574.75,Percent of total billed charges,,574.75,3950,
Closed treatment of broken end of finger or thumb,PX-45010986,CDM,26750,CPT,450,RC,,outpatient,,,605,544.5,,0.95,,574.75,Percent of total billed charges,,,0.98,,592.9,Percent of total billed charges,,,0.95,,574.75,Percent of total billed charges,,,0.95,,574.75,Percent of total billed charges,,,0.97,,586.85,Percent of total billed charges,,,0.96,,580.8,Percent of total billed charges,,,0.95,,574.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,574.75,Percent of total billed charges,,574.75,3950,
Closed treatment of broken end of finger or thumb,PX-45010996,CDM,26755,CPT,450,RC,,inpatient,,,807,726.3,,0.95,,766.65,Percent of total billed charges,,,0.98,,790.86,Percent of total billed charges,,,0.95,,766.65,Percent of total billed charges,,,0.97,,782.79,Percent of total billed charges,,,0.97,,782.79,Percent of total billed charges,,,0.96,,774.72,Percent of total billed charges,,,0.95,,766.65,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,766.65,Percent of total billed charges,,766.65,3950,
Closed treatment of broken end of finger or thumb,PX-45010996,CDM,26755,CPT,450,RC,,outpatient,,,807,726.3,,0.95,,766.65,Percent of total billed charges,,,0.98,,790.86,Percent of total billed charges,,,0.95,,766.65,Percent of total billed charges,,,0.95,,766.65,Percent of total billed charges,,,0.97,,782.79,Percent of total billed charges,,,0.96,,774.72,Percent of total billed charges,,,0.95,,766.65,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,766.65,Percent of total billed charges,,766.65,3950,
HC PR 25607 Treat Fx Rad Extra-Articul,PX-96910719,CDM,25607,CPT,983,RC,,inpatient,,,1851,1665.9,,0.95,,1758.45,Percent of total billed charges,,,0.98,,1813.98,Percent of total billed charges,,,0.95,,1758.45,Percent of total billed charges,,,0.97,,1795.47,Percent of total billed charges,,,0.97,,1795.47,Percent of total billed charges,,,0.96,,1776.96,Percent of total billed charges,,,0.95,,1758.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1758.45,Percent of total billed charges,,1758.45,1813.98,
HC PR 25607 Treat Fx Rad Extra-Articul,PX-96910719,CDM,25607,CPT,983,RC,,outpatient,,,1851,1665.9,,0.95,,1758.45,Percent of total billed charges,,,0.98,,1813.98,Percent of total billed charges,,,0.95,,1758.45,Percent of total billed charges,,,0.95,,1758.45,Percent of total billed charges,,,0.97,,1795.47,Percent of total billed charges,,,0.96,,1776.96,Percent of total billed charges,,,0.95,,1758.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1758.45,Percent of total billed charges,,1758.45,1813.98,
HC PR 26070 Arthrotomy W/Explore/Treat Hand Joint,PX-96910723,CDM,26070,CPT,983,RC,,inpatient,,,1627,1464.3,,0.95,,1545.65,Percent of total billed charges,,,0.98,,1594.46,Percent of total billed charges,,,0.95,,1545.65,Percent of total billed charges,,,0.97,,1578.19,Percent of total billed charges,,,0.97,,1578.19,Percent of total billed charges,,,0.96,,1561.92,Percent of total billed charges,,,0.95,,1545.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1545.65,Percent of total billed charges,,1545.65,1594.46,
HC PR 26070 Arthrotomy W/Explore/Treat Hand Joint,PX-96910723,CDM,26070,CPT,983,RC,,outpatient,,,1627,1464.3,,0.95,,1545.65,Percent of total billed charges,,,0.98,,1594.46,Percent of total billed charges,,,0.95,,1545.65,Percent of total billed charges,,,0.95,,1545.65,Percent of total billed charges,,,0.97,,1578.19,Percent of total billed charges,,,0.96,,1561.92,Percent of total billed charges,,,0.95,,1545.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1545.65,Percent of total billed charges,,1545.65,1594.46,
HC PR 26615 Treat Metacarpal Fracture W/Internal Fixation,PX-96910735,CDM,26615,CPT,983,RC,,inpatient,,,1444,1299.6,,0.95,,1371.8,Percent of total billed charges,,,0.98,,1415.12,Percent of total billed charges,,,0.95,,1371.8,Percent of total billed charges,,,0.97,,1400.68,Percent of total billed charges,,,0.97,,1400.68,Percent of total billed charges,,,0.96,,1386.24,Percent of total billed charges,,,0.95,,1371.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1371.8,Percent of total billed charges,,1371.8,1415.12,
HC PR 26615 Treat Metacarpal Fracture W/Internal Fixation,PX-96910735,CDM,26615,CPT,983,RC,,outpatient,,,1444,1299.6,,0.95,,1371.8,Percent of total billed charges,,,0.98,,1415.12,Percent of total billed charges,,,0.95,,1371.8,Percent of total billed charges,,,0.95,,1371.8,Percent of total billed charges,,,0.97,,1400.68,Percent of total billed charges,,,0.96,,1386.24,Percent of total billed charges,,,0.95,,1371.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1371.8,Percent of total billed charges,,1371.8,1415.12,
HC PR 24685 Treat Ulnar Fracture - Trt Fx,PX-97510907,CDM,24685,CPT,975,RC,,inpatient,,,1635,1471.5,,0.95,,1553.25,Percent of total billed charges,,,0.98,,1602.3,Percent of total billed charges,,,0.95,,1553.25,Percent of total billed charges,,,0.97,,1585.95,Percent of total billed charges,,,0.97,,1585.95,Percent of total billed charges,,,0.96,,1569.6,Percent of total billed charges,,,0.95,,1553.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1553.25,Percent of total billed charges,,1553.25,1602.3,
HC PR 24685 Treat Ulnar Fracture - Trt Fx,PX-97510907,CDM,24685,CPT,975,RC,,outpatient,,,1635,1471.5,,0.95,,1553.25,Percent of total billed charges,,,0.98,,1602.3,Percent of total billed charges,,,0.95,,1553.25,Percent of total billed charges,,,0.95,,1553.25,Percent of total billed charges,,,0.97,,1585.95,Percent of total billed charges,,,0.96,,1569.6,Percent of total billed charges,,,0.95,,1553.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1553.25,Percent of total billed charges,,1553.25,1602.3,
HC PR 25075 Exc Forearm Les Sc < 3 Cm,PX-97510908,CDM,25075,CPT,975,RC,,inpatient,,,1282,1153.8,,0.95,,1217.9,Percent of total billed charges,,,0.98,,1256.36,Percent of total billed charges,,,0.95,,1217.9,Percent of total billed charges,,,0.97,,1243.54,Percent of total billed charges,,,0.97,,1243.54,Percent of total billed charges,,,0.96,,1230.72,Percent of total billed charges,,,0.95,,1217.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1217.9,Percent of total billed charges,,1217.9,1256.36,
HC PR 25075 Exc Forearm Les Sc < 3 Cm,PX-97510908,CDM,25075,CPT,975,RC,,outpatient,,,1282,1153.8,,0.95,,1217.9,Percent of total billed charges,,,0.98,,1256.36,Percent of total billed charges,,,0.95,,1217.9,Percent of total billed charges,,,0.95,,1217.9,Percent of total billed charges,,,0.97,,1243.54,Percent of total billed charges,,,0.96,,1230.72,Percent of total billed charges,,,0.95,,1217.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1217.9,Percent of total billed charges,,1217.9,1256.36,
HC PR 25111 Remove Wrst Tend Lesion,PX-97510910,CDM,25111,CPT,975,RC,,inpatient,,,822,739.8,,0.95,,780.9,Percent of total billed charges,,,0.98,,805.56,Percent of total billed charges,,,0.95,,780.9,Percent of total billed charges,,,0.97,,797.34,Percent of total billed charges,,,0.97,,797.34,Percent of total billed charges,,,0.96,,789.12,Percent of total billed charges,,,0.95,,780.9,Percent of total billed charges,,,,,,,,,0.95,,780.9,Percent of total billed charges,,780.9,805.56,
HC PR 25111 Remove Wrst Tend Lesion,PX-97510910,CDM,25111,CPT,975,RC,,outpatient,,,822,739.8,,0.95,,780.9,Percent of total billed charges,,,0.98,,805.56,Percent of total billed charges,,,0.95,,780.9,Percent of total billed charges,,,0.95,,780.9,Percent of total billed charges,,,0.97,,797.34,Percent of total billed charges,,,0.96,,789.12,Percent of total billed charges,,,0.95,,780.9,Percent of total billed charges,,,,,,,,,0.95,,780.9,Percent of total billed charges,,780.9,805.56,
HC PR 25390 Shorten Radius or Ulna,PX-97510912,CDM,25390,CPT,975,RC,,inpatient,,,1913,1721.7,,0.95,,1817.35,Percent of total billed charges,,,0.98,,1874.74,Percent of total billed charges,,,0.95,,1817.35,Percent of total billed charges,,,0.97,,1855.61,Percent of total billed charges,,,0.97,,1855.61,Percent of total billed charges,,,0.96,,1836.48,Percent of total billed charges,,,0.95,,1817.35,Percent of total billed charges,,,,,,,,,0.95,,1817.35,Percent of total billed charges,,1817.35,1874.74,
HC PR 25390 Shorten Radius or Ulna,PX-97510912,CDM,25390,CPT,975,RC,,outpatient,,,1913,1721.7,,0.95,,1817.35,Percent of total billed charges,,,0.98,,1874.74,Percent of total billed charges,,,0.95,,1817.35,Percent of total billed charges,,,0.95,,1817.35,Percent of total billed charges,,,0.97,,1855.61,Percent of total billed charges,,,0.96,,1836.48,Percent of total billed charges,,,0.95,,1817.35,Percent of total billed charges,,,,,,,,,0.95,,1817.35,Percent of total billed charges,,1817.35,1874.74,
HC PR 26045 Release Palm Contracture,PX-97510922,CDM,26045,CPT,975,RC,,inpatient,,,1188,1069.2,,0.95,,1128.6,Percent of total billed charges,,,0.98,,1164.24,Percent of total billed charges,,,0.95,,1128.6,Percent of total billed charges,,,0.97,,1152.36,Percent of total billed charges,,,0.97,,1152.36,Percent of total billed charges,,,0.96,,1140.48,Percent of total billed charges,,,0.95,,1128.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1128.6,Percent of total billed charges,,1128.6,1164.24,
HC PR 26045 Release Palm Contracture,PX-97510922,CDM,26045,CPT,975,RC,,outpatient,,,1188,1069.2,,0.95,,1128.6,Percent of total billed charges,,,0.98,,1164.24,Percent of total billed charges,,,0.95,,1128.6,Percent of total billed charges,,,0.95,,1128.6,Percent of total billed charges,,,0.97,,1152.36,Percent of total billed charges,,,0.96,,1140.48,Percent of total billed charges,,,0.95,,1128.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1128.6,Percent of total billed charges,,1128.6,1164.24,
HC PR 26990 Drainage of Pelvis Lesion,PX-97510930,CDM,26990,CPT,975,RC,,inpatient,,,1693,1523.7,,0.95,,1608.35,Percent of total billed charges,,,0.98,,1659.14,Percent of total billed charges,,,0.95,,1608.35,Percent of total billed charges,,,0.97,,1642.21,Percent of total billed charges,,,0.97,,1642.21,Percent of total billed charges,,,0.96,,1625.28,Percent of total billed charges,,,0.95,,1608.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1608.35,Percent of total billed charges,,1608.35,1659.14,
HC PR 26990 Drainage of Pelvis Lesion,PX-97510930,CDM,26990,CPT,975,RC,,outpatient,,,1693,1523.7,,0.95,,1608.35,Percent of total billed charges,,,0.98,,1659.14,Percent of total billed charges,,,0.95,,1608.35,Percent of total billed charges,,,0.95,,1608.35,Percent of total billed charges,,,0.97,,1642.21,Percent of total billed charges,,,0.96,,1625.28,Percent of total billed charges,,,0.95,,1608.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1608.35,Percent of total billed charges,,1608.35,1659.14,
HC PR 27047 Exc Hip/Pelvis Les Sc < 3 Cm,PX-97510931,CDM,27047,CPT,975,RC,,inpatient,,,1228,1105.2,,0.95,,1166.6,Percent of total billed charges,,,0.98,,1203.44,Percent of total billed charges,,,0.95,,1166.6,Percent of total billed charges,,,0.97,,1191.16,Percent of total billed charges,,,0.97,,1191.16,Percent of total billed charges,,,0.96,,1178.88,Percent of total billed charges,,,0.95,,1166.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1166.6,Percent of total billed charges,,1166.6,1203.44,
HC PR 27047 Exc Hip/Pelvis Les Sc < 3 Cm,PX-97510931,CDM,27047,CPT,975,RC,,outpatient,,,1228,1105.2,,0.95,,1166.6,Percent of total billed charges,,,0.98,,1203.44,Percent of total billed charges,,,0.95,,1166.6,Percent of total billed charges,,,0.95,,1166.6,Percent of total billed charges,,,0.97,,1191.16,Percent of total billed charges,,,0.96,,1178.88,Percent of total billed charges,,,0.95,,1166.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1166.6,Percent of total billed charges,,1166.6,1203.44,
HC PR 27245 Tx Inter/PR/Subtrchntric Fem Fx Imed Implt Screw Cdm,PX-97510937,CDM,27245,CPT,975,RC,,inpatient,,,3025,2722.5,,0.95,,2873.75,Percent of total billed charges,,,0.98,,2964.5,Percent of total billed charges,,,0.95,,2873.75,Percent of total billed charges,,,0.97,,2934.25,Percent of total billed charges,,,0.97,,2934.25,Percent of total billed charges,,,0.96,,2904,Percent of total billed charges,,,0.95,,2873.75,Percent of total billed charges,,,,,,,,,0.95,,2873.75,Percent of total billed charges,,2873.75,2964.5,
HC PR 27245 Tx Inter/PR/Subtrchntric Fem Fx Imed Implt Screw Cdm,PX-97510937,CDM,27245,CPT,975,RC,,outpatient,,,3025,2722.5,,0.95,,2873.75,Percent of total billed charges,,,0.98,,2964.5,Percent of total billed charges,,,0.95,,2873.75,Percent of total billed charges,,,0.95,,2873.75,Percent of total billed charges,,,0.97,,2934.25,Percent of total billed charges,,,0.96,,2904,Percent of total billed charges,,,0.95,,2873.75,Percent of total billed charges,,,,,,,,,0.95,,2873.75,Percent of total billed charges,,2873.75,2964.5,
HC PR ED 24500 Treat Humerus Fx W/O Manip Cdm,PX-98110701,CDM,24500,CPT,981,RC,,inpatient,,,1284,1155.6,,0.95,,1219.8,Percent of total billed charges,,,0.98,,1258.32,Percent of total billed charges,,,0.95,,1219.8,Percent of total billed charges,,,0.97,,1245.48,Percent of total billed charges,,,0.97,,1245.48,Percent of total billed charges,,,0.96,,1232.64,Percent of total billed charges,,,0.95,,1219.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1219.8,Percent of total billed charges,,1219.8,1258.32,
HC PR ED 24500 Treat Humerus Fx W/O Manip Cdm,PX-98110701,CDM,24500,CPT,981,RC,,outpatient,,,1284,1155.6,,0.95,,1219.8,Percent of total billed charges,,,0.98,,1258.32,Percent of total billed charges,,,0.95,,1219.8,Percent of total billed charges,,,0.95,,1219.8,Percent of total billed charges,,,0.97,,1245.48,Percent of total billed charges,,,0.96,,1232.64,Percent of total billed charges,,,0.95,,1219.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1219.8,Percent of total billed charges,,1219.8,1258.32,
HC PR ED 24505 Treat Humerus Fx W/Manip Cdm,PX-98110703,CDM,24505,CPT,981,RC,,inpatient,,,1286,1157.4,,0.95,,1221.7,Percent of total billed charges,,,0.98,,1260.28,Percent of total billed charges,,,0.95,,1221.7,Percent of total billed charges,,,0.97,,1247.42,Percent of total billed charges,,,0.97,,1247.42,Percent of total billed charges,,,0.96,,1234.56,Percent of total billed charges,,,0.95,,1221.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1221.7,Percent of total billed charges,,1221.7,1260.28,
HC PR ED 24505 Treat Humerus Fx W/Manip Cdm,PX-98110703,CDM,24505,CPT,981,RC,,outpatient,,,1286,1157.4,,0.95,,1221.7,Percent of total billed charges,,,0.98,,1260.28,Percent of total billed charges,,,0.95,,1221.7,Percent of total billed charges,,,0.95,,1221.7,Percent of total billed charges,,,0.97,,1247.42,Percent of total billed charges,,,0.96,,1234.56,Percent of total billed charges,,,0.95,,1221.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1221.7,Percent of total billed charges,,1221.7,1260.28,
HC PR ED 24530 Treat Humerus Fracture Cdm,PX-98110704,CDM,24530,CPT,981,RC,,inpatient,,,1012,910.8,,0.95,,961.4,Percent of total billed charges,,,0.98,,991.76,Percent of total billed charges,,,0.95,,961.4,Percent of total billed charges,,,0.97,,981.64,Percent of total billed charges,,,0.97,,981.64,Percent of total billed charges,,,0.96,,971.52,Percent of total billed charges,,,0.95,,961.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,961.4,Percent of total billed charges,,961.4,991.76,
HC PR ED 24530 Treat Humerus Fracture Cdm,PX-98110704,CDM,24530,CPT,981,RC,,outpatient,,,1012,910.8,,0.95,,961.4,Percent of total billed charges,,,0.98,,991.76,Percent of total billed charges,,,0.95,,961.4,Percent of total billed charges,,,0.95,,961.4,Percent of total billed charges,,,0.97,,981.64,Percent of total billed charges,,,0.96,,971.52,Percent of total billed charges,,,0.95,,961.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,961.4,Percent of total billed charges,,961.4,991.76,
HC PR ED 24560 Treat Humerus Epicond Fracture Cdm,PX-98110707,CDM,24560,CPT,981,RC,,inpatient,,,1097,987.3,,0.95,,1042.15,Percent of total billed charges,,,0.98,,1075.06,Percent of total billed charges,,,0.95,,1042.15,Percent of total billed charges,,,0.97,,1064.09,Percent of total billed charges,,,0.97,,1064.09,Percent of total billed charges,,,0.96,,1053.12,Percent of total billed charges,,,0.95,,1042.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1042.15,Percent of total billed charges,,1042.15,1075.06,
HC PR ED 24560 Treat Humerus Epicond Fracture Cdm,PX-98110707,CDM,24560,CPT,981,RC,,outpatient,,,1097,987.3,,0.95,,1042.15,Percent of total billed charges,,,0.98,,1075.06,Percent of total billed charges,,,0.95,,1042.15,Percent of total billed charges,,,0.95,,1042.15,Percent of total billed charges,,,0.97,,1064.09,Percent of total billed charges,,,0.96,,1053.12,Percent of total billed charges,,,0.95,,1042.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1042.15,Percent of total billed charges,,1042.15,1075.06,
HC PR ED 24600 Treat Elbow Dislocation W/O Anesth Cdm,PX-98110713,CDM,24600,CPT,981,RC,,inpatient,,,1277,1149.3,,0.95,,1213.15,Percent of total billed charges,,,0.98,,1251.46,Percent of total billed charges,,,0.95,,1213.15,Percent of total billed charges,,,0.97,,1238.69,Percent of total billed charges,,,0.97,,1238.69,Percent of total billed charges,,,0.96,,1225.92,Percent of total billed charges,,,0.95,,1213.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1213.15,Percent of total billed charges,,1213.15,1251.46,
HC PR ED 24600 Treat Elbow Dislocation W/O Anesth Cdm,PX-98110713,CDM,24600,CPT,981,RC,,outpatient,,,1277,1149.3,,0.95,,1213.15,Percent of total billed charges,,,0.98,,1251.46,Percent of total billed charges,,,0.95,,1213.15,Percent of total billed charges,,,0.95,,1213.15,Percent of total billed charges,,,0.97,,1238.69,Percent of total billed charges,,,0.96,,1225.92,Percent of total billed charges,,,0.95,,1213.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1213.15,Percent of total billed charges,,1213.15,1251.46,
Treatment of closed elbow dislocation; requiring anesthesia,PX-98110714,CDM,24605,CPT,981,RC,,inpatient,,,1411,1269.9,,0.95,,1340.45,Percent of total billed charges,,,0.98,,1382.78,Percent of total billed charges,,,0.95,,1340.45,Percent of total billed charges,,,0.97,,1368.67,Percent of total billed charges,,,0.97,,1368.67,Percent of total billed charges,,,0.96,,1354.56,Percent of total billed charges,,,0.95,,1340.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1340.45,Percent of total billed charges,,1340.45,1382.78,
Treatment of closed elbow dislocation; requiring anesthesia,PX-98110714,CDM,24605,CPT,981,RC,,outpatient,,,1411,1269.9,,0.95,,1340.45,Percent of total billed charges,,,0.98,,1382.78,Percent of total billed charges,,,0.95,,1340.45,Percent of total billed charges,,,0.95,,1340.45,Percent of total billed charges,,,0.97,,1368.67,Percent of total billed charges,,,0.96,,1354.56,Percent of total billed charges,,,0.95,,1340.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1340.45,Percent of total billed charges,,1340.45,1382.78,
HC PR ED 24640 Closed Treat of Radial Head Subluxation W/Manip Cdm,PX-98110716,CDM,24640,CPT,981,RC,,inpatient,,,471,423.9,,0.95,,447.45,Percent of total billed charges,,,0.98,,461.58,Percent of total billed charges,,,0.95,,447.45,Percent of total billed charges,,,0.97,,456.87,Percent of total billed charges,,,0.97,,456.87,Percent of total billed charges,,,0.96,,452.16,Percent of total billed charges,,,0.95,,447.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,447.45,Percent of total billed charges,,447.45,461.58,
HC PR ED 24640 Closed Treat of Radial Head Subluxation W/Manip Cdm,PX-98110716,CDM,24640,CPT,981,RC,,outpatient,,,471,423.9,,0.95,,447.45,Percent of total billed charges,,,0.98,,461.58,Percent of total billed charges,,,0.95,,447.45,Percent of total billed charges,,,0.95,,447.45,Percent of total billed charges,,,0.97,,456.87,Percent of total billed charges,,,0.96,,452.16,Percent of total billed charges,,,0.95,,447.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,447.45,Percent of total billed charges,,447.45,461.58,
HC PR ED 24650 Treat Radius Fracture Cdm,PX-98110718,CDM,24650,CPT,981,RC,,inpatient,,,1006,905.4,,0.95,,955.7,Percent of total billed charges,,,0.98,,985.88,Percent of total billed charges,,,0.95,,955.7,Percent of total billed charges,,,0.97,,975.82,Percent of total billed charges,,,0.97,,975.82,Percent of total billed charges,,,0.96,,965.76,Percent of total billed charges,,,0.95,,955.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,955.7,Percent of total billed charges,,955.7,985.88,
HC PR ED 24650 Treat Radius Fracture Cdm,PX-98110718,CDM,24650,CPT,981,RC,,outpatient,,,1006,905.4,,0.95,,955.7,Percent of total billed charges,,,0.98,,985.88,Percent of total billed charges,,,0.95,,955.7,Percent of total billed charges,,,0.95,,955.7,Percent of total billed charges,,,0.97,,975.82,Percent of total billed charges,,,0.96,,965.76,Percent of total billed charges,,,0.95,,955.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,955.7,Percent of total billed charges,,955.7,985.88,
HC PR ED 24670 Treat Ulnar Fracture Cdm,PX-98110722,CDM,24670,CPT,981,RC,,inpatient,,,582,523.8,,0.95,,552.9,Percent of total billed charges,,,0.98,,570.36,Percent of total billed charges,,,0.95,,552.9,Percent of total billed charges,,,0.97,,564.54,Percent of total billed charges,,,0.97,,564.54,Percent of total billed charges,,,0.96,,558.72,Percent of total billed charges,,,0.95,,552.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,552.9,Percent of total billed charges,,552.9,570.36,
HC PR ED 24670 Treat Ulnar Fracture Cdm,PX-98110722,CDM,24670,CPT,981,RC,,outpatient,,,582,523.8,,0.95,,552.9,Percent of total billed charges,,,0.98,,570.36,Percent of total billed charges,,,0.95,,552.9,Percent of total billed charges,,,0.95,,552.9,Percent of total billed charges,,,0.97,,564.54,Percent of total billed charges,,,0.96,,558.72,Percent of total billed charges,,,0.95,,552.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,552.9,Percent of total billed charges,,552.9,570.36,
HC PR ED 25260 Repair Forearm Tendon/Muscle Cdm,PX-98110726,CDM,25260,CPT,981,RC,,inpatient,,,3090,2781,,0.95,,2935.5,Percent of total billed charges,,,0.98,,3028.2,Percent of total billed charges,,,0.95,,2935.5,Percent of total billed charges,,,0.97,,2997.3,Percent of total billed charges,,,0.97,,2997.3,Percent of total billed charges,,,0.96,,2966.4,Percent of total billed charges,,,0.95,,2935.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2935.5,Percent of total billed charges,,2935.5,3028.2,
HC PR ED 25260 Repair Forearm Tendon/Muscle Cdm,PX-98110726,CDM,25260,CPT,981,RC,,outpatient,,,3090,2781,,0.95,,2935.5,Percent of total billed charges,,,0.98,,3028.2,Percent of total billed charges,,,0.95,,2935.5,Percent of total billed charges,,,0.95,,2935.5,Percent of total billed charges,,,0.97,,2997.3,Percent of total billed charges,,,0.96,,2966.4,Percent of total billed charges,,,0.95,,2935.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2935.5,Percent of total billed charges,,2935.5,3028.2,
HC PR 25500 Treat Fractue of Radius W/O Manipulation,PX-98110730,CDM,25500,CPT,975,RC,,inpatient,,,1057,951.3,,0.95,,1004.15,Percent of total billed charges,,,0.98,,1035.86,Percent of total billed charges,,,0.95,,1004.15,Percent of total billed charges,,,0.97,,1025.29,Percent of total billed charges,,,0.97,,1025.29,Percent of total billed charges,,,0.96,,1014.72,Percent of total billed charges,,,0.95,,1004.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1004.15,Percent of total billed charges,,1004.15,1035.86,
HC PR 25500 Treat Fractue of Radius W/O Manipulation,PX-98110730,CDM,25500,CPT,975,RC,,outpatient,,,1057,951.3,,0.95,,1004.15,Percent of total billed charges,,,0.98,,1035.86,Percent of total billed charges,,,0.95,,1004.15,Percent of total billed charges,,,0.95,,1004.15,Percent of total billed charges,,,0.97,,1025.29,Percent of total billed charges,,,0.96,,1014.72,Percent of total billed charges,,,0.95,,1004.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1004.15,Percent of total billed charges,,1004.15,1035.86,
HC PR ED 25530 Treat Fracture of Ulna Cdm,PX-98110734,CDM,25530,CPT,981,RC,,inpatient,,,994,894.6,,0.95,,944.3,Percent of total billed charges,,,0.98,,974.12,Percent of total billed charges,,,0.95,,944.3,Percent of total billed charges,,,0.97,,964.18,Percent of total billed charges,,,0.97,,964.18,Percent of total billed charges,,,0.96,,954.24,Percent of total billed charges,,,0.95,,944.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,944.3,Percent of total billed charges,,944.3,974.12,
HC PR ED 25530 Treat Fracture of Ulna Cdm,PX-98110734,CDM,25530,CPT,981,RC,,outpatient,,,994,894.6,,0.95,,944.3,Percent of total billed charges,,,0.98,,974.12,Percent of total billed charges,,,0.95,,944.3,Percent of total billed charges,,,0.95,,944.3,Percent of total billed charges,,,0.97,,964.18,Percent of total billed charges,,,0.96,,954.24,Percent of total billed charges,,,0.95,,944.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,944.3,Percent of total billed charges,,944.3,974.12,
HC PR ED 25565 Treat Fracture Radius & Ulna W/Manipulation Cdm,PX-98110740,CDM,25565,CPT,981,RC,,inpatient,,,2011,1809.9,,0.95,,1910.45,Percent of total billed charges,,,0.98,,1970.78,Percent of total billed charges,,,0.95,,1910.45,Percent of total billed charges,,,0.97,,1950.67,Percent of total billed charges,,,0.97,,1950.67,Percent of total billed charges,,,0.96,,1930.56,Percent of total billed charges,,,0.95,,1910.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1910.45,Percent of total billed charges,,1910.45,1970.78,
HC PR ED 25565 Treat Fracture Radius & Ulna W/Manipulation Cdm,PX-98110740,CDM,25565,CPT,981,RC,,outpatient,,,2011,1809.9,,0.95,,1910.45,Percent of total billed charges,,,0.98,,1970.78,Percent of total billed charges,,,0.95,,1910.45,Percent of total billed charges,,,0.95,,1910.45,Percent of total billed charges,,,0.97,,1950.67,Percent of total billed charges,,,0.96,,1930.56,Percent of total billed charges,,,0.95,,1910.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1910.45,Percent of total billed charges,,1910.45,1970.78,
HC PR ED 25600 Treat Distal Radial Fracture Radius/Una W/O Manip Cdm,PX-98110742,CDM,25600,CPT,981,RC,,inpatient,,,1243,1118.7,,0.95,,1180.85,Percent of total billed charges,,,0.98,,1218.14,Percent of total billed charges,,,0.95,,1180.85,Percent of total billed charges,,,0.97,,1205.71,Percent of total billed charges,,,0.97,,1205.71,Percent of total billed charges,,,0.96,,1193.28,Percent of total billed charges,,,0.95,,1180.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1180.85,Percent of total billed charges,,1180.85,1218.14,
HC PR ED 25600 Treat Distal Radial Fracture Radius/Una W/O Manip Cdm,PX-98110742,CDM,25600,CPT,981,RC,,outpatient,,,1243,1118.7,,0.95,,1180.85,Percent of total billed charges,,,0.98,,1218.14,Percent of total billed charges,,,0.95,,1180.85,Percent of total billed charges,,,0.95,,1180.85,Percent of total billed charges,,,0.97,,1205.71,Percent of total billed charges,,,0.96,,1193.28,Percent of total billed charges,,,0.95,,1180.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1180.85,Percent of total billed charges,,1180.85,1218.14,
HC PR ED 25605 Cltx Dstl Rdl Fx/Epiphysl Sep W/Manj When Perf Cdm,PX-98110744,CDM,25605,CPT,981,RC,,inpatient,,,2166,1949.4,,0.95,,2057.7,Percent of total billed charges,,,0.98,,2122.68,Percent of total billed charges,,,0.95,,2057.7,Percent of total billed charges,,,0.97,,2101.02,Percent of total billed charges,,,0.97,,2101.02,Percent of total billed charges,,,0.96,,2079.36,Percent of total billed charges,,,0.95,,2057.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2057.7,Percent of total billed charges,,2057.7,2122.68,
HC PR ED 25605 Cltx Dstl Rdl Fx/Epiphysl Sep W/Manj When Perf Cdm,PX-98110744,CDM,25605,CPT,981,RC,,outpatient,,,2166,1949.4,,0.95,,2057.7,Percent of total billed charges,,,0.98,,2122.68,Percent of total billed charges,,,0.95,,2057.7,Percent of total billed charges,,,0.95,,2057.7,Percent of total billed charges,,,0.97,,2101.02,Percent of total billed charges,,,0.96,,2079.36,Percent of total billed charges,,,0.95,,2057.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2057.7,Percent of total billed charges,,2057.7,2122.68,
HC PR ED 25622 Treat Wrist Bone Fracture Cdm,PX-98110746,CDM,25622,CPT,981,RC,,inpatient,,,1025,922.5,,0.95,,973.75,Percent of total billed charges,,,0.98,,1004.5,Percent of total billed charges,,,0.95,,973.75,Percent of total billed charges,,,0.97,,994.25,Percent of total billed charges,,,0.97,,994.25,Percent of total billed charges,,,0.96,,984,Percent of total billed charges,,,0.95,,973.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,973.75,Percent of total billed charges,,973.75,1004.5,
HC PR ED 25622 Treat Wrist Bone Fracture Cdm,PX-98110746,CDM,25622,CPT,981,RC,,outpatient,,,1025,922.5,,0.95,,973.75,Percent of total billed charges,,,0.98,,1004.5,Percent of total billed charges,,,0.95,,973.75,Percent of total billed charges,,,0.95,,973.75,Percent of total billed charges,,,0.97,,994.25,Percent of total billed charges,,,0.96,,984,Percent of total billed charges,,,0.95,,973.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,973.75,Percent of total billed charges,,973.75,1004.5,
HC PR ED 25630 Treat Carpal Bone Fracture W/O Manip Each Bone Cdm,PX-98110750,CDM,25630,CPT,981,RC,,inpatient,,,1044,939.6,,0.95,,991.8,Percent of total billed charges,,,0.98,,1023.12,Percent of total billed charges,,,0.95,,991.8,Percent of total billed charges,,,0.97,,1012.68,Percent of total billed charges,,,0.97,,1012.68,Percent of total billed charges,,,0.96,,1002.24,Percent of total billed charges,,,0.95,,991.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,991.8,Percent of total billed charges,,991.8,1023.12,
HC PR ED 25630 Treat Carpal Bone Fracture W/O Manip Each Bone Cdm,PX-98110750,CDM,25630,CPT,981,RC,,outpatient,,,1044,939.6,,0.95,,991.8,Percent of total billed charges,,,0.98,,1023.12,Percent of total billed charges,,,0.95,,991.8,Percent of total billed charges,,,0.95,,991.8,Percent of total billed charges,,,0.97,,1012.68,Percent of total billed charges,,,0.96,,1002.24,Percent of total billed charges,,,0.95,,991.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,991.8,Percent of total billed charges,,991.8,1023.12,
HC PR ED 25650 Treat Ulnar Styloid Fracture Cdm,PX-98110754,CDM,25650,CPT,981,RC,,inpatient,,,1256,1130.4,,0.95,,1193.2,Percent of total billed charges,,,0.98,,1230.88,Percent of total billed charges,,,0.95,,1193.2,Percent of total billed charges,,,0.97,,1218.32,Percent of total billed charges,,,0.97,,1218.32,Percent of total billed charges,,,0.96,,1205.76,Percent of total billed charges,,,0.95,,1193.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1193.2,Percent of total billed charges,,1193.2,1230.88,
HC PR ED 25650 Treat Ulnar Styloid Fracture Cdm,PX-98110754,CDM,25650,CPT,981,RC,,outpatient,,,1256,1130.4,,0.95,,1193.2,Percent of total billed charges,,,0.98,,1230.88,Percent of total billed charges,,,0.95,,1193.2,Percent of total billed charges,,,0.95,,1193.2,Percent of total billed charges,,,0.97,,1218.32,Percent of total billed charges,,,0.96,,1205.76,Percent of total billed charges,,,0.95,,1193.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1193.2,Percent of total billed charges,,1193.2,1230.88,
HC PR ED 25660 Treat Wrist Dislocation W/Manipulation Cdm,PX-98110756,CDM,25660,CPT,981,RC,,inpatient,,,1344,1209.6,,0.95,,1276.8,Percent of total billed charges,,,0.98,,1317.12,Percent of total billed charges,,,0.95,,1276.8,Percent of total billed charges,,,0.97,,1303.68,Percent of total billed charges,,,0.97,,1303.68,Percent of total billed charges,,,0.96,,1290.24,Percent of total billed charges,,,0.95,,1276.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1276.8,Percent of total billed charges,,1276.8,1317.12,
HC PR ED 25660 Treat Wrist Dislocation W/Manipulation Cdm,PX-98110756,CDM,25660,CPT,981,RC,,outpatient,,,1344,1209.6,,0.95,,1276.8,Percent of total billed charges,,,0.98,,1317.12,Percent of total billed charges,,,0.95,,1276.8,Percent of total billed charges,,,0.95,,1276.8,Percent of total billed charges,,,0.97,,1303.68,Percent of total billed charges,,,0.96,,1290.24,Percent of total billed charges,,,0.95,,1276.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1276.8,Percent of total billed charges,,1276.8,1317.12,
HC PR ED 26010 Drainage of Finger Abscess - Smpl Cdm,PX-98110761,CDM,26010,CPT,981,RC,,inpatient,,,849,764.1,,0.95,,806.55,Percent of total billed charges,,,0.98,,832.02,Percent of total billed charges,,,0.95,,806.55,Percent of total billed charges,,,0.97,,823.53,Percent of total billed charges,,,0.97,,823.53,Percent of total billed charges,,,0.96,,815.04,Percent of total billed charges,,,0.95,,806.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,806.55,Percent of total billed charges,,806.55,832.02,
HC PR ED 26010 Drainage of Finger Abscess - Smpl Cdm,PX-98110761,CDM,26010,CPT,981,RC,,outpatient,,,849,764.1,,0.95,,806.55,Percent of total billed charges,,,0.98,,832.02,Percent of total billed charges,,,0.95,,806.55,Percent of total billed charges,,,0.95,,806.55,Percent of total billed charges,,,0.97,,823.53,Percent of total billed charges,,,0.96,,815.04,Percent of total billed charges,,,0.95,,806.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,806.55,Percent of total billed charges,,806.55,832.02,
HC PR ED 26350 Repair Finger/Hand Tendon Cdm,PX-98110763,CDM,26350,CPT,981,RC,,inpatient,,,1860,1674,,0.95,,1767,Percent of total billed charges,,,0.98,,1822.8,Percent of total billed charges,,,0.95,,1767,Percent of total billed charges,,,0.97,,1804.2,Percent of total billed charges,,,0.97,,1804.2,Percent of total billed charges,,,0.96,,1785.6,Percent of total billed charges,,,0.95,,1767,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1767,Percent of total billed charges,,1767,1822.8,
HC PR ED 26350 Repair Finger/Hand Tendon Cdm,PX-98110763,CDM,26350,CPT,981,RC,,outpatient,,,1860,1674,,0.95,,1767,Percent of total billed charges,,,0.98,,1822.8,Percent of total billed charges,,,0.95,,1767,Percent of total billed charges,,,0.95,,1767,Percent of total billed charges,,,0.97,,1804.2,Percent of total billed charges,,,0.96,,1785.6,Percent of total billed charges,,,0.95,,1767,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1767,Percent of total billed charges,,1767,1822.8,
HC PR ED 26410 Repair Extensor Tendon Hand W/Ograft Cdm,PX-98110765,CDM,26410,CPT,981,RC,,inpatient,,,2190,1971,,0.95,,2080.5,Percent of total billed charges,,,0.98,,2146.2,Percent of total billed charges,,,0.95,,2080.5,Percent of total billed charges,,,0.97,,2124.3,Percent of total billed charges,,,0.97,,2124.3,Percent of total billed charges,,,0.96,,2102.4,Percent of total billed charges,,,0.95,,2080.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2080.5,Percent of total billed charges,,2080.5,2146.2,
HC PR ED 26410 Repair Extensor Tendon Hand W/Ograft Cdm,PX-98110765,CDM,26410,CPT,981,RC,,outpatient,,,2190,1971,,0.95,,2080.5,Percent of total billed charges,,,0.98,,2146.2,Percent of total billed charges,,,0.95,,2080.5,Percent of total billed charges,,,0.95,,2080.5,Percent of total billed charges,,,0.97,,2124.3,Percent of total billed charges,,,0.96,,2102.4,Percent of total billed charges,,,0.95,,2080.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2080.5,Percent of total billed charges,,2080.5,2146.2,
HC PR ED 26418 Repair of Extensor Tendon Finger W/O Graft Cdm,PX-98110767,CDM,26418,CPT,981,RC,,inpatient,,,2113,1901.7,,0.95,,2007.35,Percent of total billed charges,,,0.98,,2070.74,Percent of total billed charges,,,0.95,,2007.35,Percent of total billed charges,,,0.97,,2049.61,Percent of total billed charges,,,0.97,,2049.61,Percent of total billed charges,,,0.96,,2028.48,Percent of total billed charges,,,0.95,,2007.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2007.35,Percent of total billed charges,,2007.35,2070.74,
HC PR ED 26418 Repair of Extensor Tendon Finger W/O Graft Cdm,PX-98110767,CDM,26418,CPT,981,RC,,outpatient,,,2113,1901.7,,0.95,,2007.35,Percent of total billed charges,,,0.98,,2070.74,Percent of total billed charges,,,0.95,,2007.35,Percent of total billed charges,,,0.95,,2007.35,Percent of total billed charges,,,0.97,,2049.61,Percent of total billed charges,,,0.96,,2028.48,Percent of total billed charges,,,0.95,,2007.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2007.35,Percent of total billed charges,,2007.35,2070.74,
HC PR ED 26600 Treat Metacarpal Fracture Single W/O Manip Cdm,PX-98110771,CDM,26600,CPT,981,RC,,inpatient,,,870,783,,0.95,,826.5,Percent of total billed charges,,,0.98,,852.6,Percent of total billed charges,,,0.95,,826.5,Percent of total billed charges,,,0.97,,843.9,Percent of total billed charges,,,0.97,,843.9,Percent of total billed charges,,,0.96,,835.2,Percent of total billed charges,,,0.95,,826.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,826.5,Percent of total billed charges,,826.5,852.6,
HC PR ED 26600 Treat Metacarpal Fracture Single W/O Manip Cdm,PX-98110771,CDM,26600,CPT,981,RC,,outpatient,,,870,783,,0.95,,826.5,Percent of total billed charges,,,0.98,,852.6,Percent of total billed charges,,,0.95,,826.5,Percent of total billed charges,,,0.95,,826.5,Percent of total billed charges,,,0.97,,843.9,Percent of total billed charges,,,0.96,,835.2,Percent of total billed charges,,,0.95,,826.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,826.5,Percent of total billed charges,,826.5,852.6,
HC PR ED 26605 Treat Metacarpal Fracture Single W/Manip Cdm,PX-98110773,CDM,26605,CPT,981,RC,,inpatient,,,987,888.3,,0.95,,937.65,Percent of total billed charges,,,0.98,,967.26,Percent of total billed charges,,,0.95,,937.65,Percent of total billed charges,,,0.97,,957.39,Percent of total billed charges,,,0.97,,957.39,Percent of total billed charges,,,0.96,,947.52,Percent of total billed charges,,,0.95,,937.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,937.65,Percent of total billed charges,,937.65,967.26,
HC PR ED 26605 Treat Metacarpal Fracture Single W/Manip Cdm,PX-98110773,CDM,26605,CPT,981,RC,,outpatient,,,987,888.3,,0.95,,937.65,Percent of total billed charges,,,0.98,,967.26,Percent of total billed charges,,,0.95,,937.65,Percent of total billed charges,,,0.95,,937.65,Percent of total billed charges,,,0.97,,957.39,Percent of total billed charges,,,0.96,,947.52,Percent of total billed charges,,,0.95,,937.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,937.65,Percent of total billed charges,,937.65,967.26,
HC PR ED 26641 Treat Carpometacarpal Dislocation W/Manip Cdm,PX-98110775,CDM,26641,CPT,981,RC,,inpatient,,,1185,1066.5,,0.95,,1125.75,Percent of total billed charges,,,0.98,,1161.3,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,0.97,,1149.45,Percent of total billed charges,,,0.97,,1149.45,Percent of total billed charges,,,0.96,,1137.6,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1125.75,Percent of total billed charges,,1125.75,1161.3,
HC PR ED 26641 Treat Carpometacarpal Dislocation W/Manip Cdm,PX-98110775,CDM,26641,CPT,981,RC,,outpatient,,,1185,1066.5,,0.95,,1125.75,Percent of total billed charges,,,0.98,,1161.3,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,0.97,,1149.45,Percent of total billed charges,,,0.96,,1137.6,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1125.75,Percent of total billed charges,,1125.75,1161.3,
HC PR ED 26645 Tx Carpometacarpal Fracture/Dislocation W/Manip Cdm,PX-98110777,CDM,26645,CPT,981,RC,,inpatient,,,1254,1128.6,,0.95,,1191.3,Percent of total billed charges,,,0.98,,1228.92,Percent of total billed charges,,,0.95,,1191.3,Percent of total billed charges,,,0.97,,1216.38,Percent of total billed charges,,,0.97,,1216.38,Percent of total billed charges,,,0.96,,1203.84,Percent of total billed charges,,,0.95,,1191.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1191.3,Percent of total billed charges,,1191.3,1228.92,
HC PR ED 26645 Tx Carpometacarpal Fracture/Dislocation W/Manip Cdm,PX-98110777,CDM,26645,CPT,981,RC,,outpatient,,,1254,1128.6,,0.95,,1191.3,Percent of total billed charges,,,0.98,,1228.92,Percent of total billed charges,,,0.95,,1191.3,Percent of total billed charges,,,0.95,,1191.3,Percent of total billed charges,,,0.97,,1216.38,Percent of total billed charges,,,0.96,,1203.84,Percent of total billed charges,,,0.95,,1191.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1191.3,Percent of total billed charges,,1191.3,1228.92,
HC PR ED 26670 Cltx Carpo/Metacarpl Dislc Not Thmb Manj Ea W/O Anes Cdm,PX-98110779,CDM,26670,CPT,981,RC,,inpatient,,,1045,940.5,,0.95,,992.75,Percent of total billed charges,,,0.98,,1024.1,Percent of total billed charges,,,0.95,,992.75,Percent of total billed charges,,,0.97,,1013.65,Percent of total billed charges,,,0.97,,1013.65,Percent of total billed charges,,,0.96,,1003.2,Percent of total billed charges,,,0.95,,992.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,992.75,Percent of total billed charges,,992.75,1024.1,
HC PR ED 26670 Cltx Carpo/Metacarpl Dislc Not Thmb Manj Ea W/O Anes Cdm,PX-98110779,CDM,26670,CPT,981,RC,,outpatient,,,1045,940.5,,0.95,,992.75,Percent of total billed charges,,,0.98,,1024.1,Percent of total billed charges,,,0.95,,992.75,Percent of total billed charges,,,0.95,,992.75,Percent of total billed charges,,,0.97,,1013.65,Percent of total billed charges,,,0.96,,1003.2,Percent of total billed charges,,,0.95,,992.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,992.75,Percent of total billed charges,,992.75,1024.1,
HC PR ED 26720 Closed Tx Phalangeal Shaft Fracture Fing or Thmb W/O MA Cdm,PX-98110783,CDM,26720,CPT,981,RC,,inpatient,,,688,619.2,,0.95,,653.6,Percent of total billed charges,,,0.98,,674.24,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,0.97,,667.36,Percent of total billed charges,,,0.97,,667.36,Percent of total billed charges,,,0.96,,660.48,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,653.6,Percent of total billed charges,,653.6,674.24,
HC PR ED 26720 Closed Tx Phalangeal Shaft Fracture Fing or Thmb W/O MA Cdm,PX-98110783,CDM,26720,CPT,981,RC,,outpatient,,,688,619.2,,0.95,,653.6,Percent of total billed charges,,,0.98,,674.24,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,0.97,,667.36,Percent of total billed charges,,,0.96,,660.48,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,653.6,Percent of total billed charges,,653.6,674.24,
HC PR ED 26725 Closed Tx Phalangeal Shaft Fracture Fing or Thmb W/Mani Cdm,PX-98110786,CDM,26725,CPT,981,RC,,inpatient,,,977,879.3,,0.95,,928.15,Percent of total billed charges,,,0.98,,957.46,Percent of total billed charges,,,0.95,,928.15,Percent of total billed charges,,,0.97,,947.69,Percent of total billed charges,,,0.97,,947.69,Percent of total billed charges,,,0.96,,937.92,Percent of total billed charges,,,0.95,,928.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,928.15,Percent of total billed charges,,928.15,957.46,
HC PR ED 26725 Closed Tx Phalangeal Shaft Fracture Fing or Thmb W/Mani Cdm,PX-98110786,CDM,26725,CPT,981,RC,,outpatient,,,977,879.3,,0.95,,928.15,Percent of total billed charges,,,0.98,,957.46,Percent of total billed charges,,,0.95,,928.15,Percent of total billed charges,,,0.95,,928.15,Percent of total billed charges,,,0.97,,947.69,Percent of total billed charges,,,0.96,,937.92,Percent of total billed charges,,,0.95,,928.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,928.15,Percent of total billed charges,,928.15,957.46,
HC PR ED 26740 Closed Tx Articular Fracture W/O Manip Cdm,PX-98110788,CDM,26740,CPT,981,RC,,inpatient,,,937,843.3,,0.95,,890.15,Percent of total billed charges,,,0.98,,918.26,Percent of total billed charges,,,0.95,,890.15,Percent of total billed charges,,,0.97,,908.89,Percent of total billed charges,,,0.97,,908.89,Percent of total billed charges,,,0.96,,899.52,Percent of total billed charges,,,0.95,,890.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,890.15,Percent of total billed charges,,890.15,918.26,
HC PR ED 26740 Closed Tx Articular Fracture W/O Manip Cdm,PX-98110788,CDM,26740,CPT,981,RC,,outpatient,,,937,843.3,,0.95,,890.15,Percent of total billed charges,,,0.98,,918.26,Percent of total billed charges,,,0.95,,890.15,Percent of total billed charges,,,0.95,,890.15,Percent of total billed charges,,,0.97,,908.89,Percent of total billed charges,,,0.96,,899.52,Percent of total billed charges,,,0.95,,890.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,890.15,Percent of total billed charges,,890.15,918.26,
HC PR ED 26742 Closed Tx Articular Fracture W/Manip Cdm,PX-98110790,CDM,26742,CPT,981,RC,,inpatient,,,1268,1141.2,,0.95,,1204.6,Percent of total billed charges,,,0.98,,1242.64,Percent of total billed charges,,,0.95,,1204.6,Percent of total billed charges,,,0.97,,1229.96,Percent of total billed charges,,,0.97,,1229.96,Percent of total billed charges,,,0.96,,1217.28,Percent of total billed charges,,,0.95,,1204.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1204.6,Percent of total billed charges,,1204.6,1242.64,
HC PR ED 26742 Closed Tx Articular Fracture W/Manip Cdm,PX-98110790,CDM,26742,CPT,981,RC,,outpatient,,,1268,1141.2,,0.95,,1204.6,Percent of total billed charges,,,0.98,,1242.64,Percent of total billed charges,,,0.95,,1204.6,Percent of total billed charges,,,0.95,,1204.6,Percent of total billed charges,,,0.97,,1229.96,Percent of total billed charges,,,0.96,,1217.28,Percent of total billed charges,,,0.95,,1204.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1204.6,Percent of total billed charges,,1204.6,1242.64,
HC PR ED 26750 Closed Tx Distal Phalangeal Fracture Fing/Thmb W/O Mani Cdm,PX-98110792,CDM,26750,CPT,981,RC,,inpatient,,,635,571.5,,0.95,,603.25,Percent of total billed charges,,,0.98,,622.3,Percent of total billed charges,,,0.95,,603.25,Percent of total billed charges,,,0.97,,615.95,Percent of total billed charges,,,0.97,,615.95,Percent of total billed charges,,,0.96,,609.6,Percent of total billed charges,,,0.95,,603.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,603.25,Percent of total billed charges,,603.25,622.3,
HC PR ED 26750 Closed Tx Distal Phalangeal Fracture Fing/Thmb W/O Mani Cdm,PX-98110792,CDM,26750,CPT,981,RC,,outpatient,,,635,571.5,,0.95,,603.25,Percent of total billed charges,,,0.98,,622.3,Percent of total billed charges,,,0.95,,603.25,Percent of total billed charges,,,0.95,,603.25,Percent of total billed charges,,,0.97,,615.95,Percent of total billed charges,,,0.96,,609.6,Percent of total billed charges,,,0.95,,603.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,603.25,Percent of total billed charges,,603.25,622.3,
HC PR ED 26755 Closed Tx Distal Phalangeal Fracture Fing/Thmb W/Manip Cdm,PX-98110794,CDM,26755,CPT,981,RC,,inpatient,,,820,738,,0.95,,779,Percent of total billed charges,,,0.98,,803.6,Percent of total billed charges,,,0.95,,779,Percent of total billed charges,,,0.97,,795.4,Percent of total billed charges,,,0.97,,795.4,Percent of total billed charges,,,0.96,,787.2,Percent of total billed charges,,,0.95,,779,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,779,Percent of total billed charges,,779,803.6,
HC PR ED 26755 Closed Tx Distal Phalangeal Fracture Fing/Thmb W/Manip Cdm,PX-98110794,CDM,26755,CPT,981,RC,,outpatient,,,820,738,,0.95,,779,Percent of total billed charges,,,0.98,,803.6,Percent of total billed charges,,,0.95,,779,Percent of total billed charges,,,0.95,,779,Percent of total billed charges,,,0.97,,795.4,Percent of total billed charges,,,0.96,,787.2,Percent of total billed charges,,,0.95,,779,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,779,Percent of total billed charges,,779,803.6,
HC PR ED 26765 Open Tx Distal Phalangeal Fracture Finger/Thumb Ea Cdm,PX-98110795,CDM,26765,CPT,981,RC,,inpatient,,,1268,1141.2,,0.95,,1204.6,Percent of total billed charges,,,0.98,,1242.64,Percent of total billed charges,,,0.95,,1204.6,Percent of total billed charges,,,0.97,,1229.96,Percent of total billed charges,,,0.97,,1229.96,Percent of total billed charges,,,0.96,,1217.28,Percent of total billed charges,,,0.95,,1204.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1204.6,Percent of total billed charges,,1204.6,1242.64,
HC PR ED 26765 Open Tx Distal Phalangeal Fracture Finger/Thumb Ea Cdm,PX-98110795,CDM,26765,CPT,981,RC,,outpatient,,,1268,1141.2,,0.95,,1204.6,Percent of total billed charges,,,0.98,,1242.64,Percent of total billed charges,,,0.95,,1204.6,Percent of total billed charges,,,0.95,,1204.6,Percent of total billed charges,,,0.97,,1229.96,Percent of total billed charges,,,0.96,,1217.28,Percent of total billed charges,,,0.95,,1204.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1204.6,Percent of total billed charges,,1204.6,1242.64,
HC PR ED 26770 Closed Tx Finger Dislocation W/O Anesth Cdm,PX-98110798,CDM,26770,CPT,981,RC,,inpatient,,,916,824.4,,0.95,,870.2,Percent of total billed charges,,,0.98,,897.68,Percent of total billed charges,,,0.95,,870.2,Percent of total billed charges,,,0.97,,888.52,Percent of total billed charges,,,0.97,,888.52,Percent of total billed charges,,,0.96,,879.36,Percent of total billed charges,,,0.95,,870.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,870.2,Percent of total billed charges,,870.2,897.68,
HC PR ED 26770 Closed Tx Finger Dislocation W/O Anesth Cdm,PX-98110798,CDM,26770,CPT,981,RC,,outpatient,,,916,824.4,,0.95,,870.2,Percent of total billed charges,,,0.98,,897.68,Percent of total billed charges,,,0.95,,870.2,Percent of total billed charges,,,0.95,,870.2,Percent of total billed charges,,,0.97,,888.52,Percent of total billed charges,,,0.96,,879.36,Percent of total billed charges,,,0.95,,870.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,870.2,Percent of total billed charges,,870.2,897.68,
HC PR ED 26775 Closed Tx Finger Dislocation W/Anesth Cdm,PX-98110800,CDM,26775,CPT,981,RC,,inpatient,,,1051,945.9,,0.95,,998.45,Percent of total billed charges,,,0.98,,1029.98,Percent of total billed charges,,,0.95,,998.45,Percent of total billed charges,,,0.97,,1019.47,Percent of total billed charges,,,0.97,,1019.47,Percent of total billed charges,,,0.96,,1008.96,Percent of total billed charges,,,0.95,,998.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,998.45,Percent of total billed charges,,998.45,1029.98,
HC PR ED 26775 Closed Tx Finger Dislocation W/Anesth Cdm,PX-98110800,CDM,26775,CPT,981,RC,,outpatient,,,1051,945.9,,0.95,,998.45,Percent of total billed charges,,,0.98,,1029.98,Percent of total billed charges,,,0.95,,998.45,Percent of total billed charges,,,0.95,,998.45,Percent of total billed charges,,,0.97,,1019.47,Percent of total billed charges,,,0.96,,1008.96,Percent of total billed charges,,,0.95,,998.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,998.45,Percent of total billed charges,,998.45,1029.98,
HC PR ED 26951 Amputate Finger/Thumb Single W/Direct Closure Cdm,PX-98110835,CDM,26951,CPT,981,RC,,inpatient,,,1427,1284.3,,0.95,,1355.65,Percent of total billed charges,,,0.98,,1398.46,Percent of total billed charges,,,0.95,,1355.65,Percent of total billed charges,,,0.97,,1384.19,Percent of total billed charges,,,0.97,,1384.19,Percent of total billed charges,,,0.96,,1369.92,Percent of total billed charges,,,0.95,,1355.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1355.65,Percent of total billed charges,,1355.65,1398.46,
HC PR ED 26951 Amputate Finger/Thumb Single W/Direct Closure Cdm,PX-98110835,CDM,26951,CPT,981,RC,,outpatient,,,1427,1284.3,,0.95,,1355.65,Percent of total billed charges,,,0.98,,1398.46,Percent of total billed charges,,,0.95,,1355.65,Percent of total billed charges,,,0.95,,1355.65,Percent of total billed charges,,,0.97,,1384.19,Percent of total billed charges,,,0.96,,1369.92,Percent of total billed charges,,,0.95,,1355.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1355.65,Percent of total billed charges,,1355.65,1398.46,
HC PR ED 27252 Closed Tx Hip Dislocation W/Anesth Cdm,PX-98110851,CDM,27252,CPT,981,RC,,inpatient,,,3402,3061.8,,0.95,,3231.9,Percent of total billed charges,,,0.98,,3333.96,Percent of total billed charges,,,0.95,,3231.9,Percent of total billed charges,,,0.97,,3299.94,Percent of total billed charges,,,0.97,,3299.94,Percent of total billed charges,,,0.96,,3265.92,Percent of total billed charges,,,0.95,,3231.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3231.9,Percent of total billed charges,,3231.9,3333.96,
HC PR ED 27252 Closed Tx Hip Dislocation W/Anesth Cdm,PX-98110851,CDM,27252,CPT,981,RC,,outpatient,,,3402,3061.8,,0.95,,3231.9,Percent of total billed charges,,,0.98,,3333.96,Percent of total billed charges,,,0.95,,3231.9,Percent of total billed charges,,,0.95,,3231.9,Percent of total billed charges,,,0.97,,3299.94,Percent of total billed charges,,,0.96,,3265.92,Percent of total billed charges,,,0.95,,3231.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3231.9,Percent of total billed charges,,3231.9,3333.96,
Closed treatment of dislocated hip prosthesis,PX-98110854,CDM,27265,CPT,981,RC,,inpatient,,,1357,1221.3,,0.95,,1289.15,Percent of total billed charges,,,0.98,,1329.86,Percent of total billed charges,,,0.95,,1289.15,Percent of total billed charges,,,0.97,,1316.29,Percent of total billed charges,,,0.97,,1316.29,Percent of total billed charges,,,0.96,,1302.72,Percent of total billed charges,,,0.95,,1289.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1289.15,Percent of total billed charges,,1289.15,1329.86,
Closed treatment of dislocated hip prosthesis,PX-98110854,CDM,27265,CPT,981,RC,,outpatient,,,1357,1221.3,,0.95,,1289.15,Percent of total billed charges,,,0.98,,1329.86,Percent of total billed charges,,,0.95,,1289.15,Percent of total billed charges,,,0.95,,1289.15,Percent of total billed charges,,,0.97,,1316.29,Percent of total billed charges,,,0.96,,1302.72,Percent of total billed charges,,,0.95,,1289.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1289.15,Percent of total billed charges,,1289.15,1329.86,
HC PR ED 27266 Tx Post Hip Arthroplasty Dislocation W/Anesth Cdm,PX-98110855,CDM,27266,CPT,981,RC,,inpatient,,,1877,1689.3,,0.95,,1783.15,Percent of total billed charges,,,0.98,,1839.46,Percent of total billed charges,,,0.95,,1783.15,Percent of total billed charges,,,0.97,,1820.69,Percent of total billed charges,,,0.97,,1820.69,Percent of total billed charges,,,0.96,,1801.92,Percent of total billed charges,,,0.95,,1783.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1783.15,Percent of total billed charges,,1783.15,1839.46,
HC PR ED 27266 Tx Post Hip Arthroplasty Dislocation W/Anesth Cdm,PX-98110855,CDM,27266,CPT,981,RC,,outpatient,,,1877,1689.3,,0.95,,1783.15,Percent of total billed charges,,,0.98,,1839.46,Percent of total billed charges,,,0.95,,1783.15,Percent of total billed charges,,,0.95,,1783.15,Percent of total billed charges,,,0.97,,1820.69,Percent of total billed charges,,,0.96,,1801.92,Percent of total billed charges,,,0.95,,1783.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1783.15,Percent of total billed charges,,1783.15,1839.46,
HC PR ED 26952 Amputate Finger/Thumb Single W/Local Adv Flaps Cdm,PX-98110858,CDM,26952,CPT,981,RC,,inpatient,,,1703,1532.7,,0.95,,1617.85,Percent of total billed charges,,,0.98,,1668.94,Percent of total billed charges,,,0.95,,1617.85,Percent of total billed charges,,,0.97,,1651.91,Percent of total billed charges,,,0.97,,1651.91,Percent of total billed charges,,,0.96,,1634.88,Percent of total billed charges,,,0.95,,1617.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1617.85,Percent of total billed charges,,1617.85,1668.94,
HC PR ED 26952 Amputate Finger/Thumb Single W/Local Adv Flaps Cdm,PX-98110858,CDM,26952,CPT,981,RC,,outpatient,,,1703,1532.7,,0.95,,1617.85,Percent of total billed charges,,,0.98,,1668.94,Percent of total billed charges,,,0.95,,1617.85,Percent of total billed charges,,,0.95,,1617.85,Percent of total billed charges,,,0.97,,1651.91,Percent of total billed charges,,,0.96,,1634.88,Percent of total billed charges,,,0.95,,1617.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1617.85,Percent of total billed charges,,1617.85,1668.94,
Placement of strapping to chest,PX-42010072,CDM,29200,CPT,420,RC,,inpatient,,,147,132.3,,0.95,,139.65,Percent of total billed charges,,,0.98,,144.06,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,0.97,,142.59,Percent of total billed charges,,,0.97,,142.59,Percent of total billed charges,,,0.96,,141.12,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,139.65,Percent of total billed charges,,139.65,144.06,
Placement of strapping to chest,PX-42010072,CDM,29200,CPT,420,RC,,outpatient,,,147,132.3,,0.95,,139.65,Percent of total billed charges,,,0.98,,144.06,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,0.97,,142.59,Percent of total billed charges,,,0.96,,141.12,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,139.65,Percent of total billed charges,,139.65,144.06,
Placement of strapping to shoulder,PX-42010073,CDM,29240,CPT,420,RC,,inpatient,,,190,171,,0.95,,180.5,Percent of total billed charges,,,0.98,,186.2,Percent of total billed charges,,,0.95,,180.5,Percent of total billed charges,,,0.97,,184.3,Percent of total billed charges,,,0.97,,184.3,Percent of total billed charges,,,0.96,,182.4,Percent of total billed charges,,,0.95,,180.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,180.5,Percent of total billed charges,,180.5,186.2,
Placement of strapping to shoulder,PX-42010073,CDM,29240,CPT,420,RC,,outpatient,,,190,171,,0.95,,180.5,Percent of total billed charges,,,0.98,,186.2,Percent of total billed charges,,,0.95,,180.5,Percent of total billed charges,,,0.95,,180.5,Percent of total billed charges,,,0.97,,184.3,Percent of total billed charges,,,0.96,,182.4,Percent of total billed charges,,,0.95,,180.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,180.5,Percent of total billed charges,,180.5,186.2,
Placement of strapping to elbow or wrist,PX-42010074,CDM,29260,CPT,420,RC,,inpatient,,,164,147.6,,0.95,,155.8,Percent of total billed charges,,,0.98,,160.72,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.96,,157.44,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,155.8,Percent of total billed charges,,155.8,160.72,
Placement of strapping to elbow or wrist,PX-42010074,CDM,29260,CPT,420,RC,,outpatient,,,164,147.6,,0.95,,155.8,Percent of total billed charges,,,0.98,,160.72,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.96,,157.44,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,155.8,Percent of total billed charges,,155.8,160.72,
Placement of strapping to hand or finger,PX-42010076,CDM,29280,CPT,420,RC,,inpatient,,,161,144.9,,0.95,,152.95,Percent of total billed charges,,,0.98,,157.78,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.96,,154.56,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,152.95,Percent of total billed charges,,152.95,157.78,
Placement of strapping to hand or finger,PX-42010076,CDM,29280,CPT,420,RC,,outpatient,,,161,144.9,,0.95,,152.95,Percent of total billed charges,,,0.98,,157.78,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.96,,154.56,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,152.95,Percent of total billed charges,,152.95,157.78,
"Strapping, Unna boot",PX-42010080,CDM,29580,CPT,420,RC,,inpatient,,,215,193.5,,0.95,,204.25,Percent of total billed charges,,,0.98,,210.7,Percent of total billed charges,,,0.95,,204.25,Percent of total billed charges,,,0.97,,208.55,Percent of total billed charges,,,0.97,,208.55,Percent of total billed charges,,,0.96,,206.4,Percent of total billed charges,,,0.95,,204.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,204.25,Percent of total billed charges,,204.25,210.7,
"Strapping, Unna boot",PX-42010080,CDM,29580,CPT,420,RC,,outpatient,,,215,193.5,,0.95,,204.25,Percent of total billed charges,,,0.98,,210.7,Percent of total billed charges,,,0.95,,204.25,Percent of total billed charges,,,0.95,,204.25,Percent of total billed charges,,,0.97,,208.55,Percent of total billed charges,,,0.96,,206.4,Percent of total billed charges,,,0.95,,204.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,204.25,Percent of total billed charges,,204.25,210.7,
Closed treatment of broken great toe,PX-45001299,CDM,28490,CPT,450,RC,,inpatient,,,499,449.1,,0.95,,474.05,Percent of total billed charges,,,0.98,,489.02,Percent of total billed charges,,,0.95,,474.05,Percent of total billed charges,,,0.97,,484.03,Percent of total billed charges,,,0.97,,484.03,Percent of total billed charges,,,0.96,,479.04,Percent of total billed charges,,,0.95,,474.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,474.05,Percent of total billed charges,,474.05,3950,
Closed treatment of broken great toe,PX-45001299,CDM,28490,CPT,450,RC,,outpatient,,,499,449.1,,0.95,,474.05,Percent of total billed charges,,,0.98,,489.02,Percent of total billed charges,,,0.95,,474.05,Percent of total billed charges,,,0.95,,474.05,Percent of total billed charges,,,0.97,,484.03,Percent of total billed charges,,,0.96,,479.04,Percent of total billed charges,,,0.95,,474.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,474.05,Percent of total billed charges,,474.05,3950,
Closed treatment of dislocated knee,PX-45010159,CDM,27550,CPT,450,RC,,inpatient,,,1602,1441.8,,0.95,,1521.9,Percent of total billed charges,,,0.98,,1569.96,Percent of total billed charges,,,0.95,,1521.9,Percent of total billed charges,,,0.97,,1553.94,Percent of total billed charges,,,0.97,,1553.94,Percent of total billed charges,,,0.96,,1537.92,Percent of total billed charges,,,0.95,,1521.9,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1521.9,Percent of total billed charges,,1521.9,3950,
Closed treatment of dislocated knee,PX-45010159,CDM,27550,CPT,450,RC,,outpatient,,,1602,1441.8,,0.95,,1521.9,Percent of total billed charges,,,0.98,,1569.96,Percent of total billed charges,,,0.95,,1521.9,Percent of total billed charges,,,0.95,,1521.9,Percent of total billed charges,,,0.97,,1553.94,Percent of total billed charges,,,0.96,,1537.92,Percent of total billed charges,,,0.95,,1521.9,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1521.9,Percent of total billed charges,,1521.9,3950,
Closed treatment of dislocated knee under anesthesia,PX-45010163,CDM,27552,CPT,450,RC,,inpatient,,,3521,3168.9,,0.95,,3344.95,Percent of total billed charges,,,0.98,,3450.58,Percent of total billed charges,,,0.95,,3344.95,Percent of total billed charges,,,0.97,,3415.37,Percent of total billed charges,,,0.97,,3415.37,Percent of total billed charges,,,0.96,,3380.16,Percent of total billed charges,,,0.95,,3344.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,3344.95,Percent of total billed charges,,3344.95,3950,
Closed treatment of dislocated knee under anesthesia,PX-45010163,CDM,27552,CPT,450,RC,,outpatient,,,3521,3168.9,,0.95,,3344.95,Percent of total billed charges,,,0.98,,3450.58,Percent of total billed charges,,,0.95,,3344.95,Percent of total billed charges,,,0.95,,3344.95,Percent of total billed charges,,,0.97,,3415.37,Percent of total billed charges,,,0.96,,3380.16,Percent of total billed charges,,,0.95,,3344.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,3344.95,Percent of total billed charges,,3344.95,3950,
Closed treatment of dislocated kneecap,PX-45010165,CDM,27560,CPT,450,RC,,inpatient,,,1094,984.6,,0.95,,1039.3,Percent of total billed charges,,,0.98,,1072.12,Percent of total billed charges,,,0.95,,1039.3,Percent of total billed charges,,,0.97,,1061.18,Percent of total billed charges,,,0.97,,1061.18,Percent of total billed charges,,,0.96,,1050.24,Percent of total billed charges,,,0.95,,1039.3,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1039.3,Percent of total billed charges,,1039.3,3950,
Closed treatment of dislocated kneecap,PX-45010165,CDM,27560,CPT,450,RC,,outpatient,,,1094,984.6,,0.95,,1039.3,Percent of total billed charges,,,0.98,,1072.12,Percent of total billed charges,,,0.95,,1039.3,Percent of total billed charges,,,0.95,,1039.3,Percent of total billed charges,,,0.97,,1061.18,Percent of total billed charges,,,0.96,,1050.24,Percent of total billed charges,,,0.95,,1039.3,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1039.3,Percent of total billed charges,,1039.3,3950,
Closed treatment of dislocated kneecap under anesthesia,PX-45010168,CDM,27562,CPT,450,RC,,inpatient,,,1822,1639.8,,0.95,,1730.9,Percent of total billed charges,,,0.98,,1785.56,Percent of total billed charges,,,0.95,,1730.9,Percent of total billed charges,,,0.97,,1767.34,Percent of total billed charges,,,0.97,,1767.34,Percent of total billed charges,,,0.96,,1749.12,Percent of total billed charges,,,0.95,,1730.9,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1730.9,Percent of total billed charges,,1730.9,3950,
Closed treatment of dislocated kneecap under anesthesia,PX-45010168,CDM,27562,CPT,450,RC,,outpatient,,,1822,1639.8,,0.95,,1730.9,Percent of total billed charges,,,0.98,,1785.56,Percent of total billed charges,,,0.95,,1730.9,Percent of total billed charges,,,0.95,,1730.9,Percent of total billed charges,,,0.97,,1767.34,Percent of total billed charges,,,0.96,,1749.12,Percent of total billed charges,,,0.95,,1730.9,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1730.9,Percent of total billed charges,,1730.9,3950,
Closed treatment of broken middle part of shin bone,PX-45010176,CDM,27750,CPT,450,RC,,inpatient,,,1560,1404,,0.95,,1482,Percent of total billed charges,,,0.98,,1528.8,Percent of total billed charges,,,0.95,,1482,Percent of total billed charges,,,0.97,,1513.2,Percent of total billed charges,,,0.97,,1513.2,Percent of total billed charges,,,0.96,,1497.6,Percent of total billed charges,,,0.95,,1482,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1482,Percent of total billed charges,,1482,3950,
Closed treatment of broken middle part of shin bone,PX-45010176,CDM,27750,CPT,450,RC,,outpatient,,,1560,1404,,0.95,,1482,Percent of total billed charges,,,0.98,,1528.8,Percent of total billed charges,,,0.95,,1482,Percent of total billed charges,,,0.95,,1482,Percent of total billed charges,,,0.97,,1513.2,Percent of total billed charges,,,0.96,,1497.6,Percent of total billed charges,,,0.95,,1482,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1482,Percent of total billed charges,,1482,3950,
Closed treatment of middle part of broken shin bone,PX-45010179,CDM,27752,CPT,450,RC,,inpatient,,,2179,1961.1,,0.95,,2070.05,Percent of total billed charges,,,0.98,,2135.42,Percent of total billed charges,,,0.95,,2070.05,Percent of total billed charges,,,0.97,,2113.63,Percent of total billed charges,,,0.97,,2113.63,Percent of total billed charges,,,0.96,,2091.84,Percent of total billed charges,,,0.95,,2070.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2070.05,Percent of total billed charges,,2070.05,3950,
Closed treatment of middle part of broken shin bone,PX-45010179,CDM,27752,CPT,450,RC,,outpatient,,,2179,1961.1,,0.95,,2070.05,Percent of total billed charges,,,0.98,,2135.42,Percent of total billed charges,,,0.95,,2070.05,Percent of total billed charges,,,0.95,,2070.05,Percent of total billed charges,,,0.97,,2113.63,Percent of total billed charges,,,0.96,,2091.84,Percent of total billed charges,,,0.95,,2070.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2070.05,Percent of total billed charges,,2070.05,3950,
Closed treatment of inside portion of shin bone at ankle,PX-45010182,CDM,27760,CPT,450,RC,,inpatient,,,1138,1024.2,,0.95,,1081.1,Percent of total billed charges,,,0.98,,1115.24,Percent of total billed charges,,,0.95,,1081.1,Percent of total billed charges,,,0.97,,1103.86,Percent of total billed charges,,,0.97,,1103.86,Percent of total billed charges,,,0.96,,1092.48,Percent of total billed charges,,,0.95,,1081.1,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1081.1,Percent of total billed charges,,1081.1,3950,
Closed treatment of inside portion of shin bone at ankle,PX-45010182,CDM,27760,CPT,450,RC,,outpatient,,,1138,1024.2,,0.95,,1081.1,Percent of total billed charges,,,0.98,,1115.24,Percent of total billed charges,,,0.95,,1081.1,Percent of total billed charges,,,0.95,,1081.1,Percent of total billed charges,,,0.97,,1103.86,Percent of total billed charges,,,0.96,,1092.48,Percent of total billed charges,,,0.95,,1081.1,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1081.1,Percent of total billed charges,,1081.1,3950,
Closed treatment of inside portion of shin bone at ankle,PX-45010185,CDM,27762,CPT,450,RC,,inpatient,,,1686,1517.4,,0.95,,1601.7,Percent of total billed charges,,,0.98,,1652.28,Percent of total billed charges,,,0.95,,1601.7,Percent of total billed charges,,,0.97,,1635.42,Percent of total billed charges,,,0.97,,1635.42,Percent of total billed charges,,,0.96,,1618.56,Percent of total billed charges,,,0.95,,1601.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1601.7,Percent of total billed charges,,1601.7,3950,
Closed treatment of inside portion of shin bone at ankle,PX-45010185,CDM,27762,CPT,450,RC,,outpatient,,,1686,1517.4,,0.95,,1601.7,Percent of total billed charges,,,0.98,,1652.28,Percent of total billed charges,,,0.95,,1601.7,Percent of total billed charges,,,0.95,,1601.7,Percent of total billed charges,,,0.97,,1635.42,Percent of total billed charges,,,0.96,,1618.56,Percent of total billed charges,,,0.95,,1601.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1601.7,Percent of total billed charges,,1601.7,3950,
Closed treatment of back portion of shin bone at ankle,PX-45010189,CDM,27767,CPT,450,RC,,inpatient,,,1234,1110.6,,0.95,,1172.3,Percent of total billed charges,,,0.98,,1209.32,Percent of total billed charges,,,0.95,,1172.3,Percent of total billed charges,,,0.97,,1196.98,Percent of total billed charges,,,0.97,,1196.98,Percent of total billed charges,,,0.96,,1184.64,Percent of total billed charges,,,0.95,,1172.3,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1172.3,Percent of total billed charges,,1172.3,3950,
Closed treatment of back portion of shin bone at ankle,PX-45010189,CDM,27767,CPT,450,RC,,outpatient,,,1234,1110.6,,0.95,,1172.3,Percent of total billed charges,,,0.98,,1209.32,Percent of total billed charges,,,0.95,,1172.3,Percent of total billed charges,,,0.95,,1172.3,Percent of total billed charges,,,0.97,,1196.98,Percent of total billed charges,,,0.96,,1184.64,Percent of total billed charges,,,0.95,,1172.3,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1172.3,Percent of total billed charges,,1172.3,3950,
Closed treatment of back portion of shin bone at ankle,PX-45010190,CDM,27768,CPT,450,RC,,inpatient,,,1234,1110.6,,0.95,,1172.3,Percent of total billed charges,,,0.98,,1209.32,Percent of total billed charges,,,0.95,,1172.3,Percent of total billed charges,,,0.97,,1196.98,Percent of total billed charges,,,0.97,,1196.98,Percent of total billed charges,,,0.96,,1184.64,Percent of total billed charges,,,0.95,,1172.3,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1172.3,Percent of total billed charges,,1172.3,3950,
Closed treatment of back portion of shin bone at ankle,PX-45010190,CDM,27768,CPT,450,RC,,outpatient,,,1234,1110.6,,0.95,,1172.3,Percent of total billed charges,,,0.98,,1209.32,Percent of total billed charges,,,0.95,,1172.3,Percent of total billed charges,,,0.95,,1172.3,Percent of total billed charges,,,0.97,,1196.98,Percent of total billed charges,,,0.96,,1184.64,Percent of total billed charges,,,0.95,,1172.3,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1172.3,Percent of total billed charges,,1172.3,3950,
Closed treatment of broken middle or upper end of leg bone,PX-45010192,CDM,27780,CPT,450,RC,,inpatient,,,966,869.4,,0.95,,917.7,Percent of total billed charges,,,0.98,,946.68,Percent of total billed charges,,,0.95,,917.7,Percent of total billed charges,,,0.97,,937.02,Percent of total billed charges,,,0.97,,937.02,Percent of total billed charges,,,0.96,,927.36,Percent of total billed charges,,,0.95,,917.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,917.7,Percent of total billed charges,,917.7,3950,
Closed treatment of broken middle or upper end of leg bone,PX-45010192,CDM,27780,CPT,450,RC,,outpatient,,,966,869.4,,0.95,,917.7,Percent of total billed charges,,,0.98,,946.68,Percent of total billed charges,,,0.95,,917.7,Percent of total billed charges,,,0.95,,917.7,Percent of total billed charges,,,0.97,,937.02,Percent of total billed charges,,,0.96,,927.36,Percent of total billed charges,,,0.95,,917.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,917.7,Percent of total billed charges,,917.7,3950,
Closed treatment of broken outside lower leg bone at ankle,PX-45010198,CDM,27786,CPT,450,RC,,inpatient,,,1096,986.4,,0.95,,1041.2,Percent of total billed charges,,,0.98,,1074.08,Percent of total billed charges,,,0.95,,1041.2,Percent of total billed charges,,,0.97,,1063.12,Percent of total billed charges,,,0.97,,1063.12,Percent of total billed charges,,,0.96,,1052.16,Percent of total billed charges,,,0.95,,1041.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1041.2,Percent of total billed charges,,1041.2,3950,
Closed treatment of broken outside lower leg bone at ankle,PX-45010198,CDM,27786,CPT,450,RC,,outpatient,,,1096,986.4,,0.95,,1041.2,Percent of total billed charges,,,0.98,,1074.08,Percent of total billed charges,,,0.95,,1041.2,Percent of total billed charges,,,0.95,,1041.2,Percent of total billed charges,,,0.97,,1063.12,Percent of total billed charges,,,0.96,,1052.16,Percent of total billed charges,,,0.95,,1041.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1041.2,Percent of total billed charges,,1041.2,3950,
Drain abscess or blood accumulation of thigh or knee,PX-45010285,CDM,27301,CPT,450,RC,,inpatient,,,1896,1706.4,,0.95,,1801.2,Percent of total billed charges,,,0.98,,1858.08,Percent of total billed charges,,,0.95,,1801.2,Percent of total billed charges,,,0.97,,1839.12,Percent of total billed charges,,,0.97,,1839.12,Percent of total billed charges,,,0.96,,1820.16,Percent of total billed charges,,,0.95,,1801.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1801.2,Percent of total billed charges,,1801.2,1858.08,
Drain abscess or blood accumulation of thigh or knee,PX-45010285,CDM,27301,CPT,450,RC,,outpatient,,,1896,1706.4,,0.95,,1801.2,Percent of total billed charges,,,0.98,,1858.08,Percent of total billed charges,,,0.95,,1801.2,Percent of total billed charges,,,0.95,,1801.2,Percent of total billed charges,,,0.97,,1839.12,Percent of total billed charges,,,0.96,,1820.16,Percent of total billed charges,,,0.95,,1801.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1801.2,Percent of total billed charges,,1801.2,1858.08,
Closed treatment of broken kneecap,PX-45010496,CDM,27520,CPT,450,RC,,inpatient,,,1175,1057.5,,0.95,,1116.25,Percent of total billed charges,,,0.98,,1151.5,Percent of total billed charges,,,0.95,,1116.25,Percent of total billed charges,,,0.97,,1139.75,Percent of total billed charges,,,0.97,,1139.75,Percent of total billed charges,,,0.96,,1128,Percent of total billed charges,,,0.95,,1116.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1116.25,Percent of total billed charges,,1116.25,3950,
Closed treatment of broken kneecap,PX-45010496,CDM,27520,CPT,450,RC,,outpatient,,,1175,1057.5,,0.95,,1116.25,Percent of total billed charges,,,0.98,,1151.5,Percent of total billed charges,,,0.95,,1116.25,Percent of total billed charges,,,0.95,,1116.25,Percent of total billed charges,,,0.97,,1139.75,Percent of total billed charges,,,0.96,,1128,Percent of total billed charges,,,0.95,,1116.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1116.25,Percent of total billed charges,,1116.25,3950,
Closed treatment of broken shin bone,PX-45010499,CDM,27530,CPT,450,RC,,inpatient,,,1457,1311.3,,0.95,,1384.15,Percent of total billed charges,,,0.98,,1427.86,Percent of total billed charges,,,0.95,,1384.15,Percent of total billed charges,,,0.97,,1413.29,Percent of total billed charges,,,0.97,,1413.29,Percent of total billed charges,,,0.96,,1398.72,Percent of total billed charges,,,0.95,,1384.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1384.15,Percent of total billed charges,,1384.15,3950,
Closed treatment of broken shin bone,PX-45010499,CDM,27530,CPT,450,RC,,outpatient,,,1457,1311.3,,0.95,,1384.15,Percent of total billed charges,,,0.98,,1427.86,Percent of total billed charges,,,0.95,,1384.15,Percent of total billed charges,,,0.95,,1384.15,Percent of total billed charges,,,0.97,,1413.29,Percent of total billed charges,,,0.96,,1398.72,Percent of total billed charges,,,0.95,,1384.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1384.15,Percent of total billed charges,,1384.15,3950,
Closed treatment of broken outside lower leg bone at ankle,PX-45013002,CDM,27788,CPT,450,RC,,inpatient,,,1490,1341,,0.95,,1415.5,Percent of total billed charges,,,0.98,,1460.2,Percent of total billed charges,,,0.95,,1415.5,Percent of total billed charges,,,0.97,,1445.3,Percent of total billed charges,,,0.97,,1445.3,Percent of total billed charges,,,0.96,,1430.4,Percent of total billed charges,,,0.95,,1415.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1415.5,Percent of total billed charges,,1415.5,3950,
Closed treatment of broken outside lower leg bone at ankle,PX-45013002,CDM,27788,CPT,450,RC,,outpatient,,,1490,1341,,0.95,,1415.5,Percent of total billed charges,,,0.98,,1460.2,Percent of total billed charges,,,0.95,,1415.5,Percent of total billed charges,,,0.95,,1415.5,Percent of total billed charges,,,0.97,,1445.3,Percent of total billed charges,,,0.96,,1430.4,Percent of total billed charges,,,0.95,,1415.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1415.5,Percent of total billed charges,,1415.5,3950,
Closed treatment of broken shin bone at wt bearing joint,PX-45013018,CDM,27824,CPT,450,RC,,inpatient,,,1289,1160.1,,0.95,,1224.55,Percent of total billed charges,,,0.98,,1263.22,Percent of total billed charges,,,0.95,,1224.55,Percent of total billed charges,,,0.97,,1250.33,Percent of total billed charges,,,0.97,,1250.33,Percent of total billed charges,,,0.96,,1237.44,Percent of total billed charges,,,0.95,,1224.55,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1224.55,Percent of total billed charges,,1224.55,3950,
Closed treatment of broken shin bone at wt bearing joint,PX-45013018,CDM,27824,CPT,450,RC,,outpatient,,,1289,1160.1,,0.95,,1224.55,Percent of total billed charges,,,0.98,,1263.22,Percent of total billed charges,,,0.95,,1224.55,Percent of total billed charges,,,0.95,,1224.55,Percent of total billed charges,,,0.97,,1250.33,Percent of total billed charges,,,0.96,,1237.44,Percent of total billed charges,,,0.95,,1224.55,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1224.55,Percent of total billed charges,,1224.55,3950,
Closed treatment of dislocated ankle,PX-45013021,CDM,27840,CPT,450,RC,,inpatient,,,1323,1190.7,,0.95,,1256.85,Percent of total billed charges,,,0.98,,1296.54,Percent of total billed charges,,,0.95,,1256.85,Percent of total billed charges,,,0.97,,1283.31,Percent of total billed charges,,,0.97,,1283.31,Percent of total billed charges,,,0.96,,1270.08,Percent of total billed charges,,,0.95,,1256.85,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1256.85,Percent of total billed charges,,1256.85,3950,
Closed treatment of dislocated ankle,PX-45013021,CDM,27840,CPT,450,RC,,outpatient,,,1323,1190.7,,0.95,,1256.85,Percent of total billed charges,,,0.98,,1296.54,Percent of total billed charges,,,0.95,,1256.85,Percent of total billed charges,,,0.95,,1256.85,Percent of total billed charges,,,0.97,,1283.31,Percent of total billed charges,,,0.96,,1270.08,Percent of total billed charges,,,0.95,,1256.85,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1256.85,Percent of total billed charges,,1256.85,3950,
Closed treatment of dislocated ankle under anesthesia,PX-45013025,CDM,27842,CPT,450,RC,,inpatient,,,1687,1518.3,,0.95,,1602.65,Percent of total billed charges,,,0.98,,1653.26,Percent of total billed charges,,,0.95,,1602.65,Percent of total billed charges,,,0.97,,1636.39,Percent of total billed charges,,,0.97,,1636.39,Percent of total billed charges,,,0.96,,1619.52,Percent of total billed charges,,,0.95,,1602.65,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1602.65,Percent of total billed charges,,1602.65,3950,
Closed treatment of dislocated ankle under anesthesia,PX-45013025,CDM,27842,CPT,450,RC,,outpatient,,,1687,1518.3,,0.95,,1602.65,Percent of total billed charges,,,0.98,,1653.26,Percent of total billed charges,,,0.95,,1602.65,Percent of total billed charges,,,0.95,,1602.65,Percent of total billed charges,,,0.97,,1636.39,Percent of total billed charges,,,0.96,,1619.52,Percent of total billed charges,,,0.95,,1602.65,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1602.65,Percent of total billed charges,,1602.65,3950,
Removal of foreign body of foot tissue,PX-45013029,CDM,28190,CPT,450,RC,,inpatient,,,811,729.9,,0.95,,770.45,Percent of total billed charges,,,0.98,,794.78,Percent of total billed charges,,,0.95,,770.45,Percent of total billed charges,,,0.97,,786.67,Percent of total billed charges,,,0.97,,786.67,Percent of total billed charges,,,0.96,,778.56,Percent of total billed charges,,,0.95,,770.45,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,770.45,Percent of total billed charges,,770.45,3950,
Removal of foreign body of foot tissue,PX-45013029,CDM,28190,CPT,450,RC,,outpatient,,,811,729.9,,0.95,,770.45,Percent of total billed charges,,,0.98,,794.78,Percent of total billed charges,,,0.95,,770.45,Percent of total billed charges,,,0.95,,770.45,Percent of total billed charges,,,0.97,,786.67,Percent of total billed charges,,,0.96,,778.56,Percent of total billed charges,,,0.95,,770.45,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,770.45,Percent of total billed charges,,770.45,3950,
"Removal of foreign body of foot tissue, deep",PX-45013032,CDM,28192,CPT,450,RC,,inpatient,,,1395,1255.5,,0.95,,1325.25,Percent of total billed charges,,,0.98,,1367.1,Percent of total billed charges,,,0.95,,1325.25,Percent of total billed charges,,,0.97,,1353.15,Percent of total billed charges,,,0.97,,1353.15,Percent of total billed charges,,,0.96,,1339.2,Percent of total billed charges,,,0.95,,1325.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1325.25,Percent of total billed charges,,1325.25,3950,
"Removal of foreign body of foot tissue, deep",PX-45013032,CDM,28192,CPT,450,RC,,outpatient,,,1395,1255.5,,0.95,,1325.25,Percent of total billed charges,,,0.98,,1367.1,Percent of total billed charges,,,0.95,,1325.25,Percent of total billed charges,,,0.95,,1325.25,Percent of total billed charges,,,0.97,,1353.15,Percent of total billed charges,,,0.96,,1339.2,Percent of total billed charges,,,0.95,,1325.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1325.25,Percent of total billed charges,,1325.25,3950,
Closed treatment of broken heel bone,PX-45013045,CDM,28400,CPT,450,RC,,inpatient,,,1046,941.4,,0.95,,993.7,Percent of total billed charges,,,0.98,,1025.08,Percent of total billed charges,,,0.95,,993.7,Percent of total billed charges,,,0.97,,1014.62,Percent of total billed charges,,,0.97,,1014.62,Percent of total billed charges,,,0.96,,1004.16,Percent of total billed charges,,,0.95,,993.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,993.7,Percent of total billed charges,,993.7,3950,
Closed treatment of broken heel bone,PX-45013045,CDM,28400,CPT,450,RC,,outpatient,,,1046,941.4,,0.95,,993.7,Percent of total billed charges,,,0.98,,1025.08,Percent of total billed charges,,,0.95,,993.7,Percent of total billed charges,,,0.95,,993.7,Percent of total billed charges,,,0.97,,1014.62,Percent of total billed charges,,,0.96,,1004.16,Percent of total billed charges,,,0.95,,993.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,993.7,Percent of total billed charges,,993.7,3950,
Closed treatment of broken ankle joint bone,PX-45013051,CDM,28430,CPT,450,RC,,inpatient,,,1025,922.5,,0.95,,973.75,Percent of total billed charges,,,0.98,,1004.5,Percent of total billed charges,,,0.95,,973.75,Percent of total billed charges,,,0.97,,994.25,Percent of total billed charges,,,0.97,,994.25,Percent of total billed charges,,,0.96,,984,Percent of total billed charges,,,0.95,,973.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,973.75,Percent of total billed charges,,973.75,3950,
Closed treatment of broken ankle joint bone,PX-45013051,CDM,28430,CPT,450,RC,,outpatient,,,1025,922.5,,0.95,,973.75,Percent of total billed charges,,,0.98,,1004.5,Percent of total billed charges,,,0.95,,973.75,Percent of total billed charges,,,0.95,,973.75,Percent of total billed charges,,,0.97,,994.25,Percent of total billed charges,,,0.96,,984,Percent of total billed charges,,,0.95,,973.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,973.75,Percent of total billed charges,,973.75,3950,
Closed treatment of broken bone in forefoot or midfoot,PX-45013063,CDM,28470,CPT,450,RC,,inpatient,,,825,742.5,,0.95,,783.75,Percent of total billed charges,,,0.98,,808.5,Percent of total billed charges,,,0.95,,783.75,Percent of total billed charges,,,0.97,,800.25,Percent of total billed charges,,,0.97,,800.25,Percent of total billed charges,,,0.96,,792,Percent of total billed charges,,,0.95,,783.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,783.75,Percent of total billed charges,,783.75,3950,
Closed treatment of broken bone in forefoot or midfoot,PX-45013063,CDM,28470,CPT,450,RC,,outpatient,,,825,742.5,,0.95,,783.75,Percent of total billed charges,,,0.98,,808.5,Percent of total billed charges,,,0.95,,783.75,Percent of total billed charges,,,0.95,,783.75,Percent of total billed charges,,,0.97,,800.25,Percent of total billed charges,,,0.96,,792,Percent of total billed charges,,,0.95,,783.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,783.75,Percent of total billed charges,,783.75,3950,
Closed treatment of broken great toe with manipulation,PX-45013069,CDM,28495,CPT,450,RC,,inpatient,,,551,495.9,,0.95,,523.45,Percent of total billed charges,,,0.98,,539.98,Percent of total billed charges,,,0.95,,523.45,Percent of total billed charges,,,0.97,,534.47,Percent of total billed charges,,,0.97,,534.47,Percent of total billed charges,,,0.96,,528.96,Percent of total billed charges,,,0.95,,523.45,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,523.45,Percent of total billed charges,,523.45,3950,
Closed treatment of broken great toe with manipulation,PX-45013069,CDM,28495,CPT,450,RC,,outpatient,,,551,495.9,,0.95,,523.45,Percent of total billed charges,,,0.98,,539.98,Percent of total billed charges,,,0.95,,523.45,Percent of total billed charges,,,0.95,,523.45,Percent of total billed charges,,,0.97,,534.47,Percent of total billed charges,,,0.96,,528.96,Percent of total billed charges,,,0.95,,523.45,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,523.45,Percent of total billed charges,,523.45,3950,
Closed treatment of broken toe,PX-45013075,CDM,28510,CPT,450,RC,,inpatient,,,469,422.1,,0.95,,445.55,Percent of total billed charges,,,0.98,,459.62,Percent of total billed charges,,,0.95,,445.55,Percent of total billed charges,,,0.97,,454.93,Percent of total billed charges,,,0.97,,454.93,Percent of total billed charges,,,0.96,,450.24,Percent of total billed charges,,,0.95,,445.55,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,445.55,Percent of total billed charges,,445.55,3950,
Closed treatment of broken toe,PX-45013075,CDM,28510,CPT,450,RC,,outpatient,,,469,422.1,,0.95,,445.55,Percent of total billed charges,,,0.98,,459.62,Percent of total billed charges,,,0.95,,445.55,Percent of total billed charges,,,0.95,,445.55,Percent of total billed charges,,,0.97,,454.93,Percent of total billed charges,,,0.96,,450.24,Percent of total billed charges,,,0.95,,445.55,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,445.55,Percent of total billed charges,,445.55,3950,
Closed treatment of broken toe with manipulation,PX-45013076,CDM,28515,CPT,450,RC,,inpatient,,,457,411.3,,0.95,,434.15,Percent of total billed charges,,,0.98,,447.86,Percent of total billed charges,,,0.95,,434.15,Percent of total billed charges,,,0.97,,443.29,Percent of total billed charges,,,0.97,,443.29,Percent of total billed charges,,,0.96,,438.72,Percent of total billed charges,,,0.95,,434.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,434.15,Percent of total billed charges,,434.15,3950,
Closed treatment of broken toe with manipulation,PX-45013076,CDM,28515,CPT,450,RC,,outpatient,,,457,411.3,,0.95,,434.15,Percent of total billed charges,,,0.98,,447.86,Percent of total billed charges,,,0.95,,434.15,Percent of total billed charges,,,0.95,,434.15,Percent of total billed charges,,,0.97,,443.29,Percent of total billed charges,,,0.96,,438.72,Percent of total billed charges,,,0.95,,434.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,434.15,Percent of total billed charges,,434.15,3950,
Closed treatment of dislocated joint between toe and foot,PX-45013087,CDM,28630,CPT,450,RC,,inpatient,,,208,187.2,,0.95,,197.6,Percent of total billed charges,,,0.98,,203.84,Percent of total billed charges,,,0.95,,197.6,Percent of total billed charges,,,0.97,,201.76,Percent of total billed charges,,,0.97,,201.76,Percent of total billed charges,,,0.96,,199.68,Percent of total billed charges,,,0.95,,197.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,197.6,Percent of total billed charges,,197.6,3950,
Closed treatment of dislocated joint between toe and foot,PX-45013087,CDM,28630,CPT,450,RC,,outpatient,,,208,187.2,,0.95,,197.6,Percent of total billed charges,,,0.98,,203.84,Percent of total billed charges,,,0.95,,197.6,Percent of total billed charges,,,0.95,,197.6,Percent of total billed charges,,,0.97,,201.76,Percent of total billed charges,,,0.96,,199.68,Percent of total billed charges,,,0.95,,197.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,197.6,Percent of total billed charges,,197.6,3950,
Closed treatment of dislocated joint between toe and foot,PX-45013090,CDM,28635,CPT,450,RC,,inpatient,,,764,687.6,,0.95,,725.8,Percent of total billed charges,,,0.98,,748.72,Percent of total billed charges,,,0.95,,725.8,Percent of total billed charges,,,0.97,,741.08,Percent of total billed charges,,,0.97,,741.08,Percent of total billed charges,,,0.96,,733.44,Percent of total billed charges,,,0.95,,725.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,725.8,Percent of total billed charges,,725.8,3950,
Closed treatment of dislocated joint between toe and foot,PX-45013090,CDM,28635,CPT,450,RC,,outpatient,,,764,687.6,,0.95,,725.8,Percent of total billed charges,,,0.98,,748.72,Percent of total billed charges,,,0.95,,725.8,Percent of total billed charges,,,0.95,,725.8,Percent of total billed charges,,,0.97,,741.08,Percent of total billed charges,,,0.96,,733.44,Percent of total billed charges,,,0.95,,725.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,725.8,Percent of total billed charges,,725.8,3950,
Closed treatment of dislocated joint in toe,PX-45013091,CDM,28660,CPT,450,RC,,inpatient,,,461,414.9,,0.95,,437.95,Percent of total billed charges,,,0.98,,451.78,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,0.97,,447.17,Percent of total billed charges,,,0.97,,447.17,Percent of total billed charges,,,0.96,,442.56,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,437.95,Percent of total billed charges,,437.95,3950,
Closed treatment of dislocated joint in toe,PX-45013091,CDM,28660,CPT,450,RC,,outpatient,,,461,414.9,,0.95,,437.95,Percent of total billed charges,,,0.98,,451.78,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,0.97,,447.17,Percent of total billed charges,,,0.96,,442.56,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,437.95,Percent of total billed charges,,437.95,3950,
Application of shoulder to hand cast,PX-45013096,CDM,29065,CPT,450,RC,,inpatient,,,363,326.7,,0.95,,344.85,Percent of total billed charges,,,0.98,,355.74,Percent of total billed charges,,,0.95,,344.85,Percent of total billed charges,,,0.97,,352.11,Percent of total billed charges,,,0.97,,352.11,Percent of total billed charges,,,0.96,,348.48,Percent of total billed charges,,,0.95,,344.85,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,344.85,Percent of total billed charges,,344.85,3950,
Application of shoulder to hand cast,PX-45013096,CDM,29065,CPT,450,RC,,outpatient,,,363,326.7,,0.95,,344.85,Percent of total billed charges,,,0.98,,355.74,Percent of total billed charges,,,0.95,,344.85,Percent of total billed charges,,,0.95,,344.85,Percent of total billed charges,,,0.97,,352.11,Percent of total billed charges,,,0.96,,348.48,Percent of total billed charges,,,0.95,,344.85,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,344.85,Percent of total billed charges,,344.85,3950,
Application of elbow to finger cast,PX-45013099,CDM,29075,CPT,450,RC,,inpatient,,,298,268.2,,0.95,,283.1,Percent of total billed charges,,,0.98,,292.04,Percent of total billed charges,,,0.95,,283.1,Percent of total billed charges,,,0.97,,289.06,Percent of total billed charges,,,0.97,,289.06,Percent of total billed charges,,,0.96,,286.08,Percent of total billed charges,,,0.95,,283.1,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,283.1,Percent of total billed charges,,283.1,3950,
Application of elbow to finger cast,PX-45013099,CDM,29075,CPT,450,RC,,outpatient,,,298,268.2,,0.95,,283.1,Percent of total billed charges,,,0.98,,292.04,Percent of total billed charges,,,0.95,,283.1,Percent of total billed charges,,,0.95,,283.1,Percent of total billed charges,,,0.97,,289.06,Percent of total billed charges,,,0.96,,286.08,Percent of total billed charges,,,0.95,,283.1,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,283.1,Percent of total billed charges,,283.1,3950,
Application of lower and upper arm splint,PX-45013106,CDM,29105,CPT,450,RC,,inpatient,,,314,282.6,,0.95,,298.3,Percent of total billed charges,,,0.98,,307.72,Percent of total billed charges,,,0.95,,298.3,Percent of total billed charges,,,0.97,,304.58,Percent of total billed charges,,,0.97,,304.58,Percent of total billed charges,,,0.96,,301.44,Percent of total billed charges,,,0.95,,298.3,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,298.3,Percent of total billed charges,,298.3,3950,
Application of lower and upper arm splint,PX-45013106,CDM,29105,CPT,450,RC,,outpatient,,,314,282.6,,0.95,,298.3,Percent of total billed charges,,,0.98,,307.72,Percent of total billed charges,,,0.95,,298.3,Percent of total billed charges,,,0.95,,298.3,Percent of total billed charges,,,0.97,,304.58,Percent of total billed charges,,,0.96,,301.44,Percent of total billed charges,,,0.95,,298.3,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,298.3,Percent of total billed charges,,298.3,3950,
Application of nonmoveable forearm to hand splint,PX-45013110,CDM,29125,CPT,450,RC,,inpatient,,,236,212.4,,0.95,,224.2,Percent of total billed charges,,,0.98,,231.28,Percent of total billed charges,,,0.95,,224.2,Percent of total billed charges,,,0.97,,228.92,Percent of total billed charges,,,0.97,,228.92,Percent of total billed charges,,,0.96,,226.56,Percent of total billed charges,,,0.95,,224.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,224.2,Percent of total billed charges,,224.2,3950,
Application of nonmoveable forearm to hand splint,PX-45013110,CDM,29125,CPT,450,RC,,outpatient,,,236,212.4,,0.95,,224.2,Percent of total billed charges,,,0.98,,231.28,Percent of total billed charges,,,0.95,,224.2,Percent of total billed charges,,,0.95,,224.2,Percent of total billed charges,,,0.97,,228.92,Percent of total billed charges,,,0.96,,226.56,Percent of total billed charges,,,0.95,,224.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,224.2,Percent of total billed charges,,224.2,3950,
Apply nonmoveable finger splint,PX-45013112,CDM,29130,CPT,450,RC,,inpatient,,,128,115.2,,0.95,,121.6,Percent of total billed charges,,,0.98,,125.44,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.96,,122.88,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,121.6,Percent of total billed charges,,121.6,3950,
Apply nonmoveable finger splint,PX-45013112,CDM,29130,CPT,450,RC,,outpatient,,,128,115.2,,0.95,,121.6,Percent of total billed charges,,,0.98,,125.44,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.96,,122.88,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,121.6,Percent of total billed charges,,121.6,3950,
Apply long leg cast from thigh to toe,PX-45013121,CDM,29345,CPT,450,RC,,inpatient,,,567,510.3,,0.95,,538.65,Percent of total billed charges,,,0.98,,555.66,Percent of total billed charges,,,0.95,,538.65,Percent of total billed charges,,,0.97,,549.99,Percent of total billed charges,,,0.97,,549.99,Percent of total billed charges,,,0.96,,544.32,Percent of total billed charges,,,0.95,,538.65,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,538.65,Percent of total billed charges,,538.65,3950,
Apply long leg cast from thigh to toe,PX-45013121,CDM,29345,CPT,450,RC,,outpatient,,,567,510.3,,0.95,,538.65,Percent of total billed charges,,,0.98,,555.66,Percent of total billed charges,,,0.95,,538.65,Percent of total billed charges,,,0.95,,538.65,Percent of total billed charges,,,0.97,,549.99,Percent of total billed charges,,,0.96,,544.32,Percent of total billed charges,,,0.95,,538.65,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,538.65,Percent of total billed charges,,538.65,3950,
Application of short leg cast,PX-45013123,CDM,29405,CPT,450,RC,,inpatient,,,441,396.9,,0.95,,418.95,Percent of total billed charges,,,0.98,,432.18,Percent of total billed charges,,,0.95,,418.95,Percent of total billed charges,,,0.97,,427.77,Percent of total billed charges,,,0.97,,427.77,Percent of total billed charges,,,0.96,,423.36,Percent of total billed charges,,,0.95,,418.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,418.95,Percent of total billed charges,,418.95,3950,
Application of short leg cast,PX-45013123,CDM,29405,CPT,450,RC,,outpatient,,,441,396.9,,0.95,,418.95,Percent of total billed charges,,,0.98,,432.18,Percent of total billed charges,,,0.95,,418.95,Percent of total billed charges,,,0.95,,418.95,Percent of total billed charges,,,0.97,,427.77,Percent of total billed charges,,,0.96,,423.36,Percent of total billed charges,,,0.95,,418.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,418.95,Percent of total billed charges,,418.95,3950,
Apply walking cast covering below knee to toe,PX-45013124,CDM,29425,CPT,450,RC,,inpatient,,,477,429.3,,0.95,,453.15,Percent of total billed charges,,,0.98,,467.46,Percent of total billed charges,,,0.95,,453.15,Percent of total billed charges,,,0.97,,462.69,Percent of total billed charges,,,0.97,,462.69,Percent of total billed charges,,,0.96,,457.92,Percent of total billed charges,,,0.95,,453.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,453.15,Percent of total billed charges,,453.15,3950,
Apply walking cast covering below knee to toe,PX-45013124,CDM,29425,CPT,450,RC,,outpatient,,,477,429.3,,0.95,,453.15,Percent of total billed charges,,,0.98,,467.46,Percent of total billed charges,,,0.95,,453.15,Percent of total billed charges,,,0.95,,453.15,Percent of total billed charges,,,0.97,,462.69,Percent of total billed charges,,,0.96,,457.92,Percent of total billed charges,,,0.95,,453.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,453.15,Percent of total billed charges,,453.15,3950,
"Apply long leg splint, thigh to ankle or toe",PX-45013127,CDM,29505,CPT,450,RC,,inpatient,,,314,282.6,,0.95,,298.3,Percent of total billed charges,,,0.98,,307.72,Percent of total billed charges,,,0.95,,298.3,Percent of total billed charges,,,0.97,,304.58,Percent of total billed charges,,,0.97,,304.58,Percent of total billed charges,,,0.96,,301.44,Percent of total billed charges,,,0.95,,298.3,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,298.3,Percent of total billed charges,,298.3,3950,
"Apply long leg splint, thigh to ankle or toe",PX-45013127,CDM,29505,CPT,450,RC,,outpatient,,,314,282.6,,0.95,,298.3,Percent of total billed charges,,,0.98,,307.72,Percent of total billed charges,,,0.95,,298.3,Percent of total billed charges,,,0.95,,298.3,Percent of total billed charges,,,0.97,,304.58,Percent of total billed charges,,,0.96,,301.44,Percent of total billed charges,,,0.95,,298.3,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,298.3,Percent of total billed charges,,298.3,3950,
Application of short leg splint from calf to foot,PX-45013130,CDM,29515,CPT,450,RC,,inpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,263.15,Percent of total billed charges,,263.15,3950,
Application of short leg splint from calf to foot,PX-45013130,CDM,29515,CPT,450,RC,,outpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,263.15,Percent of total billed charges,,263.15,3950,
Placement of strapping to ankle or foot,PX-45013137,CDM,29540,CPT,450,RC,,inpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,117.8,Percent of total billed charges,,117.8,3950,
Placement of strapping to ankle or foot,PX-45013137,CDM,29540,CPT,450,RC,,outpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,117.8,Percent of total billed charges,,117.8,3950,
Placement of strapping to toes,PX-45013139,CDM,29550,CPT,450,RC,,inpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,107.35,Percent of total billed charges,,107.35,3950,
Placement of strapping to toes,PX-45013139,CDM,29550,CPT,450,RC,,outpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,107.35,Percent of total billed charges,,107.35,3950,
"Removal or cutting of gauntlet, boot, or body cast",PX-45013145,CDM,29700,CPT,450,RC,,inpatient,,,170,153,,0.95,,161.5,Percent of total billed charges,,,0.98,,166.6,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,0.97,,164.9,Percent of total billed charges,,,0.97,,164.9,Percent of total billed charges,,,0.96,,163.2,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,161.5,Percent of total billed charges,,161.5,3950,
"Removal or cutting of gauntlet, boot, or body cast",PX-45013145,CDM,29700,CPT,450,RC,,outpatient,,,170,153,,0.95,,161.5,Percent of total billed charges,,,0.98,,166.6,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,0.97,,164.9,Percent of total billed charges,,,0.96,,163.2,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,161.5,Percent of total billed charges,,161.5,3950,
Removal or cutting of full arm or leg cast,PX-45013147,CDM,29705,CPT,450,RC,,inpatient,,,231,207.9,,0.95,,219.45,Percent of total billed charges,,,0.98,,226.38,Percent of total billed charges,,,0.95,,219.45,Percent of total billed charges,,,0.97,,224.07,Percent of total billed charges,,,0.97,,224.07,Percent of total billed charges,,,0.96,,221.76,Percent of total billed charges,,,0.95,,219.45,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,219.45,Percent of total billed charges,,219.45,3950,
Removal or cutting of full arm or leg cast,PX-45013147,CDM,29705,CPT,450,RC,,outpatient,,,231,207.9,,0.95,,219.45,Percent of total billed charges,,,0.98,,226.38,Percent of total billed charges,,,0.95,,219.45,Percent of total billed charges,,,0.95,,219.45,Percent of total billed charges,,,0.97,,224.07,Percent of total billed charges,,,0.96,,221.76,Percent of total billed charges,,,0.95,,219.45,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,219.45,Percent of total billed charges,,219.45,3950,
"Repair of spica, body cast, or jacket",PX-45013150,CDM,29720,CPT,450,RC,,inpatient,,,272,244.8,,0.95,,258.4,Percent of total billed charges,,,0.98,,266.56,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,0.97,,263.84,Percent of total billed charges,,,0.97,,263.84,Percent of total billed charges,,,0.96,,261.12,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,258.4,Percent of total billed charges,,258.4,3950,
"Repair of spica, body cast, or jacket",PX-45013150,CDM,29720,CPT,450,RC,,outpatient,,,272,244.8,,0.95,,258.4,Percent of total billed charges,,,0.98,,266.56,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,0.97,,263.84,Percent of total billed charges,,,0.96,,261.12,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,258.4,Percent of total billed charges,,258.4,3950,
Closed treatment of dislocated knee joint,PX-45013166,CDM,27830,CPT,450,RC,,inpatient,,,1106,995.4,,0.95,,1050.7,Percent of total billed charges,,,0.98,,1083.88,Percent of total billed charges,,,0.95,,1050.7,Percent of total billed charges,,,0.97,,1072.82,Percent of total billed charges,,,0.97,,1072.82,Percent of total billed charges,,,0.96,,1061.76,Percent of total billed charges,,,0.95,,1050.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1050.7,Percent of total billed charges,,1050.7,3950,
Closed treatment of dislocated knee joint,PX-45013166,CDM,27830,CPT,450,RC,,outpatient,,,1106,995.4,,0.95,,1050.7,Percent of total billed charges,,,0.98,,1083.88,Percent of total billed charges,,,0.95,,1050.7,Percent of total billed charges,,,0.95,,1050.7,Percent of total billed charges,,,0.97,,1072.82,Percent of total billed charges,,,0.96,,1061.76,Percent of total billed charges,,,0.95,,1050.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1050.7,Percent of total billed charges,,1050.7,3950,
HC PR 27613 Biopsy Lower Leg Soft Tissue,PX-96910775,CDM,27613,CPT,983,RC,,inpatient,,,628,565.2,,0.95,,596.6,Percent of total billed charges,,,0.98,,615.44,Percent of total billed charges,,,0.95,,596.6,Percent of total billed charges,,,0.97,,609.16,Percent of total billed charges,,,0.97,,609.16,Percent of total billed charges,,,0.96,,602.88,Percent of total billed charges,,,0.95,,596.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,596.6,Percent of total billed charges,,596.6,615.44,
HC PR 27613 Biopsy Lower Leg Soft Tissue,PX-96910775,CDM,27613,CPT,983,RC,,outpatient,,,628,565.2,,0.95,,596.6,Percent of total billed charges,,,0.98,,615.44,Percent of total billed charges,,,0.95,,596.6,Percent of total billed charges,,,0.95,,596.6,Percent of total billed charges,,,0.97,,609.16,Percent of total billed charges,,,0.96,,602.88,Percent of total billed charges,,,0.95,,596.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,596.6,Percent of total billed charges,,596.6,615.44,
HC PR 27823 Open Treatment of Ankle Fracture W/Fixation,PX-96910780,CDM,27823,CPT,983,RC,,inpatient,,,2441,2196.9,,0.95,,2318.95,Percent of total billed charges,,,0.98,,2392.18,Percent of total billed charges,,,0.95,,2318.95,Percent of total billed charges,,,0.97,,2367.77,Percent of total billed charges,,,0.97,,2367.77,Percent of total billed charges,,,0.96,,2343.36,Percent of total billed charges,,,0.95,,2318.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2318.95,Percent of total billed charges,,2318.95,2392.18,
HC PR 27823 Open Treatment of Ankle Fracture W/Fixation,PX-96910780,CDM,27823,CPT,983,RC,,outpatient,,,2441,2196.9,,0.95,,2318.95,Percent of total billed charges,,,0.98,,2392.18,Percent of total billed charges,,,0.95,,2318.95,Percent of total billed charges,,,0.95,,2318.95,Percent of total billed charges,,,0.97,,2367.77,Percent of total billed charges,,,0.96,,2343.36,Percent of total billed charges,,,0.95,,2318.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2318.95,Percent of total billed charges,,2318.95,2392.18,
HC PR 28820 Amputation of Toe,PX-96910798,CDM,28820,CPT,983,RC,,inpatient,,,1345,1210.5,,0.95,,1277.75,Percent of total billed charges,,,0.98,,1318.1,Percent of total billed charges,,,0.95,,1277.75,Percent of total billed charges,,,0.97,,1304.65,Percent of total billed charges,,,0.97,,1304.65,Percent of total billed charges,,,0.96,,1291.2,Percent of total billed charges,,,0.95,,1277.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1277.75,Percent of total billed charges,,1277.75,1318.1,
HC PR 28820 Amputation of Toe,PX-96910798,CDM,28820,CPT,983,RC,,outpatient,,,1345,1210.5,,0.95,,1277.75,Percent of total billed charges,,,0.98,,1318.1,Percent of total billed charges,,,0.95,,1277.75,Percent of total billed charges,,,0.95,,1277.75,Percent of total billed charges,,,0.97,,1304.65,Percent of total billed charges,,,0.96,,1291.2,Percent of total billed charges,,,0.95,,1277.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1277.75,Percent of total billed charges,,1277.75,1318.1,
HC PR 29085 Apply Hand/Wrist Cast,PX-96910800,CDM,29085,CPT,983,RC,,inpatient,,,259,233.1,,0.95,,246.05,Percent of total billed charges,,,0.98,,253.82,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,0.97,,251.23,Percent of total billed charges,,,0.97,,251.23,Percent of total billed charges,,,0.96,,248.64,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,246.05,Percent of total billed charges,,246.05,253.82,
HC PR 29085 Apply Hand/Wrist Cast,PX-96910800,CDM,29085,CPT,983,RC,,outpatient,,,259,233.1,,0.95,,246.05,Percent of total billed charges,,,0.98,,253.82,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,0.97,,251.23,Percent of total billed charges,,,0.96,,248.64,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,246.05,Percent of total billed charges,,246.05,253.82,
HC PR 29440 Addition of Walker to Cast,PX-96910873,CDM,29440,CPT,983,RC,,inpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
HC PR 29440 Addition of Walker to Cast,PX-96910873,CDM,29440,CPT,983,RC,,outpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
HC PR 29710 Removal/Revision of Cast,PX-96910874,CDM,29710,CPT,983,RC,,inpatient,,,107,96.3,,0.95,,101.65,Percent of total billed charges,,,0.98,,104.86,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.96,,102.72,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,101.65,Percent of total billed charges,,101.65,104.86,
HC PR 29710 Removal/Revision of Cast,PX-96910874,CDM,29710,CPT,983,RC,,outpatient,,,107,96.3,,0.95,,101.65,Percent of total billed charges,,,0.98,,104.86,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.96,,102.72,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,101.65,Percent of total billed charges,,101.65,104.86,
HC PR 29870 Knee Arthroscopy Dx,PX-96910882,CDM,29870,CPT,983,RC,,inpatient,,,1376,1238.4,,0.95,,1307.2,Percent of total billed charges,,,0.98,,1348.48,Percent of total billed charges,,,0.95,,1307.2,Percent of total billed charges,,,0.97,,1334.72,Percent of total billed charges,,,0.97,,1334.72,Percent of total billed charges,,,0.96,,1320.96,Percent of total billed charges,,,0.95,,1307.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1307.2,Percent of total billed charges,,1307.2,1348.48,
HC PR 29870 Knee Arthroscopy Dx,PX-96910882,CDM,29870,CPT,983,RC,,outpatient,,,1376,1238.4,,0.95,,1307.2,Percent of total billed charges,,,0.98,,1348.48,Percent of total billed charges,,,0.95,,1307.2,Percent of total billed charges,,,0.95,,1307.2,Percent of total billed charges,,,0.97,,1334.72,Percent of total billed charges,,,0.96,,1320.96,Percent of total billed charges,,,0.95,,1307.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1307.2,Percent of total billed charges,,1307.2,1348.48,
HC PR 29881 Knee Arthroscopy/Surgery Menisectomy,PX-96910890,CDM,29881,CPT,983,RC,,inpatient,,,664,597.6,,0.95,,630.8,Percent of total billed charges,,,0.98,,650.72,Percent of total billed charges,,,0.95,,630.8,Percent of total billed charges,,,0.97,,644.08,Percent of total billed charges,,,0.97,,644.08,Percent of total billed charges,,,0.96,,637.44,Percent of total billed charges,,,0.95,,630.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,630.8,Percent of total billed charges,,630.8,650.72,
HC PR 29881 Knee Arthroscopy/Surgery Menisectomy,PX-96910890,CDM,29881,CPT,983,RC,,outpatient,,,664,597.6,,0.95,,630.8,Percent of total billed charges,,,0.98,,650.72,Percent of total billed charges,,,0.95,,630.8,Percent of total billed charges,,,0.95,,630.8,Percent of total billed charges,,,0.97,,644.08,Percent of total billed charges,,,0.96,,637.44,Percent of total billed charges,,,0.95,,630.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,630.8,Percent of total billed charges,,630.8,650.72,
HC PR 29450 Application of Leg Cast,PX-96910895,CDM,29450,CPT,983,RC,,inpatient,,,362,325.8,,0.95,,343.9,Percent of total billed charges,,,0.98,,354.76,Percent of total billed charges,,,0.95,,343.9,Percent of total billed charges,,,0.97,,351.14,Percent of total billed charges,,,0.97,,351.14,Percent of total billed charges,,,0.96,,347.52,Percent of total billed charges,,,0.95,,343.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,343.9,Percent of total billed charges,,343.9,354.76,
HC PR 29450 Application of Leg Cast,PX-96910895,CDM,29450,CPT,983,RC,,outpatient,,,362,325.8,,0.95,,343.9,Percent of total billed charges,,,0.98,,354.76,Percent of total billed charges,,,0.95,,343.9,Percent of total billed charges,,,0.95,,343.9,Percent of total billed charges,,,0.97,,351.14,Percent of total billed charges,,,0.96,,347.52,Percent of total billed charges,,,0.95,,343.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,343.9,Percent of total billed charges,,343.9,354.76,
HC PR 27324 Biopsy Thigh Soft Tissues Deep,PX-97510941,CDM,27324,CPT,975,RC,,inpatient,,,1025,922.5,,0.95,,973.75,Percent of total billed charges,,,0.98,,1004.5,Percent of total billed charges,,,0.95,,973.75,Percent of total billed charges,,,0.97,,994.25,Percent of total billed charges,,,0.97,,994.25,Percent of total billed charges,,,0.96,,984,Percent of total billed charges,,,0.95,,973.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,973.75,Percent of total billed charges,,973.75,1004.5,
HC PR 27324 Biopsy Thigh Soft Tissues Deep,PX-97510941,CDM,27324,CPT,975,RC,,outpatient,,,1025,922.5,,0.95,,973.75,Percent of total billed charges,,,0.98,,1004.5,Percent of total billed charges,,,0.95,,973.75,Percent of total billed charges,,,0.95,,973.75,Percent of total billed charges,,,0.97,,994.25,Percent of total billed charges,,,0.96,,984,Percent of total billed charges,,,0.95,,973.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,973.75,Percent of total billed charges,,973.75,1004.5,
HC PR 27327 Exc Thigh/Knee Les Sc < 3 Cm,PX-97510942,CDM,27327,CPT,975,RC,,inpatient,,,1035,931.5,,0.95,,983.25,Percent of total billed charges,,,0.98,,1014.3,Percent of total billed charges,,,0.95,,983.25,Percent of total billed charges,,,0.97,,1003.95,Percent of total billed charges,,,0.97,,1003.95,Percent of total billed charges,,,0.96,,993.6,Percent of total billed charges,,,0.95,,983.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,983.25,Percent of total billed charges,,983.25,1014.3,
HC PR 27327 Exc Thigh/Knee Les Sc < 3 Cm,PX-97510942,CDM,27327,CPT,975,RC,,outpatient,,,1035,931.5,,0.95,,983.25,Percent of total billed charges,,,0.98,,1014.3,Percent of total billed charges,,,0.95,,983.25,Percent of total billed charges,,,0.95,,983.25,Percent of total billed charges,,,0.97,,1003.95,Percent of total billed charges,,,0.96,,993.6,Percent of total billed charges,,,0.95,,983.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,983.25,Percent of total billed charges,,983.25,1014.3,
HC PR 27422 Revision of Unstable Kneecap,PX-97510946,CDM,27422,CPT,975,RC,,inpatient,,,1847,1662.3,,0.95,,1754.65,Percent of total billed charges,,,0.98,,1810.06,Percent of total billed charges,,,0.95,,1754.65,Percent of total billed charges,,,0.97,,1791.59,Percent of total billed charges,,,0.97,,1791.59,Percent of total billed charges,,,0.96,,1773.12,Percent of total billed charges,,,0.95,,1754.65,Percent of total billed charges,,,,,,,,,0.95,,1754.65,Percent of total billed charges,,1754.65,1810.06,
HC PR 27422 Revision of Unstable Kneecap,PX-97510946,CDM,27422,CPT,975,RC,,outpatient,,,1847,1662.3,,0.95,,1754.65,Percent of total billed charges,,,0.98,,1810.06,Percent of total billed charges,,,0.95,,1754.65,Percent of total billed charges,,,0.95,,1754.65,Percent of total billed charges,,,0.97,,1791.59,Percent of total billed charges,,,0.96,,1773.12,Percent of total billed charges,,,0.95,,1754.65,Percent of total billed charges,,,,,,,,,0.95,,1754.65,Percent of total billed charges,,1754.65,1810.06,
HC PR 27618 Exc Leg/Ankle Tum < 3 Cm,PX-97510953,CDM,27618,CPT,975,RC,,inpatient,,,1203,1082.7,,0.95,,1142.85,Percent of total billed charges,,,0.98,,1178.94,Percent of total billed charges,,,0.95,,1142.85,Percent of total billed charges,,,0.97,,1166.91,Percent of total billed charges,,,0.97,,1166.91,Percent of total billed charges,,,0.96,,1154.88,Percent of total billed charges,,,0.95,,1142.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1142.85,Percent of total billed charges,,1142.85,1178.94,
HC PR 27618 Exc Leg/Ankle Tum < 3 Cm,PX-97510953,CDM,27618,CPT,975,RC,,outpatient,,,1203,1082.7,,0.95,,1142.85,Percent of total billed charges,,,0.98,,1178.94,Percent of total billed charges,,,0.95,,1142.85,Percent of total billed charges,,,0.95,,1142.85,Percent of total billed charges,,,0.97,,1166.91,Percent of total billed charges,,,0.96,,1154.88,Percent of total billed charges,,,0.95,,1142.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1142.85,Percent of total billed charges,,1142.85,1178.94,
HC PR 27822 Open Tx of Ankle Fracture W/O Fixation of Posterior Lip,PX-97510964,CDM,27822,CPT,975,RC,,inpatient,,,1853,1667.7,,0.95,,1760.35,Percent of total billed charges,,,0.98,,1815.94,Percent of total billed charges,,,0.95,,1760.35,Percent of total billed charges,,,0.97,,1797.41,Percent of total billed charges,,,0.97,,1797.41,Percent of total billed charges,,,0.96,,1778.88,Percent of total billed charges,,,0.95,,1760.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1760.35,Percent of total billed charges,,1760.35,1815.94,
HC PR 27822 Open Tx of Ankle Fracture W/O Fixation of Posterior Lip,PX-97510964,CDM,27822,CPT,975,RC,,outpatient,,,1853,1667.7,,0.95,,1760.35,Percent of total billed charges,,,0.98,,1815.94,Percent of total billed charges,,,0.95,,1760.35,Percent of total billed charges,,,0.95,,1760.35,Percent of total billed charges,,,0.97,,1797.41,Percent of total billed charges,,,0.96,,1778.88,Percent of total billed charges,,,0.95,,1760.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1760.35,Percent of total billed charges,,1760.35,1815.94,
HC PR 27880 Amputation Leg Through Tibia & Fibula Cdm,PX-97510966,CDM,27880,CPT,975,RC,,inpatient,,,2299,2069.1,,0.95,,2184.05,Percent of total billed charges,,,0.98,,2253.02,Percent of total billed charges,,,0.95,,2184.05,Percent of total billed charges,,,0.97,,2230.03,Percent of total billed charges,,,0.97,,2230.03,Percent of total billed charges,,,0.96,,2207.04,Percent of total billed charges,,,0.95,,2184.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2184.05,Percent of total billed charges,,2184.05,2253.02,
HC PR 27880 Amputation Leg Through Tibia & Fibula Cdm,PX-97510966,CDM,27880,CPT,975,RC,,outpatient,,,2299,2069.1,,0.95,,2184.05,Percent of total billed charges,,,0.98,,2253.02,Percent of total billed charges,,,0.95,,2184.05,Percent of total billed charges,,,0.95,,2184.05,Percent of total billed charges,,,0.97,,2230.03,Percent of total billed charges,,,0.96,,2207.04,Percent of total billed charges,,,0.95,,2184.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2184.05,Percent of total billed charges,,2184.05,2253.02,
HC PR 27886 Amputation Follow-Up Surgery,PX-97510967,CDM,27886,CPT,975,RC,,inpatient,,,1594,1434.6,,0.95,,1514.3,Percent of total billed charges,,,0.98,,1562.12,Percent of total billed charges,,,0.95,,1514.3,Percent of total billed charges,,,0.97,,1546.18,Percent of total billed charges,,,0.97,,1546.18,Percent of total billed charges,,,0.96,,1530.24,Percent of total billed charges,,,0.95,,1514.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1514.3,Percent of total billed charges,,1514.3,1562.12,
HC PR 27886 Amputation Follow-Up Surgery,PX-97510967,CDM,27886,CPT,975,RC,,outpatient,,,1594,1434.6,,0.95,,1514.3,Percent of total billed charges,,,0.98,,1562.12,Percent of total billed charges,,,0.95,,1514.3,Percent of total billed charges,,,0.95,,1514.3,Percent of total billed charges,,,0.97,,1546.18,Percent of total billed charges,,,0.96,,1530.24,Percent of total billed charges,,,0.95,,1514.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1514.3,Percent of total billed charges,,1514.3,1562.12,
HC PR 28043 Excision Tumor Soft Tissue Foot/Toe Subq Lt 1.5cm Cdm,PX-97510970,CDM,28043,CPT,975,RC,,inpatient,,,943,848.7,,0.95,,895.85,Percent of total billed charges,,,0.98,,924.14,Percent of total billed charges,,,0.95,,895.85,Percent of total billed charges,,,0.97,,914.71,Percent of total billed charges,,,0.97,,914.71,Percent of total billed charges,,,0.96,,905.28,Percent of total billed charges,,,0.95,,895.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,895.85,Percent of total billed charges,,895.85,924.14,
HC PR 28043 Excision Tumor Soft Tissue Foot/Toe Subq Lt 1.5cm Cdm,PX-97510970,CDM,28043,CPT,975,RC,,outpatient,,,943,848.7,,0.95,,895.85,Percent of total billed charges,,,0.98,,924.14,Percent of total billed charges,,,0.95,,895.85,Percent of total billed charges,,,0.95,,895.85,Percent of total billed charges,,,0.97,,914.71,Percent of total billed charges,,,0.96,,905.28,Percent of total billed charges,,,0.95,,895.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,895.85,Percent of total billed charges,,895.85,924.14,
HC PR 28285 Repair of Hammertoe,PX-97510973,CDM,28285,CPT,975,RC,,inpatient,,,1200,1080,,0.95,,1140,Percent of total billed charges,,,0.98,,1176,Percent of total billed charges,,,0.95,,1140,Percent of total billed charges,,,0.97,,1164,Percent of total billed charges,,,0.97,,1164,Percent of total billed charges,,,0.96,,1152,Percent of total billed charges,,,0.95,,1140,Percent of total billed charges,,,,,,,,,0.95,,1140,Percent of total billed charges,,1140,1176,
HC PR 28285 Repair of Hammertoe,PX-97510973,CDM,28285,CPT,975,RC,,outpatient,,,1200,1080,,0.95,,1140,Percent of total billed charges,,,0.98,,1176,Percent of total billed charges,,,0.95,,1140,Percent of total billed charges,,,0.95,,1140,Percent of total billed charges,,,0.97,,1164,Percent of total billed charges,,,0.96,,1152,Percent of total billed charges,,,0.95,,1140,Percent of total billed charges,,,,,,,,,0.95,,1140,Percent of total billed charges,,1140,1176,
HC PR 29824 Shoulder Arthroscopy/Surgery,PX-97510979,CDM,29824,CPT,975,RC,,inpatient,,,1686,1517.4,,0.95,,1601.7,Percent of total billed charges,,,0.98,,1652.28,Percent of total billed charges,,,0.95,,1601.7,Percent of total billed charges,,,0.97,,1635.42,Percent of total billed charges,,,0.97,,1635.42,Percent of total billed charges,,,0.96,,1618.56,Percent of total billed charges,,,0.95,,1601.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1601.7,Percent of total billed charges,,1601.7,1652.28,
HC PR 29824 Shoulder Arthroscopy/Surgery,PX-97510979,CDM,29824,CPT,975,RC,,outpatient,,,1686,1517.4,,0.95,,1601.7,Percent of total billed charges,,,0.98,,1652.28,Percent of total billed charges,,,0.95,,1601.7,Percent of total billed charges,,,0.95,,1601.7,Percent of total billed charges,,,0.97,,1635.42,Percent of total billed charges,,,0.96,,1618.56,Percent of total billed charges,,,0.95,,1601.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1601.7,Percent of total billed charges,,1601.7,1652.28,
HC PR 29876 Knee Arthro Synovectomy >=2,PX-97510981,CDM,29876,CPT,975,RC,,inpatient,,,1625,1462.5,,0.95,,1543.75,Percent of total billed charges,,,0.98,,1592.5,Percent of total billed charges,,,0.95,,1543.75,Percent of total billed charges,,,0.97,,1576.25,Percent of total billed charges,,,0.97,,1576.25,Percent of total billed charges,,,0.96,,1560,Percent of total billed charges,,,0.95,,1543.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1543.75,Percent of total billed charges,,1543.75,1592.5,
HC PR 29876 Knee Arthro Synovectomy >=2,PX-97510981,CDM,29876,CPT,975,RC,,outpatient,,,1625,1462.5,,0.95,,1543.75,Percent of total billed charges,,,0.98,,1592.5,Percent of total billed charges,,,0.95,,1543.75,Percent of total billed charges,,,0.95,,1543.75,Percent of total billed charges,,,0.97,,1576.25,Percent of total billed charges,,,0.96,,1560,Percent of total billed charges,,,0.95,,1543.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1543.75,Percent of total billed charges,,1543.75,1592.5,
HC PR ED 27786 Closed Treatment of Ankle Fracture W/O Manip Cdm,PX-98110402,CDM,27786,CPT,981,RC,,inpatient,,,1155,1039.5,,0.95,,1097.25,Percent of total billed charges,,,0.98,,1131.9,Percent of total billed charges,,,0.95,,1097.25,Percent of total billed charges,,,0.97,,1120.35,Percent of total billed charges,,,0.97,,1120.35,Percent of total billed charges,,,0.96,,1108.8,Percent of total billed charges,,,0.95,,1097.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1097.25,Percent of total billed charges,,1097.25,1131.9,
HC PR ED 27786 Closed Treatment of Ankle Fracture W/O Manip Cdm,PX-98110402,CDM,27786,CPT,981,RC,,outpatient,,,1155,1039.5,,0.95,,1097.25,Percent of total billed charges,,,0.98,,1131.9,Percent of total billed charges,,,0.95,,1097.25,Percent of total billed charges,,,0.95,,1097.25,Percent of total billed charges,,,0.97,,1120.35,Percent of total billed charges,,,0.96,,1108.8,Percent of total billed charges,,,0.95,,1097.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1097.25,Percent of total billed charges,,1097.25,1131.9,
HC PR ED 27788 Closed Treatment of Ankle Fracture W/Manip Cdm,PX-98110405,CDM,27788,CPT,981,RC,,inpatient,,,1096,986.4,,0.95,,1041.2,Percent of total billed charges,,,0.98,,1074.08,Percent of total billed charges,,,0.95,,1041.2,Percent of total billed charges,,,0.97,,1063.12,Percent of total billed charges,,,0.97,,1063.12,Percent of total billed charges,,,0.96,,1052.16,Percent of total billed charges,,,0.95,,1041.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1041.2,Percent of total billed charges,,1041.2,1074.08,
HC PR ED 27788 Closed Treatment of Ankle Fracture W/Manip Cdm,PX-98110405,CDM,27788,CPT,981,RC,,outpatient,,,1096,986.4,,0.95,,1041.2,Percent of total billed charges,,,0.98,,1074.08,Percent of total billed charges,,,0.95,,1041.2,Percent of total billed charges,,,0.95,,1041.2,Percent of total billed charges,,,0.97,,1063.12,Percent of total billed charges,,,0.96,,1052.16,Percent of total billed charges,,,0.95,,1041.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1041.2,Percent of total billed charges,,1041.2,1074.08,
HC PR ED 27840 Closed Treatment of Ankle Dislocation W/O Anesth Cdm,PX-98110417,CDM,27840,CPT,981,RC,,inpatient,,,983,884.7,,0.95,,933.85,Percent of total billed charges,,,0.98,,963.34,Percent of total billed charges,,,0.95,,933.85,Percent of total billed charges,,,0.97,,953.51,Percent of total billed charges,,,0.97,,953.51,Percent of total billed charges,,,0.96,,943.68,Percent of total billed charges,,,0.95,,933.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,933.85,Percent of total billed charges,,933.85,963.34,
HC PR ED 27840 Closed Treatment of Ankle Dislocation W/O Anesth Cdm,PX-98110417,CDM,27840,CPT,981,RC,,outpatient,,,983,884.7,,0.95,,933.85,Percent of total billed charges,,,0.98,,963.34,Percent of total billed charges,,,0.95,,933.85,Percent of total billed charges,,,0.95,,933.85,Percent of total billed charges,,,0.97,,953.51,Percent of total billed charges,,,0.96,,943.68,Percent of total billed charges,,,0.95,,933.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,933.85,Percent of total billed charges,,933.85,963.34,
HC PR ED 27842 Closed Treat Ankle Dislocation W/Anesth Cdm,PX-98110418,CDM,27842,CPT,981,RC,,inpatient,,,1823,1640.7,,0.95,,1731.85,Percent of total billed charges,,,0.98,,1786.54,Percent of total billed charges,,,0.95,,1731.85,Percent of total billed charges,,,0.97,,1768.31,Percent of total billed charges,,,0.97,,1768.31,Percent of total billed charges,,,0.96,,1750.08,Percent of total billed charges,,,0.95,,1731.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1731.85,Percent of total billed charges,,1731.85,1786.54,
HC PR ED 27842 Closed Treat Ankle Dislocation W/Anesth Cdm,PX-98110418,CDM,27842,CPT,981,RC,,outpatient,,,1823,1640.7,,0.95,,1731.85,Percent of total billed charges,,,0.98,,1786.54,Percent of total billed charges,,,0.95,,1731.85,Percent of total billed charges,,,0.95,,1731.85,Percent of total billed charges,,,0.97,,1768.31,Percent of total billed charges,,,0.96,,1750.08,Percent of total billed charges,,,0.95,,1731.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1731.85,Percent of total billed charges,,1731.85,1786.54,
HC PR ED 28192 Removal of Foot Foreign Body Deep Cdm,PX-98110419,CDM,28192,CPT,981,RC,,inpatient,,,1232,1108.8,,0.95,,1170.4,Percent of total billed charges,,,0.98,,1207.36,Percent of total billed charges,,,0.95,,1170.4,Percent of total billed charges,,,0.97,,1195.04,Percent of total billed charges,,,0.97,,1195.04,Percent of total billed charges,,,0.96,,1182.72,Percent of total billed charges,,,0.95,,1170.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1170.4,Percent of total billed charges,,1170.4,1207.36,
HC PR ED 28192 Removal of Foot Foreign Body Deep Cdm,PX-98110419,CDM,28192,CPT,981,RC,,outpatient,,,1232,1108.8,,0.95,,1170.4,Percent of total billed charges,,,0.98,,1207.36,Percent of total billed charges,,,0.95,,1170.4,Percent of total billed charges,,,0.95,,1170.4,Percent of total billed charges,,,0.97,,1195.04,Percent of total billed charges,,,0.96,,1182.72,Percent of total billed charges,,,0.95,,1170.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1170.4,Percent of total billed charges,,1170.4,1207.36,
HC PR ED 28430 Treatment of Talus Fracture W/O Manipulation Cdm,PX-98110429,CDM,28430,CPT,981,RC,,inpatient,,,669,602.1,,0.95,,635.55,Percent of total billed charges,,,0.98,,655.62,Percent of total billed charges,,,0.95,,635.55,Percent of total billed charges,,,0.97,,648.93,Percent of total billed charges,,,0.97,,648.93,Percent of total billed charges,,,0.96,,642.24,Percent of total billed charges,,,0.95,,635.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,635.55,Percent of total billed charges,,635.55,655.62,
HC PR ED 28430 Treatment of Talus Fracture W/O Manipulation Cdm,PX-98110429,CDM,28430,CPT,981,RC,,outpatient,,,669,602.1,,0.95,,635.55,Percent of total billed charges,,,0.98,,655.62,Percent of total billed charges,,,0.95,,635.55,Percent of total billed charges,,,0.95,,635.55,Percent of total billed charges,,,0.97,,648.93,Percent of total billed charges,,,0.96,,642.24,Percent of total billed charges,,,0.95,,635.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,635.55,Percent of total billed charges,,635.55,655.62,
HC PR ED 29700 Remov Bival Gaun Boot/Body Cast Cdm,PX-98110430,CDM,29700,CPT,981,RC,,inpatient,,,174,156.6,,0.95,,165.3,Percent of total billed charges,,,0.98,,170.52,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,0.97,,168.78,Percent of total billed charges,,,0.97,,168.78,Percent of total billed charges,,,0.96,,167.04,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,165.3,Percent of total billed charges,,165.3,170.52,
HC PR ED 29700 Remov Bival Gaun Boot/Body Cast Cdm,PX-98110430,CDM,29700,CPT,981,RC,,outpatient,,,174,156.6,,0.95,,165.3,Percent of total billed charges,,,0.98,,170.52,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,0.97,,168.78,Percent of total billed charges,,,0.96,,167.04,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,165.3,Percent of total billed charges,,165.3,170.52,
HC PR ED 28470 Treat Metatarsal Fracture W/O Manipulation Cdm,PX-98110436,CDM,28470,CPT,981,RC,,inpatient,,,869,782.1,,0.95,,825.55,Percent of total billed charges,,,0.98,,851.62,Percent of total billed charges,,,0.95,,825.55,Percent of total billed charges,,,0.97,,842.93,Percent of total billed charges,,,0.97,,842.93,Percent of total billed charges,,,0.96,,834.24,Percent of total billed charges,,,0.95,,825.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,825.55,Percent of total billed charges,,825.55,851.62,
HC PR ED 28470 Treat Metatarsal Fracture W/O Manipulation Cdm,PX-98110436,CDM,28470,CPT,981,RC,,outpatient,,,869,782.1,,0.95,,825.55,Percent of total billed charges,,,0.98,,851.62,Percent of total billed charges,,,0.95,,825.55,Percent of total billed charges,,,0.95,,825.55,Percent of total billed charges,,,0.97,,842.93,Percent of total billed charges,,,0.96,,834.24,Percent of total billed charges,,,0.95,,825.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,825.55,Percent of total billed charges,,825.55,851.62,
HC PR ED 28490 Closed Treat Big Toe Fracture W/O Manip Cdm,PX-98110440,CDM,28490,CPT,981,RC,,inpatient,,,452,406.8,,0.95,,429.4,Percent of total billed charges,,,0.98,,442.96,Percent of total billed charges,,,0.95,,429.4,Percent of total billed charges,,,0.97,,438.44,Percent of total billed charges,,,0.97,,438.44,Percent of total billed charges,,,0.96,,433.92,Percent of total billed charges,,,0.95,,429.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,429.4,Percent of total billed charges,,429.4,442.96,
HC PR ED 28490 Closed Treat Big Toe Fracture W/O Manip Cdm,PX-98110440,CDM,28490,CPT,981,RC,,outpatient,,,452,406.8,,0.95,,429.4,Percent of total billed charges,,,0.98,,442.96,Percent of total billed charges,,,0.95,,429.4,Percent of total billed charges,,,0.95,,429.4,Percent of total billed charges,,,0.97,,438.44,Percent of total billed charges,,,0.96,,433.92,Percent of total billed charges,,,0.95,,429.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,429.4,Percent of total billed charges,,429.4,442.96,
HC PR ED 28495 Treat Big Toe Fracture W/Manipulation Cdm,PX-98110443,CDM,28495,CPT,981,RC,,inpatient,,,456,410.4,,0.95,,433.2,Percent of total billed charges,,,0.98,,446.88,Percent of total billed charges,,,0.95,,433.2,Percent of total billed charges,,,0.97,,442.32,Percent of total billed charges,,,0.97,,442.32,Percent of total billed charges,,,0.96,,437.76,Percent of total billed charges,,,0.95,,433.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,433.2,Percent of total billed charges,,433.2,446.88,
HC PR ED 28495 Treat Big Toe Fracture W/Manipulation Cdm,PX-98110443,CDM,28495,CPT,981,RC,,outpatient,,,456,410.4,,0.95,,433.2,Percent of total billed charges,,,0.98,,446.88,Percent of total billed charges,,,0.95,,433.2,Percent of total billed charges,,,0.95,,433.2,Percent of total billed charges,,,0.97,,442.32,Percent of total billed charges,,,0.96,,437.76,Percent of total billed charges,,,0.95,,433.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,433.2,Percent of total billed charges,,433.2,446.88,
HC PR ED 28510 Treatment of Toe Fracture Phalanx Cdm,PX-98110445,CDM,28510,CPT,981,RC,,inpatient,,,473,425.7,,0.95,,449.35,Percent of total billed charges,,,0.98,,463.54,Percent of total billed charges,,,0.95,,449.35,Percent of total billed charges,,,0.97,,458.81,Percent of total billed charges,,,0.97,,458.81,Percent of total billed charges,,,0.96,,454.08,Percent of total billed charges,,,0.95,,449.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,449.35,Percent of total billed charges,,449.35,463.54,
HC PR ED 28510 Treatment of Toe Fracture Phalanx Cdm,PX-98110445,CDM,28510,CPT,981,RC,,outpatient,,,473,425.7,,0.95,,449.35,Percent of total billed charges,,,0.98,,463.54,Percent of total billed charges,,,0.95,,449.35,Percent of total billed charges,,,0.95,,449.35,Percent of total billed charges,,,0.97,,458.81,Percent of total billed charges,,,0.96,,454.08,Percent of total billed charges,,,0.95,,449.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,449.35,Percent of total billed charges,,449.35,463.54,
HC PR ED 28515 Treatment of Toe Fracture Phalanx W/Manip Cdm,PX-98110448,CDM,28515,CPT,981,RC,,inpatient,,,523,470.7,,0.95,,496.85,Percent of total billed charges,,,0.98,,512.54,Percent of total billed charges,,,0.95,,496.85,Percent of total billed charges,,,0.97,,507.31,Percent of total billed charges,,,0.97,,507.31,Percent of total billed charges,,,0.96,,502.08,Percent of total billed charges,,,0.95,,496.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,496.85,Percent of total billed charges,,496.85,512.54,
HC PR ED 28515 Treatment of Toe Fracture Phalanx W/Manip Cdm,PX-98110448,CDM,28515,CPT,981,RC,,outpatient,,,523,470.7,,0.95,,496.85,Percent of total billed charges,,,0.98,,512.54,Percent of total billed charges,,,0.95,,496.85,Percent of total billed charges,,,0.95,,496.85,Percent of total billed charges,,,0.97,,507.31,Percent of total billed charges,,,0.96,,502.08,Percent of total billed charges,,,0.95,,496.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,496.85,Percent of total billed charges,,496.85,512.54,
HC PR ED 28630 Treat Metatarsophal Dislocation Cdm,PX-98110460,CDM,28630,CPT,981,RC,,inpatient,,,517,465.3,,0.95,,491.15,Percent of total billed charges,,,0.98,,506.66,Percent of total billed charges,,,0.95,,491.15,Percent of total billed charges,,,0.97,,501.49,Percent of total billed charges,,,0.97,,501.49,Percent of total billed charges,,,0.96,,496.32,Percent of total billed charges,,,0.95,,491.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,491.15,Percent of total billed charges,,491.15,506.66,
HC PR ED 28630 Treat Metatarsophal Dislocation Cdm,PX-98110460,CDM,28630,CPT,981,RC,,outpatient,,,517,465.3,,0.95,,491.15,Percent of total billed charges,,,0.98,,506.66,Percent of total billed charges,,,0.95,,491.15,Percent of total billed charges,,,0.95,,491.15,Percent of total billed charges,,,0.97,,501.49,Percent of total billed charges,,,0.96,,496.32,Percent of total billed charges,,,0.95,,491.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,491.15,Percent of total billed charges,,491.15,506.66,
HC PR ED 28660 Closed Treat Toe Dislocation Cdm,PX-98110462,CDM,28660,CPT,981,RC,,inpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,440.8,Percent of total billed charges,,440.8,454.72,
HC PR ED 28660 Closed Treat Toe Dislocation Cdm,PX-98110462,CDM,28660,CPT,981,RC,,outpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,440.8,Percent of total billed charges,,440.8,454.72,
HC PR ED 29065 Long Arm Cast Application Cdm,PX-98110466,CDM,29065,CPT,981,RC,,inpatient,,,298,268.2,,0.95,,283.1,Percent of total billed charges,,,0.98,,292.04,Percent of total billed charges,,,0.95,,283.1,Percent of total billed charges,,,0.97,,289.06,Percent of total billed charges,,,0.97,,289.06,Percent of total billed charges,,,0.96,,286.08,Percent of total billed charges,,,0.95,,283.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,283.1,Percent of total billed charges,,283.1,292.04,
HC PR ED 29065 Long Arm Cast Application Cdm,PX-98110466,CDM,29065,CPT,981,RC,,outpatient,,,298,268.2,,0.95,,283.1,Percent of total billed charges,,,0.98,,292.04,Percent of total billed charges,,,0.95,,283.1,Percent of total billed charges,,,0.95,,283.1,Percent of total billed charges,,,0.97,,289.06,Percent of total billed charges,,,0.96,,286.08,Percent of total billed charges,,,0.95,,283.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,283.1,Percent of total billed charges,,283.1,292.04,
HC PR ED 29075 Application Cast Elbow Finger Short Arm Cdm,PX-98110467,CDM,29075,CPT,981,RC,,inpatient,,,267,240.3,,0.95,,253.65,Percent of total billed charges,,,0.98,,261.66,Percent of total billed charges,,,0.95,,253.65,Percent of total billed charges,,,0.97,,258.99,Percent of total billed charges,,,0.97,,258.99,Percent of total billed charges,,,0.96,,256.32,Percent of total billed charges,,,0.95,,253.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,253.65,Percent of total billed charges,,253.65,261.66,
HC PR ED 29075 Application Cast Elbow Finger Short Arm Cdm,PX-98110467,CDM,29075,CPT,981,RC,,outpatient,,,267,240.3,,0.95,,253.65,Percent of total billed charges,,,0.98,,261.66,Percent of total billed charges,,,0.95,,253.65,Percent of total billed charges,,,0.95,,253.65,Percent of total billed charges,,,0.97,,258.99,Percent of total billed charges,,,0.96,,256.32,Percent of total billed charges,,,0.95,,253.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,253.65,Percent of total billed charges,,253.65,261.66,
HC PR ED 29105 Long Arm Splint Application Cdm,PX-98110468,CDM,29105,CPT,981,RC,,inpatient,,,229,206.1,,0.95,,217.55,Percent of total billed charges,,,0.98,,224.42,Percent of total billed charges,,,0.95,,217.55,Percent of total billed charges,,,0.97,,222.13,Percent of total billed charges,,,0.97,,222.13,Percent of total billed charges,,,0.96,,219.84,Percent of total billed charges,,,0.95,,217.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,217.55,Percent of total billed charges,,217.55,224.42,
HC PR ED 29105 Long Arm Splint Application Cdm,PX-98110468,CDM,29105,CPT,981,RC,,outpatient,,,229,206.1,,0.95,,217.55,Percent of total billed charges,,,0.98,,224.42,Percent of total billed charges,,,0.95,,217.55,Percent of total billed charges,,,0.95,,217.55,Percent of total billed charges,,,0.97,,222.13,Percent of total billed charges,,,0.96,,219.84,Percent of total billed charges,,,0.95,,217.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,217.55,Percent of total billed charges,,217.55,224.42,
HC PR ED 29125 Short Arm Splint Application Cdm,PX-98110469,CDM,29125,CPT,981,RC,,inpatient,,,199,179.1,,0.95,,189.05,Percent of total billed charges,,,0.98,,195.02,Percent of total billed charges,,,0.95,,189.05,Percent of total billed charges,,,0.97,,193.03,Percent of total billed charges,,,0.97,,193.03,Percent of total billed charges,,,0.96,,191.04,Percent of total billed charges,,,0.95,,189.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,189.05,Percent of total billed charges,,189.05,195.02,
HC PR ED 29125 Short Arm Splint Application Cdm,PX-98110469,CDM,29125,CPT,981,RC,,outpatient,,,199,179.1,,0.95,,189.05,Percent of total billed charges,,,0.98,,195.02,Percent of total billed charges,,,0.95,,189.05,Percent of total billed charges,,,0.95,,189.05,Percent of total billed charges,,,0.97,,193.03,Percent of total billed charges,,,0.96,,191.04,Percent of total billed charges,,,0.95,,189.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,189.05,Percent of total billed charges,,189.05,195.02,
HC PR ED 29126 Apply Forearm Splint Dyn Cdm,PX-98110470,CDM,29126,CPT,981,RC,,inpatient,,,197,177.3,,0.95,,187.15,Percent of total billed charges,,,0.98,,193.06,Percent of total billed charges,,,0.95,,187.15,Percent of total billed charges,,,0.97,,191.09,Percent of total billed charges,,,0.97,,191.09,Percent of total billed charges,,,0.96,,189.12,Percent of total billed charges,,,0.95,,187.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,187.15,Percent of total billed charges,,187.15,193.06,
HC PR ED 29126 Apply Forearm Splint Dyn Cdm,PX-98110470,CDM,29126,CPT,981,RC,,outpatient,,,197,177.3,,0.95,,187.15,Percent of total billed charges,,,0.98,,193.06,Percent of total billed charges,,,0.95,,187.15,Percent of total billed charges,,,0.95,,187.15,Percent of total billed charges,,,0.97,,191.09,Percent of total billed charges,,,0.96,,189.12,Percent of total billed charges,,,0.95,,187.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,187.15,Percent of total billed charges,,187.15,193.06,
HC PR ED 29240 Strapping Shoulder Cdm,PX-98110472,CDM,29240,CPT,981,RC,,inpatient,,,180,162,,0.95,,171,Percent of total billed charges,,,0.98,,176.4,Percent of total billed charges,,,0.95,,171,Percent of total billed charges,,,0.97,,174.6,Percent of total billed charges,,,0.97,,174.6,Percent of total billed charges,,,0.96,,172.8,Percent of total billed charges,,,0.95,,171,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,171,Percent of total billed charges,,171,176.4,
HC PR ED 29240 Strapping Shoulder Cdm,PX-98110472,CDM,29240,CPT,981,RC,,outpatient,,,180,162,,0.95,,171,Percent of total billed charges,,,0.98,,176.4,Percent of total billed charges,,,0.95,,171,Percent of total billed charges,,,0.95,,171,Percent of total billed charges,,,0.97,,174.6,Percent of total billed charges,,,0.96,,172.8,Percent of total billed charges,,,0.95,,171,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,171,Percent of total billed charges,,171,176.4,
HC PR ED 29305 Application of Hip Cast Cdm,PX-98110474,CDM,29305,CPT,981,RC,,inpatient,,,631,567.9,,0.95,,599.45,Percent of total billed charges,,,0.98,,618.38,Percent of total billed charges,,,0.95,,599.45,Percent of total billed charges,,,0.97,,612.07,Percent of total billed charges,,,0.97,,612.07,Percent of total billed charges,,,0.96,,605.76,Percent of total billed charges,,,0.95,,599.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,599.45,Percent of total billed charges,,599.45,618.38,
HC PR ED 29305 Application of Hip Cast Cdm,PX-98110474,CDM,29305,CPT,981,RC,,outpatient,,,631,567.9,,0.95,,599.45,Percent of total billed charges,,,0.98,,618.38,Percent of total billed charges,,,0.95,,599.45,Percent of total billed charges,,,0.95,,599.45,Percent of total billed charges,,,0.97,,612.07,Percent of total billed charges,,,0.96,,605.76,Percent of total billed charges,,,0.95,,599.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,599.45,Percent of total billed charges,,599.45,618.38,
HC PR ED 29405 Short Leg Cast Application Cdm,PX-98110476,CDM,29405,CPT,981,RC,,inpatient,,,439,395.1,,0.95,,417.05,Percent of total billed charges,,,0.98,,430.22,Percent of total billed charges,,,0.95,,417.05,Percent of total billed charges,,,0.97,,425.83,Percent of total billed charges,,,0.97,,425.83,Percent of total billed charges,,,0.96,,421.44,Percent of total billed charges,,,0.95,,417.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,417.05,Percent of total billed charges,,417.05,430.22,
HC PR ED 29405 Short Leg Cast Application Cdm,PX-98110476,CDM,29405,CPT,981,RC,,outpatient,,,439,395.1,,0.95,,417.05,Percent of total billed charges,,,0.98,,430.22,Percent of total billed charges,,,0.95,,417.05,Percent of total billed charges,,,0.95,,417.05,Percent of total billed charges,,,0.97,,425.83,Percent of total billed charges,,,0.96,,421.44,Percent of total billed charges,,,0.95,,417.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,417.05,Percent of total billed charges,,417.05,430.22,
HC PR ED 29425 Apply Short Walking Leg Cast Cdm,PX-98110477,CDM,29425,CPT,981,RC,,inpatient,,,476,428.4,,0.95,,452.2,Percent of total billed charges,,,0.98,,466.48,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,0.97,,461.72,Percent of total billed charges,,,0.97,,461.72,Percent of total billed charges,,,0.96,,456.96,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,452.2,Percent of total billed charges,,452.2,466.48,
HC PR ED 29425 Apply Short Walking Leg Cast Cdm,PX-98110477,CDM,29425,CPT,981,RC,,outpatient,,,476,428.4,,0.95,,452.2,Percent of total billed charges,,,0.98,,466.48,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,0.97,,461.72,Percent of total billed charges,,,0.96,,456.96,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,452.2,Percent of total billed charges,,452.2,466.48,
HC PR ED 29445 Apply Rigid Leg Cast Cdm,PX-98110478,CDM,29445,CPT,981,RC,,inpatient,,,339,305.1,,0.95,,322.05,Percent of total billed charges,,,0.98,,332.22,Percent of total billed charges,,,0.95,,322.05,Percent of total billed charges,,,0.97,,328.83,Percent of total billed charges,,,0.97,,328.83,Percent of total billed charges,,,0.96,,325.44,Percent of total billed charges,,,0.95,,322.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,322.05,Percent of total billed charges,,322.05,332.22,
HC PR ED 29445 Apply Rigid Leg Cast Cdm,PX-98110478,CDM,29445,CPT,981,RC,,outpatient,,,339,305.1,,0.95,,322.05,Percent of total billed charges,,,0.98,,332.22,Percent of total billed charges,,,0.95,,322.05,Percent of total billed charges,,,0.95,,322.05,Percent of total billed charges,,,0.97,,328.83,Percent of total billed charges,,,0.96,,325.44,Percent of total billed charges,,,0.95,,322.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,322.05,Percent of total billed charges,,322.05,332.22,
HC PR ED 29505 Application Long Leg Splint Cdm,PX-98110479,CDM,29505,CPT,981,RC,,inpatient,,,324,291.6,,0.95,,307.8,Percent of total billed charges,,,0.98,,317.52,Percent of total billed charges,,,0.95,,307.8,Percent of total billed charges,,,0.97,,314.28,Percent of total billed charges,,,0.97,,314.28,Percent of total billed charges,,,0.96,,311.04,Percent of total billed charges,,,0.95,,307.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,307.8,Percent of total billed charges,,307.8,317.52,
HC PR ED 29505 Application Long Leg Splint Cdm,PX-98110479,CDM,29505,CPT,981,RC,,outpatient,,,324,291.6,,0.95,,307.8,Percent of total billed charges,,,0.98,,317.52,Percent of total billed charges,,,0.95,,307.8,Percent of total billed charges,,,0.95,,307.8,Percent of total billed charges,,,0.97,,314.28,Percent of total billed charges,,,0.96,,311.04,Percent of total billed charges,,,0.95,,307.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,307.8,Percent of total billed charges,,307.8,317.52,
HC PR ED 29515 Short Leg Splint Application Cdm,PX-98110480,CDM,29515,CPT,981,RC,,inpatient,,,293,263.7,,0.95,,278.35,Percent of total billed charges,,,0.98,,287.14,Percent of total billed charges,,,0.95,,278.35,Percent of total billed charges,,,0.97,,284.21,Percent of total billed charges,,,0.97,,284.21,Percent of total billed charges,,,0.96,,281.28,Percent of total billed charges,,,0.95,,278.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,278.35,Percent of total billed charges,,278.35,287.14,
HC PR ED 29515 Short Leg Splint Application Cdm,PX-98110480,CDM,29515,CPT,981,RC,,outpatient,,,293,263.7,,0.95,,278.35,Percent of total billed charges,,,0.98,,287.14,Percent of total billed charges,,,0.95,,278.35,Percent of total billed charges,,,0.95,,278.35,Percent of total billed charges,,,0.97,,284.21,Percent of total billed charges,,,0.96,,281.28,Percent of total billed charges,,,0.95,,278.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,278.35,Percent of total billed charges,,278.35,287.14,
HC PR ED 29580 Application of Unaboot Cdm,PX-98110482,CDM,29580,CPT,981,RC,,inpatient,,,158,142.2,,0.95,,150.1,Percent of total billed charges,,,0.98,,154.84,Percent of total billed charges,,,0.95,,150.1,Percent of total billed charges,,,0.97,,153.26,Percent of total billed charges,,,0.97,,153.26,Percent of total billed charges,,,0.96,,151.68,Percent of total billed charges,,,0.95,,150.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,150.1,Percent of total billed charges,,150.1,154.84,
HC PR ED 29580 Application of Unaboot Cdm,PX-98110482,CDM,29580,CPT,981,RC,,outpatient,,,158,142.2,,0.95,,150.1,Percent of total billed charges,,,0.98,,154.84,Percent of total billed charges,,,0.95,,150.1,Percent of total billed charges,,,0.95,,150.1,Percent of total billed charges,,,0.97,,153.26,Percent of total billed charges,,,0.96,,151.68,Percent of total billed charges,,,0.95,,150.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,150.1,Percent of total billed charges,,150.1,154.84,
HC PR ED 29705 Remove or Bivalve Cast-Arm or Leg Cdm,PX-98110483,CDM,29705,CPT,981,RC,,inpatient,,,220,198,,0.95,,209,Percent of total billed charges,,,0.98,,215.6,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,0.97,,213.4,Percent of total billed charges,,,0.97,,213.4,Percent of total billed charges,,,0.96,,211.2,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,209,Percent of total billed charges,,209,215.6,
HC PR ED 29705 Remove or Bivalve Cast-Arm or Leg Cdm,PX-98110483,CDM,29705,CPT,981,RC,,outpatient,,,220,198,,0.95,,209,Percent of total billed charges,,,0.98,,215.6,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,0.97,,213.4,Percent of total billed charges,,,0.96,,211.2,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,209,Percent of total billed charges,,209,215.6,
HC PR ED 29730 Windowing of Cast Cdm,PX-98110484,CDM,29730,CPT,981,RC,,inpatient,,,170,153,,0.95,,161.5,Percent of total billed charges,,,0.98,,166.6,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,0.97,,164.9,Percent of total billed charges,,,0.97,,164.9,Percent of total billed charges,,,0.96,,163.2,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,161.5,Percent of total billed charges,,161.5,166.6,
HC PR ED 29730 Windowing of Cast Cdm,PX-98110484,CDM,29730,CPT,981,RC,,outpatient,,,170,153,,0.95,,161.5,Percent of total billed charges,,,0.98,,166.6,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,0.97,,164.9,Percent of total billed charges,,,0.96,,163.2,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,161.5,Percent of total billed charges,,161.5,166.6,
HC PR ED 28190 Removal of Foot Foreign Body Cdm,PX-98110485,CDM,28190,CPT,981,RC,,inpatient,,,793,713.7,,0.95,,753.35,Percent of total billed charges,,,0.98,,777.14,Percent of total billed charges,,,0.95,,753.35,Percent of total billed charges,,,0.97,,769.21,Percent of total billed charges,,,0.97,,769.21,Percent of total billed charges,,,0.96,,761.28,Percent of total billed charges,,,0.95,,753.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,753.35,Percent of total billed charges,,753.35,777.14,
HC PR ED 28190 Removal of Foot Foreign Body Cdm,PX-98110485,CDM,28190,CPT,981,RC,,outpatient,,,793,713.7,,0.95,,753.35,Percent of total billed charges,,,0.98,,777.14,Percent of total billed charges,,,0.95,,753.35,Percent of total billed charges,,,0.95,,753.35,Percent of total billed charges,,,0.97,,769.21,Percent of total billed charges,,,0.96,,761.28,Percent of total billed charges,,,0.95,,753.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,753.35,Percent of total billed charges,,753.35,777.14,
HC PR ED 29345 Application/Long Leg Cast Cdm,PX-98110486,CDM,29345,CPT,981,RC,,inpatient,,,402,361.8,,0.95,,381.9,Percent of total billed charges,,,0.98,,393.96,Percent of total billed charges,,,0.95,,381.9,Percent of total billed charges,,,0.97,,389.94,Percent of total billed charges,,,0.97,,389.94,Percent of total billed charges,,,0.96,,385.92,Percent of total billed charges,,,0.95,,381.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,381.9,Percent of total billed charges,,381.9,393.96,
HC PR ED 29345 Application/Long Leg Cast Cdm,PX-98110486,CDM,29345,CPT,981,RC,,outpatient,,,402,361.8,,0.95,,381.9,Percent of total billed charges,,,0.98,,393.96,Percent of total billed charges,,,0.95,,381.9,Percent of total billed charges,,,0.95,,381.9,Percent of total billed charges,,,0.97,,389.94,Percent of total billed charges,,,0.96,,385.92,Percent of total billed charges,,,0.95,,381.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,381.9,Percent of total billed charges,,381.9,393.96,
HC PR ED 29550 Strapping of Toes Cdm,PX-98110625,CDM,29550,CPT,981,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
HC PR ED 29550 Strapping of Toes Cdm,PX-98110625,CDM,29550,CPT,981,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
HC PR ED 29530 Strapping of Knee Cdm,PX-98110626,CDM,29530,CPT,981,RC,,inpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
HC PR ED 29530 Strapping of Knee Cdm,PX-98110626,CDM,29530,CPT,981,RC,,outpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
Drain Thigh/Knee Lesion,PX-98110864,CDM,27301,CPT,981,RC,,inpatient,,,2665,2398.5,,0.95,,2531.75,Percent of total billed charges,,,0.98,,2611.7,Percent of total billed charges,,,0.95,,2531.75,Percent of total billed charges,,,0.97,,2585.05,Percent of total billed charges,,,0.97,,2585.05,Percent of total billed charges,,,0.96,,2558.4,Percent of total billed charges,,,0.95,,2531.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2531.75,Percent of total billed charges,,2531.75,2611.7,
Drain Thigh/Knee Lesion,PX-98110864,CDM,27301,CPT,981,RC,,outpatient,,,2665,2398.5,,0.95,,2531.75,Percent of total billed charges,,,0.98,,2611.7,Percent of total billed charges,,,0.95,,2531.75,Percent of total billed charges,,,0.95,,2531.75,Percent of total billed charges,,,0.97,,2585.05,Percent of total billed charges,,,0.96,,2558.4,Percent of total billed charges,,,0.95,,2531.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2531.75,Percent of total billed charges,,2531.75,2611.7,
HC PR ED 27550 Treat Knee Dislocation Cdm,PX-98110878,CDM,27550,CPT,981,RC,,inpatient,,,1686,1517.4,,0.95,,1601.7,Percent of total billed charges,,,0.98,,1652.28,Percent of total billed charges,,,0.95,,1601.7,Percent of total billed charges,,,0.97,,1635.42,Percent of total billed charges,,,0.97,,1635.42,Percent of total billed charges,,,0.96,,1618.56,Percent of total billed charges,,,0.95,,1601.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1601.7,Percent of total billed charges,,1601.7,1652.28,
HC PR ED 27550 Treat Knee Dislocation Cdm,PX-98110878,CDM,27550,CPT,981,RC,,outpatient,,,1686,1517.4,,0.95,,1601.7,Percent of total billed charges,,,0.98,,1652.28,Percent of total billed charges,,,0.95,,1601.7,Percent of total billed charges,,,0.95,,1601.7,Percent of total billed charges,,,0.97,,1635.42,Percent of total billed charges,,,0.96,,1618.56,Percent of total billed charges,,,0.95,,1601.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1601.7,Percent of total billed charges,,1601.7,1652.28,
HC PR ED 27552 Closed Treat Knee Dislocation W/Anesth Cdm,PX-98110879,CDM,27552,CPT,981,RC,,inpatient,,,2048,1843.2,,0.95,,1945.6,Percent of total billed charges,,,0.98,,2007.04,Percent of total billed charges,,,0.95,,1945.6,Percent of total billed charges,,,0.97,,1986.56,Percent of total billed charges,,,0.97,,1986.56,Percent of total billed charges,,,0.96,,1966.08,Percent of total billed charges,,,0.95,,1945.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1945.6,Percent of total billed charges,,1945.6,2007.04,
HC PR ED 27552 Closed Treat Knee Dislocation W/Anesth Cdm,PX-98110879,CDM,27552,CPT,981,RC,,outpatient,,,2048,1843.2,,0.95,,1945.6,Percent of total billed charges,,,0.98,,2007.04,Percent of total billed charges,,,0.95,,1945.6,Percent of total billed charges,,,0.95,,1945.6,Percent of total billed charges,,,0.97,,1986.56,Percent of total billed charges,,,0.96,,1966.08,Percent of total billed charges,,,0.95,,1945.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1945.6,Percent of total billed charges,,1945.6,2007.04,
HC PR ED 27560 Closed Treat Knee Dislocation W/O Anesth Cdm,PX-98110881,CDM,27560,CPT,981,RC,,inpatient,,,1240,1116,,0.95,,1178,Percent of total billed charges,,,0.98,,1215.2,Percent of total billed charges,,,0.95,,1178,Percent of total billed charges,,,0.97,,1202.8,Percent of total billed charges,,,0.97,,1202.8,Percent of total billed charges,,,0.96,,1190.4,Percent of total billed charges,,,0.95,,1178,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1178,Percent of total billed charges,,1178,1215.2,
HC PR ED 27560 Closed Treat Knee Dislocation W/O Anesth Cdm,PX-98110881,CDM,27560,CPT,981,RC,,outpatient,,,1240,1116,,0.95,,1178,Percent of total billed charges,,,0.98,,1215.2,Percent of total billed charges,,,0.95,,1178,Percent of total billed charges,,,0.95,,1178,Percent of total billed charges,,,0.97,,1202.8,Percent of total billed charges,,,0.96,,1190.4,Percent of total billed charges,,,0.95,,1178,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1178,Percent of total billed charges,,1178,1215.2,
HC PR ED 27562 Closed Treat Patella Dislocation W/Anseth Cdm,PX-98110882,CDM,27562,CPT,981,RC,,inpatient,,,2071,1863.9,,0.95,,1967.45,Percent of total billed charges,,,0.98,,2029.58,Percent of total billed charges,,,0.95,,1967.45,Percent of total billed charges,,,0.97,,2008.87,Percent of total billed charges,,,0.97,,2008.87,Percent of total billed charges,,,0.96,,1988.16,Percent of total billed charges,,,0.95,,1967.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1967.45,Percent of total billed charges,,1967.45,2029.58,
HC PR ED 27562 Closed Treat Patella Dislocation W/Anseth Cdm,PX-98110882,CDM,27562,CPT,981,RC,,outpatient,,,2071,1863.9,,0.95,,1967.45,Percent of total billed charges,,,0.98,,2029.58,Percent of total billed charges,,,0.95,,1967.45,Percent of total billed charges,,,0.95,,1967.45,Percent of total billed charges,,,0.97,,2008.87,Percent of total billed charges,,,0.96,,1988.16,Percent of total billed charges,,,0.95,,1967.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1967.45,Percent of total billed charges,,1967.45,2029.58,
HC PR ED 27603 Drain Lower Leg Lesion Deep Cdm,PX-98110884,CDM,27603,CPT,981,RC,,inpatient,,,1297,1167.3,,0.95,,1232.15,Percent of total billed charges,,,0.98,,1271.06,Percent of total billed charges,,,0.95,,1232.15,Percent of total billed charges,,,0.97,,1258.09,Percent of total billed charges,,,0.97,,1258.09,Percent of total billed charges,,,0.96,,1245.12,Percent of total billed charges,,,0.95,,1232.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1232.15,Percent of total billed charges,,1232.15,1271.06,
HC PR ED 27603 Drain Lower Leg Lesion Deep Cdm,PX-98110884,CDM,27603,CPT,981,RC,,outpatient,,,1297,1167.3,,0.95,,1232.15,Percent of total billed charges,,,0.98,,1271.06,Percent of total billed charges,,,0.95,,1232.15,Percent of total billed charges,,,0.95,,1232.15,Percent of total billed charges,,,0.97,,1258.09,Percent of total billed charges,,,0.96,,1245.12,Percent of total billed charges,,,0.95,,1232.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1232.15,Percent of total billed charges,,1232.15,1271.06,
HC PR ED 27760 Closed Tx of Medial Malleolus Fracture W/O Manip Cdm,PX-98110892,CDM,27760,CPT,981,RC,,inpatient,,,1233,1109.7,,0.95,,1171.35,Percent of total billed charges,,,0.98,,1208.34,Percent of total billed charges,,,0.95,,1171.35,Percent of total billed charges,,,0.97,,1196.01,Percent of total billed charges,,,0.97,,1196.01,Percent of total billed charges,,,0.96,,1183.68,Percent of total billed charges,,,0.95,,1171.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1171.35,Percent of total billed charges,,1171.35,1208.34,
HC PR ED 27760 Closed Tx of Medial Malleolus Fracture W/O Manip Cdm,PX-98110892,CDM,27760,CPT,981,RC,,outpatient,,,1233,1109.7,,0.95,,1171.35,Percent of total billed charges,,,0.98,,1208.34,Percent of total billed charges,,,0.95,,1171.35,Percent of total billed charges,,,0.95,,1171.35,Percent of total billed charges,,,0.97,,1196.01,Percent of total billed charges,,,0.96,,1183.68,Percent of total billed charges,,,0.95,,1171.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1171.35,Percent of total billed charges,,1171.35,1208.34,
HC PR ED 27762 Closed Tx of Medial Malleolus Fracture W/Manip Cdm,PX-98110895,CDM,27762,CPT,981,RC,,inpatient,,,1894,1704.6,,0.95,,1799.3,Percent of total billed charges,,,0.98,,1856.12,Percent of total billed charges,,,0.95,,1799.3,Percent of total billed charges,,,0.97,,1837.18,Percent of total billed charges,,,0.97,,1837.18,Percent of total billed charges,,,0.96,,1818.24,Percent of total billed charges,,,0.95,,1799.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1799.3,Percent of total billed charges,,1799.3,1856.12,
HC PR ED 27762 Closed Tx of Medial Malleolus Fracture W/Manip Cdm,PX-98110895,CDM,27762,CPT,981,RC,,outpatient,,,1894,1704.6,,0.95,,1799.3,Percent of total billed charges,,,0.98,,1856.12,Percent of total billed charges,,,0.95,,1799.3,Percent of total billed charges,,,0.95,,1799.3,Percent of total billed charges,,,0.97,,1837.18,Percent of total billed charges,,,0.96,,1818.24,Percent of total billed charges,,,0.95,,1799.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1799.3,Percent of total billed charges,,1799.3,1856.12,
HC PR ED 27768 Cltx Post Ankle Fx W/Manipulation Cdm,PX-98110897,CDM,27768,CPT,981,RC,,inpatient,,,1241,1116.9,,0.95,,1178.95,Percent of total billed charges,,,0.98,,1216.18,Percent of total billed charges,,,0.95,,1178.95,Percent of total billed charges,,,0.97,,1203.77,Percent of total billed charges,,,0.97,,1203.77,Percent of total billed charges,,,0.96,,1191.36,Percent of total billed charges,,,0.95,,1178.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1178.95,Percent of total billed charges,,1178.95,1216.18,
HC PR ED 27768 Cltx Post Ankle Fx W/Manipulation Cdm,PX-98110897,CDM,27768,CPT,981,RC,,outpatient,,,1241,1116.9,,0.95,,1178.95,Percent of total billed charges,,,0.98,,1216.18,Percent of total billed charges,,,0.95,,1178.95,Percent of total billed charges,,,0.95,,1178.95,Percent of total billed charges,,,0.97,,1203.77,Percent of total billed charges,,,0.96,,1191.36,Percent of total billed charges,,,0.95,,1178.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1178.95,Percent of total billed charges,,1178.95,1216.18,
HC PR ED 29130 Aplication of Finger Splint Static Cdm,PX-98110906,CDM,29130,CPT,981,RC,,inpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
HC PR ED 29130 Aplication of Finger Splint Static Cdm,PX-98110906,CDM,29130,CPT,981,RC,,outpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
"Inject anesthetic agent, trigeminal nerve bundle",PX-45010236,CDM,64505,CPT,450,RC,,inpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,440.8,Percent of total billed charges,,440.8,3950,
"Inject anesthetic agent, trigeminal nerve bundle",PX-45010236,CDM,64505,CPT,450,RC,,outpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,440.8,Percent of total billed charges,,440.8,3950,
HC PR ED 41899 Unlisted Procedure Dentoalveolar Structures Cdm,PX-98110088,CDM,41899,CPT,981,RC,,inpatient,,,359,323.1,,0.95,,341.05,Percent of total billed charges,,,0.98,,351.82,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,0.97,,348.23,Percent of total billed charges,,,0.97,,348.23,Percent of total billed charges,,,0.96,,344.64,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,341.05,Percent of total billed charges,,341.05,351.82,
HC PR ED 41899 Unlisted Procedure Dentoalveolar Structures Cdm,PX-98110088,CDM,41899,CPT,981,RC,,outpatient,,,359,323.1,,0.95,,341.05,Percent of total billed charges,,,0.98,,351.82,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,0.97,,348.23,Percent of total billed charges,,,0.96,,344.64,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,341.05,Percent of total billed charges,,341.05,351.82,
HC OB Scalp Elect. #Crm7000aa0h,PX-3254198WWM,CDM,3254198WWM,LOCAL,270,RC,,inpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
HC OB Scalp Elect. #Crm7000aa0h,PX-3254198WWM,CDM,3254198WWM,LOCAL,270,RC,,outpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
HC Quikclotzfold #1095413,PX-3254199WWM,CDM,3254199WWM,LOCAL,270,RC,,inpatient,,,232,208.8,,0.95,,220.4,Percent of total billed charges,,,0.98,,227.36,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,0.97,,225.04,Percent of total billed charges,,,0.97,,225.04,Percent of total billed charges,,,0.96,,222.72,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,220.4,Percent of total billed charges,,220.4,227.36,
HC Quikclotzfold #1095413,PX-3254199WWM,CDM,3254199WWM,LOCAL,270,RC,,outpatient,,,232,208.8,,0.95,,220.4,Percent of total billed charges,,,0.98,,227.36,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,0.97,,225.04,Percent of total billed charges,,,0.96,,222.72,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,220.4,Percent of total billed charges,,220.4,227.36,
HC Venaflow Calf Cuff Elite #3040,PX-3254202WWM,CDM,3254202WWM,LOCAL,270,RC,,inpatient,,,86,77.4,,0.95,,81.7,Percent of total billed charges,,,0.98,,84.28,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,0.97,,83.42,Percent of total billed charges,,,0.97,,83.42,Percent of total billed charges,,,0.96,,82.56,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,81.7,Percent of total billed charges,,81.7,84.28,
HC Venaflow Calf Cuff Elite #3040,PX-3254202WWM,CDM,3254202WWM,LOCAL,270,RC,,outpatient,,,86,77.4,,0.95,,81.7,Percent of total billed charges,,,0.98,,84.28,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,0.97,,83.42,Percent of total billed charges,,,0.96,,82.56,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,81.7,Percent of total billed charges,,81.7,84.28,
HC or Blade Ace 700 #Me7251e,PX-3254203WWM,CDM,3254203WWM,LOCAL,270,RC,,inpatient,,,477,429.3,,0.95,,453.15,Percent of total billed charges,,,0.98,,467.46,Percent of total billed charges,,,0.95,,453.15,Percent of total billed charges,,,0.97,,462.69,Percent of total billed charges,,,0.97,,462.69,Percent of total billed charges,,,0.96,,457.92,Percent of total billed charges,,,0.95,,453.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,453.15,Percent of total billed charges,,453.15,467.46,
HC or Blade Ace 700 #Me7251e,PX-3254203WWM,CDM,3254203WWM,LOCAL,270,RC,,outpatient,,,477,429.3,,0.95,,453.15,Percent of total billed charges,,,0.98,,467.46,Percent of total billed charges,,,0.95,,453.15,Percent of total billed charges,,,0.95,,453.15,Percent of total billed charges,,,0.97,,462.69,Percent of total billed charges,,,0.96,,457.92,Percent of total billed charges,,,0.95,,453.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,453.15,Percent of total billed charges,,453.15,467.46,
HC or Zip Pencil #252510ec,PX-3254204WWM,CDM,3254204WWM,LOCAL,270,RC,,inpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
HC or Zip Pencil #252510ec,PX-3254204WWM,CDM,3254204WWM,LOCAL,270,RC,,outpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
HC PR 99422 Online Digital E/M Svc Est Pt <7 D 11-20 Minutes Rhc,PX-52110013,CDM,99422,CPT,521,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
HC PR 99422 Online Digital E/M Svc Est Pt <7 D 11-20 Minutes Rhc,PX-52110013,CDM,99422,CPT,521,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
HC PR 11055 Paring/Cutting Benign Hyperkeratotic Lesion 1 Rhc,PX-52110032,CDM,11055,CPT,521,RC,,inpatient,,,260,234,,0.95,,247,Percent of total billed charges,,,0.98,,254.8,Percent of total billed charges,,,0.95,,247,Percent of total billed charges,,,0.97,,252.2,Percent of total billed charges,,,0.97,,252.2,Percent of total billed charges,,,0.96,,249.6,Percent of total billed charges,,,0.95,,247,Percent of total billed charges,,,,,,,,,0.95,,247,Percent of total billed charges,,247,254.8,
HC PR 11055 Paring/Cutting Benign Hyperkeratotic Lesion 1 Rhc,PX-52110032,CDM,11055,CPT,521,RC,,outpatient,,,260,234,,0.95,,247,Percent of total billed charges,,,0.98,,254.8,Percent of total billed charges,,,0.95,,247,Percent of total billed charges,,,0.95,,247,Percent of total billed charges,,,0.97,,252.2,Percent of total billed charges,,,0.96,,249.6,Percent of total billed charges,,,0.95,,247,Percent of total billed charges,,,,,,,,,0.95,,247,Percent of total billed charges,,247,254.8,
HC PR 11301 Shvg Skin Lesion 1 Trunk/Arm/Leg Diam 0.6-1.0 Cm Rhc,PX-52110044,CDM,11301,CPT,521,RC,,inpatient,,,299,269.1,,0.95,,284.05,Percent of total billed charges,,,0.98,,293.02,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,0.97,,290.03,Percent of total billed charges,,,0.97,,290.03,Percent of total billed charges,,,0.96,,287.04,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,284.05,Percent of total billed charges,,284.05,293.02,
HC PR 11301 Shvg Skin Lesion 1 Trunk/Arm/Leg Diam 0.6-1.0 Cm Rhc,PX-52110044,CDM,11301,CPT,521,RC,,outpatient,,,299,269.1,,0.95,,284.05,Percent of total billed charges,,,0.98,,293.02,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,0.97,,290.03,Percent of total billed charges,,,0.96,,287.04,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,284.05,Percent of total billed charges,,284.05,293.02,
HC PR 12015 Simple Repair F/E/E/N/L/M 7.6cm-12.5 Cm Rhc,PX-52110125,CDM,12015,CPT,521,RC,,inpatient,,,425,382.5,,0.95,,403.75,Percent of total billed charges,,,0.98,,416.5,Percent of total billed charges,,,0.95,,403.75,Percent of total billed charges,,,0.97,,412.25,Percent of total billed charges,,,0.97,,412.25,Percent of total billed charges,,,0.96,,408,Percent of total billed charges,,,0.95,,403.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,403.75,Percent of total billed charges,,403.75,416.5,
HC PR 12015 Simple Repair F/E/E/N/L/M 7.6cm-12.5 Cm Rhc,PX-52110125,CDM,12015,CPT,521,RC,,outpatient,,,425,382.5,,0.95,,403.75,Percent of total billed charges,,,0.98,,416.5,Percent of total billed charges,,,0.95,,403.75,Percent of total billed charges,,,0.95,,403.75,Percent of total billed charges,,,0.97,,412.25,Percent of total billed charges,,,0.96,,408,Percent of total billed charges,,,0.95,,403.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,403.75,Percent of total billed charges,,403.75,416.5,
HC PR 12031 Repair Intermediate Sclp/Axl/Trk/Extm Lte 2.5 Cm Rhc,PX-52110131,CDM,12031,CPT,521,RC,,inpatient,,,648,583.2,,0.95,,615.6,Percent of total billed charges,,,0.98,,635.04,Percent of total billed charges,,,0.95,,615.6,Percent of total billed charges,,,0.97,,628.56,Percent of total billed charges,,,0.97,,628.56,Percent of total billed charges,,,0.96,,622.08,Percent of total billed charges,,,0.95,,615.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,615.6,Percent of total billed charges,,615.6,635.04,
HC PR 12031 Repair Intermediate Sclp/Axl/Trk/Extm Lte 2.5 Cm Rhc,PX-52110131,CDM,12031,CPT,521,RC,,outpatient,,,648,583.2,,0.95,,615.6,Percent of total billed charges,,,0.98,,635.04,Percent of total billed charges,,,0.95,,615.6,Percent of total billed charges,,,0.95,,615.6,Percent of total billed charges,,,0.97,,628.56,Percent of total billed charges,,,0.96,,622.08,Percent of total billed charges,,,0.95,,615.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,615.6,Percent of total billed charges,,615.6,635.04,
HC PR 16020 Drs&/Dbrdmt Prtl-Thkns Burns 1st/Sbsq Small Rhc,PX-52110171,CDM,16020,CPT,521,RC,,inpatient,,,213,191.7,,0.95,,202.35,Percent of total billed charges,,,0.98,,208.74,Percent of total billed charges,,,0.95,,202.35,Percent of total billed charges,,,0.97,,206.61,Percent of total billed charges,,,0.97,,206.61,Percent of total billed charges,,,0.96,,204.48,Percent of total billed charges,,,0.95,,202.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,202.35,Percent of total billed charges,,202.35,208.74,
HC PR 16020 Drs&/Dbrdmt Prtl-Thkns Burns 1st/Sbsq Small Rhc,PX-52110171,CDM,16020,CPT,521,RC,,outpatient,,,213,191.7,,0.95,,202.35,Percent of total billed charges,,,0.98,,208.74,Percent of total billed charges,,,0.95,,202.35,Percent of total billed charges,,,0.95,,202.35,Percent of total billed charges,,,0.97,,206.61,Percent of total billed charges,,,0.96,,204.48,Percent of total billed charges,,,0.95,,202.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,202.35,Percent of total billed charges,,202.35,208.74,
HC PR 20526 Injection Therapeutic Carpal Tunnel Rhc,PX-52110216,CDM,20526,CPT,521,RC,,inpatient,,,204,183.6,,0.95,,193.8,Percent of total billed charges,,,0.98,,199.92,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.96,,195.84,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,,,,,,,0.95,,193.8,Percent of total billed charges,,193.8,199.92,
HC PR 20526 Injection Therapeutic Carpal Tunnel Rhc,PX-52110216,CDM,20526,CPT,521,RC,,outpatient,,,204,183.6,,0.95,,193.8,Percent of total billed charges,,,0.98,,199.92,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.96,,195.84,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,,,,,,,0.95,,193.8,Percent of total billed charges,,193.8,199.92,
HC PR 29435 Application Patellar Tendon Bearing Cast Rhc,PX-52110320,CDM,29435,CPT,521,RC,,inpatient,,,312,280.8,,0.95,,296.4,Percent of total billed charges,,,0.98,,305.76,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,0.97,,302.64,Percent of total billed charges,,,0.97,,302.64,Percent of total billed charges,,,0.96,,299.52,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,296.4,Percent of total billed charges,,296.4,305.76,
HC PR 29435 Application Patellar Tendon Bearing Cast Rhc,PX-52110320,CDM,29435,CPT,521,RC,,outpatient,,,312,280.8,,0.95,,296.4,Percent of total billed charges,,,0.98,,305.76,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,0.97,,302.64,Percent of total billed charges,,,0.96,,299.52,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,296.4,Percent of total billed charges,,296.4,305.76,
HC PR 29897 Arthroscopy Ankle Surgical Debridement Limited Rhc,PX-52110336,CDM,29897,CPT,521,RC,,inpatient,,,1208,1087.2,,0.95,,1147.6,Percent of total billed charges,,,0.98,,1183.84,Percent of total billed charges,,,0.95,,1147.6,Percent of total billed charges,,,0.97,,1171.76,Percent of total billed charges,,,0.97,,1171.76,Percent of total billed charges,,,0.96,,1159.68,Percent of total billed charges,,,0.95,,1147.6,Percent of total billed charges,,,,,,,,,0.95,,1147.6,Percent of total billed charges,,1147.6,1183.84,
HC PR 29897 Arthroscopy Ankle Surgical Debridement Limited Rhc,PX-52110336,CDM,29897,CPT,521,RC,,outpatient,,,1208,1087.2,,0.95,,1147.6,Percent of total billed charges,,,0.98,,1183.84,Percent of total billed charges,,,0.95,,1147.6,Percent of total billed charges,,,0.95,,1147.6,Percent of total billed charges,,,0.97,,1171.76,Percent of total billed charges,,,0.96,,1159.68,Percent of total billed charges,,,0.95,,1147.6,Percent of total billed charges,,,,,,,,,0.95,,1147.6,Percent of total billed charges,,1147.6,1183.84,
HC PR 40810 Exc Les Mucosa & Sbmcsl Vestibule Mouth W/O Rpr Rhc,PX-52110365,CDM,40810,CPT,521,RC,,inpatient,,,535,481.5,,0.95,,508.25,Percent of total billed charges,,,0.98,,524.3,Percent of total billed charges,,,0.95,,508.25,Percent of total billed charges,,,0.97,,518.95,Percent of total billed charges,,,0.97,,518.95,Percent of total billed charges,,,0.96,,513.6,Percent of total billed charges,,,0.95,,508.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,508.25,Percent of total billed charges,,508.25,524.3,
HC PR 40810 Exc Les Mucosa & Sbmcsl Vestibule Mouth W/O Rpr Rhc,PX-52110365,CDM,40810,CPT,521,RC,,outpatient,,,535,481.5,,0.95,,508.25,Percent of total billed charges,,,0.98,,524.3,Percent of total billed charges,,,0.95,,508.25,Percent of total billed charges,,,0.95,,508.25,Percent of total billed charges,,,0.97,,518.95,Percent of total billed charges,,,0.96,,513.6,Percent of total billed charges,,,0.95,,508.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,508.25,Percent of total billed charges,,508.25,524.3,
HC PR 43235 Egd Diagnostic Brush Wash,PX-97510294,CDM,43235,CPT,975,RC,,inpatient,,,755,679.5,,0.95,,717.25,Percent of total billed charges,,,0.98,,739.9,Percent of total billed charges,,,0.95,,717.25,Percent of total billed charges,,,0.97,,732.35,Percent of total billed charges,,,0.97,,732.35,Percent of total billed charges,,,0.96,,724.8,Percent of total billed charges,,,0.95,,717.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,717.25,Percent of total billed charges,,717.25,739.9,
HC PR 43235 Egd Diagnostic Brush Wash,PX-97510294,CDM,43235,CPT,975,RC,,outpatient,,,755,679.5,,0.95,,717.25,Percent of total billed charges,,,0.98,,739.9,Percent of total billed charges,,,0.95,,717.25,Percent of total billed charges,,,0.95,,717.25,Percent of total billed charges,,,0.97,,732.35,Percent of total billed charges,,,0.96,,724.8,Percent of total billed charges,,,0.95,,717.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,717.25,Percent of total billed charges,,717.25,739.9,
HC PR 43239 Egd Biopsy Single/Multiple,PX-97510296,CDM,43239,CPT,975,RC,,inpatient,,,1082,973.8,,0.95,,1027.9,Percent of total billed charges,,,0.98,,1060.36,Percent of total billed charges,,,0.95,,1027.9,Percent of total billed charges,,,0.97,,1049.54,Percent of total billed charges,,,0.97,,1049.54,Percent of total billed charges,,,0.96,,1038.72,Percent of total billed charges,,,0.95,,1027.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1027.9,Percent of total billed charges,,1027.9,1060.36,
HC PR 43239 Egd Biopsy Single/Multiple,PX-97510296,CDM,43239,CPT,975,RC,,outpatient,,,1082,973.8,,0.95,,1027.9,Percent of total billed charges,,,0.98,,1060.36,Percent of total billed charges,,,0.95,,1027.9,Percent of total billed charges,,,0.95,,1027.9,Percent of total billed charges,,,0.97,,1049.54,Percent of total billed charges,,,0.96,,1038.72,Percent of total billed charges,,,0.95,,1027.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1027.9,Percent of total billed charges,,1027.9,1060.36,
HC PR 43245 Egd Dilate Stricture,PX-97511161,CDM,43245,CPT,975,RC,,inpatient,,,1564,1407.6,,0.95,,1485.8,Percent of total billed charges,,,0.98,,1532.72,Percent of total billed charges,,,0.95,,1485.8,Percent of total billed charges,,,0.97,,1517.08,Percent of total billed charges,,,0.97,,1517.08,Percent of total billed charges,,,0.96,,1501.44,Percent of total billed charges,,,0.95,,1485.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1485.8,Percent of total billed charges,,1485.8,1532.72,
HC PR 43245 Egd Dilate Stricture,PX-97511161,CDM,43245,CPT,975,RC,,outpatient,,,1564,1407.6,,0.95,,1485.8,Percent of total billed charges,,,0.98,,1532.72,Percent of total billed charges,,,0.95,,1485.8,Percent of total billed charges,,,0.95,,1485.8,Percent of total billed charges,,,0.97,,1517.08,Percent of total billed charges,,,0.96,,1501.44,Percent of total billed charges,,,0.95,,1485.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1485.8,Percent of total billed charges,,1485.8,1532.72,
HC PR 43247 Operative Upper GI Endoscopy W/ FB Removal,PX-97510501,CDM,43247,CPT,975,RC,,inpatient,,,1011,909.9,,0.95,,960.45,Percent of total billed charges,,,0.98,,990.78,Percent of total billed charges,,,0.95,,960.45,Percent of total billed charges,,,0.97,,980.67,Percent of total billed charges,,,0.97,,980.67,Percent of total billed charges,,,0.96,,970.56,Percent of total billed charges,,,0.95,,960.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,960.45,Percent of total billed charges,,960.45,990.78,
HC PR 43247 Operative Upper GI Endoscopy W/ FB Removal,PX-97510501,CDM,43247,CPT,975,RC,,outpatient,,,1011,909.9,,0.95,,960.45,Percent of total billed charges,,,0.98,,990.78,Percent of total billed charges,,,0.95,,960.45,Percent of total billed charges,,,0.95,,960.45,Percent of total billed charges,,,0.97,,980.67,Percent of total billed charges,,,0.96,,970.56,Percent of total billed charges,,,0.95,,960.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,960.45,Percent of total billed charges,,960.45,990.78,
HC PR 43249 Esoph Egd Dilation <30 Mm,PX-97510503,CDM,43249,CPT,975,RC,,inpatient,,,2623,2360.7,,0.95,,2491.85,Percent of total billed charges,,,0.98,,2570.54,Percent of total billed charges,,,0.95,,2491.85,Percent of total billed charges,,,0.97,,2544.31,Percent of total billed charges,,,0.97,,2544.31,Percent of total billed charges,,,0.96,,2518.08,Percent of total billed charges,,,0.95,,2491.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2491.85,Percent of total billed charges,,2491.85,2570.54,
HC PR 43249 Esoph Egd Dilation <30 Mm,PX-97510503,CDM,43249,CPT,975,RC,,outpatient,,,2623,2360.7,,0.95,,2491.85,Percent of total billed charges,,,0.98,,2570.54,Percent of total billed charges,,,0.95,,2491.85,Percent of total billed charges,,,0.95,,2491.85,Percent of total billed charges,,,0.97,,2544.31,Percent of total billed charges,,,0.96,,2518.08,Percent of total billed charges,,,0.95,,2491.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2491.85,Percent of total billed charges,,2491.85,2570.54,
HC PR 44388 Colonoscopy,PX-97510717,CDM,44388,CPT,975,RC,,inpatient,,,777,699.3,,0.95,,738.15,Percent of total billed charges,,,0.98,,761.46,Percent of total billed charges,,,0.95,,738.15,Percent of total billed charges,,,0.97,,753.69,Percent of total billed charges,,,0.97,,753.69,Percent of total billed charges,,,0.96,,745.92,Percent of total billed charges,,,0.95,,738.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,738.15,Percent of total billed charges,,738.15,761.46,
HC PR 44388 Colonoscopy,PX-97510717,CDM,44388,CPT,975,RC,,outpatient,,,777,699.3,,0.95,,738.15,Percent of total billed charges,,,0.98,,761.46,Percent of total billed charges,,,0.95,,738.15,Percent of total billed charges,,,0.95,,738.15,Percent of total billed charges,,,0.97,,753.69,Percent of total billed charges,,,0.96,,745.92,Percent of total billed charges,,,0.95,,738.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,738.15,Percent of total billed charges,,738.15,761.46,
HC PR 45330 Diagnostic Sigmoidoscopy,PX-97510758,CDM,45330,CPT,975,RC,,inpatient,,,699,629.1,,0.95,,664.05,Percent of total billed charges,,,0.98,,685.02,Percent of total billed charges,,,0.95,,664.05,Percent of total billed charges,,,0.97,,678.03,Percent of total billed charges,,,0.97,,678.03,Percent of total billed charges,,,0.96,,671.04,Percent of total billed charges,,,0.95,,664.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,664.05,Percent of total billed charges,,664.05,685.02,
HC PR 45330 Diagnostic Sigmoidoscopy,PX-97510758,CDM,45330,CPT,975,RC,,outpatient,,,699,629.1,,0.95,,664.05,Percent of total billed charges,,,0.98,,685.02,Percent of total billed charges,,,0.95,,664.05,Percent of total billed charges,,,0.95,,664.05,Percent of total billed charges,,,0.97,,678.03,Percent of total billed charges,,,0.96,,671.04,Percent of total billed charges,,,0.95,,664.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,664.05,Percent of total billed charges,,664.05,685.02,
HC PR 45331 Sigmoidoscopy and Biopsy,PX-97510759,CDM,45331,CPT,975,RC,,inpatient,,,593,533.7,,0.95,,563.35,Percent of total billed charges,,,0.98,,581.14,Percent of total billed charges,,,0.95,,563.35,Percent of total billed charges,,,0.97,,575.21,Percent of total billed charges,,,0.97,,575.21,Percent of total billed charges,,,0.96,,569.28,Percent of total billed charges,,,0.95,,563.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,563.35,Percent of total billed charges,,563.35,581.14,
HC PR 45331 Sigmoidoscopy and Biopsy,PX-97510759,CDM,45331,CPT,975,RC,,outpatient,,,593,533.7,,0.95,,563.35,Percent of total billed charges,,,0.98,,581.14,Percent of total billed charges,,,0.95,,563.35,Percent of total billed charges,,,0.95,,563.35,Percent of total billed charges,,,0.97,,575.21,Percent of total billed charges,,,0.96,,569.28,Percent of total billed charges,,,0.95,,563.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,563.35,Percent of total billed charges,,563.35,581.14,
HC PR 45335 Sigmoidoscopy W/Submuc Inj,PX-97510764,CDM,45335,CPT,975,RC,,inpatient,,,714,642.6,,0.95,,678.3,Percent of total billed charges,,,0.98,,699.72,Percent of total billed charges,,,0.95,,678.3,Percent of total billed charges,,,0.97,,692.58,Percent of total billed charges,,,0.97,,692.58,Percent of total billed charges,,,0.96,,685.44,Percent of total billed charges,,,0.95,,678.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,678.3,Percent of total billed charges,,678.3,699.72,
HC PR 45335 Sigmoidoscopy W/Submuc Inj,PX-97510764,CDM,45335,CPT,975,RC,,outpatient,,,714,642.6,,0.95,,678.3,Percent of total billed charges,,,0.98,,699.72,Percent of total billed charges,,,0.95,,678.3,Percent of total billed charges,,,0.95,,678.3,Percent of total billed charges,,,0.97,,692.58,Percent of total billed charges,,,0.96,,685.44,Percent of total billed charges,,,0.95,,678.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,678.3,Percent of total billed charges,,678.3,699.72,
HC PR 45338 Sigmoidoscopy W/Tumor Removal,PX-97510765,CDM,45338,CPT,975,RC,,inpatient,,,1092,982.8,,0.95,,1037.4,Percent of total billed charges,,,0.98,,1070.16,Percent of total billed charges,,,0.95,,1037.4,Percent of total billed charges,,,0.97,,1059.24,Percent of total billed charges,,,0.97,,1059.24,Percent of total billed charges,,,0.96,,1048.32,Percent of total billed charges,,,0.95,,1037.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1037.4,Percent of total billed charges,,1037.4,1070.16,
HC PR 45338 Sigmoidoscopy W/Tumor Removal,PX-97510765,CDM,45338,CPT,975,RC,,outpatient,,,1092,982.8,,0.95,,1037.4,Percent of total billed charges,,,0.98,,1070.16,Percent of total billed charges,,,0.95,,1037.4,Percent of total billed charges,,,0.95,,1037.4,Percent of total billed charges,,,0.97,,1059.24,Percent of total billed charges,,,0.96,,1048.32,Percent of total billed charges,,,0.95,,1037.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1037.4,Percent of total billed charges,,1037.4,1070.16,
HC PR 45378 Diagnostic Colonoscopy,PX-97510766,CDM,45378,CPT,975,RC,,inpatient,,,1041,936.9,,0.95,,988.95,Percent of total billed charges,,,0.98,,1020.18,Percent of total billed charges,,,0.95,,988.95,Percent of total billed charges,,,0.97,,1009.77,Percent of total billed charges,,,0.97,,1009.77,Percent of total billed charges,,,0.96,,999.36,Percent of total billed charges,,,0.95,,988.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,988.95,Percent of total billed charges,,988.95,1020.18,
HC PR 45378 Diagnostic Colonoscopy,PX-97510766,CDM,45378,CPT,975,RC,,outpatient,,,1041,936.9,,0.95,,988.95,Percent of total billed charges,,,0.98,,1020.18,Percent of total billed charges,,,0.95,,988.95,Percent of total billed charges,,,0.95,,988.95,Percent of total billed charges,,,0.97,,1009.77,Percent of total billed charges,,,0.96,,999.36,Percent of total billed charges,,,0.95,,988.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,988.95,Percent of total billed charges,,988.95,1020.18,
HC PR 45380 Colonoscopy and Biopsy,PX-97510768,CDM,45380,CPT,975,RC,,inpatient,,,1240,1116,,0.95,,1178,Percent of total billed charges,,,0.98,,1215.2,Percent of total billed charges,,,0.95,,1178,Percent of total billed charges,,,0.97,,1202.8,Percent of total billed charges,,,0.97,,1202.8,Percent of total billed charges,,,0.96,,1190.4,Percent of total billed charges,,,0.95,,1178,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1178,Percent of total billed charges,,1178,1215.2,
HC PR 45380 Colonoscopy and Biopsy,PX-97510768,CDM,45380,CPT,975,RC,,outpatient,,,1240,1116,,0.95,,1178,Percent of total billed charges,,,0.98,,1215.2,Percent of total billed charges,,,0.95,,1178,Percent of total billed charges,,,0.95,,1178,Percent of total billed charges,,,0.97,,1202.8,Percent of total billed charges,,,0.96,,1190.4,Percent of total billed charges,,,0.95,,1178,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1178,Percent of total billed charges,,1178,1215.2,
HC PR 45384 Lesion Remove Colonoscopy,PX-97510772,CDM,45384,CPT,975,RC,,inpatient,,,1242,1117.8,,0.95,,1179.9,Percent of total billed charges,,,0.98,,1217.16,Percent of total billed charges,,,0.95,,1179.9,Percent of total billed charges,,,0.97,,1204.74,Percent of total billed charges,,,0.97,,1204.74,Percent of total billed charges,,,0.96,,1192.32,Percent of total billed charges,,,0.95,,1179.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1179.9,Percent of total billed charges,,1179.9,1217.16,
HC PR 45384 Lesion Remove Colonoscopy,PX-97510772,CDM,45384,CPT,975,RC,,outpatient,,,1242,1117.8,,0.95,,1179.9,Percent of total billed charges,,,0.98,,1217.16,Percent of total billed charges,,,0.95,,1179.9,Percent of total billed charges,,,0.95,,1179.9,Percent of total billed charges,,,0.97,,1204.74,Percent of total billed charges,,,0.96,,1192.32,Percent of total billed charges,,,0.95,,1179.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1179.9,Percent of total billed charges,,1179.9,1217.16,
"HC PR 45385 Lesion Removal Colonoscopy, Polyp Snare",PX-97510773,CDM,45385,CPT,975,RC,,inpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
"HC PR 45385 Lesion Removal Colonoscopy, Polyp Snare",PX-97510773,CDM,45385,CPT,975,RC,,outpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
Drain abscess or blood accumulation nose cartilage,PX-45010024,CDM,30020,CPT,450,RC,,inpatient,,,305,274.5,,0.95,,289.75,Percent of total billed charges,,,0.98,,298.9,Percent of total billed charges,,,0.95,,289.75,Percent of total billed charges,,,0.97,,295.85,Percent of total billed charges,,,0.97,,295.85,Percent of total billed charges,,,0.96,,292.8,Percent of total billed charges,,,0.95,,289.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,289.75,Percent of total billed charges,,289.75,298.9,
Drain abscess or blood accumulation nose cartilage,PX-45010024,CDM,30020,CPT,450,RC,,outpatient,,,305,274.5,,0.95,,289.75,Percent of total billed charges,,,0.98,,298.9,Percent of total billed charges,,,0.95,,289.75,Percent of total billed charges,,,0.95,,289.75,Percent of total billed charges,,,0.97,,295.85,Percent of total billed charges,,,0.96,,292.8,Percent of total billed charges,,,0.95,,289.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,289.75,Percent of total billed charges,,289.75,298.9,
Removal of foreign body in nose,PX-45010025,CDM,30300,CPT,450,RC,,inpatient,,,476,428.4,,0.95,,452.2,Percent of total billed charges,,,0.98,,466.48,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,0.97,,461.72,Percent of total billed charges,,,0.97,,461.72,Percent of total billed charges,,,0.96,,456.96,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,452.2,Percent of total billed charges,,452.2,3950,
Removal of foreign body in nose,PX-45010025,CDM,30300,CPT,450,RC,,outpatient,,,476,428.4,,0.95,,452.2,Percent of total billed charges,,,0.98,,466.48,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,0.97,,461.72,Percent of total billed charges,,,0.96,,456.96,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,452.2,Percent of total billed charges,,452.2,3950,
Simple control of nose bleed,PX-45010028,CDM,30901,CPT,450,RC,,inpatient,,,408,367.2,,0.95,,387.6,Percent of total billed charges,,,0.98,,399.84,Percent of total billed charges,,,0.95,,387.6,Percent of total billed charges,,,0.97,,395.76,Percent of total billed charges,,,0.97,,395.76,Percent of total billed charges,,,0.96,,391.68,Percent of total billed charges,,,0.95,,387.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,387.6,Percent of total billed charges,,387.6,3950,
Simple control of nose bleed,PX-45010028,CDM,30901,CPT,450,RC,,outpatient,,,408,367.2,,0.95,,387.6,Percent of total billed charges,,,0.98,,399.84,Percent of total billed charges,,,0.95,,387.6,Percent of total billed charges,,,0.95,,387.6,Percent of total billed charges,,,0.97,,395.76,Percent of total billed charges,,,0.96,,391.68,Percent of total billed charges,,,0.95,,387.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,387.6,Percent of total billed charges,,387.6,3950,
Complex control of nose bleed,PX-45010030,CDM,30903,CPT,450,RC,,inpatient,,,523,470.7,,0.95,,496.85,Percent of total billed charges,,,0.98,,512.54,Percent of total billed charges,,,0.95,,496.85,Percent of total billed charges,,,0.97,,507.31,Percent of total billed charges,,,0.97,,507.31,Percent of total billed charges,,,0.96,,502.08,Percent of total billed charges,,,0.95,,496.85,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,496.85,Percent of total billed charges,,496.85,3950,
Complex control of nose bleed,PX-45010030,CDM,30903,CPT,450,RC,,outpatient,,,523,470.7,,0.95,,496.85,Percent of total billed charges,,,0.98,,512.54,Percent of total billed charges,,,0.95,,496.85,Percent of total billed charges,,,0.95,,496.85,Percent of total billed charges,,,0.97,,507.31,Percent of total billed charges,,,0.96,,502.08,Percent of total billed charges,,,0.95,,496.85,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,496.85,Percent of total billed charges,,496.85,3950,
Initial control nose bleed and packing insertion,PX-45013183,CDM,30905,CPT,450,RC,,inpatient,,,879,791.1,,0.95,,835.05,Percent of total billed charges,,,0.98,,861.42,Percent of total billed charges,,,0.95,,835.05,Percent of total billed charges,,,0.97,,852.63,Percent of total billed charges,,,0.97,,852.63,Percent of total billed charges,,,0.96,,843.84,Percent of total billed charges,,,0.95,,835.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,835.05,Percent of total billed charges,,835.05,3950,
Initial control nose bleed and packing insertion,PX-45013183,CDM,30905,CPT,450,RC,,outpatient,,,879,791.1,,0.95,,835.05,Percent of total billed charges,,,0.98,,861.42,Percent of total billed charges,,,0.95,,835.05,Percent of total billed charges,,,0.95,,835.05,Percent of total billed charges,,,0.97,,852.63,Percent of total billed charges,,,0.96,,843.84,Percent of total billed charges,,,0.95,,835.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,835.05,Percent of total billed charges,,835.05,3950,
Subsequent control nosebleed and packing insertion,PX-45013185,CDM,30906,CPT,450,RC,,inpatient,,,741,666.9,,0.95,,703.95,Percent of total billed charges,,,0.98,,726.18,Percent of total billed charges,,,0.95,,703.95,Percent of total billed charges,,,0.97,,718.77,Percent of total billed charges,,,0.97,,718.77,Percent of total billed charges,,,0.96,,711.36,Percent of total billed charges,,,0.95,,703.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,703.95,Percent of total billed charges,,703.95,3950,
Subsequent control nosebleed and packing insertion,PX-45013185,CDM,30906,CPT,450,RC,,outpatient,,,741,666.9,,0.95,,703.95,Percent of total billed charges,,,0.98,,726.18,Percent of total billed charges,,,0.95,,703.95,Percent of total billed charges,,,0.95,,703.95,Percent of total billed charges,,,0.97,,718.77,Percent of total billed charges,,,0.96,,711.36,Percent of total billed charges,,,0.95,,703.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,703.95,Percent of total billed charges,,703.95,3950,
Instillation of agent onto lung surface using chest tube,PX-36110912,CDM,32560,CPT,361,RC,,inpatient,,,881,792.9,,0.95,,836.95,Percent of total billed charges,,,0.98,,863.38,Percent of total billed charges,,,0.95,,836.95,Percent of total billed charges,,,0.97,,854.57,Percent of total billed charges,,,0.97,,854.57,Percent of total billed charges,,,0.96,,845.76,Percent of total billed charges,,,0.95,,836.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,836.95,Percent of total billed charges,,836.95,863.38,
Instillation of agent onto lung surface using chest tube,PX-36110912,CDM,32560,CPT,361,RC,,outpatient,,,881,792.9,,0.95,,836.95,Percent of total billed charges,,,0.98,,863.38,Percent of total billed charges,,,0.95,,836.95,Percent of total billed charges,,,0.95,,836.95,Percent of total billed charges,,,0.97,,854.57,Percent of total billed charges,,,0.96,,845.76,Percent of total billed charges,,,0.95,,836.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,836.95,Percent of total billed charges,,836.95,863.38,
Repair of lip and border,PX-45013214,CDM,40650,CPT,450,RC,,inpatient,,,361,324.9,,0.95,,342.95,Percent of total billed charges,,,0.98,,353.78,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,0.97,,350.17,Percent of total billed charges,,,0.97,,350.17,Percent of total billed charges,,,0.96,,346.56,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,342.95,Percent of total billed charges,,342.95,3950,
Repair of lip and border,PX-45013214,CDM,40650,CPT,450,RC,,outpatient,,,361,324.9,,0.95,,342.95,Percent of total billed charges,,,0.98,,353.78,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,0.97,,350.17,Percent of total billed charges,,,0.96,,346.56,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,342.95,Percent of total billed charges,,342.95,3950,
Remove growth of mouth with simple repair,PX-51010369,CDM,40812,CPT,510,RC,,inpatient,,,266,239.4,,0.95,,252.7,Percent of total billed charges,,,0.98,,260.68,Percent of total billed charges,,,0.95,,252.7,Percent of total billed charges,,,0.97,,258.02,Percent of total billed charges,,,0.97,,258.02,Percent of total billed charges,,,0.96,,255.36,Percent of total billed charges,,,0.95,,252.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,252.7,Percent of total billed charges,,252.7,260.68,
Remove growth of mouth with simple repair,PX-51010369,CDM,40812,CPT,510,RC,,outpatient,,,266,239.4,,0.95,,252.7,Percent of total billed charges,,,0.98,,260.68,Percent of total billed charges,,,0.95,,252.7,Percent of total billed charges,,,0.95,,252.7,Percent of total billed charges,,,0.97,,258.02,Percent of total billed charges,,,0.96,,255.36,Percent of total billed charges,,,0.95,,252.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,252.7,Percent of total billed charges,,252.7,260.68,
"Repair of lacerated mouth, 2.5 cm or less",PX-45013220,CDM,40830,CPT,450,RC,,inpatient,,,526,473.4,,0.95,,499.7,Percent of total billed charges,,,0.98,,515.48,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,,0.97,,510.22,Percent of total billed charges,,,0.97,,510.22,Percent of total billed charges,,,0.96,,504.96,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,499.7,Percent of total billed charges,,499.7,3950,
"Repair of lacerated mouth, 2.5 cm or less",PX-45013220,CDM,40830,CPT,450,RC,,outpatient,,,526,473.4,,0.95,,499.7,Percent of total billed charges,,,0.98,,515.48,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,,0.97,,510.22,Percent of total billed charges,,,0.96,,504.96,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,499.7,Percent of total billed charges,,499.7,3950,
Biopsy of front 2/3 of tongue,PX-51010370,CDM,41100,CPT,510,RC,,inpatient,,,538,484.2,,0.95,,511.1,Percent of total billed charges,,,0.98,,527.24,Percent of total billed charges,,,0.95,,511.1,Percent of total billed charges,,,0.97,,521.86,Percent of total billed charges,,,0.97,,521.86,Percent of total billed charges,,,0.96,,516.48,Percent of total billed charges,,,0.95,,511.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,511.1,Percent of total billed charges,,511.1,527.24,
Biopsy of front 2/3 of tongue,PX-51010370,CDM,41100,CPT,510,RC,,outpatient,,,538,484.2,,0.95,,511.1,Percent of total billed charges,,,0.98,,527.24,Percent of total billed charges,,,0.95,,511.1,Percent of total billed charges,,,0.95,,511.1,Percent of total billed charges,,,0.97,,521.86,Percent of total billed charges,,,0.96,,516.48,Percent of total billed charges,,,0.95,,511.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,511.1,Percent of total billed charges,,511.1,527.24,
"Repair lacerated floor of mouth and/or tongue, <=2.5 cm",PX-45013224,CDM,41250,CPT,450,RC,,inpatient,,,570,513,,0.95,,541.5,Percent of total billed charges,,,0.98,,558.6,Percent of total billed charges,,,0.95,,541.5,Percent of total billed charges,,,0.97,,552.9,Percent of total billed charges,,,0.97,,552.9,Percent of total billed charges,,,0.96,,547.2,Percent of total billed charges,,,0.95,,541.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,541.5,Percent of total billed charges,,541.5,3950,
"Repair lacerated floor of mouth and/or tongue, <=2.5 cm",PX-45013224,CDM,41250,CPT,450,RC,,outpatient,,,570,513,,0.95,,541.5,Percent of total billed charges,,,0.98,,558.6,Percent of total billed charges,,,0.95,,541.5,Percent of total billed charges,,,0.95,,541.5,Percent of total billed charges,,,0.97,,552.9,Percent of total billed charges,,,0.96,,547.2,Percent of total billed charges,,,0.95,,541.5,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,541.5,Percent of total billed charges,,541.5,3950,
"Reparir lacerated tongue or floor of mouth, > 2.6 cm",PX-45013226,CDM,41252,CPT,450,RC,,inpatient,,,1186,1067.4,,0.95,,1126.7,Percent of total billed charges,,,0.98,,1162.28,Percent of total billed charges,,,0.95,,1126.7,Percent of total billed charges,,,0.97,,1150.42,Percent of total billed charges,,,0.97,,1150.42,Percent of total billed charges,,,0.96,,1138.56,Percent of total billed charges,,,0.95,,1126.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1126.7,Percent of total billed charges,,1126.7,3950,
"Reparir lacerated tongue or floor of mouth, > 2.6 cm",PX-45013226,CDM,41252,CPT,450,RC,,outpatient,,,1186,1067.4,,0.95,,1126.7,Percent of total billed charges,,,0.98,,1162.28,Percent of total billed charges,,,0.95,,1126.7,Percent of total billed charges,,,0.95,,1126.7,Percent of total billed charges,,,0.97,,1150.42,Percent of total billed charges,,,0.96,,1138.56,Percent of total billed charges,,,0.95,,1126.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1126.7,Percent of total billed charges,,1126.7,3950,
Drainage of abscess near tonsil,PX-45013232,CDM,42700,CPT,450,RC,,inpatient,,,499,449.1,,0.95,,474.05,Percent of total billed charges,,,0.98,,489.02,Percent of total billed charges,,,0.95,,474.05,Percent of total billed charges,,,0.97,,484.03,Percent of total billed charges,,,0.97,,484.03,Percent of total billed charges,,,0.96,,479.04,Percent of total billed charges,,,0.95,,474.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,474.05,Percent of total billed charges,,474.05,3950,
Drainage of abscess near tonsil,PX-45013232,CDM,42700,CPT,450,RC,,outpatient,,,499,449.1,,0.95,,474.05,Percent of total billed charges,,,0.98,,489.02,Percent of total billed charges,,,0.95,,474.05,Percent of total billed charges,,,0.95,,474.05,Percent of total billed charges,,,0.97,,484.03,Percent of total billed charges,,,0.96,,479.04,Percent of total billed charges,,,0.95,,474.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,474.05,Percent of total billed charges,,474.05,3950,
Removal of foreign body in throat,PX-45013234,CDM,42809,CPT,450,RC,,inpatient,,,606,545.4,,0.95,,575.7,Percent of total billed charges,,,0.98,,593.88,Percent of total billed charges,,,0.95,,575.7,Percent of total billed charges,,,0.97,,587.82,Percent of total billed charges,,,0.97,,587.82,Percent of total billed charges,,,0.96,,581.76,Percent of total billed charges,,,0.95,,575.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,575.7,Percent of total billed charges,,575.7,3950,
Removal of foreign body in throat,PX-45013234,CDM,42809,CPT,450,RC,,outpatient,,,606,545.4,,0.95,,575.7,Percent of total billed charges,,,0.98,,593.88,Percent of total billed charges,,,0.95,,575.7,Percent of total billed charges,,,0.95,,575.7,Percent of total billed charges,,,0.97,,587.82,Percent of total billed charges,,,0.96,,581.76,Percent of total billed charges,,,0.95,,575.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,575.7,Percent of total billed charges,,575.7,3950,
Incision of external hemorrhoid with blood clot,PX-45010410,CDM,46083,CPT,450,RC,,inpatient,,,512,460.8,,0.95,,486.4,Percent of total billed charges,,,0.98,,501.76,Percent of total billed charges,,,0.95,,486.4,Percent of total billed charges,,,0.97,,496.64,Percent of total billed charges,,,0.97,,496.64,Percent of total billed charges,,,0.96,,491.52,Percent of total billed charges,,,0.95,,486.4,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,486.4,Percent of total billed charges,,486.4,3950,
Incision of external hemorrhoid with blood clot,PX-45010410,CDM,46083,CPT,450,RC,,outpatient,,,512,460.8,,0.95,,486.4,Percent of total billed charges,,,0.98,,501.76,Percent of total billed charges,,,0.95,,486.4,Percent of total billed charges,,,0.95,,486.4,Percent of total billed charges,,,0.97,,496.64,Percent of total billed charges,,,0.96,,491.52,Percent of total billed charges,,,0.95,,486.4,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,486.4,Percent of total billed charges,,486.4,3950,
Removal of external hemorrhoid with blood clot,PX-45010413,CDM,46320,CPT,450,RC,,inpatient,,,526,473.4,,0.95,,499.7,Percent of total billed charges,,,0.98,,515.48,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,,0.97,,510.22,Percent of total billed charges,,,0.97,,510.22,Percent of total billed charges,,,0.96,,504.96,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,499.7,Percent of total billed charges,,499.7,3950,
Removal of external hemorrhoid with blood clot,PX-45010413,CDM,46320,CPT,450,RC,,outpatient,,,526,473.4,,0.95,,499.7,Percent of total billed charges,,,0.98,,515.48,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,,0.97,,510.22,Percent of total billed charges,,,0.96,,504.96,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,499.7,Percent of total billed charges,,499.7,3950,
Diagnostic exam of anus using an endoscope,PX-45010414,CDM,46600,CPT,450,RC,,inpatient,,,216,194.4,,0.95,,205.2,Percent of total billed charges,,,0.98,,211.68,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,0.97,,209.52,Percent of total billed charges,,,0.97,,209.52,Percent of total billed charges,,,0.96,,207.36,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,205.2,Percent of total billed charges,,205.2,3950,
Diagnostic exam of anus using an endoscope,PX-45010414,CDM,46600,CPT,450,RC,,outpatient,,,216,194.4,,0.95,,205.2,Percent of total billed charges,,,0.98,,211.68,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,0.97,,209.52,Percent of total billed charges,,,0.96,,207.36,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,205.2,Percent of total billed charges,,205.2,3950,
Simple bladder irrigation and/or instillation,PX-45010423,CDM,51700,CPT,450,RC,,inpatient,,,345,310.5,,0.95,,327.75,Percent of total billed charges,,,0.98,,338.1,Percent of total billed charges,,,0.95,,327.75,Percent of total billed charges,,,0.97,,334.65,Percent of total billed charges,,,0.97,,334.65,Percent of total billed charges,,,0.96,,331.2,Percent of total billed charges,,,0.95,,327.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,327.75,Percent of total billed charges,,327.75,3950,
Simple bladder irrigation and/or instillation,PX-45010423,CDM,51700,CPT,450,RC,,outpatient,,,345,310.5,,0.95,,327.75,Percent of total billed charges,,,0.98,,338.1,Percent of total billed charges,,,0.95,,327.75,Percent of total billed charges,,,0.95,,327.75,Percent of total billed charges,,,0.97,,334.65,Percent of total billed charges,,,0.96,,331.2,Percent of total billed charges,,,0.95,,327.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,327.75,Percent of total billed charges,,327.75,3950,
HC PR 57455 Colposcopy Cervix Uppr/Adjcnt Vagina W/Cervix Bx Rhc,PX-52110531,CDM,57455,CPT,521,RC,,inpatient,,,401,360.9,,0.95,,380.95,Percent of total billed charges,,,0.98,,392.98,Percent of total billed charges,,,0.95,,380.95,Percent of total billed charges,,,0.97,,388.97,Percent of total billed charges,,,0.97,,388.97,Percent of total billed charges,,,0.96,,384.96,Percent of total billed charges,,,0.95,,380.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,380.95,Percent of total billed charges,,380.95,392.98,
HC PR 57455 Colposcopy Cervix Uppr/Adjcnt Vagina W/Cervix Bx Rhc,PX-52110531,CDM,57455,CPT,521,RC,,outpatient,,,401,360.9,,0.95,,380.95,Percent of total billed charges,,,0.98,,392.98,Percent of total billed charges,,,0.95,,380.95,Percent of total billed charges,,,0.95,,380.95,Percent of total billed charges,,,0.97,,388.97,Percent of total billed charges,,,0.96,,384.96,Percent of total billed charges,,,0.95,,380.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,380.95,Percent of total billed charges,,380.95,392.98,
Removal of abdominal fluid,PX-45010443,CDM,57020,CPT,450,RC,,inpatient,,,581,522.9,,0.95,,551.95,Percent of total billed charges,,,0.98,,569.38,Percent of total billed charges,,,0.95,,551.95,Percent of total billed charges,,,0.97,,563.57,Percent of total billed charges,,,0.97,,563.57,Percent of total billed charges,,,0.96,,557.76,Percent of total billed charges,,,0.95,,551.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,551.95,Percent of total billed charges,,551.95,3950,
Removal of abdominal fluid,PX-45010443,CDM,57020,CPT,450,RC,,outpatient,,,581,522.9,,0.95,,551.95,Percent of total billed charges,,,0.98,,569.38,Percent of total billed charges,,,0.95,,551.95,Percent of total billed charges,,,0.95,,551.95,Percent of total billed charges,,,0.97,,563.57,Percent of total billed charges,,,0.96,,557.76,Percent of total billed charges,,,0.95,,551.95,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,551.95,Percent of total billed charges,,551.95,3950,
Suture of nonobstetrical injury of vagina,PX-45010445,CDM,57200,CPT,450,RC,,inpatient,,,1186,1067.4,,0.95,,1126.7,Percent of total billed charges,,,0.98,,1162.28,Percent of total billed charges,,,0.95,,1126.7,Percent of total billed charges,,,0.97,,1150.42,Percent of total billed charges,,,0.97,,1150.42,Percent of total billed charges,,,0.96,,1138.56,Percent of total billed charges,,,0.95,,1126.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1126.7,Percent of total billed charges,,1126.7,3950,
Suture of nonobstetrical injury of vagina,PX-45010445,CDM,57200,CPT,450,RC,,outpatient,,,1186,1067.4,,0.95,,1126.7,Percent of total billed charges,,,0.98,,1162.28,Percent of total billed charges,,,0.95,,1126.7,Percent of total billed charges,,,0.95,,1126.7,Percent of total billed charges,,,0.97,,1150.42,Percent of total billed charges,,,0.96,,1138.56,Percent of total billed charges,,,0.95,,1126.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1126.7,Percent of total billed charges,,1126.7,3950,
Removal of IUD,PX-45010455,CDM,58301,CPT,450,RC,,inpatient,,,536,482.4,,0.95,,509.2,Percent of total billed charges,,,0.98,,525.28,Percent of total billed charges,,,0.95,,509.2,Percent of total billed charges,,,0.97,,519.92,Percent of total billed charges,,,0.97,,519.92,Percent of total billed charges,,,0.96,,514.56,Percent of total billed charges,,,0.95,,509.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,509.2,Percent of total billed charges,,509.2,3950,
Removal of IUD,PX-45010455,CDM,58301,CPT,450,RC,,outpatient,,,536,482.4,,0.95,,509.2,Percent of total billed charges,,,0.98,,525.28,Percent of total billed charges,,,0.95,,509.2,Percent of total billed charges,,,0.95,,509.2,Percent of total billed charges,,,0.97,,519.92,Percent of total billed charges,,,0.96,,514.56,Percent of total billed charges,,,0.95,,509.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,509.2,Percent of total billed charges,,509.2,3950,
HC PR 64405 Injection Anesthetic Agent Greater Occipital Nrv Rhc,PX-52110569,CDM,64405,CPT,521,RC,,inpatient,,,186,167.4,,0.95,,176.7,Percent of total billed charges,,,0.98,,182.28,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.96,,178.56,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,176.7,Percent of total billed charges,,176.7,182.28,
HC PR 64405 Injection Anesthetic Agent Greater Occipital Nrv Rhc,PX-52110569,CDM,64405,CPT,521,RC,,outpatient,,,186,167.4,,0.95,,176.7,Percent of total billed charges,,,0.98,,182.28,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.96,,178.56,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,176.7,Percent of total billed charges,,176.7,182.28,
"Inject anesthetic agent and/or steroid, face nerve",PX-45010459,CDM,64400,CPT,450,RC,,inpatient,,,393,353.7,,0.95,,373.35,Percent of total billed charges,,,0.98,,385.14,Percent of total billed charges,,,0.95,,373.35,Percent of total billed charges,,,0.97,,381.21,Percent of total billed charges,,,0.97,,381.21,Percent of total billed charges,,,0.96,,377.28,Percent of total billed charges,,,0.95,,373.35,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,373.35,Percent of total billed charges,,373.35,3950,
"Inject anesthetic agent and/or steroid, face nerve",PX-45010459,CDM,64400,CPT,450,RC,,outpatient,,,393,353.7,,0.95,,373.35,Percent of total billed charges,,,0.98,,385.14,Percent of total billed charges,,,0.95,,373.35,Percent of total billed charges,,,0.95,,373.35,Percent of total billed charges,,,0.97,,381.21,Percent of total billed charges,,,0.96,,377.28,Percent of total billed charges,,,0.95,,373.35,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,373.35,Percent of total billed charges,,373.35,3950,
Injection of anesthetic and/or steroid drug into foot nerve,PX-45010465,CDM,64455,CPT,450,RC,,inpatient,,,135,121.5,,0.95,,128.25,Percent of total billed charges,,,0.98,,132.3,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,0.97,,130.95,Percent of total billed charges,,,0.97,,130.95,Percent of total billed charges,,,0.96,,129.6,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,128.25,Percent of total billed charges,,128.25,3950,
Injection of anesthetic and/or steroid drug into foot nerve,PX-45010465,CDM,64455,CPT,450,RC,,outpatient,,,135,121.5,,0.95,,128.25,Percent of total billed charges,,,0.98,,132.3,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,0.97,,130.95,Percent of total billed charges,,,0.96,,129.6,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,128.25,Percent of total billed charges,,128.25,3950,
Removal of foreign body from external eye,PX-45010467,CDM,65205,CPT,450,RC,,inpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,263.15,Percent of total billed charges,,263.15,3950,
Removal of foreign body from external eye,PX-45010467,CDM,65205,CPT,450,RC,,outpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,263.15,Percent of total billed charges,,263.15,3950,
Removal of foreign body from external eye,PX-45010469,CDM,65210,CPT,450,RC,,inpatient,,,355,319.5,,0.95,,337.25,Percent of total billed charges,,,0.98,,347.9,Percent of total billed charges,,,0.95,,337.25,Percent of total billed charges,,,0.97,,344.35,Percent of total billed charges,,,0.97,,344.35,Percent of total billed charges,,,0.96,,340.8,Percent of total billed charges,,,0.95,,337.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,337.25,Percent of total billed charges,,337.25,3950,
Removal of foreign body from external eye,PX-45010469,CDM,65210,CPT,450,RC,,outpatient,,,355,319.5,,0.95,,337.25,Percent of total billed charges,,,0.98,,347.9,Percent of total billed charges,,,0.95,,337.25,Percent of total billed charges,,,0.95,,337.25,Percent of total billed charges,,,0.97,,344.35,Percent of total billed charges,,,0.96,,340.8,Percent of total billed charges,,,0.95,,337.25,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,337.25,Percent of total billed charges,,337.25,3950,
Removal of foreign body in cornea,PX-45010471,CDM,65220,CPT,450,RC,,inpatient,,,299,269.1,,0.95,,284.05,Percent of total billed charges,,,0.98,,293.02,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,0.97,,290.03,Percent of total billed charges,,,0.97,,290.03,Percent of total billed charges,,,0.96,,287.04,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,284.05,Percent of total billed charges,,284.05,3950,
Removal of foreign body in cornea,PX-45010471,CDM,65220,CPT,450,RC,,outpatient,,,299,269.1,,0.95,,284.05,Percent of total billed charges,,,0.98,,293.02,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,0.97,,290.03,Percent of total billed charges,,,0.96,,287.04,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,284.05,Percent of total billed charges,,284.05,3950,
Removal of foreign body in cornea using slit lamp,PX-45013170,CDM,65222,CPT,450,RC,,inpatient,,,306,275.4,,0.95,,290.7,Percent of total billed charges,,,0.98,,299.88,Percent of total billed charges,,,0.95,,290.7,Percent of total billed charges,,,0.97,,296.82,Percent of total billed charges,,,0.97,,296.82,Percent of total billed charges,,,0.96,,293.76,Percent of total billed charges,,,0.95,,290.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,290.7,Percent of total billed charges,,290.7,3950,
Removal of foreign body in cornea using slit lamp,PX-45013170,CDM,65222,CPT,450,RC,,outpatient,,,306,275.4,,0.95,,290.7,Percent of total billed charges,,,0.98,,299.88,Percent of total billed charges,,,0.95,,290.7,Percent of total billed charges,,,0.95,,290.7,Percent of total billed charges,,,0.97,,296.82,Percent of total billed charges,,,0.96,,293.76,Percent of total billed charges,,,0.95,,290.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,290.7,Percent of total billed charges,,290.7,3950,
Repair of lacerated conjunctiva,PX-45010474,CDM,65270,CPT,450,RC,,inpatient,,,802,721.8,,0.95,,761.9,Percent of total billed charges,,,0.98,,785.96,Percent of total billed charges,,,0.95,,761.9,Percent of total billed charges,,,0.97,,777.94,Percent of total billed charges,,,0.97,,777.94,Percent of total billed charges,,,0.96,,769.92,Percent of total billed charges,,,0.95,,761.9,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,761.9,Percent of total billed charges,,761.9,3950,
Repair of lacerated conjunctiva,PX-45010474,CDM,65270,CPT,450,RC,,outpatient,,,802,721.8,,0.95,,761.9,Percent of total billed charges,,,0.98,,785.96,Percent of total billed charges,,,0.95,,761.9,Percent of total billed charges,,,0.95,,761.9,Percent of total billed charges,,,0.97,,777.94,Percent of total billed charges,,,0.96,,769.92,Percent of total billed charges,,,0.95,,761.9,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,761.9,Percent of total billed charges,,761.9,3950,
"Remove recurring cataract in lens capsule, laser",PX-36111099,CDM,66821,CPT,361,RC,,inpatient,,,1956,1760.4,,0.95,,1858.2,Percent of total billed charges,,,0.98,,1916.88,Percent of total billed charges,,,0.95,,1858.2,Percent of total billed charges,,,0.97,,1897.32,Percent of total billed charges,,,0.97,,1897.32,Percent of total billed charges,,,0.96,,1877.76,Percent of total billed charges,,,0.95,,1858.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1858.2,Percent of total billed charges,,1858.2,1916.88,
"Remove recurring cataract in lens capsule, laser",PX-36111099,CDM,66821,CPT,361,RC,,outpatient,,,1956,1760.4,,0.95,,1858.2,Percent of total billed charges,,,0.98,,1916.88,Percent of total billed charges,,,0.95,,1858.2,Percent of total billed charges,,,0.95,,1858.2,Percent of total billed charges,,,0.97,,1897.32,Percent of total billed charges,,,0.96,,1877.76,Percent of total billed charges,,,0.95,,1858.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1858.2,Percent of total billed charges,,1858.2,1916.88,
Incision and drainage of abscess of eyelid,PX-45010482,CDM,67700,CPT,450,RC,,inpatient,,,798,718.2,,0.95,,758.1,Percent of total billed charges,,,0.98,,782.04,Percent of total billed charges,,,0.95,,758.1,Percent of total billed charges,,,0.97,,774.06,Percent of total billed charges,,,0.97,,774.06,Percent of total billed charges,,,0.96,,766.08,Percent of total billed charges,,,0.95,,758.1,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,758.1,Percent of total billed charges,,758.1,3950,
Incision and drainage of abscess of eyelid,PX-45010482,CDM,67700,CPT,450,RC,,outpatient,,,798,718.2,,0.95,,758.1,Percent of total billed charges,,,0.98,,782.04,Percent of total billed charges,,,0.95,,758.1,Percent of total billed charges,,,0.95,,758.1,Percent of total billed charges,,,0.97,,774.06,Percent of total billed charges,,,0.96,,766.08,Percent of total billed charges,,,0.95,,758.1,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,758.1,Percent of total billed charges,,758.1,3950,
Removal of embedded foreign body in eyelid,PX-45010484,CDM,67938,CPT,450,RC,,inpatient,,,897,807.3,,0.95,,852.15,Percent of total billed charges,,,0.98,,879.06,Percent of total billed charges,,,0.95,,852.15,Percent of total billed charges,,,0.97,,870.09,Percent of total billed charges,,,0.97,,870.09,Percent of total billed charges,,,0.96,,861.12,Percent of total billed charges,,,0.95,,852.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,852.15,Percent of total billed charges,,852.15,3950,
Removal of embedded foreign body in eyelid,PX-45010484,CDM,67938,CPT,450,RC,,outpatient,,,897,807.3,,0.95,,852.15,Percent of total billed charges,,,0.98,,879.06,Percent of total billed charges,,,0.95,,852.15,Percent of total billed charges,,,0.95,,852.15,Percent of total billed charges,,,0.97,,870.09,Percent of total billed charges,,,0.96,,861.12,Percent of total billed charges,,,0.95,,852.15,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,852.15,Percent of total billed charges,,852.15,3950,
Removal of foreign body in ear canal,PX-45010489,CDM,69200,CPT,450,RC,,inpatient,,,204,183.6,,0.95,,193.8,Percent of total billed charges,,,0.98,,199.92,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.96,,195.84,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,193.8,Percent of total billed charges,,193.8,3950,
Removal of foreign body in ear canal,PX-45010489,CDM,69200,CPT,450,RC,,outpatient,,,204,183.6,,0.95,,193.8,Percent of total billed charges,,,0.98,,199.92,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.96,,195.84,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,193.8,Percent of total billed charges,,193.8,3950,
Drainage of abscess in rectum,PX-45010407,CDM,46040,CPT,450,RC,,inpatient,,,468,421.2,,0.95,,444.6,Percent of total billed charges,,,0.98,,458.64,Percent of total billed charges,,,0.95,,444.6,Percent of total billed charges,,,0.97,,453.96,Percent of total billed charges,,,0.97,,453.96,Percent of total billed charges,,,0.96,,449.28,Percent of total billed charges,,,0.95,,444.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,444.6,Percent of total billed charges,,444.6,3950,
Drainage of abscess in rectum,PX-45010407,CDM,46040,CPT,450,RC,,outpatient,,,468,421.2,,0.95,,444.6,Percent of total billed charges,,,0.98,,458.64,Percent of total billed charges,,,0.95,,444.6,Percent of total billed charges,,,0.95,,444.6,Percent of total billed charges,,,0.97,,453.96,Percent of total billed charges,,,0.96,,449.28,Percent of total billed charges,,,0.95,,444.6,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,444.6,Percent of total billed charges,,444.6,3950,
HC PR ED 30020 Drainage of Nasal Septum Abscess/Hematoma Cdm,PX-98110315,CDM,30020,CPT,981,RC,,inpatient,,,1499,1349.1,,0.95,,1424.05,Percent of total billed charges,,,0.98,,1469.02,Percent of total billed charges,,,0.95,,1424.05,Percent of total billed charges,,,0.97,,1454.03,Percent of total billed charges,,,0.97,,1454.03,Percent of total billed charges,,,0.96,,1439.04,Percent of total billed charges,,,0.95,,1424.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1424.05,Percent of total billed charges,,1424.05,1469.02,
HC PR ED 30020 Drainage of Nasal Septum Abscess/Hematoma Cdm,PX-98110315,CDM,30020,CPT,981,RC,,outpatient,,,1499,1349.1,,0.95,,1424.05,Percent of total billed charges,,,0.98,,1469.02,Percent of total billed charges,,,0.95,,1424.05,Percent of total billed charges,,,0.95,,1424.05,Percent of total billed charges,,,0.97,,1454.03,Percent of total billed charges,,,0.96,,1439.04,Percent of total billed charges,,,0.95,,1424.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1424.05,Percent of total billed charges,,1424.05,1469.02,
HC PR ED 30300 Remove Nasal Foreign Body Cdm,PX-98110316,CDM,30300,CPT,981,RC,,inpatient,,,519,467.1,,0.95,,493.05,Percent of total billed charges,,,0.98,,508.62,Percent of total billed charges,,,0.95,,493.05,Percent of total billed charges,,,0.97,,503.43,Percent of total billed charges,,,0.97,,503.43,Percent of total billed charges,,,0.96,,498.24,Percent of total billed charges,,,0.95,,493.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,493.05,Percent of total billed charges,,493.05,508.62,
HC PR ED 30300 Remove Nasal Foreign Body Cdm,PX-98110316,CDM,30300,CPT,981,RC,,outpatient,,,519,467.1,,0.95,,493.05,Percent of total billed charges,,,0.98,,508.62,Percent of total billed charges,,,0.95,,493.05,Percent of total billed charges,,,0.95,,493.05,Percent of total billed charges,,,0.97,,503.43,Percent of total billed charges,,,0.96,,498.24,Percent of total billed charges,,,0.95,,493.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,493.05,Percent of total billed charges,,493.05,508.62,
HC PR 93351 Echo Tthrc R-T 2d W/WO M-Mode Rest&Strs Cont Ecg Rhc,PX-52110627,CDM,93351,CPT,521,RC,,inpatient,,,2186,1967.4,,0.95,,2076.7,Percent of total billed charges,,,0.98,,2142.28,Percent of total billed charges,,,0.95,,2076.7,Percent of total billed charges,,,0.97,,2120.42,Percent of total billed charges,,,0.97,,2120.42,Percent of total billed charges,,,0.96,,2098.56,Percent of total billed charges,,,0.95,,2076.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2076.7,Percent of total billed charges,,2076.7,2142.28,
HC PR 93351 Echo Tthrc R-T 2d W/WO M-Mode Rest&Strs Cont Ecg Rhc,PX-52110627,CDM,93351,CPT,521,RC,,outpatient,,,2186,1967.4,,0.95,,2076.7,Percent of total billed charges,,,0.98,,2142.28,Percent of total billed charges,,,0.95,,2076.7,Percent of total billed charges,,,0.95,,2076.7,Percent of total billed charges,,,0.97,,2120.42,Percent of total billed charges,,,0.96,,2098.56,Percent of total billed charges,,,0.95,,2076.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2076.7,Percent of total billed charges,,2076.7,2142.28,
HC PR ED 30901 Control of Nosebleed Simple Cdm,PX-98110317,CDM,30901,CPT,981,RC,,inpatient,,,385,346.5,,0.95,,365.75,Percent of total billed charges,,,0.98,,377.3,Percent of total billed charges,,,0.95,,365.75,Percent of total billed charges,,,0.97,,373.45,Percent of total billed charges,,,0.97,,373.45,Percent of total billed charges,,,0.96,,369.6,Percent of total billed charges,,,0.95,,365.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,365.75,Percent of total billed charges,,365.75,377.3,
HC PR ED 30901 Control of Nosebleed Simple Cdm,PX-98110317,CDM,30901,CPT,981,RC,,outpatient,,,385,346.5,,0.95,,365.75,Percent of total billed charges,,,0.98,,377.3,Percent of total billed charges,,,0.95,,365.75,Percent of total billed charges,,,0.95,,365.75,Percent of total billed charges,,,0.97,,373.45,Percent of total billed charges,,,0.96,,369.6,Percent of total billed charges,,,0.95,,365.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,365.75,Percent of total billed charges,,365.75,377.3,
HC PR ED 30903 Control of Nosebleed Complex Cdm,PX-98110319,CDM,30903,CPT,981,RC,,inpatient,,,655,589.5,,0.95,,622.25,Percent of total billed charges,,,0.98,,641.9,Percent of total billed charges,,,0.95,,622.25,Percent of total billed charges,,,0.97,,635.35,Percent of total billed charges,,,0.97,,635.35,Percent of total billed charges,,,0.96,,628.8,Percent of total billed charges,,,0.95,,622.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,622.25,Percent of total billed charges,,622.25,641.9,
HC PR ED 30903 Control of Nosebleed Complex Cdm,PX-98110319,CDM,30903,CPT,981,RC,,outpatient,,,655,589.5,,0.95,,622.25,Percent of total billed charges,,,0.98,,641.9,Percent of total billed charges,,,0.95,,622.25,Percent of total billed charges,,,0.95,,622.25,Percent of total billed charges,,,0.97,,635.35,Percent of total billed charges,,,0.96,,628.8,Percent of total billed charges,,,0.95,,622.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,622.25,Percent of total billed charges,,622.25,641.9,
HC PR ED 30905 Control of Nosebleed Posterior Cdm,PX-98110321,CDM,30905,CPT,981,RC,,inpatient,,,863,776.7,,0.95,,819.85,Percent of total billed charges,,,0.98,,845.74,Percent of total billed charges,,,0.95,,819.85,Percent of total billed charges,,,0.97,,837.11,Percent of total billed charges,,,0.97,,837.11,Percent of total billed charges,,,0.96,,828.48,Percent of total billed charges,,,0.95,,819.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,819.85,Percent of total billed charges,,819.85,845.74,
HC PR ED 30905 Control of Nosebleed Posterior Cdm,PX-98110321,CDM,30905,CPT,981,RC,,outpatient,,,863,776.7,,0.95,,819.85,Percent of total billed charges,,,0.98,,845.74,Percent of total billed charges,,,0.95,,819.85,Percent of total billed charges,,,0.95,,819.85,Percent of total billed charges,,,0.97,,837.11,Percent of total billed charges,,,0.96,,828.48,Percent of total billed charges,,,0.95,,819.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,819.85,Percent of total billed charges,,819.85,845.74,
HC PR ED 30906 Repeat Control of Nosebleed Cdm,PX-98110322,CDM,30906,CPT,981,RC,,inpatient,,,772,694.8,,0.95,,733.4,Percent of total billed charges,,,0.98,,756.56,Percent of total billed charges,,,0.95,,733.4,Percent of total billed charges,,,0.97,,748.84,Percent of total billed charges,,,0.97,,748.84,Percent of total billed charges,,,0.96,,741.12,Percent of total billed charges,,,0.95,,733.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,733.4,Percent of total billed charges,,733.4,756.56,
HC PR ED 30906 Repeat Control of Nosebleed Cdm,PX-98110322,CDM,30906,CPT,981,RC,,outpatient,,,772,694.8,,0.95,,733.4,Percent of total billed charges,,,0.98,,756.56,Percent of total billed charges,,,0.95,,733.4,Percent of total billed charges,,,0.95,,733.4,Percent of total billed charges,,,0.97,,748.84,Percent of total billed charges,,,0.96,,741.12,Percent of total billed charges,,,0.95,,733.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,733.4,Percent of total billed charges,,733.4,756.56,
HC PR 95250 Cont Gluc Mntr Physician/Qhp Provided Equiptment Rhc,PX-52110643,CDM,95250,CPT,521,RC,,inpatient,,,363,326.7,,0.95,,344.85,Percent of total billed charges,,,0.98,,355.74,Percent of total billed charges,,,0.95,,344.85,Percent of total billed charges,,,0.97,,352.11,Percent of total billed charges,,,0.97,,352.11,Percent of total billed charges,,,0.96,,348.48,Percent of total billed charges,,,0.95,,344.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,344.85,Percent of total billed charges,,344.85,355.74,
HC PR 95250 Cont Gluc Mntr Physician/Qhp Provided Equiptment Rhc,PX-52110643,CDM,95250,CPT,521,RC,,outpatient,,,363,326.7,,0.95,,344.85,Percent of total billed charges,,,0.98,,355.74,Percent of total billed charges,,,0.95,,344.85,Percent of total billed charges,,,0.95,,344.85,Percent of total billed charges,,,0.97,,352.11,Percent of total billed charges,,,0.96,,348.48,Percent of total billed charges,,,0.95,,344.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,344.85,Percent of total billed charges,,344.85,355.74,
HC PR ED 31500 Ins Emergency Airway Cdm,PX-98110324,CDM,31500,CPT,981,RC,,inpatient,,,342,307.8,,0.95,,324.9,Percent of total billed charges,,,0.98,,335.16,Percent of total billed charges,,,0.95,,324.9,Percent of total billed charges,,,0.97,,331.74,Percent of total billed charges,,,0.97,,331.74,Percent of total billed charges,,,0.96,,328.32,Percent of total billed charges,,,0.95,,324.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,324.9,Percent of total billed charges,,324.9,335.16,
HC PR ED 31500 Ins Emergency Airway Cdm,PX-98110324,CDM,31500,CPT,981,RC,,outpatient,,,342,307.8,,0.95,,324.9,Percent of total billed charges,,,0.98,,335.16,Percent of total billed charges,,,0.95,,324.9,Percent of total billed charges,,,0.95,,324.9,Percent of total billed charges,,,0.97,,331.74,Percent of total billed charges,,,0.96,,328.32,Percent of total billed charges,,,0.95,,324.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,324.9,Percent of total billed charges,,324.9,335.16,
HC PR ED 31505 Diagnostic Laryngoscopy Indirect Cdm,PX-98110326,CDM,31505,CPT,981,RC,,inpatient,,,265,238.5,,0.95,,251.75,Percent of total billed charges,,,0.98,,259.7,Percent of total billed charges,,,0.95,,251.75,Percent of total billed charges,,,0.97,,257.05,Percent of total billed charges,,,0.97,,257.05,Percent of total billed charges,,,0.96,,254.4,Percent of total billed charges,,,0.95,,251.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,251.75,Percent of total billed charges,,251.75,259.7,
HC PR ED 31505 Diagnostic Laryngoscopy Indirect Cdm,PX-98110326,CDM,31505,CPT,981,RC,,outpatient,,,265,238.5,,0.95,,251.75,Percent of total billed charges,,,0.98,,259.7,Percent of total billed charges,,,0.95,,251.75,Percent of total billed charges,,,0.95,,251.75,Percent of total billed charges,,,0.97,,257.05,Percent of total billed charges,,,0.96,,254.4,Percent of total billed charges,,,0.95,,251.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,251.75,Percent of total billed charges,,251.75,259.7,
HC PR ED 31511 Remove Foreign Body Larynx Cdm,PX-98110328,CDM,31511,CPT,981,RC,,inpatient,,,761,684.9,,0.95,,722.95,Percent of total billed charges,,,0.98,,745.78,Percent of total billed charges,,,0.95,,722.95,Percent of total billed charges,,,0.97,,738.17,Percent of total billed charges,,,0.97,,738.17,Percent of total billed charges,,,0.96,,730.56,Percent of total billed charges,,,0.95,,722.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,722.95,Percent of total billed charges,,722.95,745.78,
HC PR ED 31511 Remove Foreign Body Larynx Cdm,PX-98110328,CDM,31511,CPT,981,RC,,outpatient,,,761,684.9,,0.95,,722.95,Percent of total billed charges,,,0.98,,745.78,Percent of total billed charges,,,0.95,,722.95,Percent of total billed charges,,,0.95,,722.95,Percent of total billed charges,,,0.97,,738.17,Percent of total billed charges,,,0.96,,730.56,Percent of total billed charges,,,0.95,,722.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,722.95,Percent of total billed charges,,722.95,745.78,
HC PR 97535 Self-Care/Home Mgmt Training Each 15 Minutes Rhc,PX-52110658,CDM,97535,CPT,521,RC,,inpatient,,,81,72.9,,0.95,,76.95,Percent of total billed charges,,,0.98,,79.38,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.96,,77.76,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76.95,Percent of total billed charges,,76.95,79.38,
HC PR 97535 Self-Care/Home Mgmt Training Each 15 Minutes Rhc,PX-52110658,CDM,97535,CPT,521,RC,,outpatient,,,81,72.9,,0.95,,76.95,Percent of total billed charges,,,0.98,,79.38,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.96,,77.76,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76.95,Percent of total billed charges,,76.95,79.38,
HC PR 97802 Medical Nutrition Assmt&Ivntj Indiv Each 15 Mi Rhc,PX-52110665,CDM,97802,CPT,521,RC,,inpatient,,,90,81,,0.95,,85.5,Percent of total billed charges,,,0.98,,88.2,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,0.97,,87.3,Percent of total billed charges,,,0.97,,87.3,Percent of total billed charges,,,0.96,,86.4,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,85.5,Percent of total billed charges,,85.5,88.2,
HC PR 97802 Medical Nutrition Assmt&Ivntj Indiv Each 15 Mi Rhc,PX-52110665,CDM,97802,CPT,521,RC,,outpatient,,,90,81,,0.95,,85.5,Percent of total billed charges,,,0.98,,88.2,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,0.97,,87.3,Percent of total billed charges,,,0.96,,86.4,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,85.5,Percent of total billed charges,,85.5,88.2,
HC PR 97803 Medical Nutrition Re-Assmt&Ivntj Indiv Ea 15 M Rhc,PX-52110666,CDM,97803,CPT,521,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
HC PR 97803 Medical Nutrition Re-Assmt&Ivntj Indiv Ea 15 M Rhc,PX-52110666,CDM,97803,CPT,521,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
HC PR ED 31605 Cricothyroidotomy Cdm,PX-98110336,CDM,31605,CPT,981,RC,,inpatient,,,2096,1886.4,,0.95,,1991.2,Percent of total billed charges,,,0.98,,2054.08,Percent of total billed charges,,,0.95,,1991.2,Percent of total billed charges,,,0.97,,2033.12,Percent of total billed charges,,,0.97,,2033.12,Percent of total billed charges,,,0.96,,2012.16,Percent of total billed charges,,,0.95,,1991.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1991.2,Percent of total billed charges,,1991.2,2054.08,
HC PR ED 31605 Cricothyroidotomy Cdm,PX-98110336,CDM,31605,CPT,981,RC,,outpatient,,,2096,1886.4,,0.95,,1991.2,Percent of total billed charges,,,0.98,,2054.08,Percent of total billed charges,,,0.95,,1991.2,Percent of total billed charges,,,0.95,,1991.2,Percent of total billed charges,,,0.97,,2033.12,Percent of total billed charges,,,0.96,,2012.16,Percent of total billed charges,,,0.95,,1991.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1991.2,Percent of total billed charges,,1991.2,2054.08,
HC PR 98960 Education&Training Self-Mgmt Nonphys 1 Pt Rhc,PX-52110671,CDM,98960,CPT,521,RC,,inpatient,,,76,68.4,,0.95,,72.2,Percent of total billed charges,,,0.98,,74.48,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,0.97,,73.72,Percent of total billed charges,,,0.97,,73.72,Percent of total billed charges,,,0.96,,72.96,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,72.2,Percent of total billed charges,,72.2,74.48,
HC PR 98960 Education&Training Self-Mgmt Nonphys 1 Pt Rhc,PX-52110671,CDM,98960,CPT,521,RC,,outpatient,,,76,68.4,,0.95,,72.2,Percent of total billed charges,,,0.98,,74.48,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,0.97,,73.72,Percent of total billed charges,,,0.96,,72.96,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,72.2,Percent of total billed charges,,72.2,74.48,
HC PR 98967 Nonphysician Telephone Assessment 11-20 Min Rhc,PX-52110673,CDM,98967,CPT,521,RC,,inpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
HC PR 98967 Nonphysician Telephone Assessment 11-20 Min Rhc,PX-52110673,CDM,98967,CPT,521,RC,,outpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
HC PR ED 32551 Insertion of Chest Tube Cdm,PX-98110342,CDM,32551,CPT,981,RC,,inpatient,,,952,856.8,,0.95,,904.4,Percent of total billed charges,,,0.98,,932.96,Percent of total billed charges,,,0.95,,904.4,Percent of total billed charges,,,0.97,,923.44,Percent of total billed charges,,,0.97,,923.44,Percent of total billed charges,,,0.96,,913.92,Percent of total billed charges,,,0.95,,904.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,904.4,Percent of total billed charges,,904.4,932.96,
HC PR ED 32551 Insertion of Chest Tube Cdm,PX-98110342,CDM,32551,CPT,981,RC,,outpatient,,,952,856.8,,0.95,,904.4,Percent of total billed charges,,,0.98,,932.96,Percent of total billed charges,,,0.95,,904.4,Percent of total billed charges,,,0.95,,904.4,Percent of total billed charges,,,0.97,,923.44,Percent of total billed charges,,,0.96,,913.92,Percent of total billed charges,,,0.95,,904.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,904.4,Percent of total billed charges,,904.4,932.96,
HC PR 35840 Explore Abdominal Vessels,PX-97510203,CDM,35840,CPT,975,RC,,inpatient,,,2964,2667.6,,0.95,,2815.8,Percent of total billed charges,,,0.98,,2904.72,Percent of total billed charges,,,0.95,,2815.8,Percent of total billed charges,,,0.97,,2875.08,Percent of total billed charges,,,0.97,,2875.08,Percent of total billed charges,,,0.96,,2845.44,Percent of total billed charges,,,0.95,,2815.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2815.8,Percent of total billed charges,,2815.8,2904.72,
HC PR 35840 Explore Abdominal Vessels,PX-97510203,CDM,35840,CPT,975,RC,,outpatient,,,2964,2667.6,,0.95,,2815.8,Percent of total billed charges,,,0.98,,2904.72,Percent of total billed charges,,,0.95,,2815.8,Percent of total billed charges,,,0.95,,2815.8,Percent of total billed charges,,,0.97,,2875.08,Percent of total billed charges,,,0.96,,2845.44,Percent of total billed charges,,,0.95,,2815.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2815.8,Percent of total billed charges,,2815.8,2904.72,
HC PR ED 36000 Place Needle in Vein Cdm,PX-98110348,CDM,36000,CPT,981,RC,,inpatient,,,216,194.4,,0.95,,205.2,Percent of total billed charges,,,0.98,,211.68,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,0.97,,209.52,Percent of total billed charges,,,0.97,,209.52,Percent of total billed charges,,,0.96,,207.36,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,205.2,Percent of total billed charges,,205.2,211.68,
HC PR ED 36000 Place Needle in Vein Cdm,PX-98110348,CDM,36000,CPT,981,RC,,outpatient,,,216,194.4,,0.95,,205.2,Percent of total billed charges,,,0.98,,211.68,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,0.97,,209.52,Percent of total billed charges,,,0.96,,207.36,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,205.2,Percent of total billed charges,,205.2,211.68,
HC PR 99383 Initial Preventive Medicine New Pt Age 5-11 Yrs Rhc,PX-52110747,CDM,99383,CPT,521,RC,,inpatient,,,353,317.7,,0.95,,335.35,Percent of total billed charges,,,0.98,,345.94,Percent of total billed charges,,,0.95,,335.35,Percent of total billed charges,,,0.97,,342.41,Percent of total billed charges,,,0.97,,342.41,Percent of total billed charges,,,0.96,,338.88,Percent of total billed charges,,,0.95,,335.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,335.35,Percent of total billed charges,,335.35,345.94,
HC PR 99383 Initial Preventive Medicine New Pt Age 5-11 Yrs Rhc,PX-52110747,CDM,99383,CPT,521,RC,,outpatient,,,353,317.7,,0.95,,335.35,Percent of total billed charges,,,0.98,,345.94,Percent of total billed charges,,,0.95,,335.35,Percent of total billed charges,,,0.95,,335.35,Percent of total billed charges,,,0.97,,342.41,Percent of total billed charges,,,0.96,,338.88,Percent of total billed charges,,,0.95,,335.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,335.35,Percent of total billed charges,,335.35,345.94,
HC PR 99384 Preventive Visit New 12-17 Rhc,PX-52110748,CDM,99384,CPT,521,RC,,inpatient,,,399,359.1,,0.95,,379.05,Percent of total billed charges,,,0.98,,391.02,Percent of total billed charges,,,0.95,,379.05,Percent of total billed charges,,,0.97,,387.03,Percent of total billed charges,,,0.97,,387.03,Percent of total billed charges,,,0.96,,383.04,Percent of total billed charges,,,0.95,,379.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,379.05,Percent of total billed charges,,379.05,391.02,
HC PR 99384 Preventive Visit New 12-17 Rhc,PX-52110748,CDM,99384,CPT,521,RC,,outpatient,,,399,359.1,,0.95,,379.05,Percent of total billed charges,,,0.98,,391.02,Percent of total billed charges,,,0.95,,379.05,Percent of total billed charges,,,0.95,,379.05,Percent of total billed charges,,,0.97,,387.03,Percent of total billed charges,,,0.96,,383.04,Percent of total billed charges,,,0.95,,379.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,379.05,Percent of total billed charges,,379.05,391.02,
HC PR 99385 Initial Preventive Medicine New Pt Age 18-39yrs Rhc,PX-52110749,CDM,99385,CPT,521,RC,,inpatient,,,390,351,,0.95,,370.5,Percent of total billed charges,,,0.98,,382.2,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,0.97,,378.3,Percent of total billed charges,,,0.97,,378.3,Percent of total billed charges,,,0.96,,374.4,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,370.5,Percent of total billed charges,,370.5,382.2,
HC PR 99385 Initial Preventive Medicine New Pt Age 18-39yrs Rhc,PX-52110749,CDM,99385,CPT,521,RC,,outpatient,,,390,351,,0.95,,370.5,Percent of total billed charges,,,0.98,,382.2,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,0.97,,378.3,Percent of total billed charges,,,0.96,,374.4,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,370.5,Percent of total billed charges,,370.5,382.2,
HC PR 38500 Biopsy/Removal Lymph Nodes,PX-97510220,CDM,38500,CPT,975,RC,,inpatient,,,937,843.3,,0.95,,890.15,Percent of total billed charges,,,0.98,,918.26,Percent of total billed charges,,,0.95,,890.15,Percent of total billed charges,,,0.97,,908.89,Percent of total billed charges,,,0.97,,908.89,Percent of total billed charges,,,0.96,,899.52,Percent of total billed charges,,,0.95,,890.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,890.15,Percent of total billed charges,,890.15,918.26,
HC PR 38500 Biopsy/Removal Lymph Nodes,PX-97510220,CDM,38500,CPT,975,RC,,outpatient,,,937,843.3,,0.95,,890.15,Percent of total billed charges,,,0.98,,918.26,Percent of total billed charges,,,0.95,,890.15,Percent of total billed charges,,,0.95,,890.15,Percent of total billed charges,,,0.97,,908.89,Percent of total billed charges,,,0.96,,899.52,Percent of total billed charges,,,0.95,,890.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,890.15,Percent of total billed charges,,890.15,918.26,
HC PR 99386 Preventive Visit New 40-64 Rhc,PX-52110750,CDM,99386,CPT,521,RC,,inpatient,,,449,404.1,,0.95,,426.55,Percent of total billed charges,,,0.98,,440.02,Percent of total billed charges,,,0.95,,426.55,Percent of total billed charges,,,0.97,,435.53,Percent of total billed charges,,,0.97,,435.53,Percent of total billed charges,,,0.96,,431.04,Percent of total billed charges,,,0.95,,426.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,426.55,Percent of total billed charges,,426.55,440.02,
HC PR 99386 Preventive Visit New 40-64 Rhc,PX-52110750,CDM,99386,CPT,521,RC,,outpatient,,,449,404.1,,0.95,,426.55,Percent of total billed charges,,,0.98,,440.02,Percent of total billed charges,,,0.95,,426.55,Percent of total billed charges,,,0.95,,426.55,Percent of total billed charges,,,0.97,,435.53,Percent of total billed charges,,,0.96,,431.04,Percent of total billed charges,,,0.95,,426.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,426.55,Percent of total billed charges,,426.55,440.02,
"HC PR 38510 Biopsy/Removal Lymph Nodes Open, Deep Cervical Node(S)",PX-97510222,CDM,38510,CPT,975,RC,,inpatient,,,1303,1172.7,,0.95,,1237.85,Percent of total billed charges,,,0.98,,1276.94,Percent of total billed charges,,,0.95,,1237.85,Percent of total billed charges,,,0.97,,1263.91,Percent of total billed charges,,,0.97,,1263.91,Percent of total billed charges,,,0.96,,1250.88,Percent of total billed charges,,,0.95,,1237.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1237.85,Percent of total billed charges,,1237.85,1276.94,
"HC PR 38510 Biopsy/Removal Lymph Nodes Open, Deep Cervical Node(S)",PX-97510222,CDM,38510,CPT,975,RC,,outpatient,,,1303,1172.7,,0.95,,1237.85,Percent of total billed charges,,,0.98,,1276.94,Percent of total billed charges,,,0.95,,1237.85,Percent of total billed charges,,,0.95,,1237.85,Percent of total billed charges,,,0.97,,1263.91,Percent of total billed charges,,,0.96,,1250.88,Percent of total billed charges,,,0.95,,1237.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1237.85,Percent of total billed charges,,1237.85,1276.94,
HC PR 99387 Initial Preventive Medicine New Patient 65yrs&> Rhc,PX-52110751,CDM,99387,CPT,521,RC,,inpatient,,,463,416.7,,0.95,,439.85,Percent of total billed charges,,,0.98,,453.74,Percent of total billed charges,,,0.95,,439.85,Percent of total billed charges,,,0.97,,449.11,Percent of total billed charges,,,0.97,,449.11,Percent of total billed charges,,,0.96,,444.48,Percent of total billed charges,,,0.95,,439.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,439.85,Percent of total billed charges,,439.85,453.74,
HC PR 99387 Initial Preventive Medicine New Patient 65yrs&> Rhc,PX-52110751,CDM,99387,CPT,521,RC,,outpatient,,,463,416.7,,0.95,,439.85,Percent of total billed charges,,,0.98,,453.74,Percent of total billed charges,,,0.95,,439.85,Percent of total billed charges,,,0.95,,439.85,Percent of total billed charges,,,0.97,,449.11,Percent of total billed charges,,,0.96,,444.48,Percent of total billed charges,,,0.95,,439.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,439.85,Percent of total billed charges,,439.85,453.74,
"HC PR 38525 Biopsy/Removal Lymph Nodes, Deep Auxillary",PX-97510224,CDM,38525,CPT,975,RC,,inpatient,,,1185,1066.5,,0.95,,1125.75,Percent of total billed charges,,,0.98,,1161.3,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,0.97,,1149.45,Percent of total billed charges,,,0.97,,1149.45,Percent of total billed charges,,,0.96,,1137.6,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1125.75,Percent of total billed charges,,1125.75,1161.3,
"HC PR 38525 Biopsy/Removal Lymph Nodes, Deep Auxillary",PX-97510224,CDM,38525,CPT,975,RC,,outpatient,,,1185,1066.5,,0.95,,1125.75,Percent of total billed charges,,,0.98,,1161.3,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,0.97,,1149.45,Percent of total billed charges,,,0.96,,1137.6,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1125.75,Percent of total billed charges,,1125.75,1161.3,
HC PR 99393 Prev Visit Est Age 5-11 Rhc,PX-52110754,CDM,99393,CPT,521,RC,,inpatient,,,312,280.8,,0.95,,296.4,Percent of total billed charges,,,0.98,,305.76,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,0.97,,302.64,Percent of total billed charges,,,0.97,,302.64,Percent of total billed charges,,,0.96,,299.52,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,296.4,Percent of total billed charges,,296.4,305.76,
HC PR 99393 Prev Visit Est Age 5-11 Rhc,PX-52110754,CDM,99393,CPT,521,RC,,outpatient,,,312,280.8,,0.95,,296.4,Percent of total billed charges,,,0.98,,305.76,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,0.97,,302.64,Percent of total billed charges,,,0.96,,299.52,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,296.4,Percent of total billed charges,,296.4,305.76,
HC PR 99394 Preventive Visit Est 12-17 Rhc,PX-52110755,CDM,99394,CPT,521,RC,,inpatient,,,340,306,,0.95,,323,Percent of total billed charges,,,0.98,,333.2,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.96,,326.4,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,323,Percent of total billed charges,,323,333.2,
HC PR 99394 Preventive Visit Est 12-17 Rhc,PX-52110755,CDM,99394,CPT,521,RC,,outpatient,,,340,306,,0.95,,323,Percent of total billed charges,,,0.98,,333.2,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.96,,326.4,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,323,Percent of total billed charges,,323,333.2,
HC PR 99395 Preventive Visit Est 18-39 Rhc,PX-52110756,CDM,99395,CPT,521,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,332.5,Percent of total billed charges,,332.5,343,
HC PR 99395 Preventive Visit Est 18-39 Rhc,PX-52110756,CDM,99395,CPT,521,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,332.5,Percent of total billed charges,,332.5,343,
HC PR 99396 Preventive Visit Est 40-64 Rhc,PX-52110757,CDM,99396,CPT,521,RC,,inpatient,,,373,335.7,,0.95,,354.35,Percent of total billed charges,,,0.98,,365.54,Percent of total billed charges,,,0.95,,354.35,Percent of total billed charges,,,0.97,,361.81,Percent of total billed charges,,,0.97,,361.81,Percent of total billed charges,,,0.96,,358.08,Percent of total billed charges,,,0.95,,354.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,354.35,Percent of total billed charges,,354.35,365.54,
HC PR 99396 Preventive Visit Est 40-64 Rhc,PX-52110757,CDM,99396,CPT,521,RC,,outpatient,,,373,335.7,,0.95,,354.35,Percent of total billed charges,,,0.98,,365.54,Percent of total billed charges,,,0.95,,354.35,Percent of total billed charges,,,0.95,,354.35,Percent of total billed charges,,,0.97,,361.81,Percent of total billed charges,,,0.96,,358.08,Percent of total billed charges,,,0.95,,354.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,354.35,Percent of total billed charges,,354.35,365.54,
HC PR 99397 Preventive Visit Est 65 & Over Rhc,PX-52110758,CDM,99397,CPT,521,RC,,inpatient,,,401,360.9,,0.95,,380.95,Percent of total billed charges,,,0.98,,392.98,Percent of total billed charges,,,0.95,,380.95,Percent of total billed charges,,,0.97,,388.97,Percent of total billed charges,,,0.97,,388.97,Percent of total billed charges,,,0.96,,384.96,Percent of total billed charges,,,0.95,,380.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,380.95,Percent of total billed charges,,380.95,392.98,
HC PR 99397 Preventive Visit Est 65 & Over Rhc,PX-52110758,CDM,99397,CPT,521,RC,,outpatient,,,401,360.9,,0.95,,380.95,Percent of total billed charges,,,0.98,,392.98,Percent of total billed charges,,,0.95,,380.95,Percent of total billed charges,,,0.95,,380.95,Percent of total billed charges,,,0.97,,388.97,Percent of total billed charges,,,0.96,,384.96,Percent of total billed charges,,,0.95,,380.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,380.95,Percent of total billed charges,,380.95,392.98,
HC PR 99406 Behav Chng Smoking 3-10 Min Rhc,PX-52110763,CDM,99406,CPT,521,RC,,inpatient,,,37,33.3,,0.95,,35.15,Percent of total billed charges,,,0.98,,36.26,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.96,,35.52,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,35.15,Percent of total billed charges,,35.15,36.26,
HC PR 99406 Behav Chng Smoking 3-10 Min Rhc,PX-52110763,CDM,99406,CPT,521,RC,,outpatient,,,37,33.3,,0.95,,35.15,Percent of total billed charges,,,0.98,,36.26,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.96,,35.52,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,35.15,Percent of total billed charges,,35.15,36.26,
"HC PR ED 40650 Repair Lip, Full Thickness Vermilion Only Cdm",PX-98110349,CDM,40650,CPT,981,RC,,inpatient,,,682,613.8,,0.95,,647.9,Percent of total billed charges,,,0.98,,668.36,Percent of total billed charges,,,0.95,,647.9,Percent of total billed charges,,,0.97,,661.54,Percent of total billed charges,,,0.97,,661.54,Percent of total billed charges,,,0.96,,654.72,Percent of total billed charges,,,0.95,,647.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,647.9,Percent of total billed charges,,647.9,668.36,
"HC PR ED 40650 Repair Lip, Full Thickness Vermilion Only Cdm",PX-98110349,CDM,40650,CPT,981,RC,,outpatient,,,682,613.8,,0.95,,647.9,Percent of total billed charges,,,0.98,,668.36,Percent of total billed charges,,,0.95,,647.9,Percent of total billed charges,,,0.95,,647.9,Percent of total billed charges,,,0.97,,661.54,Percent of total billed charges,,,0.96,,654.72,Percent of total billed charges,,,0.95,,647.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,647.9,Percent of total billed charges,,647.9,668.36,
HC PR 99490 CHRONIC CARE MGMT SERVICES 1ST 20 MIN p/ CALENDAR MONTH,PX-52110784,CDM,99490,CPT,521,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
HC PR 99490 CHRONIC CARE MGMT SERVICES 1ST 20 MIN p/ CALENDAR MONTH,PX-52110784,CDM,99490,CPT,521,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
HC PR ED 40654 Repair Lip Full Thickness Over One-Half Vertical Height Cdm,PX-98110351,CDM,40654,CPT,981,RC,,inpatient,,,710,639,,0.95,,674.5,Percent of total billed charges,,,0.98,,695.8,Percent of total billed charges,,,0.95,,674.5,Percent of total billed charges,,,0.97,,688.7,Percent of total billed charges,,,0.97,,688.7,Percent of total billed charges,,,0.96,,681.6,Percent of total billed charges,,,0.95,,674.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,674.5,Percent of total billed charges,,674.5,695.8,
HC PR ED 40654 Repair Lip Full Thickness Over One-Half Vertical Height Cdm,PX-98110351,CDM,40654,CPT,981,RC,,outpatient,,,710,639,,0.95,,674.5,Percent of total billed charges,,,0.98,,695.8,Percent of total billed charges,,,0.95,,674.5,Percent of total billed charges,,,0.95,,674.5,Percent of total billed charges,,,0.97,,688.7,Percent of total billed charges,,,0.96,,681.6,Percent of total billed charges,,,0.95,,674.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,674.5,Percent of total billed charges,,674.5,695.8,
HC PR 99497 Advance Care Planning First 30 Mins Rhc,PX-52110786,CDM,99497,CPT,521,RC,,inpatient,,,202,181.8,,0.95,,191.9,Percent of total billed charges,,,0.98,,197.96,Percent of total billed charges,,,0.95,,191.9,Percent of total billed charges,,,0.97,,195.94,Percent of total billed charges,,,0.97,,195.94,Percent of total billed charges,,,0.96,,193.92,Percent of total billed charges,,,0.95,,191.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,191.9,Percent of total billed charges,,191.9,197.96,
HC PR 99497 Advance Care Planning First 30 Mins Rhc,PX-52110786,CDM,99497,CPT,521,RC,,outpatient,,,202,181.8,,0.95,,191.9,Percent of total billed charges,,,0.98,,197.96,Percent of total billed charges,,,0.95,,191.9,Percent of total billed charges,,,0.95,,191.9,Percent of total billed charges,,,0.97,,195.94,Percent of total billed charges,,,0.96,,193.92,Percent of total billed charges,,,0.95,,191.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,191.9,Percent of total billed charges,,191.9,197.96,
HC PR 40812 Excise/Repair Mouth Lesion,PX-96910211,CDM,40812,CPT,983,RC,,inpatient,,,441,396.9,,0.95,,418.95,Percent of total billed charges,,,0.98,,432.18,Percent of total billed charges,,,0.95,,418.95,Percent of total billed charges,,,0.97,,427.77,Percent of total billed charges,,,0.97,,427.77,Percent of total billed charges,,,0.96,,423.36,Percent of total billed charges,,,0.95,,418.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,418.95,Percent of total billed charges,,418.95,432.18,
HC PR 40812 Excise/Repair Mouth Lesion,PX-96910211,CDM,40812,CPT,983,RC,,outpatient,,,441,396.9,,0.95,,418.95,Percent of total billed charges,,,0.98,,432.18,Percent of total billed charges,,,0.95,,418.95,Percent of total billed charges,,,0.95,,418.95,Percent of total billed charges,,,0.97,,427.77,Percent of total billed charges,,,0.96,,423.36,Percent of total billed charges,,,0.95,,418.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,418.95,Percent of total billed charges,,418.95,432.18,
HC PR ED 40830 Repair Mouth Laceration <2.5cm Cdm,PX-98110354,CDM,40830,CPT,981,RC,,inpatient,,,551,495.9,,0.95,,523.45,Percent of total billed charges,,,0.98,,539.98,Percent of total billed charges,,,0.95,,523.45,Percent of total billed charges,,,0.97,,534.47,Percent of total billed charges,,,0.97,,534.47,Percent of total billed charges,,,0.96,,528.96,Percent of total billed charges,,,0.95,,523.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,523.45,Percent of total billed charges,,523.45,539.98,
HC PR ED 40830 Repair Mouth Laceration <2.5cm Cdm,PX-98110354,CDM,40830,CPT,981,RC,,outpatient,,,551,495.9,,0.95,,523.45,Percent of total billed charges,,,0.98,,539.98,Percent of total billed charges,,,0.95,,523.45,Percent of total billed charges,,,0.95,,523.45,Percent of total billed charges,,,0.97,,534.47,Percent of total billed charges,,,0.96,,528.96,Percent of total billed charges,,,0.95,,523.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,523.45,Percent of total billed charges,,523.45,539.98,
Incision of lingual frenum (frenotomy),PX-98310172,CDM,41010,CPT,983,RC,,inpatient,,,534,480.6,,0.95,,507.3,Percent of total billed charges,,,0.98,,523.32,Percent of total billed charges,,,0.95,,507.3,Percent of total billed charges,,,0.97,,517.98,Percent of total billed charges,,,0.97,,517.98,Percent of total billed charges,,,0.96,,512.64,Percent of total billed charges,,,0.95,,507.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,507.3,Percent of total billed charges,,507.3,523.32,
Incision of lingual frenum (frenotomy),PX-98310172,CDM,41010,CPT,983,RC,,outpatient,,,534,480.6,,0.95,,507.3,Percent of total billed charges,,,0.98,,523.32,Percent of total billed charges,,,0.95,,507.3,Percent of total billed charges,,,0.95,,507.3,Percent of total billed charges,,,0.97,,517.98,Percent of total billed charges,,,0.96,,512.64,Percent of total billed charges,,,0.95,,507.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,507.3,Percent of total billed charges,,507.3,523.32,
HC PR 41100 Biopsy of Tongue,PX-97510239,CDM,41100,CPT,975,RC,,inpatient,,,526,473.4,,0.95,,499.7,Percent of total billed charges,,,0.98,,515.48,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,,0.97,,510.22,Percent of total billed charges,,,0.97,,510.22,Percent of total billed charges,,,0.96,,504.96,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,499.7,Percent of total billed charges,,499.7,515.48,
HC PR 41100 Biopsy of Tongue,PX-97510239,CDM,41100,CPT,975,RC,,outpatient,,,526,473.4,,0.95,,499.7,Percent of total billed charges,,,0.98,,515.48,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,,0.97,,510.22,Percent of total billed charges,,,0.96,,504.96,Percent of total billed charges,,,0.95,,499.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,499.7,Percent of total billed charges,,499.7,515.48,
HC PR 99242 Office/OP Consltj New/Est Pt Sf Mdm 20 Minutes Rhc,PX-52110692,CDM,99242,CPT,521,RC,,inpatient,,,391,351.9,,0.95,,371.45,Percent of total billed charges,,,0.98,,383.18,Percent of total billed charges,,,0.95,,371.45,Percent of total billed charges,,,0.97,,379.27,Percent of total billed charges,,,0.97,,379.27,Percent of total billed charges,,,0.96,,375.36,Percent of total billed charges,,,0.95,,371.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,371.45,Percent of total billed charges,,371.45,383.18,
HC PR 99242 Office/OP Consltj New/Est Pt Sf Mdm 20 Minutes Rhc,PX-52110692,CDM,99242,CPT,521,RC,,outpatient,,,391,351.9,,0.95,,371.45,Percent of total billed charges,,,0.98,,383.18,Percent of total billed charges,,,0.95,,371.45,Percent of total billed charges,,,0.95,,371.45,Percent of total billed charges,,,0.97,,379.27,Percent of total billed charges,,,0.96,,375.36,Percent of total billed charges,,,0.95,,371.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,371.45,Percent of total billed charges,,371.45,383.18,
HC PR 99244 Office/OP Consltj New/Est Pt Mod Mdm 40 Minutes Rhc,PX-52110694,CDM,99244,CPT,521,RC,,inpatient,,,408,367.2,,0.95,,387.6,Percent of total billed charges,,,0.98,,399.84,Percent of total billed charges,,,0.95,,387.6,Percent of total billed charges,,,0.97,,395.76,Percent of total billed charges,,,0.97,,395.76,Percent of total billed charges,,,0.96,,391.68,Percent of total billed charges,,,0.95,,387.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,387.6,Percent of total billed charges,,387.6,399.84,
HC PR 99244 Office/OP Consltj New/Est Pt Mod Mdm 40 Minutes Rhc,PX-52110694,CDM,99244,CPT,521,RC,,outpatient,,,408,367.2,,0.95,,387.6,Percent of total billed charges,,,0.98,,399.84,Percent of total billed charges,,,0.95,,387.6,Percent of total billed charges,,,0.95,,387.6,Percent of total billed charges,,,0.97,,395.76,Percent of total billed charges,,,0.96,,391.68,Percent of total billed charges,,,0.95,,387.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,387.6,Percent of total billed charges,,387.6,399.84,
HC PR ED 41250 Repair Tongue Lac <2.6cm Floor of Mouth and/or Ant Cdm,PX-98110357,CDM,41250,CPT,981,RC,,inpatient,,,699,629.1,,0.95,,664.05,Percent of total billed charges,,,0.98,,685.02,Percent of total billed charges,,,0.95,,664.05,Percent of total billed charges,,,0.97,,678.03,Percent of total billed charges,,,0.97,,678.03,Percent of total billed charges,,,0.96,,671.04,Percent of total billed charges,,,0.95,,664.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,664.05,Percent of total billed charges,,664.05,685.02,
HC PR ED 41250 Repair Tongue Lac <2.6cm Floor of Mouth and/or Ant Cdm,PX-98110357,CDM,41250,CPT,981,RC,,outpatient,,,699,629.1,,0.95,,664.05,Percent of total billed charges,,,0.98,,685.02,Percent of total billed charges,,,0.95,,664.05,Percent of total billed charges,,,0.95,,664.05,Percent of total billed charges,,,0.97,,678.03,Percent of total billed charges,,,0.96,,671.04,Percent of total billed charges,,,0.95,,664.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,664.05,Percent of total billed charges,,664.05,685.02,
HC PR ED 41252 Repair of Lacer of Tongue Floor of Mouth >2.6 C Cdm,PX-98110359,CDM,41252,CPT,981,RC,,inpatient,,,1221,1098.9,,0.95,,1159.95,Percent of total billed charges,,,0.98,,1196.58,Percent of total billed charges,,,0.95,,1159.95,Percent of total billed charges,,,0.97,,1184.37,Percent of total billed charges,,,0.97,,1184.37,Percent of total billed charges,,,0.96,,1172.16,Percent of total billed charges,,,0.95,,1159.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1159.95,Percent of total billed charges,,1159.95,1196.58,
HC PR ED 41252 Repair of Lacer of Tongue Floor of Mouth >2.6 C Cdm,PX-98110359,CDM,41252,CPT,981,RC,,outpatient,,,1221,1098.9,,0.95,,1159.95,Percent of total billed charges,,,0.98,,1196.58,Percent of total billed charges,,,0.95,,1159.95,Percent of total billed charges,,,0.95,,1159.95,Percent of total billed charges,,,0.97,,1184.37,Percent of total billed charges,,,0.96,,1172.16,Percent of total billed charges,,,0.95,,1159.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1159.95,Percent of total billed charges,,1159.95,1196.58,
HC PR ED 41800 Drainage of Gum Lesion Cdm,PX-98110360,CDM,41800,CPT,981,RC,,inpatient,,,288,259.2,,0.95,,273.6,Percent of total billed charges,,,0.98,,282.24,Percent of total billed charges,,,0.95,,273.6,Percent of total billed charges,,,0.97,,279.36,Percent of total billed charges,,,0.97,,279.36,Percent of total billed charges,,,0.96,,276.48,Percent of total billed charges,,,0.95,,273.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,273.6,Percent of total billed charges,,273.6,282.24,
HC PR ED 41800 Drainage of Gum Lesion Cdm,PX-98110360,CDM,41800,CPT,981,RC,,outpatient,,,288,259.2,,0.95,,273.6,Percent of total billed charges,,,0.98,,282.24,Percent of total billed charges,,,0.95,,273.6,Percent of total billed charges,,,0.95,,273.6,Percent of total billed charges,,,0.97,,279.36,Percent of total billed charges,,,0.96,,276.48,Percent of total billed charges,,,0.95,,273.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,273.6,Percent of total billed charges,,273.6,282.24,
HC PR 99307 Sbsq Nursing Facility Care Sf Mdm 10 Minutes Rhc,PX-52110704,CDM,99307,CPT,524,RC,,inpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
HC PR 99307 Sbsq Nursing Facility Care Sf Mdm 10 Minutes Rhc,PX-52110704,CDM,99307,CPT,524,RC,,outpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
Initial Nursing Facility Care Hi Mdm 50 Minutes Rhc,PX-52110705,CDM,99308,CPT,524,RC,,inpatient,,,191,171.9,,0.95,,181.45,Percent of total billed charges,,,0.98,,187.18,Percent of total billed charges,,,0.95,,181.45,Percent of total billed charges,,,0.97,,185.27,Percent of total billed charges,,,0.97,,185.27,Percent of total billed charges,,,0.96,,183.36,Percent of total billed charges,,,0.95,,181.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,181.45,Percent of total billed charges,,181.45,187.18,
Initial Nursing Facility Care Hi Mdm 50 Minutes Rhc,PX-52110705,CDM,99308,CPT,524,RC,,outpatient,,,191,171.9,,0.95,,181.45,Percent of total billed charges,,,0.98,,187.18,Percent of total billed charges,,,0.95,,181.45,Percent of total billed charges,,,0.95,,181.45,Percent of total billed charges,,,0.97,,185.27,Percent of total billed charges,,,0.96,,183.36,Percent of total billed charges,,,0.95,,181.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,181.45,Percent of total billed charges,,181.45,187.18,
HC PR 99309 Sbsq Nursing Facility Care Mod Mdm 30 Minutes Rhc,PX-52110706,CDM,99309,CPT,524,RC,,inpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
HC PR 99309 Sbsq Nursing Facility Care Mod Mdm 30 Minutes Rhc,PX-52110706,CDM,99309,CPT,524,RC,,outpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
HC PR 99310 Sbsq Nursing Facility Care High Mdm 45 Minutes Rhc,PX-52110707,CDM,99310,CPT,524,RC,,inpatient,,,375,337.5,,0.95,,356.25,Percent of total billed charges,,,0.98,,367.5,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.96,,360,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,356.25,Percent of total billed charges,,356.25,367.5,
HC PR 99310 Sbsq Nursing Facility Care High Mdm 45 Minutes Rhc,PX-52110707,CDM,99310,CPT,524,RC,,outpatient,,,375,337.5,,0.95,,356.25,Percent of total billed charges,,,0.98,,367.5,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.96,,360,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,356.25,Percent of total billed charges,,356.25,367.5,
HC PR ED 42700 Drainage of Tonsil Abscess Cdm,PX-98110366,CDM,42700,CPT,981,RC,,inpatient,,,477,429.3,,0.95,,453.15,Percent of total billed charges,,,0.98,,467.46,Percent of total billed charges,,,0.95,,453.15,Percent of total billed charges,,,0.97,,462.69,Percent of total billed charges,,,0.97,,462.69,Percent of total billed charges,,,0.96,,457.92,Percent of total billed charges,,,0.95,,453.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,453.15,Percent of total billed charges,,453.15,467.46,
HC PR ED 42700 Drainage of Tonsil Abscess Cdm,PX-98110366,CDM,42700,CPT,981,RC,,outpatient,,,477,429.3,,0.95,,453.15,Percent of total billed charges,,,0.98,,467.46,Percent of total billed charges,,,0.95,,453.15,Percent of total billed charges,,,0.95,,453.15,Percent of total billed charges,,,0.97,,462.69,Percent of total billed charges,,,0.96,,457.92,Percent of total billed charges,,,0.95,,453.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,453.15,Percent of total billed charges,,453.15,467.46,
HC PR ED 42809 Remove Pharynx Foreign Body Cdm,PX-98110368,CDM,42809,CPT,981,RC,,inpatient,,,606,545.4,,0.95,,575.7,Percent of total billed charges,,,0.98,,593.88,Percent of total billed charges,,,0.95,,575.7,Percent of total billed charges,,,0.97,,587.82,Percent of total billed charges,,,0.97,,587.82,Percent of total billed charges,,,0.96,,581.76,Percent of total billed charges,,,0.95,,575.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,575.7,Percent of total billed charges,,575.7,593.88,
HC PR ED 42809 Remove Pharynx Foreign Body Cdm,PX-98110368,CDM,42809,CPT,981,RC,,outpatient,,,606,545.4,,0.95,,575.7,Percent of total billed charges,,,0.98,,593.88,Percent of total billed charges,,,0.95,,575.7,Percent of total billed charges,,,0.95,,575.7,Percent of total billed charges,,,0.97,,587.82,Percent of total billed charges,,,0.96,,581.76,Percent of total billed charges,,,0.95,,575.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,575.7,Percent of total billed charges,,575.7,593.88,
HC PR 99341 Home/Res Visit New Patient Sf Mdm 15 Minutes Rhc,PX-52110720,CDM,99341,CPT,522,RC,,inpatient,,,247,222.3,,0.95,,234.65,Percent of total billed charges,,,0.98,,242.06,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.96,,237.12,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,234.65,Percent of total billed charges,,234.65,242.06,
HC PR 99341 Home/Res Visit New Patient Sf Mdm 15 Minutes Rhc,PX-52110720,CDM,99341,CPT,522,RC,,outpatient,,,247,222.3,,0.95,,234.65,Percent of total billed charges,,,0.98,,242.06,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.96,,237.12,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,234.65,Percent of total billed charges,,234.65,242.06,
HC PR 99342 Home/Res Visit New Patient Low Mdm 30 Minutes Rhc,PX-52110721,CDM,99342,CPT,522,RC,,inpatient,,,391,351.9,,0.95,,371.45,Percent of total billed charges,,,0.98,,383.18,Percent of total billed charges,,,0.95,,371.45,Percent of total billed charges,,,0.97,,379.27,Percent of total billed charges,,,0.97,,379.27,Percent of total billed charges,,,0.96,,375.36,Percent of total billed charges,,,0.95,,371.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,371.45,Percent of total billed charges,,371.45,383.18,
HC PR 99342 Home/Res Visit New Patient Low Mdm 30 Minutes Rhc,PX-52110721,CDM,99342,CPT,522,RC,,outpatient,,,391,351.9,,0.95,,371.45,Percent of total billed charges,,,0.98,,383.18,Percent of total billed charges,,,0.95,,371.45,Percent of total billed charges,,,0.95,,371.45,Percent of total billed charges,,,0.97,,379.27,Percent of total billed charges,,,0.96,,375.36,Percent of total billed charges,,,0.95,,371.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,371.45,Percent of total billed charges,,371.45,383.18,
HC PR 99344 Home/Res Visit New Patient Mod Mdm 60 Minutes Rhc,PX-52110723,CDM,99344,CPT,522,RC,,inpatient,,,555,499.5,,0.95,,527.25,Percent of total billed charges,,,0.98,,543.9,Percent of total billed charges,,,0.95,,527.25,Percent of total billed charges,,,0.97,,538.35,Percent of total billed charges,,,0.97,,538.35,Percent of total billed charges,,,0.96,,532.8,Percent of total billed charges,,,0.95,,527.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,527.25,Percent of total billed charges,,527.25,543.9,
HC PR 99344 Home/Res Visit New Patient Mod Mdm 60 Minutes Rhc,PX-52110723,CDM,99344,CPT,522,RC,,outpatient,,,555,499.5,,0.95,,527.25,Percent of total billed charges,,,0.98,,543.9,Percent of total billed charges,,,0.95,,527.25,Percent of total billed charges,,,0.95,,527.25,Percent of total billed charges,,,0.97,,538.35,Percent of total billed charges,,,0.96,,532.8,Percent of total billed charges,,,0.95,,527.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,527.25,Percent of total billed charges,,527.25,543.9,
HC PR 99345 Home/Res Visit New Patient High Mdm 75 Minutes Rhc,PX-52110724,CDM,99345,CPT,522,RC,,inpatient,,,794,714.6,,0.95,,754.3,Percent of total billed charges,,,0.98,,778.12,Percent of total billed charges,,,0.95,,754.3,Percent of total billed charges,,,0.97,,770.18,Percent of total billed charges,,,0.97,,770.18,Percent of total billed charges,,,0.96,,762.24,Percent of total billed charges,,,0.95,,754.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,754.3,Percent of total billed charges,,754.3,778.12,
HC PR 99345 Home/Res Visit New Patient High Mdm 75 Minutes Rhc,PX-52110724,CDM,99345,CPT,522,RC,,outpatient,,,794,714.6,,0.95,,754.3,Percent of total billed charges,,,0.98,,778.12,Percent of total billed charges,,,0.95,,754.3,Percent of total billed charges,,,0.95,,754.3,Percent of total billed charges,,,0.97,,770.18,Percent of total billed charges,,,0.96,,762.24,Percent of total billed charges,,,0.95,,754.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,754.3,Percent of total billed charges,,754.3,778.12,
HC PR 43215 Esophagoscopy Flex Remove FB,PX-97510289,CDM,43215,CPT,975,RC,,inpatient,,,962,865.8,,0.95,,913.9,Percent of total billed charges,,,0.98,,942.76,Percent of total billed charges,,,0.95,,913.9,Percent of total billed charges,,,0.97,,933.14,Percent of total billed charges,,,0.97,,933.14,Percent of total billed charges,,,0.96,,923.52,Percent of total billed charges,,,0.95,,913.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,913.9,Percent of total billed charges,,913.9,942.76,
HC PR 43215 Esophagoscopy Flex Remove FB,PX-97510289,CDM,43215,CPT,975,RC,,outpatient,,,962,865.8,,0.95,,913.9,Percent of total billed charges,,,0.98,,942.76,Percent of total billed charges,,,0.95,,913.9,Percent of total billed charges,,,0.95,,913.9,Percent of total billed charges,,,0.97,,933.14,Percent of total billed charges,,,0.96,,923.52,Percent of total billed charges,,,0.95,,913.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,913.9,Percent of total billed charges,,913.9,942.76,
HC PR 99347 Home/Res Visit Est Patient Sf Mdm 20 Minutes Rhc,PX-52110725,CDM,99347,CPT,522,RC,,inpatient,,,152,136.8,,0.95,,144.4,Percent of total billed charges,,,0.98,,148.96,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,0.97,,147.44,Percent of total billed charges,,,0.97,,147.44,Percent of total billed charges,,,0.96,,145.92,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,144.4,Percent of total billed charges,,144.4,148.96,
HC PR 99347 Home/Res Visit Est Patient Sf Mdm 20 Minutes Rhc,PX-52110725,CDM,99347,CPT,522,RC,,outpatient,,,152,136.8,,0.95,,144.4,Percent of total billed charges,,,0.98,,148.96,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,0.97,,147.44,Percent of total billed charges,,,0.96,,145.92,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,144.4,Percent of total billed charges,,144.4,148.96,
HC PR 99348 Home/Res Visit Est Patient Low Mdm 30 Minutes Rhc,PX-52110726,CDM,99348,CPT,522,RC,,inpatient,,,240,216,,0.95,,228,Percent of total billed charges,,,0.98,,235.2,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,0.97,,232.8,Percent of total billed charges,,,0.97,,232.8,Percent of total billed charges,,,0.96,,230.4,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,228,Percent of total billed charges,,228,235.2,
HC PR 99348 Home/Res Visit Est Patient Low Mdm 30 Minutes Rhc,PX-52110726,CDM,99348,CPT,522,RC,,outpatient,,,240,216,,0.95,,228,Percent of total billed charges,,,0.98,,235.2,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,0.97,,232.8,Percent of total billed charges,,,0.96,,230.4,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,228,Percent of total billed charges,,228,235.2,
HC PR 99349 Home/Res Visit Est Patient Mod Mdm 40 Minutes Rhc,PX-52110727,CDM,99349,CPT,522,RC,,inpatient,,,358,322.2,,0.95,,340.1,Percent of total billed charges,,,0.98,,350.84,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,0.97,,347.26,Percent of total billed charges,,,0.97,,347.26,Percent of total billed charges,,,0.96,,343.68,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,340.1,Percent of total billed charges,,340.1,350.84,
HC PR 99349 Home/Res Visit Est Patient Mod Mdm 40 Minutes Rhc,PX-52110727,CDM,99349,CPT,522,RC,,outpatient,,,358,322.2,,0.95,,340.1,Percent of total billed charges,,,0.98,,350.84,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,0.97,,347.26,Percent of total billed charges,,,0.96,,343.68,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,340.1,Percent of total billed charges,,340.1,350.84,
HC PR 43241 Egd Tube/Cath Insertion,PX-97510297,CDM,43241,CPT,975,RC,,inpatient,,,345,310.5,,0.95,,327.75,Percent of total billed charges,,,0.98,,338.1,Percent of total billed charges,,,0.95,,327.75,Percent of total billed charges,,,0.97,,334.65,Percent of total billed charges,,,0.97,,334.65,Percent of total billed charges,,,0.96,,331.2,Percent of total billed charges,,,0.95,,327.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,327.75,Percent of total billed charges,,327.75,338.1,
HC PR 43241 Egd Tube/Cath Insertion,PX-97510297,CDM,43241,CPT,975,RC,,outpatient,,,345,310.5,,0.95,,327.75,Percent of total billed charges,,,0.98,,338.1,Percent of total billed charges,,,0.95,,327.75,Percent of total billed charges,,,0.95,,327.75,Percent of total billed charges,,,0.97,,334.65,Percent of total billed charges,,,0.96,,331.2,Percent of total billed charges,,,0.95,,327.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,327.75,Percent of total billed charges,,327.75,338.1,
HC PR 43246 Egd Place Gastrostomy Tube,PX-96910212,CDM,43246,CPT,983,RC,,inpatient,,,485,436.5,,0.95,,460.75,Percent of total billed charges,,,0.98,,475.3,Percent of total billed charges,,,0.95,,460.75,Percent of total billed charges,,,0.97,,470.45,Percent of total billed charges,,,0.97,,470.45,Percent of total billed charges,,,0.96,,465.6,Percent of total billed charges,,,0.95,,460.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,460.75,Percent of total billed charges,,460.75,475.3,
HC PR 43246 Egd Place Gastrostomy Tube,PX-96910212,CDM,43246,CPT,983,RC,,outpatient,,,485,436.5,,0.95,,460.75,Percent of total billed charges,,,0.98,,475.3,Percent of total billed charges,,,0.95,,460.75,Percent of total billed charges,,,0.95,,460.75,Percent of total billed charges,,,0.97,,470.45,Percent of total billed charges,,,0.96,,465.6,Percent of total billed charges,,,0.95,,460.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,460.75,Percent of total billed charges,,460.75,475.3,
HC PR 43250 Egd Cautery Tumor Polyp,PX-97510504,CDM,43250,CPT,975,RC,,inpatient,,,1112,1000.8,,0.95,,1056.4,Percent of total billed charges,,,0.98,,1089.76,Percent of total billed charges,,,0.95,,1056.4,Percent of total billed charges,,,0.97,,1078.64,Percent of total billed charges,,,0.97,,1078.64,Percent of total billed charges,,,0.96,,1067.52,Percent of total billed charges,,,0.95,,1056.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1056.4,Percent of total billed charges,,1056.4,1089.76,
HC PR 43250 Egd Cautery Tumor Polyp,PX-97510504,CDM,43250,CPT,975,RC,,outpatient,,,1112,1000.8,,0.95,,1056.4,Percent of total billed charges,,,0.98,,1089.76,Percent of total billed charges,,,0.95,,1056.4,Percent of total billed charges,,,0.95,,1056.4,Percent of total billed charges,,,0.97,,1078.64,Percent of total billed charges,,,0.96,,1067.52,Percent of total billed charges,,,0.95,,1056.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1056.4,Percent of total billed charges,,1056.4,1089.76,
HC PR 99350 Home/Res Visit Est Patient High Mdm 60 Minutes Rhc,PX-52110728,CDM,99350,CPT,522,RC,,inpatient,,,488,439.2,,0.95,,463.6,Percent of total billed charges,,,0.98,,478.24,Percent of total billed charges,,,0.95,,463.6,Percent of total billed charges,,,0.97,,473.36,Percent of total billed charges,,,0.97,,473.36,Percent of total billed charges,,,0.96,,468.48,Percent of total billed charges,,,0.95,,463.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,463.6,Percent of total billed charges,,463.6,478.24,
HC PR 99350 Home/Res Visit Est Patient High Mdm 60 Minutes Rhc,PX-52110728,CDM,99350,CPT,522,RC,,outpatient,,,488,439.2,,0.95,,463.6,Percent of total billed charges,,,0.98,,478.24,Percent of total billed charges,,,0.95,,463.6,Percent of total billed charges,,,0.95,,463.6,Percent of total billed charges,,,0.97,,473.36,Percent of total billed charges,,,0.96,,468.48,Percent of total billed charges,,,0.95,,463.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,463.6,Percent of total billed charges,,463.6,478.24,
HC PR 43251 Egd Remove Lesion Snare,PX-97510505,CDM,43251,CPT,975,RC,,inpatient,,,1211,1089.9,,0.95,,1150.45,Percent of total billed charges,,,0.98,,1186.78,Percent of total billed charges,,,0.95,,1150.45,Percent of total billed charges,,,0.97,,1174.67,Percent of total billed charges,,,0.97,,1174.67,Percent of total billed charges,,,0.96,,1162.56,Percent of total billed charges,,,0.95,,1150.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1150.45,Percent of total billed charges,,1150.45,1186.78,
HC PR 43251 Egd Remove Lesion Snare,PX-97510505,CDM,43251,CPT,975,RC,,outpatient,,,1211,1089.9,,0.95,,1150.45,Percent of total billed charges,,,0.98,,1186.78,Percent of total billed charges,,,0.95,,1150.45,Percent of total billed charges,,,0.95,,1150.45,Percent of total billed charges,,,0.97,,1174.67,Percent of total billed charges,,,0.96,,1162.56,Percent of total billed charges,,,0.95,,1150.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1150.45,Percent of total billed charges,,1150.45,1186.78,
HC PR 99381 Initial Preventive Medicine New Patient <1year Rhc,PX-52110745,CDM,99381,CPT,521,RC,,inpatient,,,326,293.4,,0.95,,309.7,Percent of total billed charges,,,0.98,,319.48,Percent of total billed charges,,,0.95,,309.7,Percent of total billed charges,,,0.97,,316.22,Percent of total billed charges,,,0.97,,316.22,Percent of total billed charges,,,0.96,,312.96,Percent of total billed charges,,,0.95,,309.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,309.7,Percent of total billed charges,,309.7,319.48,
HC PR 99381 Initial Preventive Medicine New Patient <1year Rhc,PX-52110745,CDM,99381,CPT,521,RC,,outpatient,,,326,293.4,,0.95,,309.7,Percent of total billed charges,,,0.98,,319.48,Percent of total billed charges,,,0.95,,309.7,Percent of total billed charges,,,0.95,,309.7,Percent of total billed charges,,,0.97,,316.22,Percent of total billed charges,,,0.96,,312.96,Percent of total billed charges,,,0.95,,309.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,309.7,Percent of total billed charges,,309.7,319.48,
HC PR 99382 Initial Preventive Medicine New Pt Age 1-4 Yrs Rhc,PX-52110746,CDM,99382,CPT,521,RC,,inpatient,,,340,306,,0.95,,323,Percent of total billed charges,,,0.98,,333.2,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.96,,326.4,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,323,Percent of total billed charges,,323,333.2,
HC PR 99382 Initial Preventive Medicine New Pt Age 1-4 Yrs Rhc,PX-52110746,CDM,99382,CPT,521,RC,,outpatient,,,340,306,,0.95,,323,Percent of total billed charges,,,0.98,,333.2,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.96,,326.4,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,323,Percent of total billed charges,,323,333.2,
HC PR 99391 Periodic Preventive Med Established Patient <1y Rhc,PX-52110752,CDM,99391,CPT,521,RC,,inpatient,,,293,263.7,,0.95,,278.35,Percent of total billed charges,,,0.98,,287.14,Percent of total billed charges,,,0.95,,278.35,Percent of total billed charges,,,0.97,,284.21,Percent of total billed charges,,,0.97,,284.21,Percent of total billed charges,,,0.96,,281.28,Percent of total billed charges,,,0.95,,278.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,278.35,Percent of total billed charges,,278.35,287.14,
HC PR 99391 Periodic Preventive Med Established Patient <1y Rhc,PX-52110752,CDM,99391,CPT,521,RC,,outpatient,,,293,263.7,,0.95,,278.35,Percent of total billed charges,,,0.98,,287.14,Percent of total billed charges,,,0.95,,278.35,Percent of total billed charges,,,0.95,,278.35,Percent of total billed charges,,,0.97,,284.21,Percent of total billed charges,,,0.96,,281.28,Percent of total billed charges,,,0.95,,278.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,278.35,Percent of total billed charges,,278.35,287.14,
HC PR 99392 Periodic Preventive Med Est Patient 1-4yrs Rhc,PX-52110753,CDM,99392,CPT,521,RC,,inpatient,,,312,280.8,,0.95,,296.4,Percent of total billed charges,,,0.98,,305.76,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,0.97,,302.64,Percent of total billed charges,,,0.97,,302.64,Percent of total billed charges,,,0.96,,299.52,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,296.4,Percent of total billed charges,,296.4,305.76,
HC PR 99392 Periodic Preventive Med Est Patient 1-4yrs Rhc,PX-52110753,CDM,99392,CPT,521,RC,,outpatient,,,312,280.8,,0.95,,296.4,Percent of total billed charges,,,0.98,,305.76,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,0.97,,302.64,Percent of total billed charges,,,0.96,,299.52,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,296.4,Percent of total billed charges,,296.4,305.76,
HC PR 99402 Preventive Counseling Indiv 30 Min Rhc,PX-52110760,CDM,99402,CPT,521,RC,,inpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
HC PR 99402 Preventive Counseling Indiv 30 Min Rhc,PX-52110760,CDM,99402,CPT,521,RC,,outpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
HC PR 99403 Preventive Counseling Indiv 45 Min Rhc,PX-52110761,CDM,99403,CPT,521,RC,,inpatient,,,211,189.9,,0.95,,200.45,Percent of total billed charges,,,0.98,,206.78,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,0.97,,204.67,Percent of total billed charges,,,0.97,,204.67,Percent of total billed charges,,,0.96,,202.56,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,200.45,Percent of total billed charges,,200.45,206.78,
HC PR 99403 Preventive Counseling Indiv 45 Min Rhc,PX-52110761,CDM,99403,CPT,521,RC,,outpatient,,,211,189.9,,0.95,,200.45,Percent of total billed charges,,,0.98,,206.78,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,0.97,,204.67,Percent of total billed charges,,,0.96,,202.56,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,200.45,Percent of total billed charges,,200.45,206.78,
HC PR 99404 Preventive Counseling Indiv 60 Min Rhc,PX-52110762,CDM,99404,CPT,521,RC,,inpatient,,,269,242.1,,0.95,,255.55,Percent of total billed charges,,,0.98,,263.62,Percent of total billed charges,,,0.95,,255.55,Percent of total billed charges,,,0.97,,260.93,Percent of total billed charges,,,0.97,,260.93,Percent of total billed charges,,,0.96,,258.24,Percent of total billed charges,,,0.95,,255.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,255.55,Percent of total billed charges,,255.55,263.62,
HC PR 99404 Preventive Counseling Indiv 60 Min Rhc,PX-52110762,CDM,99404,CPT,521,RC,,outpatient,,,269,242.1,,0.95,,255.55,Percent of total billed charges,,,0.98,,263.62,Percent of total billed charges,,,0.95,,255.55,Percent of total billed charges,,,0.95,,255.55,Percent of total billed charges,,,0.97,,260.93,Percent of total billed charges,,,0.96,,258.24,Percent of total billed charges,,,0.95,,255.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,255.55,Percent of total billed charges,,255.55,263.62,
HC PR 99407 Behav Chng Smoking > 10 Min Rhc,PX-52110764,CDM,99407,CPT,521,RC,,inpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
HC PR 99407 Behav Chng Smoking > 10 Min Rhc,PX-52110764,CDM,99407,CPT,521,RC,,outpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
HC PR 99408 Alcohol/Drug Screen 15-30 Min Rhc,PX-52110765,CDM,99408,CPT,521,RC,,inpatient,,,84,75.6,,0.95,,79.8,Percent of total billed charges,,,0.98,,82.32,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,0.97,,81.48,Percent of total billed charges,,,0.97,,81.48,Percent of total billed charges,,,0.96,,80.64,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,79.8,Percent of total billed charges,,79.8,82.32,
HC PR 99408 Alcohol/Drug Screen 15-30 Min Rhc,PX-52110765,CDM,99408,CPT,521,RC,,outpatient,,,84,75.6,,0.95,,79.8,Percent of total billed charges,,,0.98,,82.32,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,0.97,,81.48,Percent of total billed charges,,,0.96,,80.64,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,79.8,Percent of total billed charges,,79.8,82.32,
HC PR 99409 Alcohol/Drug Screen > 30 Min Rhc,PX-52110766,CDM,99409,CPT,521,RC,,inpatient,,,162,145.8,,0.95,,153.9,Percent of total billed charges,,,0.98,,158.76,Percent of total billed charges,,,0.95,,153.9,Percent of total billed charges,,,0.97,,157.14,Percent of total billed charges,,,0.97,,157.14,Percent of total billed charges,,,0.96,,155.52,Percent of total billed charges,,,0.95,,153.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,153.9,Percent of total billed charges,,153.9,158.76,
HC PR 99409 Alcohol/Drug Screen > 30 Min Rhc,PX-52110766,CDM,99409,CPT,521,RC,,outpatient,,,162,145.8,,0.95,,153.9,Percent of total billed charges,,,0.98,,158.76,Percent of total billed charges,,,0.95,,153.9,Percent of total billed charges,,,0.95,,153.9,Percent of total billed charges,,,0.97,,157.14,Percent of total billed charges,,,0.96,,155.52,Percent of total billed charges,,,0.95,,153.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,153.9,Percent of total billed charges,,153.9,158.76,
HC PR 43840 Repair of Stomach Lesion,PX-97510562,CDM,43840,CPT,975,RC,,inpatient,,,3340,3006,,0.95,,3173,Percent of total billed charges,,,0.98,,3273.2,Percent of total billed charges,,,0.95,,3173,Percent of total billed charges,,,0.97,,3239.8,Percent of total billed charges,,,0.97,,3239.8,Percent of total billed charges,,,0.96,,3206.4,Percent of total billed charges,,,0.95,,3173,Percent of total billed charges,,,,,,,,,0.95,,3173,Percent of total billed charges,,3173,3273.2,
HC PR 43840 Repair of Stomach Lesion,PX-97510562,CDM,43840,CPT,975,RC,,outpatient,,,3340,3006,,0.95,,3173,Percent of total billed charges,,,0.98,,3273.2,Percent of total billed charges,,,0.95,,3173,Percent of total billed charges,,,0.95,,3173,Percent of total billed charges,,,0.97,,3239.8,Percent of total billed charges,,,0.96,,3206.4,Percent of total billed charges,,,0.95,,3173,Percent of total billed charges,,,,,,,,,0.95,,3173,Percent of total billed charges,,3173,3273.2,
HC PR 44005 Freeing of Bowel Adhesion,PX-97510569,CDM,44005,CPT,975,RC,,inpatient,,,2847,2562.3,,0.95,,2704.65,Percent of total billed charges,,,0.98,,2790.06,Percent of total billed charges,,,0.95,,2704.65,Percent of total billed charges,,,0.97,,2761.59,Percent of total billed charges,,,0.97,,2761.59,Percent of total billed charges,,,0.96,,2733.12,Percent of total billed charges,,,0.95,,2704.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2704.65,Percent of total billed charges,,2704.65,2790.06,
HC PR 44005 Freeing of Bowel Adhesion,PX-97510569,CDM,44005,CPT,975,RC,,outpatient,,,2847,2562.3,,0.95,,2704.65,Percent of total billed charges,,,0.98,,2790.06,Percent of total billed charges,,,0.95,,2704.65,Percent of total billed charges,,,0.95,,2704.65,Percent of total billed charges,,,0.97,,2761.59,Percent of total billed charges,,,0.96,,2733.12,Percent of total billed charges,,,0.95,,2704.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2704.65,Percent of total billed charges,,2704.65,2790.06,
HC PR 44025 Incision of Large Bowel,PX-97511168,CDM,44025,CPT,975,RC,,inpatient,,,2410,2169,,0.95,,2289.5,Percent of total billed charges,,,0.98,,2361.8,Percent of total billed charges,,,0.95,,2289.5,Percent of total billed charges,,,0.97,,2337.7,Percent of total billed charges,,,0.97,,2337.7,Percent of total billed charges,,,0.96,,2313.6,Percent of total billed charges,,,0.95,,2289.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2289.5,Percent of total billed charges,,2289.5,2361.8,
HC PR 44025 Incision of Large Bowel,PX-97511168,CDM,44025,CPT,975,RC,,outpatient,,,2410,2169,,0.95,,2289.5,Percent of total billed charges,,,0.98,,2361.8,Percent of total billed charges,,,0.95,,2289.5,Percent of total billed charges,,,0.95,,2289.5,Percent of total billed charges,,,0.97,,2337.7,Percent of total billed charges,,,0.96,,2313.6,Percent of total billed charges,,,0.95,,2289.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2289.5,Percent of total billed charges,,2289.5,2361.8,
HC PR 44050 Reduce Bowel Obstruction,PX-97511169,CDM,44050,CPT,975,RC,,inpatient,,,2302,2071.8,,0.95,,2186.9,Percent of total billed charges,,,0.98,,2255.96,Percent of total billed charges,,,0.95,,2186.9,Percent of total billed charges,,,0.97,,2232.94,Percent of total billed charges,,,0.97,,2232.94,Percent of total billed charges,,,0.96,,2209.92,Percent of total billed charges,,,0.95,,2186.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2186.9,Percent of total billed charges,,2186.9,2255.96,
HC PR 44050 Reduce Bowel Obstruction,PX-97511169,CDM,44050,CPT,975,RC,,outpatient,,,2302,2071.8,,0.95,,2186.9,Percent of total billed charges,,,0.98,,2255.96,Percent of total billed charges,,,0.95,,2186.9,Percent of total billed charges,,,0.95,,2186.9,Percent of total billed charges,,,0.97,,2232.94,Percent of total billed charges,,,0.96,,2209.92,Percent of total billed charges,,,0.95,,2186.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2186.9,Percent of total billed charges,,2186.9,2255.96,
"HC PR 44120 Removal of Small Intestine, Single Resection",PX-97510579,CDM,44120,CPT,975,RC,,inpatient,,,2996,2696.4,,0.95,,2846.2,Percent of total billed charges,,,0.98,,2936.08,Percent of total billed charges,,,0.95,,2846.2,Percent of total billed charges,,,0.97,,2906.12,Percent of total billed charges,,,0.97,,2906.12,Percent of total billed charges,,,0.96,,2876.16,Percent of total billed charges,,,0.95,,2846.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2846.2,Percent of total billed charges,,2846.2,2936.08,
"HC PR 44120 Removal of Small Intestine, Single Resection",PX-97510579,CDM,44120,CPT,975,RC,,outpatient,,,2996,2696.4,,0.95,,2846.2,Percent of total billed charges,,,0.98,,2936.08,Percent of total billed charges,,,0.95,,2846.2,Percent of total billed charges,,,0.95,,2846.2,Percent of total billed charges,,,0.97,,2906.12,Percent of total billed charges,,,0.96,,2876.16,Percent of total billed charges,,,0.95,,2846.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2846.2,Percent of total billed charges,,2846.2,2936.08,
"HC PR 44121 Removal of Small Intestine, Each Add'l Resection",PX-97510580,CDM,44121,CPT,975,RC,,inpatient,,,605,544.5,,0.95,,574.75,Percent of total billed charges,,,0.98,,592.9,Percent of total billed charges,,,0.95,,574.75,Percent of total billed charges,,,0.97,,586.85,Percent of total billed charges,,,0.97,,586.85,Percent of total billed charges,,,0.96,,580.8,Percent of total billed charges,,,0.95,,574.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,574.75,Percent of total billed charges,,574.75,592.9,
"HC PR 44121 Removal of Small Intestine, Each Add'l Resection",PX-97510580,CDM,44121,CPT,975,RC,,outpatient,,,605,544.5,,0.95,,574.75,Percent of total billed charges,,,0.98,,592.9,Percent of total billed charges,,,0.95,,574.75,Percent of total billed charges,,,0.95,,574.75,Percent of total billed charges,,,0.97,,586.85,Percent of total billed charges,,,0.96,,580.8,Percent of total billed charges,,,0.95,,574.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,574.75,Percent of total billed charges,,574.75,592.9,
"HC PR 44125 Removal of Small Intestine, W/ Enterostomy",PX-97510581,CDM,44125,CPT,975,RC,,inpatient,,,2882,2593.8,,0.95,,2737.9,Percent of total billed charges,,,0.98,,2824.36,Percent of total billed charges,,,0.95,,2737.9,Percent of total billed charges,,,0.97,,2795.54,Percent of total billed charges,,,0.97,,2795.54,Percent of total billed charges,,,0.96,,2766.72,Percent of total billed charges,,,0.95,,2737.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2737.9,Percent of total billed charges,,2737.9,2824.36,
"HC PR 44125 Removal of Small Intestine, W/ Enterostomy",PX-97510581,CDM,44125,CPT,975,RC,,outpatient,,,2882,2593.8,,0.95,,2737.9,Percent of total billed charges,,,0.98,,2824.36,Percent of total billed charges,,,0.95,,2737.9,Percent of total billed charges,,,0.95,,2737.9,Percent of total billed charges,,,0.97,,2795.54,Percent of total billed charges,,,0.96,,2766.72,Percent of total billed charges,,,0.95,,2737.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2737.9,Percent of total billed charges,,2737.9,2824.36,
HC PR 44139 Mobilization of Colon,PX-97510584,CDM,44139,CPT,975,RC,,inpatient,,,292,262.8,,0.95,,277.4,Percent of total billed charges,,,0.98,,286.16,Percent of total billed charges,,,0.95,,277.4,Percent of total billed charges,,,0.97,,283.24,Percent of total billed charges,,,0.97,,283.24,Percent of total billed charges,,,0.96,,280.32,Percent of total billed charges,,,0.95,,277.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,277.4,Percent of total billed charges,,277.4,286.16,
HC PR 44139 Mobilization of Colon,PX-97510584,CDM,44139,CPT,975,RC,,outpatient,,,292,262.8,,0.95,,277.4,Percent of total billed charges,,,0.98,,286.16,Percent of total billed charges,,,0.95,,277.4,Percent of total billed charges,,,0.95,,277.4,Percent of total billed charges,,,0.97,,283.24,Percent of total billed charges,,,0.96,,280.32,Percent of total billed charges,,,0.95,,277.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,277.4,Percent of total billed charges,,277.4,286.16,
HC PR 44140 Partial Removal of Colon W/ Anastomosis,PX-97510585,CDM,44140,CPT,975,RC,,inpatient,,,3290,2961,,0.95,,3125.5,Percent of total billed charges,,,0.98,,3224.2,Percent of total billed charges,,,0.95,,3125.5,Percent of total billed charges,,,0.97,,3191.3,Percent of total billed charges,,,0.97,,3191.3,Percent of total billed charges,,,0.96,,3158.4,Percent of total billed charges,,,0.95,,3125.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3125.5,Percent of total billed charges,,3125.5,3224.2,
HC PR 44140 Partial Removal of Colon W/ Anastomosis,PX-97510585,CDM,44140,CPT,975,RC,,outpatient,,,3290,2961,,0.95,,3125.5,Percent of total billed charges,,,0.98,,3224.2,Percent of total billed charges,,,0.95,,3125.5,Percent of total billed charges,,,0.95,,3125.5,Percent of total billed charges,,,0.97,,3191.3,Percent of total billed charges,,,0.96,,3158.4,Percent of total billed charges,,,0.95,,3125.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3125.5,Percent of total billed charges,,3125.5,3224.2,
"HC PR 44141 Partial Removal of Colon, W/ Skin Level Cecostomy or Colos",PX-97510586,CDM,44141,CPT,975,RC,,inpatient,,,4435,3991.5,,0.95,,4213.25,Percent of total billed charges,,,0.98,,4346.3,Percent of total billed charges,,,0.95,,4213.25,Percent of total billed charges,,,0.97,,4301.95,Percent of total billed charges,,,0.97,,4301.95,Percent of total billed charges,,,0.96,,4257.6,Percent of total billed charges,,,0.95,,4213.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4213.25,Percent of total billed charges,,4213.25,4346.3,
"HC PR 44141 Partial Removal of Colon, W/ Skin Level Cecostomy or Colos",PX-97510586,CDM,44141,CPT,975,RC,,outpatient,,,4435,3991.5,,0.95,,4213.25,Percent of total billed charges,,,0.98,,4346.3,Percent of total billed charges,,,0.95,,4213.25,Percent of total billed charges,,,0.95,,4213.25,Percent of total billed charges,,,0.97,,4301.95,Percent of total billed charges,,,0.96,,4257.6,Percent of total billed charges,,,0.95,,4213.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4213.25,Percent of total billed charges,,4213.25,4346.3,
"HC PR 44143 Partial Removal of Colon, Hartmann Procedure",PX-97510587,CDM,44143,CPT,975,RC,,inpatient,,,4122,3709.8,,0.95,,3915.9,Percent of total billed charges,,,0.98,,4039.56,Percent of total billed charges,,,0.95,,3915.9,Percent of total billed charges,,,0.97,,3998.34,Percent of total billed charges,,,0.97,,3998.34,Percent of total billed charges,,,0.96,,3957.12,Percent of total billed charges,,,0.95,,3915.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3915.9,Percent of total billed charges,,3915.9,4039.56,
"HC PR 44143 Partial Removal of Colon, Hartmann Procedure",PX-97510587,CDM,44143,CPT,975,RC,,outpatient,,,4122,3709.8,,0.95,,3915.9,Percent of total billed charges,,,0.98,,4039.56,Percent of total billed charges,,,0.95,,3915.9,Percent of total billed charges,,,0.95,,3915.9,Percent of total billed charges,,,0.97,,3998.34,Percent of total billed charges,,,0.96,,3957.12,Percent of total billed charges,,,0.95,,3915.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3915.9,Percent of total billed charges,,3915.9,4039.56,
"HC PR 44144 Partial Removal of Colon, With Resection",PX-97510588,CDM,44144,CPT,975,RC,,inpatient,,,4311,3879.9,,0.95,,4095.45,Percent of total billed charges,,,0.98,,4224.78,Percent of total billed charges,,,0.95,,4095.45,Percent of total billed charges,,,0.97,,4181.67,Percent of total billed charges,,,0.97,,4181.67,Percent of total billed charges,,,0.96,,4138.56,Percent of total billed charges,,,0.95,,4095.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4095.45,Percent of total billed charges,,4095.45,4224.78,
"HC PR 44144 Partial Removal of Colon, With Resection",PX-97510588,CDM,44144,CPT,975,RC,,outpatient,,,4311,3879.9,,0.95,,4095.45,Percent of total billed charges,,,0.98,,4224.78,Percent of total billed charges,,,0.95,,4095.45,Percent of total billed charges,,,0.95,,4095.45,Percent of total billed charges,,,0.97,,4181.67,Percent of total billed charges,,,0.96,,4138.56,Percent of total billed charges,,,0.95,,4095.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4095.45,Percent of total billed charges,,4095.45,4224.78,
HC PR 99487 Cmplx Chron Care Mgmt W/O Pt Vst 1st Hr per Mo Rhc,PX-52110782,CDM,99487,CPT,521,RC,,inpatient,,,339,305.1,,0.95,,322.05,Percent of total billed charges,,,0.98,,332.22,Percent of total billed charges,,,0.95,,322.05,Percent of total billed charges,,,0.97,,328.83,Percent of total billed charges,,,0.97,,328.83,Percent of total billed charges,,,0.96,,325.44,Percent of total billed charges,,,0.95,,322.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,322.05,Percent of total billed charges,,322.05,332.22,
HC PR 99487 Cmplx Chron Care Mgmt W/O Pt Vst 1st Hr per Mo Rhc,PX-52110782,CDM,99487,CPT,521,RC,,outpatient,,,339,305.1,,0.95,,322.05,Percent of total billed charges,,,0.98,,332.22,Percent of total billed charges,,,0.95,,322.05,Percent of total billed charges,,,0.95,,322.05,Percent of total billed charges,,,0.97,,328.83,Percent of total billed charges,,,0.96,,325.44,Percent of total billed charges,,,0.95,,322.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,322.05,Percent of total billed charges,,322.05,332.22,
HC PR 99489 Cmplx Chron Care Mgmt Ea Addl 30 Min per Month Rhc,PX-52110783,CDM,99489,CPT,521,RC,,inpatient,,,178,160.2,,0.95,,169.1,Percent of total billed charges,,,0.98,,174.44,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,0.97,,172.66,Percent of total billed charges,,,0.97,,172.66,Percent of total billed charges,,,0.96,,170.88,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,169.1,Percent of total billed charges,,169.1,174.44,
HC PR 99489 Cmplx Chron Care Mgmt Ea Addl 30 Min per Month Rhc,PX-52110783,CDM,99489,CPT,521,RC,,outpatient,,,178,160.2,,0.95,,169.1,Percent of total billed charges,,,0.98,,174.44,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,0.97,,172.66,Percent of total billed charges,,,0.96,,170.88,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,169.1,Percent of total billed charges,,169.1,174.44,
HC PR 99491 Chronic Care Mgmt Svc First 30 Min per Month Rhc,PX-52110785,CDM,99491,CPT,521,RC,,inpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
HC PR 99491 Chronic Care Mgmt Svc First 30 Min per Month Rhc,PX-52110785,CDM,99491,CPT,521,RC,,outpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
HC PR 99495 Transj Care Mgmt Mod Mdm F2f 14 Cal D Discharge Rhc,PX-52110792,CDM,99495,CPT,521,RC,,inpatient,,,509,458.1,,0.95,,483.55,Percent of total billed charges,,,0.98,,498.82,Percent of total billed charges,,,0.95,,483.55,Percent of total billed charges,,,0.97,,493.73,Percent of total billed charges,,,0.97,,493.73,Percent of total billed charges,,,0.96,,488.64,Percent of total billed charges,,,0.95,,483.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,483.55,Percent of total billed charges,,483.55,498.82,
HC PR 99495 Transj Care Mgmt Mod Mdm F2f 14 Cal D Discharge Rhc,PX-52110792,CDM,99495,CPT,521,RC,,outpatient,,,509,458.1,,0.95,,483.55,Percent of total billed charges,,,0.98,,498.82,Percent of total billed charges,,,0.95,,483.55,Percent of total billed charges,,,0.95,,483.55,Percent of total billed charges,,,0.97,,493.73,Percent of total billed charges,,,0.96,,488.64,Percent of total billed charges,,,0.95,,483.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,483.55,Percent of total billed charges,,483.55,498.82,
HC PR 99496 Transj Care Mgmt High Mdm F2f 7 Cal D Discharge Rhc,PX-52110793,CDM,99496,CPT,521,RC,,inpatient,,,688,619.2,,0.95,,653.6,Percent of total billed charges,,,0.98,,674.24,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,0.97,,667.36,Percent of total billed charges,,,0.97,,667.36,Percent of total billed charges,,,0.96,,660.48,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,653.6,Percent of total billed charges,,653.6,674.24,
HC PR 99496 Transj Care Mgmt High Mdm F2f 7 Cal D Discharge Rhc,PX-52110793,CDM,99496,CPT,521,RC,,outpatient,,,688,619.2,,0.95,,653.6,Percent of total billed charges,,,0.98,,674.24,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,0.97,,667.36,Percent of total billed charges,,,0.96,,660.48,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,653.6,Percent of total billed charges,,653.6,674.24,
HC PR 99498 Advance Care Planning Ea Addl 30 Mins Rhc,PX-52110794,CDM,99498,CPT,521,RC,,inpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
HC PR 99498 Advance Care Planning Ea Addl 30 Mins Rhc,PX-52110794,CDM,99498,CPT,521,RC,,outpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
HC PR 44180 Laparoscopy Enterolysis,PX-97510599,CDM,44180,CPT,975,RC,,inpatient,,,4646,4181.4,,0.95,,4413.7,Percent of total billed charges,,,0.98,,4553.08,Percent of total billed charges,,,0.95,,4413.7,Percent of total billed charges,,,0.97,,4506.62,Percent of total billed charges,,,0.97,,4506.62,Percent of total billed charges,,,0.96,,4460.16,Percent of total billed charges,,,0.95,,4413.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4413.7,Percent of total billed charges,,4413.7,4553.08,
HC PR 44180 Laparoscopy Enterolysis,PX-97510599,CDM,44180,CPT,975,RC,,outpatient,,,4646,4181.4,,0.95,,4413.7,Percent of total billed charges,,,0.98,,4553.08,Percent of total billed charges,,,0.95,,4413.7,Percent of total billed charges,,,0.95,,4413.7,Percent of total billed charges,,,0.97,,4506.62,Percent of total billed charges,,,0.96,,4460.16,Percent of total billed charges,,,0.95,,4413.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4413.7,Percent of total billed charges,,4413.7,4553.08,
HC PR 44204 Laparoscopy Partial Colectomy,PX-96910214,CDM,44204,CPT,975,RC,,inpatient,,,3831,3447.9,,0.95,,3639.45,Percent of total billed charges,,,0.98,,3754.38,Percent of total billed charges,,,0.95,,3639.45,Percent of total billed charges,,,0.97,,3716.07,Percent of total billed charges,,,0.97,,3716.07,Percent of total billed charges,,,0.96,,3677.76,Percent of total billed charges,,,0.95,,3639.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3639.45,Percent of total billed charges,,3639.45,3754.38,
HC PR 44204 Laparoscopy Partial Colectomy,PX-96910214,CDM,44204,CPT,975,RC,,outpatient,,,3831,3447.9,,0.95,,3639.45,Percent of total billed charges,,,0.98,,3754.38,Percent of total billed charges,,,0.95,,3639.45,Percent of total billed charges,,,0.95,,3639.45,Percent of total billed charges,,,0.97,,3716.07,Percent of total billed charges,,,0.96,,3677.76,Percent of total billed charges,,,0.95,,3639.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3639.45,Percent of total billed charges,,3639.45,3754.38,
HC PR 44213 Laparoscopy Mobilization Splenic Flexure Add-On,PX-97510705,CDM,44213,CPT,975,RC,,inpatient,,,469,422.1,,0.95,,445.55,Percent of total billed charges,,,0.98,,459.62,Percent of total billed charges,,,0.95,,445.55,Percent of total billed charges,,,0.97,,454.93,Percent of total billed charges,,,0.97,,454.93,Percent of total billed charges,,,0.96,,450.24,Percent of total billed charges,,,0.95,,445.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,445.55,Percent of total billed charges,,445.55,459.62,
HC PR 44213 Laparoscopy Mobilization Splenic Flexure Add-On,PX-97510705,CDM,44213,CPT,975,RC,,outpatient,,,469,422.1,,0.95,,445.55,Percent of total billed charges,,,0.98,,459.62,Percent of total billed charges,,,0.95,,445.55,Percent of total billed charges,,,0.95,,445.55,Percent of total billed charges,,,0.97,,454.93,Percent of total billed charges,,,0.96,,450.24,Percent of total billed charges,,,0.95,,445.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,445.55,Percent of total billed charges,,445.55,459.62,
Colostomy/Skin Level Cecostomy,PX-97510709,CDM,44320,CPT,975,RC,,inpatient,,,2994,2694.6,,0.95,,2844.3,Percent of total billed charges,,,0.98,,2934.12,Percent of total billed charges,,,0.95,,2844.3,Percent of total billed charges,,,0.97,,2904.18,Percent of total billed charges,,,0.97,,2904.18,Percent of total billed charges,,,0.96,,2874.24,Percent of total billed charges,,,0.95,,2844.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2844.3,Percent of total billed charges,,2844.3,2934.12,
Colostomy/Skin Level Cecostomy,PX-97510709,CDM,44320,CPT,975,RC,,outpatient,,,2994,2694.6,,0.95,,2844.3,Percent of total billed charges,,,0.98,,2934.12,Percent of total billed charges,,,0.95,,2844.3,Percent of total billed charges,,,0.95,,2844.3,Percent of total billed charges,,,0.97,,2904.18,Percent of total billed charges,,,0.96,,2874.24,Percent of total billed charges,,,0.95,,2844.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2844.3,Percent of total billed charges,,2844.3,2934.12,
HC PR 44392 Colonoscopy & Polypectomy,PX-97510721,CDM,44392,CPT,975,RC,,inpatient,,,1020,918,,0.95,,969,Percent of total billed charges,,,0.98,,999.6,Percent of total billed charges,,,0.95,,969,Percent of total billed charges,,,0.97,,989.4,Percent of total billed charges,,,0.97,,989.4,Percent of total billed charges,,,0.96,,979.2,Percent of total billed charges,,,0.95,,969,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,969,Percent of total billed charges,,969,999.6,
HC PR 44392 Colonoscopy & Polypectomy,PX-97510721,CDM,44392,CPT,975,RC,,outpatient,,,1020,918,,0.95,,969,Percent of total billed charges,,,0.98,,999.6,Percent of total billed charges,,,0.95,,969,Percent of total billed charges,,,0.95,,969,Percent of total billed charges,,,0.97,,989.4,Percent of total billed charges,,,0.96,,979.2,Percent of total billed charges,,,0.95,,969,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,969,Percent of total billed charges,,969,999.6,
HC PR 44394 Colonoscopy W/Snare,PX-97510723,CDM,44394,CPT,975,RC,,inpatient,,,1145,1030.5,,0.95,,1087.75,Percent of total billed charges,,,0.98,,1122.1,Percent of total billed charges,,,0.95,,1087.75,Percent of total billed charges,,,0.97,,1110.65,Percent of total billed charges,,,0.97,,1110.65,Percent of total billed charges,,,0.96,,1099.2,Percent of total billed charges,,,0.95,,1087.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1087.75,Percent of total billed charges,,1087.75,1122.1,
HC PR 44394 Colonoscopy W/Snare,PX-97510723,CDM,44394,CPT,975,RC,,outpatient,,,1145,1030.5,,0.95,,1087.75,Percent of total billed charges,,,0.98,,1122.1,Percent of total billed charges,,,0.95,,1087.75,Percent of total billed charges,,,0.95,,1087.75,Percent of total billed charges,,,0.97,,1110.65,Percent of total billed charges,,,0.96,,1099.2,Percent of total billed charges,,,0.95,,1087.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1087.75,Percent of total billed charges,,1087.75,1122.1,
HC PR G0511 Ccm/Bhi by Rhc/FQHC 20min Mo Rhc,PX-52110811,CDM,G0511,CPT,521,RC,,inpatient,,,180,162,,0.95,,171,Percent of total billed charges,,,0.98,,176.4,Percent of total billed charges,,,0.95,,171,Percent of total billed charges,,,0.97,,174.6,Percent of total billed charges,,,0.97,,174.6,Percent of total billed charges,,,0.96,,172.8,Percent of total billed charges,,,0.95,,171,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,171,Percent of total billed charges,,171,176.4,
HC PR G0511 Ccm/Bhi by Rhc/FQHC 20min Mo Rhc,PX-52110811,CDM,G0511,CPT,521,RC,,outpatient,,,180,162,,0.95,,171,Percent of total billed charges,,,0.98,,176.4,Percent of total billed charges,,,0.95,,171,Percent of total billed charges,,,0.95,,171,Percent of total billed charges,,,0.97,,174.6,Percent of total billed charges,,,0.96,,172.8,Percent of total billed charges,,,0.95,,171,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,171,Percent of total billed charges,,171,176.4,
HC PR G0512 Cocm by Rhc/FQHC 60 Min Mo Rhc,PX-52110812,CDM,G0512,CPT,521,RC,,inpatient,,,361,324.9,,0.95,,342.95,Percent of total billed charges,,,0.98,,353.78,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,0.97,,350.17,Percent of total billed charges,,,0.97,,350.17,Percent of total billed charges,,,0.96,,346.56,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,342.95,Percent of total billed charges,,342.95,353.78,
HC PR G0512 Cocm by Rhc/FQHC 60 Min Mo Rhc,PX-52110812,CDM,G0512,CPT,521,RC,,outpatient,,,361,324.9,,0.95,,342.95,Percent of total billed charges,,,0.98,,353.78,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,0.97,,350.17,Percent of total billed charges,,,0.96,,346.56,Percent of total billed charges,,,0.95,,342.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,342.95,Percent of total billed charges,,342.95,353.78,
HC PR 44800 Excision of Bowel Pouch,PX-97510734,CDM,44800,CPT,975,RC,,inpatient,,,1918,1726.2,,0.95,,1822.1,Percent of total billed charges,,,0.98,,1879.64,Percent of total billed charges,,,0.95,,1822.1,Percent of total billed charges,,,0.97,,1860.46,Percent of total billed charges,,,0.97,,1860.46,Percent of total billed charges,,,0.96,,1841.28,Percent of total billed charges,,,0.95,,1822.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1822.1,Percent of total billed charges,,1822.1,1879.64,
HC PR 44800 Excision of Bowel Pouch,PX-97510734,CDM,44800,CPT,975,RC,,outpatient,,,1918,1726.2,,0.95,,1822.1,Percent of total billed charges,,,0.98,,1879.64,Percent of total billed charges,,,0.95,,1822.1,Percent of total billed charges,,,0.95,,1822.1,Percent of total billed charges,,,0.97,,1860.46,Percent of total billed charges,,,0.96,,1841.28,Percent of total billed charges,,,0.95,,1822.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1822.1,Percent of total billed charges,,1822.1,1879.64,
HC PR 44950 Appendectomy,PX-97510738,CDM,44950,CPT,975,RC,,inpatient,,,1582,1423.8,,0.95,,1502.9,Percent of total billed charges,,,0.98,,1550.36,Percent of total billed charges,,,0.95,,1502.9,Percent of total billed charges,,,0.97,,1534.54,Percent of total billed charges,,,0.97,,1534.54,Percent of total billed charges,,,0.96,,1518.72,Percent of total billed charges,,,0.95,,1502.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1502.9,Percent of total billed charges,,1502.9,1550.36,
HC PR 44950 Appendectomy,PX-97510738,CDM,44950,CPT,975,RC,,outpatient,,,1582,1423.8,,0.95,,1502.9,Percent of total billed charges,,,0.98,,1550.36,Percent of total billed charges,,,0.95,,1502.9,Percent of total billed charges,,,0.95,,1502.9,Percent of total billed charges,,,0.97,,1534.54,Percent of total billed charges,,,0.96,,1518.72,Percent of total billed charges,,,0.95,,1502.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1502.9,Percent of total billed charges,,1502.9,1550.36,
"HC PR 44960 Appendectomy, Ruptured",PX-97510740,CDM,44960,CPT,975,RC,,inpatient,,,2158,1942.2,,0.95,,2050.1,Percent of total billed charges,,,0.98,,2114.84,Percent of total billed charges,,,0.95,,2050.1,Percent of total billed charges,,,0.97,,2093.26,Percent of total billed charges,,,0.97,,2093.26,Percent of total billed charges,,,0.96,,2071.68,Percent of total billed charges,,,0.95,,2050.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2050.1,Percent of total billed charges,,2050.1,2114.84,
"HC PR 44960 Appendectomy, Ruptured",PX-97510740,CDM,44960,CPT,975,RC,,outpatient,,,2158,1942.2,,0.95,,2050.1,Percent of total billed charges,,,0.98,,2114.84,Percent of total billed charges,,,0.95,,2050.1,Percent of total billed charges,,,0.95,,2050.1,Percent of total billed charges,,,0.97,,2093.26,Percent of total billed charges,,,0.96,,2071.68,Percent of total billed charges,,,0.95,,2050.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2050.1,Percent of total billed charges,,2050.1,2114.84,
HC PR 44970 Laparoscopy Appendectomy,PX-97510741,CDM,44970,CPT,975,RC,,inpatient,,,1490,1341,,0.95,,1415.5,Percent of total billed charges,,,0.98,,1460.2,Percent of total billed charges,,,0.95,,1415.5,Percent of total billed charges,,,0.97,,1445.3,Percent of total billed charges,,,0.97,,1445.3,Percent of total billed charges,,,0.96,,1430.4,Percent of total billed charges,,,0.95,,1415.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1415.5,Percent of total billed charges,,1415.5,1460.2,
HC PR 44970 Laparoscopy Appendectomy,PX-97510741,CDM,44970,CPT,975,RC,,outpatient,,,1490,1341,,0.95,,1415.5,Percent of total billed charges,,,0.98,,1460.2,Percent of total billed charges,,,0.95,,1415.5,Percent of total billed charges,,,0.95,,1415.5,Percent of total billed charges,,,0.97,,1445.3,Percent of total billed charges,,,0.96,,1430.4,Percent of total billed charges,,,0.95,,1415.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1415.5,Percent of total billed charges,,1415.5,1460.2,
HC PR ED 45005 Drainage of Rectal Abscess Cdm,PX-98110377,CDM,45005,CPT,981,RC,,inpatient,,,777,699.3,,0.95,,738.15,Percent of total billed charges,,,0.98,,761.46,Percent of total billed charges,,,0.95,,738.15,Percent of total billed charges,,,0.97,,753.69,Percent of total billed charges,,,0.97,,753.69,Percent of total billed charges,,,0.96,,745.92,Percent of total billed charges,,,0.95,,738.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,738.15,Percent of total billed charges,,738.15,761.46,
HC PR ED 45005 Drainage of Rectal Abscess Cdm,PX-98110377,CDM,45005,CPT,981,RC,,outpatient,,,777,699.3,,0.95,,738.15,Percent of total billed charges,,,0.98,,761.46,Percent of total billed charges,,,0.95,,738.15,Percent of total billed charges,,,0.95,,738.15,Percent of total billed charges,,,0.97,,753.69,Percent of total billed charges,,,0.96,,745.92,Percent of total billed charges,,,0.95,,738.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,738.15,Percent of total billed charges,,738.15,761.46,
HC PR 45100 Biopsy of Rectum,PX-97510744,CDM,45100,CPT,975,RC,,inpatient,,,654,588.6,,0.95,,621.3,Percent of total billed charges,,,0.98,,640.92,Percent of total billed charges,,,0.95,,621.3,Percent of total billed charges,,,0.97,,634.38,Percent of total billed charges,,,0.97,,634.38,Percent of total billed charges,,,0.96,,627.84,Percent of total billed charges,,,0.95,,621.3,Percent of total billed charges,,,,,,,,,0.95,,621.3,Percent of total billed charges,,621.3,640.92,
HC PR 45100 Biopsy of Rectum,PX-97510744,CDM,45100,CPT,975,RC,,outpatient,,,654,588.6,,0.95,,621.3,Percent of total billed charges,,,0.98,,640.92,Percent of total billed charges,,,0.95,,621.3,Percent of total billed charges,,,0.95,,621.3,Percent of total billed charges,,,0.97,,634.38,Percent of total billed charges,,,0.96,,627.84,Percent of total billed charges,,,0.95,,621.3,Percent of total billed charges,,,,,,,,,0.95,,621.3,Percent of total billed charges,,621.3,640.92,
HC PR 45333 Sigmoidoscopy & Polypectomy,PX-97510761,CDM,45333,CPT,975,RC,,inpatient,,,889,800.1,,0.95,,844.55,Percent of total billed charges,,,0.98,,871.22,Percent of total billed charges,,,0.95,,844.55,Percent of total billed charges,,,0.97,,862.33,Percent of total billed charges,,,0.97,,862.33,Percent of total billed charges,,,0.96,,853.44,Percent of total billed charges,,,0.95,,844.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,844.55,Percent of total billed charges,,844.55,871.22,
HC PR 45333 Sigmoidoscopy & Polypectomy,PX-97510761,CDM,45333,CPT,975,RC,,outpatient,,,889,800.1,,0.95,,844.55,Percent of total billed charges,,,0.98,,871.22,Percent of total billed charges,,,0.95,,844.55,Percent of total billed charges,,,0.95,,844.55,Percent of total billed charges,,,0.97,,862.33,Percent of total billed charges,,,0.96,,853.44,Percent of total billed charges,,,0.95,,844.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,844.55,Percent of total billed charges,,844.55,871.22,
HC PR 45381 Colonoscopy Submucous Inj,PX-97510769,CDM,45381,CPT,975,RC,,inpatient,,,1094,984.6,,0.95,,1039.3,Percent of total billed charges,,,0.98,,1072.12,Percent of total billed charges,,,0.95,,1039.3,Percent of total billed charges,,,0.97,,1061.18,Percent of total billed charges,,,0.97,,1061.18,Percent of total billed charges,,,0.96,,1050.24,Percent of total billed charges,,,0.95,,1039.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1039.3,Percent of total billed charges,,1039.3,1072.12,
HC PR 45381 Colonoscopy Submucous Inj,PX-97510769,CDM,45381,CPT,975,RC,,outpatient,,,1094,984.6,,0.95,,1039.3,Percent of total billed charges,,,0.98,,1072.12,Percent of total billed charges,,,0.95,,1039.3,Percent of total billed charges,,,0.95,,1039.3,Percent of total billed charges,,,0.97,,1061.18,Percent of total billed charges,,,0.96,,1050.24,Percent of total billed charges,,,0.95,,1039.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1039.3,Percent of total billed charges,,1039.3,1072.12,
HC PR ED 45915 Remove Rectal Obstruction W Gen Anesth Cdm,PX-98110380,CDM,45915,CPT,981,RC,,inpatient,,,871,783.9,,0.95,,827.45,Percent of total billed charges,,,0.98,,853.58,Percent of total billed charges,,,0.95,,827.45,Percent of total billed charges,,,0.97,,844.87,Percent of total billed charges,,,0.97,,844.87,Percent of total billed charges,,,0.96,,836.16,Percent of total billed charges,,,0.95,,827.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,827.45,Percent of total billed charges,,827.45,853.58,
HC PR ED 45915 Remove Rectal Obstruction W Gen Anesth Cdm,PX-98110380,CDM,45915,CPT,981,RC,,outpatient,,,871,783.9,,0.95,,827.45,Percent of total billed charges,,,0.98,,853.58,Percent of total billed charges,,,0.95,,827.45,Percent of total billed charges,,,0.95,,827.45,Percent of total billed charges,,,0.97,,844.87,Percent of total billed charges,,,0.96,,836.16,Percent of total billed charges,,,0.95,,827.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,827.45,Percent of total billed charges,,827.45,853.58,
HC PR 45990 Surg Dx Exam Anorectal,PX-97510782,CDM,45990,CPT,975,RC,,inpatient,,,342,307.8,,0.95,,324.9,Percent of total billed charges,,,0.98,,335.16,Percent of total billed charges,,,0.95,,324.9,Percent of total billed charges,,,0.97,,331.74,Percent of total billed charges,,,0.97,,331.74,Percent of total billed charges,,,0.96,,328.32,Percent of total billed charges,,,0.95,,324.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,324.9,Percent of total billed charges,,324.9,335.16,
HC PR 45990 Surg Dx Exam Anorectal,PX-97510782,CDM,45990,CPT,975,RC,,outpatient,,,342,307.8,,0.95,,324.9,Percent of total billed charges,,,0.98,,335.16,Percent of total billed charges,,,0.95,,324.9,Percent of total billed charges,,,0.95,,324.9,Percent of total billed charges,,,0.97,,331.74,Percent of total billed charges,,,0.96,,328.32,Percent of total billed charges,,,0.95,,324.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,324.9,Percent of total billed charges,,324.9,335.16,
HC PR ED 46040 Incision of Rectal Abscess Cdm,PX-98110381,CDM,46040,CPT,981,RC,,inpatient,,,1487,1338.3,,0.95,,1412.65,Percent of total billed charges,,,0.98,,1457.26,Percent of total billed charges,,,0.95,,1412.65,Percent of total billed charges,,,0.97,,1442.39,Percent of total billed charges,,,0.97,,1442.39,Percent of total billed charges,,,0.96,,1427.52,Percent of total billed charges,,,0.95,,1412.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1412.65,Percent of total billed charges,,1412.65,1457.26,
HC PR ED 46040 Incision of Rectal Abscess Cdm,PX-98110381,CDM,46040,CPT,981,RC,,outpatient,,,1487,1338.3,,0.95,,1412.65,Percent of total billed charges,,,0.98,,1457.26,Percent of total billed charges,,,0.95,,1412.65,Percent of total billed charges,,,0.95,,1412.65,Percent of total billed charges,,,0.97,,1442.39,Percent of total billed charges,,,0.96,,1427.52,Percent of total billed charges,,,0.95,,1412.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1412.65,Percent of total billed charges,,1412.65,1457.26,
HC PR ED 46050 Incision of Anal Abscess Cdm,PX-98110382,CDM,46050,CPT,981,RC,,inpatient,,,583,524.7,,0.95,,553.85,Percent of total billed charges,,,0.98,,571.34,Percent of total billed charges,,,0.95,,553.85,Percent of total billed charges,,,0.97,,565.51,Percent of total billed charges,,,0.97,,565.51,Percent of total billed charges,,,0.96,,559.68,Percent of total billed charges,,,0.95,,553.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,553.85,Percent of total billed charges,,553.85,571.34,
HC PR ED 46050 Incision of Anal Abscess Cdm,PX-98110382,CDM,46050,CPT,981,RC,,outpatient,,,583,524.7,,0.95,,553.85,Percent of total billed charges,,,0.98,,571.34,Percent of total billed charges,,,0.95,,553.85,Percent of total billed charges,,,0.95,,553.85,Percent of total billed charges,,,0.97,,565.51,Percent of total billed charges,,,0.96,,559.68,Percent of total billed charges,,,0.95,,553.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,553.85,Percent of total billed charges,,553.85,571.34,
HC PR ED 46083 Incise External Hemorrhoid Cdm,PX-98110383,CDM,46083,CPT,981,RC,,inpatient,,,529,476.1,,0.95,,502.55,Percent of total billed charges,,,0.98,,518.42,Percent of total billed charges,,,0.95,,502.55,Percent of total billed charges,,,0.97,,513.13,Percent of total billed charges,,,0.97,,513.13,Percent of total billed charges,,,0.96,,507.84,Percent of total billed charges,,,0.95,,502.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,502.55,Percent of total billed charges,,502.55,518.42,
HC PR ED 46083 Incise External Hemorrhoid Cdm,PX-98110383,CDM,46083,CPT,981,RC,,outpatient,,,529,476.1,,0.95,,502.55,Percent of total billed charges,,,0.98,,518.42,Percent of total billed charges,,,0.95,,502.55,Percent of total billed charges,,,0.95,,502.55,Percent of total billed charges,,,0.97,,513.13,Percent of total billed charges,,,0.96,,507.84,Percent of total billed charges,,,0.95,,502.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,502.55,Percent of total billed charges,,502.55,518.42,
HC PR 46200 Removal of Anal Fissure,PX-97510785,CDM,46200,CPT,975,RC,,inpatient,,,1174,1056.6,,0.95,,1115.3,Percent of total billed charges,,,0.98,,1150.52,Percent of total billed charges,,,0.95,,1115.3,Percent of total billed charges,,,0.97,,1138.78,Percent of total billed charges,,,0.97,,1138.78,Percent of total billed charges,,,0.96,,1127.04,Percent of total billed charges,,,0.95,,1115.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1115.3,Percent of total billed charges,,1115.3,1150.52,
HC PR 46200 Removal of Anal Fissure,PX-97510785,CDM,46200,CPT,975,RC,,outpatient,,,1174,1056.6,,0.95,,1115.3,Percent of total billed charges,,,0.98,,1150.52,Percent of total billed charges,,,0.95,,1115.3,Percent of total billed charges,,,0.95,,1115.3,Percent of total billed charges,,,0.97,,1138.78,Percent of total billed charges,,,0.96,,1127.04,Percent of total billed charges,,,0.95,,1115.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1115.3,Percent of total billed charges,,1115.3,1150.52,
HC PR ED 46221 Ligation of Hemorrhoid(S) Cdm,PX-98110384,CDM,46221,CPT,981,RC,,inpatient,,,781,702.9,,0.95,,741.95,Percent of total billed charges,,,0.98,,765.38,Percent of total billed charges,,,0.95,,741.95,Percent of total billed charges,,,0.97,,757.57,Percent of total billed charges,,,0.97,,757.57,Percent of total billed charges,,,0.96,,749.76,Percent of total billed charges,,,0.95,,741.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,741.95,Percent of total billed charges,,741.95,765.38,
HC PR ED 46221 Ligation of Hemorrhoid(S) Cdm,PX-98110384,CDM,46221,CPT,981,RC,,outpatient,,,781,702.9,,0.95,,741.95,Percent of total billed charges,,,0.98,,765.38,Percent of total billed charges,,,0.95,,741.95,Percent of total billed charges,,,0.95,,741.95,Percent of total billed charges,,,0.97,,757.57,Percent of total billed charges,,,0.96,,749.76,Percent of total billed charges,,,0.95,,741.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,741.95,Percent of total billed charges,,741.95,765.38,
HC PR ED 46230 Removal of Anal Tags Cdm,PX-98110385,CDM,46230,CPT,981,RC,,inpatient,,,850,765,,0.95,,807.5,Percent of total billed charges,,,0.98,,833,Percent of total billed charges,,,0.95,,807.5,Percent of total billed charges,,,0.97,,824.5,Percent of total billed charges,,,0.97,,824.5,Percent of total billed charges,,,0.96,,816,Percent of total billed charges,,,0.95,,807.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,807.5,Percent of total billed charges,,807.5,833,
HC PR ED 46230 Removal of Anal Tags Cdm,PX-98110385,CDM,46230,CPT,981,RC,,outpatient,,,850,765,,0.95,,807.5,Percent of total billed charges,,,0.98,,833,Percent of total billed charges,,,0.95,,807.5,Percent of total billed charges,,,0.95,,807.5,Percent of total billed charges,,,0.97,,824.5,Percent of total billed charges,,,0.96,,816,Percent of total billed charges,,,0.95,,807.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,807.5,Percent of total billed charges,,807.5,833,
HC PR 46250 Remove Ext Hem Groups 2+,PX-97510787,CDM,46250,CPT,975,RC,,inpatient,,,1180,1062,,0.95,,1121,Percent of total billed charges,,,0.98,,1156.4,Percent of total billed charges,,,0.95,,1121,Percent of total billed charges,,,0.97,,1144.6,Percent of total billed charges,,,0.97,,1144.6,Percent of total billed charges,,,0.96,,1132.8,Percent of total billed charges,,,0.95,,1121,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1121,Percent of total billed charges,,1121,1156.4,
HC PR 46250 Remove Ext Hem Groups 2+,PX-97510787,CDM,46250,CPT,975,RC,,outpatient,,,1180,1062,,0.95,,1121,Percent of total billed charges,,,0.98,,1156.4,Percent of total billed charges,,,0.95,,1121,Percent of total billed charges,,,0.95,,1121,Percent of total billed charges,,,0.97,,1144.6,Percent of total billed charges,,,0.96,,1132.8,Percent of total billed charges,,,0.95,,1121,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1121,Percent of total billed charges,,1121,1156.4,
HC PR 46255 Remove Internal/External Hemorroid Single Group,PX-97510788,CDM,46255,CPT,975,RC,,inpatient,,,1282,1153.8,,0.95,,1217.9,Percent of total billed charges,,,0.98,,1256.36,Percent of total billed charges,,,0.95,,1217.9,Percent of total billed charges,,,0.97,,1243.54,Percent of total billed charges,,,0.97,,1243.54,Percent of total billed charges,,,0.96,,1230.72,Percent of total billed charges,,,0.95,,1217.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1217.9,Percent of total billed charges,,1217.9,1256.36,
HC PR 46255 Remove Internal/External Hemorroid Single Group,PX-97510788,CDM,46255,CPT,975,RC,,outpatient,,,1282,1153.8,,0.95,,1217.9,Percent of total billed charges,,,0.98,,1256.36,Percent of total billed charges,,,0.95,,1217.9,Percent of total billed charges,,,0.95,,1217.9,Percent of total billed charges,,,0.97,,1243.54,Percent of total billed charges,,,0.96,,1230.72,Percent of total billed charges,,,0.95,,1217.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1217.9,Percent of total billed charges,,1217.9,1256.36,
HC PR 46260 Remove Internal/External Hemorroid Groups 2+,PX-97510791,CDM,46260,CPT,975,RC,,inpatient,,,1192,1072.8,,0.95,,1132.4,Percent of total billed charges,,,0.98,,1168.16,Percent of total billed charges,,,0.95,,1132.4,Percent of total billed charges,,,0.97,,1156.24,Percent of total billed charges,,,0.97,,1156.24,Percent of total billed charges,,,0.96,,1144.32,Percent of total billed charges,,,0.95,,1132.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1132.4,Percent of total billed charges,,1132.4,1168.16,
HC PR 46260 Remove Internal/External Hemorroid Groups 2+,PX-97510791,CDM,46260,CPT,975,RC,,outpatient,,,1192,1072.8,,0.95,,1132.4,Percent of total billed charges,,,0.98,,1168.16,Percent of total billed charges,,,0.95,,1132.4,Percent of total billed charges,,,0.95,,1132.4,Percent of total billed charges,,,0.97,,1156.24,Percent of total billed charges,,,0.96,,1144.32,Percent of total billed charges,,,0.95,,1132.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1132.4,Percent of total billed charges,,1132.4,1168.16,
HC PR ED 46320 Removal of Hemorrhoid Clot Cdm,PX-98110386,CDM,46320,CPT,981,RC,,inpatient,,,528,475.2,,0.95,,501.6,Percent of total billed charges,,,0.98,,517.44,Percent of total billed charges,,,0.95,,501.6,Percent of total billed charges,,,0.97,,512.16,Percent of total billed charges,,,0.97,,512.16,Percent of total billed charges,,,0.96,,506.88,Percent of total billed charges,,,0.95,,501.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,501.6,Percent of total billed charges,,501.6,517.44,
HC PR ED 46320 Removal of Hemorrhoid Clot Cdm,PX-98110386,CDM,46320,CPT,981,RC,,outpatient,,,528,475.2,,0.95,,501.6,Percent of total billed charges,,,0.98,,517.44,Percent of total billed charges,,,0.95,,501.6,Percent of total billed charges,,,0.95,,501.6,Percent of total billed charges,,,0.97,,512.16,Percent of total billed charges,,,0.96,,506.88,Percent of total billed charges,,,0.95,,501.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,501.6,Percent of total billed charges,,501.6,517.44,
HC PR ED 46600 Diagnostic Anoscopy Cdm,PX-98110387,CDM,46600,CPT,981,RC,,inpatient,,,290,261,,0.95,,275.5,Percent of total billed charges,,,0.98,,284.2,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.96,,278.4,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,275.5,Percent of total billed charges,,275.5,284.2,
HC PR ED 46600 Diagnostic Anoscopy Cdm,PX-98110387,CDM,46600,CPT,981,RC,,outpatient,,,290,261,,0.95,,275.5,Percent of total billed charges,,,0.98,,284.2,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.96,,278.4,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,275.5,Percent of total billed charges,,275.5,284.2,
HC PR 46922 Excision of Anal Lesion(S),PX-97510803,CDM,46922,CPT,975,RC,,inpatient,,,773,695.7,,0.95,,734.35,Percent of total billed charges,,,0.98,,757.54,Percent of total billed charges,,,0.95,,734.35,Percent of total billed charges,,,0.97,,749.81,Percent of total billed charges,,,0.97,,749.81,Percent of total billed charges,,,0.96,,742.08,Percent of total billed charges,,,0.95,,734.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,734.35,Percent of total billed charges,,734.35,757.54,
HC PR 46922 Excision of Anal Lesion(S),PX-97510803,CDM,46922,CPT,975,RC,,outpatient,,,773,695.7,,0.95,,734.35,Percent of total billed charges,,,0.98,,757.54,Percent of total billed charges,,,0.95,,734.35,Percent of total billed charges,,,0.95,,734.35,Percent of total billed charges,,,0.97,,749.81,Percent of total billed charges,,,0.96,,742.08,Percent of total billed charges,,,0.95,,734.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,734.35,Percent of total billed charges,,734.35,757.54,
HC PR 47562 Laparoscopic Cholecystectomy,PX-97510818,CDM,47562,CPT,975,RC,,inpatient,,,1626,1463.4,,0.95,,1544.7,Percent of total billed charges,,,0.98,,1593.48,Percent of total billed charges,,,0.95,,1544.7,Percent of total billed charges,,,0.97,,1577.22,Percent of total billed charges,,,0.97,,1577.22,Percent of total billed charges,,,0.96,,1560.96,Percent of total billed charges,,,0.95,,1544.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1544.7,Percent of total billed charges,,1544.7,1593.48,
HC PR 47562 Laparoscopic Cholecystectomy,PX-97510818,CDM,47562,CPT,975,RC,,outpatient,,,1626,1463.4,,0.95,,1544.7,Percent of total billed charges,,,0.98,,1593.48,Percent of total billed charges,,,0.95,,1544.7,Percent of total billed charges,,,0.95,,1544.7,Percent of total billed charges,,,0.97,,1577.22,Percent of total billed charges,,,0.96,,1560.96,Percent of total billed charges,,,0.95,,1544.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1544.7,Percent of total billed charges,,1544.7,1593.48,
HC PR 47563 Laparoscopy Cholecystectomy/Graph,PX-97510819,CDM,47563,CPT,975,RC,,inpatient,,,2038,1834.2,,0.95,,1936.1,Percent of total billed charges,,,0.98,,1997.24,Percent of total billed charges,,,0.95,,1936.1,Percent of total billed charges,,,0.97,,1976.86,Percent of total billed charges,,,0.97,,1976.86,Percent of total billed charges,,,0.96,,1956.48,Percent of total billed charges,,,0.95,,1936.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1936.1,Percent of total billed charges,,1936.1,1997.24,
HC PR 47563 Laparoscopy Cholecystectomy/Graph,PX-97510819,CDM,47563,CPT,975,RC,,outpatient,,,2038,1834.2,,0.95,,1936.1,Percent of total billed charges,,,0.98,,1997.24,Percent of total billed charges,,,0.95,,1936.1,Percent of total billed charges,,,0.95,,1936.1,Percent of total billed charges,,,0.97,,1976.86,Percent of total billed charges,,,0.96,,1956.48,Percent of total billed charges,,,0.95,,1936.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1936.1,Percent of total billed charges,,1936.1,1997.24,
HC PR 47600 Cholecystectomy,PX-97510822,CDM,47600,CPT,975,RC,,inpatient,,,2658,2392.2,,0.95,,2525.1,Percent of total billed charges,,,0.98,,2604.84,Percent of total billed charges,,,0.95,,2525.1,Percent of total billed charges,,,0.97,,2578.26,Percent of total billed charges,,,0.97,,2578.26,Percent of total billed charges,,,0.96,,2551.68,Percent of total billed charges,,,0.95,,2525.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2525.1,Percent of total billed charges,,2525.1,2604.84,
HC PR 47600 Cholecystectomy,PX-97510822,CDM,47600,CPT,975,RC,,outpatient,,,2658,2392.2,,0.95,,2525.1,Percent of total billed charges,,,0.98,,2604.84,Percent of total billed charges,,,0.95,,2525.1,Percent of total billed charges,,,0.95,,2525.1,Percent of total billed charges,,,0.97,,2578.26,Percent of total billed charges,,,0.96,,2551.68,Percent of total billed charges,,,0.95,,2525.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2525.1,Percent of total billed charges,,2525.1,2604.84,
HC PR 49000 Exploration of Abdomen,PX-97510843,CDM,49000,CPT,975,RC,,inpatient,,,1891,1701.9,,0.95,,1796.45,Percent of total billed charges,,,0.98,,1853.18,Percent of total billed charges,,,0.95,,1796.45,Percent of total billed charges,,,0.97,,1834.27,Percent of total billed charges,,,0.97,,1834.27,Percent of total billed charges,,,0.96,,1815.36,Percent of total billed charges,,,0.95,,1796.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1796.45,Percent of total billed charges,,1796.45,1853.18,
HC PR 49000 Exploration of Abdomen,PX-97510843,CDM,49000,CPT,975,RC,,outpatient,,,1891,1701.9,,0.95,,1796.45,Percent of total billed charges,,,0.98,,1853.18,Percent of total billed charges,,,0.95,,1796.45,Percent of total billed charges,,,0.95,,1796.45,Percent of total billed charges,,,0.97,,1834.27,Percent of total billed charges,,,0.96,,1815.36,Percent of total billed charges,,,0.95,,1796.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1796.45,Percent of total billed charges,,1796.45,1853.18,
HC PR 49320 Diagnostic Laparoscopy Separate Proc,PX-97510856,CDM,49320,CPT,975,RC,,inpatient,,,814,732.6,,0.95,,773.3,Percent of total billed charges,,,0.98,,797.72,Percent of total billed charges,,,0.95,,773.3,Percent of total billed charges,,,0.97,,789.58,Percent of total billed charges,,,0.97,,789.58,Percent of total billed charges,,,0.96,,781.44,Percent of total billed charges,,,0.95,,773.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,773.3,Percent of total billed charges,,773.3,797.72,
HC PR 49320 Diagnostic Laparoscopy Separate Proc,PX-97510856,CDM,49320,CPT,975,RC,,outpatient,,,814,732.6,,0.95,,773.3,Percent of total billed charges,,,0.98,,797.72,Percent of total billed charges,,,0.95,,773.3,Percent of total billed charges,,,0.95,,773.3,Percent of total billed charges,,,0.97,,789.58,Percent of total billed charges,,,0.96,,781.44,Percent of total billed charges,,,0.95,,773.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,773.3,Percent of total billed charges,,773.3,797.72,
HC PR 49322 Laparoscopy Aspiration,PX-97510859,CDM,49322,CPT,975,RC,,inpatient,,,926,833.4,,0.95,,879.7,Percent of total billed charges,,,0.98,,907.48,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,0.97,,898.22,Percent of total billed charges,,,0.97,,898.22,Percent of total billed charges,,,0.96,,888.96,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,879.7,Percent of total billed charges,,879.7,907.48,
HC PR 49322 Laparoscopy Aspiration,PX-97510859,CDM,49322,CPT,975,RC,,outpatient,,,926,833.4,,0.95,,879.7,Percent of total billed charges,,,0.98,,907.48,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,0.97,,898.22,Percent of total billed charges,,,0.96,,888.96,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,879.7,Percent of total billed charges,,879.7,907.48,
HC PR 49422 Remove Tunneled Intraperitoneal Cath,PX-97510864,CDM,49422,CPT,975,RC,,inpatient,,,949,854.1,,0.95,,901.55,Percent of total billed charges,,,0.98,,930.02,Percent of total billed charges,,,0.95,,901.55,Percent of total billed charges,,,0.97,,920.53,Percent of total billed charges,,,0.97,,920.53,Percent of total billed charges,,,0.96,,911.04,Percent of total billed charges,,,0.95,,901.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,901.55,Percent of total billed charges,,901.55,930.02,
HC PR 49422 Remove Tunneled Intraperitoneal Cath,PX-97510864,CDM,49422,CPT,975,RC,,outpatient,,,949,854.1,,0.95,,901.55,Percent of total billed charges,,,0.98,,930.02,Percent of total billed charges,,,0.95,,901.55,Percent of total billed charges,,,0.95,,901.55,Percent of total billed charges,,,0.97,,920.53,Percent of total billed charges,,,0.96,,911.04,Percent of total billed charges,,,0.95,,901.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,901.55,Percent of total billed charges,,901.55,930.02,
"Repair initial inguinal hernia, age 5 years or older; reducible",PX-97510130,CDM,49505,CPT,975,RC,,inpatient,,,1296,1166.4,,0.95,,1231.2,Percent of total billed charges,,,0.98,,1270.08,Percent of total billed charges,,,0.95,,1231.2,Percent of total billed charges,,,0.97,,1257.12,Percent of total billed charges,,,0.97,,1257.12,Percent of total billed charges,,,0.96,,1244.16,Percent of total billed charges,,,0.95,,1231.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1231.2,Percent of total billed charges,,1231.2,1270.08,
"Repair initial inguinal hernia, age 5 years or older; reducible",PX-97510130,CDM,49505,CPT,975,RC,,outpatient,,,1296,1166.4,,0.95,,1231.2,Percent of total billed charges,,,0.98,,1270.08,Percent of total billed charges,,,0.95,,1231.2,Percent of total billed charges,,,0.95,,1231.2,Percent of total billed charges,,,0.97,,1257.12,Percent of total billed charges,,,0.96,,1244.16,Percent of total billed charges,,,0.95,,1231.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1231.2,Percent of total billed charges,,1231.2,1270.08,
HC PR 49507 Repair Inguinal Hernia Initial Block >5 Yr,PX-97510870,CDM,49507,CPT,975,RC,,inpatient,,,1455,1309.5,,0.95,,1382.25,Percent of total billed charges,,,0.98,,1425.9,Percent of total billed charges,,,0.95,,1382.25,Percent of total billed charges,,,0.97,,1411.35,Percent of total billed charges,,,0.97,,1411.35,Percent of total billed charges,,,0.96,,1396.8,Percent of total billed charges,,,0.95,,1382.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1382.25,Percent of total billed charges,,1382.25,1425.9,
HC PR 49507 Repair Inguinal Hernia Initial Block >5 Yr,PX-97510870,CDM,49507,CPT,975,RC,,outpatient,,,1455,1309.5,,0.95,,1382.25,Percent of total billed charges,,,0.98,,1425.9,Percent of total billed charges,,,0.95,,1382.25,Percent of total billed charges,,,0.95,,1382.25,Percent of total billed charges,,,0.97,,1411.35,Percent of total billed charges,,,0.96,,1396.8,Percent of total billed charges,,,0.95,,1382.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1382.25,Percent of total billed charges,,1382.25,1425.9,
HC PR 49520 Rerepair Inguinal Hernia Reduce,PX-96910221,CDM,49520,CPT,983,RC,,inpatient,,,1571,1413.9,,0.95,,1492.45,Percent of total billed charges,,,0.98,,1539.58,Percent of total billed charges,,,0.95,,1492.45,Percent of total billed charges,,,0.97,,1523.87,Percent of total billed charges,,,0.97,,1523.87,Percent of total billed charges,,,0.96,,1508.16,Percent of total billed charges,,,0.95,,1492.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1492.45,Percent of total billed charges,,1492.45,1539.58,
HC PR 49520 Rerepair Inguinal Hernia Reduce,PX-96910221,CDM,49520,CPT,983,RC,,outpatient,,,1571,1413.9,,0.95,,1492.45,Percent of total billed charges,,,0.98,,1539.58,Percent of total billed charges,,,0.95,,1492.45,Percent of total billed charges,,,0.95,,1492.45,Percent of total billed charges,,,0.97,,1523.87,Percent of total billed charges,,,0.96,,1508.16,Percent of total billed charges,,,0.95,,1492.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1492.45,Percent of total billed charges,,1492.45,1539.58,
HC PR 49553 Repair Femoral Hernia Initial Blocked,PX-97510872,CDM,49553,CPT,975,RC,,inpatient,,,1564,1407.6,,0.95,,1485.8,Percent of total billed charges,,,0.98,,1532.72,Percent of total billed charges,,,0.95,,1485.8,Percent of total billed charges,,,0.97,,1517.08,Percent of total billed charges,,,0.97,,1517.08,Percent of total billed charges,,,0.96,,1501.44,Percent of total billed charges,,,0.95,,1485.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1485.8,Percent of total billed charges,,1485.8,1532.72,
HC PR 49553 Repair Femoral Hernia Initial Blocked,PX-97510872,CDM,49553,CPT,975,RC,,outpatient,,,1564,1407.6,,0.95,,1485.8,Percent of total billed charges,,,0.98,,1532.72,Percent of total billed charges,,,0.95,,1485.8,Percent of total billed charges,,,0.95,,1485.8,Percent of total billed charges,,,0.97,,1517.08,Percent of total billed charges,,,0.96,,1501.44,Percent of total billed charges,,,0.95,,1485.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1485.8,Percent of total billed charges,,1485.8,1532.72,
"HC PR 49650 Laparoscopy Inguinal Hernia Repair, Initial",PX-97510880,CDM,49650,CPT,975,RC,,inpatient,,,1633,1469.7,,0.95,,1551.35,Percent of total billed charges,,,0.98,,1600.34,Percent of total billed charges,,,0.95,,1551.35,Percent of total billed charges,,,0.97,,1584.01,Percent of total billed charges,,,0.97,,1584.01,Percent of total billed charges,,,0.96,,1567.68,Percent of total billed charges,,,0.95,,1551.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1551.35,Percent of total billed charges,,1551.35,1600.34,
"HC PR 49650 Laparoscopy Inguinal Hernia Repair, Initial",PX-97510880,CDM,49650,CPT,975,RC,,outpatient,,,1633,1469.7,,0.95,,1551.35,Percent of total billed charges,,,0.98,,1600.34,Percent of total billed charges,,,0.95,,1551.35,Percent of total billed charges,,,0.95,,1551.35,Percent of total billed charges,,,0.97,,1584.01,Percent of total billed charges,,,0.96,,1567.68,Percent of total billed charges,,,0.95,,1551.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1551.35,Percent of total billed charges,,1551.35,1600.34,
"HC PR 49651 Laparoscopy Inguinal Hernia Repair, Recurrent",PX-97510881,CDM,49651,CPT,975,RC,,inpatient,,,1463,1316.7,,0.95,,1389.85,Percent of total billed charges,,,0.98,,1433.74,Percent of total billed charges,,,0.95,,1389.85,Percent of total billed charges,,,0.97,,1419.11,Percent of total billed charges,,,0.97,,1419.11,Percent of total billed charges,,,0.96,,1404.48,Percent of total billed charges,,,0.95,,1389.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1389.85,Percent of total billed charges,,1389.85,1433.74,
"HC PR 49651 Laparoscopy Inguinal Hernia Repair, Recurrent",PX-97510881,CDM,49651,CPT,975,RC,,outpatient,,,1463,1316.7,,0.95,,1389.85,Percent of total billed charges,,,0.98,,1433.74,Percent of total billed charges,,,0.95,,1389.85,Percent of total billed charges,,,0.95,,1389.85,Percent of total billed charges,,,0.97,,1419.11,Percent of total billed charges,,,0.96,,1404.48,Percent of total billed charges,,,0.95,,1389.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1389.85,Percent of total billed charges,,1389.85,1433.74,
HC PR 49999 Abdomen Surgery Procedure,PX-97510890,CDM,49999,CPT,975,RC,,inpatient,,,2680,2412,,0.95,,2546,Percent of total billed charges,,,0.98,,2626.4,Percent of total billed charges,,,0.95,,2546,Percent of total billed charges,,,0.97,,2599.6,Percent of total billed charges,,,0.97,,2599.6,Percent of total billed charges,,,0.96,,2572.8,Percent of total billed charges,,,0.95,,2546,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2546,Percent of total billed charges,,2546,2626.4,
HC PR 49999 Abdomen Surgery Procedure,PX-97510890,CDM,49999,CPT,975,RC,,outpatient,,,2680,2412,,0.95,,2546,Percent of total billed charges,,,0.98,,2626.4,Percent of total billed charges,,,0.95,,2546,Percent of total billed charges,,,0.95,,2546,Percent of total billed charges,,,0.97,,2599.6,Percent of total billed charges,,,0.96,,2572.8,Percent of total billed charges,,,0.95,,2546,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2546,Percent of total billed charges,,2546,2626.4,
HC PR 20553 Injection Single/Mlt Trigger Point 3/> Muscles Rhc,PX-52110834,CDM,20553,HCPCS,521,RC,,inpatient,,,149,134.1,,0.95,,141.55,Percent of total billed charges,,,0.98,,146.02,Percent of total billed charges,,,0.95,,141.55,Percent of total billed charges,,,0.97,,144.53,Percent of total billed charges,,,0.97,,144.53,Percent of total billed charges,,,0.96,,143.04,Percent of total billed charges,,,0.95,,141.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,141.55,Percent of total billed charges,,141.55,146.02,
HC PR 20553 Injection Single/Mlt Trigger Point 3/> Muscles Rhc,PX-52110834,CDM,20553,HCPCS,521,RC,,outpatient,,,149,134.1,,0.95,,141.55,Percent of total billed charges,,,0.98,,146.02,Percent of total billed charges,,,0.95,,141.55,Percent of total billed charges,,,0.95,,141.55,Percent of total billed charges,,,0.97,,144.53,Percent of total billed charges,,,0.96,,143.04,Percent of total billed charges,,,0.95,,141.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,141.55,Percent of total billed charges,,141.55,146.02,
HC PR 24640 Cltx Rdl Head Sublxtj Chld Nursemaid Elbw W/Manj Rhc,PX-52110839,CDM,24640,HCPCS,521,RC,,inpatient,,,259,233.1,,0.95,,246.05,Percent of total billed charges,,,0.98,,253.82,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,0.97,,251.23,Percent of total billed charges,,,0.97,,251.23,Percent of total billed charges,,,0.96,,248.64,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,246.05,Percent of total billed charges,,246.05,253.82,
HC PR 24640 Cltx Rdl Head Sublxtj Chld Nursemaid Elbw W/Manj Rhc,PX-52110839,CDM,24640,HCPCS,521,RC,,outpatient,,,259,233.1,,0.95,,246.05,Percent of total billed charges,,,0.98,,253.82,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,0.97,,251.23,Percent of total billed charges,,,0.96,,248.64,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,246.05,Percent of total billed charges,,246.05,253.82,
HC PR ED 51702 Insert Temp Bladder Catheter Cdm,PX-98110396,CDM,51702,CPT,981,RC,,inpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
HC PR ED 51702 Insert Temp Bladder Catheter Cdm,PX-98110396,CDM,51702,CPT,981,RC,,outpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
HC PR 51705 Change Cystostomy Tube Simple,PX-96910238,CDM,51705,CPT,983,RC,,inpatient,,,290,261,,0.95,,275.5,Percent of total billed charges,,,0.98,,284.2,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.96,,278.4,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,275.5,Percent of total billed charges,,275.5,284.2,
HC PR 51705 Change Cystostomy Tube Simple,PX-96910238,CDM,51705,CPT,983,RC,,outpatient,,,290,261,,0.95,,275.5,Percent of total billed charges,,,0.98,,284.2,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.96,,278.4,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,275.5,Percent of total billed charges,,275.5,284.2,
HC PR 28080 Excision Interdigital Morton Neuroma Single Each Rhc,PX-52110855,CDM,28080,HCPCS,521,RC,,inpatient,,,1307,1176.3,,0.95,,1241.65,Percent of total billed charges,,,0.98,,1280.86,Percent of total billed charges,,,0.95,,1241.65,Percent of total billed charges,,,0.97,,1267.79,Percent of total billed charges,,,0.97,,1267.79,Percent of total billed charges,,,0.96,,1254.72,Percent of total billed charges,,,0.95,,1241.65,Percent of total billed charges,,,,,,,,,0.95,,1241.65,Percent of total billed charges,,1241.65,1280.86,
HC PR 28080 Excision Interdigital Morton Neuroma Single Each Rhc,PX-52110855,CDM,28080,HCPCS,521,RC,,outpatient,,,1307,1176.3,,0.95,,1241.65,Percent of total billed charges,,,0.98,,1280.86,Percent of total billed charges,,,0.95,,1241.65,Percent of total billed charges,,,0.95,,1241.65,Percent of total billed charges,,,0.97,,1267.79,Percent of total billed charges,,,0.96,,1254.72,Percent of total billed charges,,,0.95,,1241.65,Percent of total billed charges,,,,,,,,,0.95,,1241.65,Percent of total billed charges,,1241.65,1280.86,
HC PR 28232 Tx Open Tendon Flexor Toe 1 Tendon Spx Rhc,PX-52110857,CDM,28232,HCPCS,521,RC,,inpatient,,,924,831.6,,0.95,,877.8,Percent of total billed charges,,,0.98,,905.52,Percent of total billed charges,,,0.95,,877.8,Percent of total billed charges,,,0.97,,896.28,Percent of total billed charges,,,0.97,,896.28,Percent of total billed charges,,,0.96,,887.04,Percent of total billed charges,,,0.95,,877.8,Percent of total billed charges,,,,,,,,,0.95,,877.8,Percent of total billed charges,,877.8,905.52,
HC PR 28232 Tx Open Tendon Flexor Toe 1 Tendon Spx Rhc,PX-52110857,CDM,28232,HCPCS,521,RC,,outpatient,,,924,831.6,,0.95,,877.8,Percent of total billed charges,,,0.98,,905.52,Percent of total billed charges,,,0.95,,877.8,Percent of total billed charges,,,0.95,,877.8,Percent of total billed charges,,,0.97,,896.28,Percent of total billed charges,,,0.96,,887.04,Percent of total billed charges,,,0.95,,877.8,Percent of total billed charges,,,,,,,,,0.95,,877.8,Percent of total billed charges,,877.8,905.52,
"HC PR 53620 Dilate Urethra Stricture W/ Filiform Male, Initial",PX-96910292,CDM,53620,CPT,983,RC,,inpatient,,,458,412.2,,0.95,,435.1,Percent of total billed charges,,,0.98,,448.84,Percent of total billed charges,,,0.95,,435.1,Percent of total billed charges,,,0.97,,444.26,Percent of total billed charges,,,0.97,,444.26,Percent of total billed charges,,,0.96,,439.68,Percent of total billed charges,,,0.95,,435.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,435.1,Percent of total billed charges,,435.1,448.84,
"HC PR 53620 Dilate Urethra Stricture W/ Filiform Male, Initial",PX-96910292,CDM,53620,CPT,983,RC,,outpatient,,,458,412.2,,0.95,,435.1,Percent of total billed charges,,,0.98,,448.84,Percent of total billed charges,,,0.95,,435.1,Percent of total billed charges,,,0.95,,435.1,Percent of total billed charges,,,0.97,,444.26,Percent of total billed charges,,,0.96,,439.68,Percent of total billed charges,,,0.95,,435.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,435.1,Percent of total billed charges,,435.1,448.84,
HC PR 54100 Biopsy of Penis,PX-98310177,CDM,54100,CPT,983,RC,,inpatient,,,500,450,,0.95,,475,Percent of total billed charges,,,0.98,,490,Percent of total billed charges,,,0.95,,475,Percent of total billed charges,,,0.97,,485,Percent of total billed charges,,,0.97,,485,Percent of total billed charges,,,0.96,,480,Percent of total billed charges,,,0.95,,475,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,475,Percent of total billed charges,,475,490,
HC PR 54100 Biopsy of Penis,PX-98310177,CDM,54100,CPT,983,RC,,outpatient,,,500,450,,0.95,,475,Percent of total billed charges,,,0.98,,490,Percent of total billed charges,,,0.95,,475,Percent of total billed charges,,,0.95,,475,Percent of total billed charges,,,0.97,,485,Percent of total billed charges,,,0.96,,480,Percent of total billed charges,,,0.95,,475,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,475,Percent of total billed charges,,475,490,
HC PR 54150 Circumcision W/Regional Block,PX-96910802,CDM,54150,CPT,983,RC,,inpatient,,,414,372.6,,0.95,,393.3,Percent of total billed charges,,,0.98,,405.72,Percent of total billed charges,,,0.95,,393.3,Percent of total billed charges,,,0.97,,401.58,Percent of total billed charges,,,0.97,,401.58,Percent of total billed charges,,,0.96,,397.44,Percent of total billed charges,,,0.95,,393.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,393.3,Percent of total billed charges,,393.3,405.72,
HC PR 54150 Circumcision W/Regional Block,PX-96910802,CDM,54150,CPT,983,RC,,outpatient,,,414,372.6,,0.95,,393.3,Percent of total billed charges,,,0.98,,405.72,Percent of total billed charges,,,0.95,,393.3,Percent of total billed charges,,,0.95,,393.3,Percent of total billed charges,,,0.97,,401.58,Percent of total billed charges,,,0.96,,397.44,Percent of total billed charges,,,0.95,,393.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,393.3,Percent of total billed charges,,393.3,405.72,
HC PR 54700 Drainage of Scrotum,PX-96910823,CDM,54700,CPT,983,RC,,inpatient,,,525,472.5,,0.95,,498.75,Percent of total billed charges,,,0.98,,514.5,Percent of total billed charges,,,0.95,,498.75,Percent of total billed charges,,,0.97,,509.25,Percent of total billed charges,,,0.97,,509.25,Percent of total billed charges,,,0.96,,504,Percent of total billed charges,,,0.95,,498.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,498.75,Percent of total billed charges,,498.75,514.5,
HC PR 54700 Drainage of Scrotum,PX-96910823,CDM,54700,CPT,983,RC,,outpatient,,,525,472.5,,0.95,,498.75,Percent of total billed charges,,,0.98,,514.5,Percent of total billed charges,,,0.95,,498.75,Percent of total billed charges,,,0.95,,498.75,Percent of total billed charges,,,0.97,,509.25,Percent of total billed charges,,,0.96,,504,Percent of total billed charges,,,0.95,,498.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,498.75,Percent of total billed charges,,498.75,514.5,
HC PR 55040 Removal of Hydrocele,PX-97511033,CDM,55040,CPT,975,RC,,inpatient,,,836,752.4,,0.95,,794.2,Percent of total billed charges,,,0.98,,819.28,Percent of total billed charges,,,0.95,,794.2,Percent of total billed charges,,,0.97,,810.92,Percent of total billed charges,,,0.97,,810.92,Percent of total billed charges,,,0.96,,802.56,Percent of total billed charges,,,0.95,,794.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,794.2,Percent of total billed charges,,794.2,819.28,
HC PR 55040 Removal of Hydrocele,PX-97511033,CDM,55040,CPT,975,RC,,outpatient,,,836,752.4,,0.95,,794.2,Percent of total billed charges,,,0.98,,819.28,Percent of total billed charges,,,0.95,,794.2,Percent of total billed charges,,,0.95,,794.2,Percent of total billed charges,,,0.97,,810.92,Percent of total billed charges,,,0.96,,802.56,Percent of total billed charges,,,0.95,,794.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,794.2,Percent of total billed charges,,794.2,819.28,
HC PR 55250 Removal of Sperm Duct(S),PX-97511034,CDM,55250,CPT,975,RC,,inpatient,,,1023,920.7,,0.95,,971.85,Percent of total billed charges,,,0.98,,1002.54,Percent of total billed charges,,,0.95,,971.85,Percent of total billed charges,,,0.97,,992.31,Percent of total billed charges,,,0.97,,992.31,Percent of total billed charges,,,0.96,,982.08,Percent of total billed charges,,,0.95,,971.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,971.85,Percent of total billed charges,,971.85,1002.54,
HC PR 55250 Removal of Sperm Duct(S),PX-97511034,CDM,55250,CPT,975,RC,,outpatient,,,1023,920.7,,0.95,,971.85,Percent of total billed charges,,,0.98,,1002.54,Percent of total billed charges,,,0.95,,971.85,Percent of total billed charges,,,0.95,,971.85,Percent of total billed charges,,,0.97,,992.31,Percent of total billed charges,,,0.96,,982.08,Percent of total billed charges,,,0.95,,971.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,971.85,Percent of total billed charges,,971.85,1002.54,
"HC PR 1123f Adv Care Plan Discussed, Plan or Surrogate Documented Rhc",PX-52110918,CDM,1123F,HCPCS,521,RC,,inpatient,,,147,132.3,,0.95,,139.65,Percent of total billed charges,,,0.98,,144.06,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,0.97,,142.59,Percent of total billed charges,,,0.97,,142.59,Percent of total billed charges,,,0.96,,141.12,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,139.65,Percent of total billed charges,,139.65,144.06,
"HC PR 1123f Adv Care Plan Discussed, Plan or Surrogate Documented Rhc",PX-52110918,CDM,1123F,HCPCS,521,RC,,outpatient,,,147,132.3,,0.95,,139.65,Percent of total billed charges,,,0.98,,144.06,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,0.97,,142.59,Percent of total billed charges,,,0.96,,141.12,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,139.65,Percent of total billed charges,,139.65,144.06,
"HC PR 1124f Adv Care Plan Discussd, Unable/Unwill Doc Plan or Surrogate Rhc",PX-52110919,CDM,1124F,HCPCS,521,RC,,inpatient,,,143,128.7,,0.95,,135.85,Percent of total billed charges,,,0.98,,140.14,Percent of total billed charges,,,0.95,,135.85,Percent of total billed charges,,,0.97,,138.71,Percent of total billed charges,,,0.97,,138.71,Percent of total billed charges,,,0.96,,137.28,Percent of total billed charges,,,0.95,,135.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,135.85,Percent of total billed charges,,135.85,140.14,
"HC PR 1124f Adv Care Plan Discussd, Unable/Unwill Doc Plan or Surrogate Rhc",PX-52110919,CDM,1124F,HCPCS,521,RC,,outpatient,,,143,128.7,,0.95,,135.85,Percent of total billed charges,,,0.98,,140.14,Percent of total billed charges,,,0.95,,135.85,Percent of total billed charges,,,0.95,,135.85,Percent of total billed charges,,,0.97,,138.71,Percent of total billed charges,,,0.96,,137.28,Percent of total billed charges,,,0.95,,135.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,135.85,Percent of total billed charges,,135.85,140.14,
HC PR G0506 Comp Assessment Care Plan Ccm Svc Rhc,PX-52110921,CDM,G0506,HCPCS,521,RC,,inpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
HC PR G0506 Comp Assessment Care Plan Ccm Svc Rhc,PX-52110921,CDM,G0506,HCPCS,521,RC,,outpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
HC PR 56501 Destroy Vulva Lesions Simple,PX-98310059,CDM,56501,CPT,983,RC,,inpatient,,,334,300.6,,0.95,,317.3,Percent of total billed charges,,,0.98,,327.32,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,0.97,,323.98,Percent of total billed charges,,,0.97,,323.98,Percent of total billed charges,,,0.96,,320.64,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,317.3,Percent of total billed charges,,317.3,327.32,
HC PR 56501 Destroy Vulva Lesions Simple,PX-98310059,CDM,56501,CPT,983,RC,,outpatient,,,334,300.6,,0.95,,317.3,Percent of total billed charges,,,0.98,,327.32,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,0.97,,323.98,Percent of total billed charges,,,0.96,,320.64,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,317.3,Percent of total billed charges,,317.3,327.32,
"HC PR 56605 Biopsy of Vulva/Perineum, Single Lesion",PX-97511043,CDM,56605,CPT,975,RC,,inpatient,,,239,215.1,,0.95,,227.05,Percent of total billed charges,,,0.98,,234.22,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,0.97,,231.83,Percent of total billed charges,,,0.97,,231.83,Percent of total billed charges,,,0.96,,229.44,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,227.05,Percent of total billed charges,,227.05,234.22,
"HC PR 56605 Biopsy of Vulva/Perineum, Single Lesion",PX-97511043,CDM,56605,CPT,975,RC,,outpatient,,,239,215.1,,0.95,,227.05,Percent of total billed charges,,,0.98,,234.22,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,0.97,,231.83,Percent of total billed charges,,,0.96,,229.44,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,227.05,Percent of total billed charges,,227.05,234.22,
HC PR 56700 Partial Removal of Hymen,PX-97511044,CDM,56700,CPT,975,RC,,inpatient,,,1237,1113.3,,0.95,,1175.15,Percent of total billed charges,,,0.98,,1212.26,Percent of total billed charges,,,0.95,,1175.15,Percent of total billed charges,,,0.97,,1199.89,Percent of total billed charges,,,0.97,,1199.89,Percent of total billed charges,,,0.96,,1187.52,Percent of total billed charges,,,0.95,,1175.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1175.15,Percent of total billed charges,,1175.15,1212.26,
HC PR 56700 Partial Removal of Hymen,PX-97511044,CDM,56700,CPT,975,RC,,outpatient,,,1237,1113.3,,0.95,,1175.15,Percent of total billed charges,,,0.98,,1212.26,Percent of total billed charges,,,0.95,,1175.15,Percent of total billed charges,,,0.95,,1175.15,Percent of total billed charges,,,0.97,,1199.89,Percent of total billed charges,,,0.96,,1187.52,Percent of total billed charges,,,0.95,,1175.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1175.15,Percent of total billed charges,,1175.15,1212.26,
HC PR 56740 Remove Vagina Gland Lesion,PX-97511045,CDM,56740,CPT,975,RC,,inpatient,,,780,702,,0.95,,741,Percent of total billed charges,,,0.98,,764.4,Percent of total billed charges,,,0.95,,741,Percent of total billed charges,,,0.97,,756.6,Percent of total billed charges,,,0.97,,756.6,Percent of total billed charges,,,0.96,,748.8,Percent of total billed charges,,,0.95,,741,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,741,Percent of total billed charges,,741,764.4,
HC PR 56740 Remove Vagina Gland Lesion,PX-97511045,CDM,56740,CPT,975,RC,,outpatient,,,780,702,,0.95,,741,Percent of total billed charges,,,0.98,,764.4,Percent of total billed charges,,,0.95,,741,Percent of total billed charges,,,0.95,,741,Percent of total billed charges,,,0.97,,756.6,Percent of total billed charges,,,0.96,,748.8,Percent of total billed charges,,,0.95,,741,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,741,Percent of total billed charges,,741,764.4,
HC PR 57160 Insert Pessary/Other Device,PX-96910839,CDM,57160,CPT,983,RC,,inpatient,,,204,183.6,,0.95,,193.8,Percent of total billed charges,,,0.98,,199.92,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.96,,195.84,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,193.8,Percent of total billed charges,,193.8,199.92,
HC PR 57160 Insert Pessary/Other Device,PX-96910839,CDM,57160,CPT,983,RC,,outpatient,,,204,183.6,,0.95,,193.8,Percent of total billed charges,,,0.98,,199.92,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.96,,195.84,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,193.8,Percent of total billed charges,,193.8,199.92,
"HC PR 57200 Repair of Vagina, Suture",PX-96910841,CDM,57200,CPT,983,RC,,inpatient,,,1128,1015.2,,0.95,,1071.6,Percent of total billed charges,,,0.98,,1105.44,Percent of total billed charges,,,0.95,,1071.6,Percent of total billed charges,,,0.97,,1094.16,Percent of total billed charges,,,0.97,,1094.16,Percent of total billed charges,,,0.96,,1082.88,Percent of total billed charges,,,0.95,,1071.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1071.6,Percent of total billed charges,,1071.6,1105.44,
"HC PR 57200 Repair of Vagina, Suture",PX-96910841,CDM,57200,CPT,983,RC,,outpatient,,,1128,1015.2,,0.95,,1071.6,Percent of total billed charges,,,0.98,,1105.44,Percent of total billed charges,,,0.95,,1071.6,Percent of total billed charges,,,0.95,,1071.6,Percent of total billed charges,,,0.97,,1094.16,Percent of total billed charges,,,0.96,,1082.88,Percent of total billed charges,,,0.95,,1071.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1071.6,Percent of total billed charges,,1071.6,1105.44,
HC PR 57452 Exam of Cervix W/Scope,PX-97511071,CDM,57452,CPT,975,RC,,inpatient,,,314,282.6,,0.95,,298.3,Percent of total billed charges,,,0.98,,307.72,Percent of total billed charges,,,0.95,,298.3,Percent of total billed charges,,,0.97,,304.58,Percent of total billed charges,,,0.97,,304.58,Percent of total billed charges,,,0.96,,301.44,Percent of total billed charges,,,0.95,,298.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,298.3,Percent of total billed charges,,298.3,307.72,
HC PR 57452 Exam of Cervix W/Scope,PX-97511071,CDM,57452,CPT,975,RC,,outpatient,,,314,282.6,,0.95,,298.3,Percent of total billed charges,,,0.98,,307.72,Percent of total billed charges,,,0.95,,298.3,Percent of total billed charges,,,0.95,,298.3,Percent of total billed charges,,,0.97,,304.58,Percent of total billed charges,,,0.96,,301.44,Percent of total billed charges,,,0.95,,298.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,298.3,Percent of total billed charges,,298.3,307.72,
HC PR 57454 Bx/Curett of Cervix W/Scope,PX-97511072,CDM,57454,CPT,975,RC,,inpatient,,,418,376.2,,0.95,,397.1,Percent of total billed charges,,,0.98,,409.64,Percent of total billed charges,,,0.95,,397.1,Percent of total billed charges,,,0.97,,405.46,Percent of total billed charges,,,0.97,,405.46,Percent of total billed charges,,,0.96,,401.28,Percent of total billed charges,,,0.95,,397.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,397.1,Percent of total billed charges,,397.1,409.64,
HC PR 57454 Bx/Curett of Cervix W/Scope,PX-97511072,CDM,57454,CPT,975,RC,,outpatient,,,418,376.2,,0.95,,397.1,Percent of total billed charges,,,0.98,,409.64,Percent of total billed charges,,,0.95,,397.1,Percent of total billed charges,,,0.95,,397.1,Percent of total billed charges,,,0.97,,405.46,Percent of total billed charges,,,0.96,,401.28,Percent of total billed charges,,,0.95,,397.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,397.1,Percent of total billed charges,,397.1,409.64,
HC PR 58100 Biopsy of Uterus Lining,PX-96910848,CDM,58100,CPT,983,RC,,inpatient,,,291,261.9,,0.95,,276.45,Percent of total billed charges,,,0.98,,285.18,Percent of total billed charges,,,0.95,,276.45,Percent of total billed charges,,,0.97,,282.27,Percent of total billed charges,,,0.97,,282.27,Percent of total billed charges,,,0.96,,279.36,Percent of total billed charges,,,0.95,,276.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,276.45,Percent of total billed charges,,276.45,285.18,
HC PR 58100 Biopsy of Uterus Lining,PX-96910848,CDM,58100,CPT,983,RC,,outpatient,,,291,261.9,,0.95,,276.45,Percent of total billed charges,,,0.98,,285.18,Percent of total billed charges,,,0.95,,276.45,Percent of total billed charges,,,0.95,,276.45,Percent of total billed charges,,,0.97,,282.27,Percent of total billed charges,,,0.96,,279.36,Percent of total billed charges,,,0.95,,276.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,276.45,Percent of total billed charges,,276.45,285.18,
HC PR 58120 Dilation and Curettage,PX-97511079,CDM,58120,CPT,975,RC,,inpatient,,,739,665.1,,0.95,,702.05,Percent of total billed charges,,,0.98,,724.22,Percent of total billed charges,,,0.95,,702.05,Percent of total billed charges,,,0.97,,716.83,Percent of total billed charges,,,0.97,,716.83,Percent of total billed charges,,,0.96,,709.44,Percent of total billed charges,,,0.95,,702.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,702.05,Percent of total billed charges,,702.05,724.22,
HC PR 58120 Dilation and Curettage,PX-97511079,CDM,58120,CPT,975,RC,,outpatient,,,739,665.1,,0.95,,702.05,Percent of total billed charges,,,0.98,,724.22,Percent of total billed charges,,,0.95,,702.05,Percent of total billed charges,,,0.95,,702.05,Percent of total billed charges,,,0.97,,716.83,Percent of total billed charges,,,0.96,,709.44,Percent of total billed charges,,,0.95,,702.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,702.05,Percent of total billed charges,,702.05,724.22,
Remove uterus cervix via abdomen w/wo tubes or ovaries,PX-97511083,CDM,58150,CPT,975,RC,,inpatient,,,2507,2256.3,,0.95,,2381.65,Percent of total billed charges,,,0.98,,2456.86,Percent of total billed charges,,,0.95,,2381.65,Percent of total billed charges,,,0.97,,2431.79,Percent of total billed charges,,,0.97,,2431.79,Percent of total billed charges,,,0.96,,2406.72,Percent of total billed charges,,,0.95,,2381.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2381.65,Percent of total billed charges,,2381.65,2456.86,
Remove uterus cervix via abdomen w/wo tubes or ovaries,PX-97511083,CDM,58150,CPT,975,RC,,outpatient,,,2507,2256.3,,0.95,,2381.65,Percent of total billed charges,,,0.98,,2456.86,Percent of total billed charges,,,0.95,,2381.65,Percent of total billed charges,,,0.95,,2381.65,Percent of total billed charges,,,0.97,,2431.79,Percent of total billed charges,,,0.96,,2406.72,Percent of total billed charges,,,0.95,,2381.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2381.65,Percent of total billed charges,,2381.65,2456.86,
HC PR 58180 Partial Hysterectomy,PX-97511086,CDM,58180,CPT,975,RC,,inpatient,,,2371,2133.9,,0.95,,2252.45,Percent of total billed charges,,,0.98,,2323.58,Percent of total billed charges,,,0.95,,2252.45,Percent of total billed charges,,,0.97,,2299.87,Percent of total billed charges,,,0.97,,2299.87,Percent of total billed charges,,,0.96,,2276.16,Percent of total billed charges,,,0.95,,2252.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2252.45,Percent of total billed charges,,2252.45,2323.58,
HC PR 58180 Partial Hysterectomy,PX-97511086,CDM,58180,CPT,975,RC,,outpatient,,,2371,2133.9,,0.95,,2252.45,Percent of total billed charges,,,0.98,,2323.58,Percent of total billed charges,,,0.95,,2252.45,Percent of total billed charges,,,0.95,,2252.45,Percent of total billed charges,,,0.97,,2299.87,Percent of total billed charges,,,0.96,,2276.16,Percent of total billed charges,,,0.95,,2252.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2252.45,Percent of total billed charges,,2252.45,2323.58,
HC PR 58262 Vaginal Hysterectomy Incl Tubes/Ovary(S),PX-97511089,CDM,58262,CPT,975,RC,,inpatient,,,2289,2060.1,,0.95,,2174.55,Percent of total billed charges,,,0.98,,2243.22,Percent of total billed charges,,,0.95,,2174.55,Percent of total billed charges,,,0.97,,2220.33,Percent of total billed charges,,,0.97,,2220.33,Percent of total billed charges,,,0.96,,2197.44,Percent of total billed charges,,,0.95,,2174.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2174.55,Percent of total billed charges,,2174.55,2243.22,
HC PR 58262 Vaginal Hysterectomy Incl Tubes/Ovary(S),PX-97511089,CDM,58262,CPT,975,RC,,outpatient,,,2289,2060.1,,0.95,,2174.55,Percent of total billed charges,,,0.98,,2243.22,Percent of total billed charges,,,0.95,,2174.55,Percent of total billed charges,,,0.95,,2174.55,Percent of total billed charges,,,0.97,,2220.33,Percent of total billed charges,,,0.96,,2197.44,Percent of total billed charges,,,0.95,,2174.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2174.55,Percent of total billed charges,,2174.55,2243.22,
HC PR 58291 Vaginal Hysterectomy Incl Tubes/Ovary(S) Complex,PX-96910849,CDM,58291,CPT,983,RC,,inpatient,,,3063,2756.7,,0.95,,2909.85,Percent of total billed charges,,,0.98,,3001.74,Percent of total billed charges,,,0.95,,2909.85,Percent of total billed charges,,,0.97,,2971.11,Percent of total billed charges,,,0.97,,2971.11,Percent of total billed charges,,,0.96,,2940.48,Percent of total billed charges,,,0.95,,2909.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2909.85,Percent of total billed charges,,2909.85,3001.74,
HC PR 58291 Vaginal Hysterectomy Incl Tubes/Ovary(S) Complex,PX-96910849,CDM,58291,CPT,983,RC,,outpatient,,,3063,2756.7,,0.95,,2909.85,Percent of total billed charges,,,0.98,,3001.74,Percent of total billed charges,,,0.95,,2909.85,Percent of total billed charges,,,0.95,,2909.85,Percent of total billed charges,,,0.97,,2971.11,Percent of total billed charges,,,0.96,,2940.48,Percent of total billed charges,,,0.95,,2909.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2909.85,Percent of total billed charges,,2909.85,3001.74,
HC PR 58300 Insert Intrauterine Device,PX-96910850,CDM,58300,CPT,983,RC,,inpatient,,,189,170.1,,0.95,,179.55,Percent of total billed charges,,,0.98,,185.22,Percent of total billed charges,,,0.95,,179.55,Percent of total billed charges,,,0.97,,183.33,Percent of total billed charges,,,0.97,,183.33,Percent of total billed charges,,,0.96,,181.44,Percent of total billed charges,,,0.95,,179.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,179.55,Percent of total billed charges,,179.55,185.22,
HC PR 58300 Insert Intrauterine Device,PX-96910850,CDM,58300,CPT,983,RC,,outpatient,,,189,170.1,,0.95,,179.55,Percent of total billed charges,,,0.98,,185.22,Percent of total billed charges,,,0.95,,179.55,Percent of total billed charges,,,0.95,,179.55,Percent of total billed charges,,,0.97,,183.33,Percent of total billed charges,,,0.96,,181.44,Percent of total billed charges,,,0.95,,179.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,179.55,Percent of total billed charges,,179.55,185.22,
HC PR ED 58301 Remove Intrauterine Device Cdm,PX-98110808,CDM,58301,CPT,981,RC,,inpatient,,,346,311.4,,0.95,,328.7,Percent of total billed charges,,,0.98,,339.08,Percent of total billed charges,,,0.95,,328.7,Percent of total billed charges,,,0.97,,335.62,Percent of total billed charges,,,0.97,,335.62,Percent of total billed charges,,,0.96,,332.16,Percent of total billed charges,,,0.95,,328.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,328.7,Percent of total billed charges,,328.7,339.08,
HC PR ED 58301 Remove Intrauterine Device Cdm,PX-98110808,CDM,58301,CPT,981,RC,,outpatient,,,346,311.4,,0.95,,328.7,Percent of total billed charges,,,0.98,,339.08,Percent of total billed charges,,,0.95,,328.7,Percent of total billed charges,,,0.95,,328.7,Percent of total billed charges,,,0.97,,335.62,Percent of total billed charges,,,0.96,,332.16,Percent of total billed charges,,,0.95,,328.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,328.7,Percent of total billed charges,,328.7,339.08,
HC PR 58322 Artificial Insemination,PX-97511204,CDM,58322,CPT,975,RC,,inpatient,,,226,203.4,,0.95,,214.7,Percent of total billed charges,,,0.98,,221.48,Percent of total billed charges,,,0.95,,214.7,Percent of total billed charges,,,0.97,,219.22,Percent of total billed charges,,,0.97,,219.22,Percent of total billed charges,,,0.96,,216.96,Percent of total billed charges,,,0.95,,214.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,214.7,Percent of total billed charges,,214.7,221.48,
HC PR 58322 Artificial Insemination,PX-97511204,CDM,58322,CPT,975,RC,,outpatient,,,226,203.4,,0.95,,214.7,Percent of total billed charges,,,0.98,,221.48,Percent of total billed charges,,,0.95,,214.7,Percent of total billed charges,,,0.95,,214.7,Percent of total billed charges,,,0.97,,219.22,Percent of total billed charges,,,0.96,,216.96,Percent of total billed charges,,,0.95,,214.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,214.7,Percent of total billed charges,,214.7,221.48,
HC PR 58323 Sperm Washing,PX-97511094,CDM,58323,CPT,975,RC,,inpatient,,,37,33.3,,0.95,,35.15,Percent of total billed charges,,,0.98,,36.26,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.96,,35.52,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,35.15,Percent of total billed charges,,35.15,36.26,
HC PR 58323 Sperm Washing,PX-97511094,CDM,58323,CPT,975,RC,,outpatient,,,37,33.3,,0.95,,35.15,Percent of total billed charges,,,0.98,,36.26,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.96,,35.52,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,35.15,Percent of total billed charges,,35.15,36.26,
HC PR 58550 Laparo-Asst Vaginal Hysterectomy,PX-97511099,CDM,58550,CPT,975,RC,,inpatient,,,2178,1960.2,,0.95,,2069.1,Percent of total billed charges,,,0.98,,2134.44,Percent of total billed charges,,,0.95,,2069.1,Percent of total billed charges,,,0.97,,2112.66,Percent of total billed charges,,,0.97,,2112.66,Percent of total billed charges,,,0.96,,2090.88,Percent of total billed charges,,,0.95,,2069.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2069.1,Percent of total billed charges,,2069.1,2134.44,
HC PR 58550 Laparo-Asst Vaginal Hysterectomy,PX-97511099,CDM,58550,CPT,975,RC,,outpatient,,,2178,1960.2,,0.95,,2069.1,Percent of total billed charges,,,0.98,,2134.44,Percent of total billed charges,,,0.95,,2069.1,Percent of total billed charges,,,0.95,,2069.1,Percent of total billed charges,,,0.97,,2112.66,Percent of total billed charges,,,0.96,,2090.88,Percent of total billed charges,,,0.95,,2069.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2069.1,Percent of total billed charges,,2069.1,2134.44,
HC PR 58553 Laparo-Vaginal Hysterectomy Complex,PX-97511101,CDM,58553,CPT,975,RC,,inpatient,,,2768,2491.2,,0.95,,2629.6,Percent of total billed charges,,,0.98,,2712.64,Percent of total billed charges,,,0.95,,2629.6,Percent of total billed charges,,,0.97,,2684.96,Percent of total billed charges,,,0.97,,2684.96,Percent of total billed charges,,,0.96,,2657.28,Percent of total billed charges,,,0.95,,2629.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2629.6,Percent of total billed charges,,2629.6,2712.64,
HC PR 58553 Laparo-Vaginal Hysterectomy Complex,PX-97511101,CDM,58553,CPT,975,RC,,outpatient,,,2768,2491.2,,0.95,,2629.6,Percent of total billed charges,,,0.98,,2712.64,Percent of total billed charges,,,0.95,,2629.6,Percent of total billed charges,,,0.95,,2629.6,Percent of total billed charges,,,0.97,,2684.96,Percent of total billed charges,,,0.96,,2657.28,Percent of total billed charges,,,0.95,,2629.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2629.6,Percent of total billed charges,,2629.6,2712.64,
HC PR 58600 Division of Fallopian Tube,PX-98310068,CDM,58600,CPT,983,RC,,inpatient,,,920,828,,0.95,,874,Percent of total billed charges,,,0.98,,901.6,Percent of total billed charges,,,0.95,,874,Percent of total billed charges,,,0.97,,892.4,Percent of total billed charges,,,0.97,,892.4,Percent of total billed charges,,,0.96,,883.2,Percent of total billed charges,,,0.95,,874,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,874,Percent of total billed charges,,874,901.6,
HC PR 58600 Division of Fallopian Tube,PX-98310068,CDM,58600,CPT,983,RC,,outpatient,,,920,828,,0.95,,874,Percent of total billed charges,,,0.98,,901.6,Percent of total billed charges,,,0.95,,874,Percent of total billed charges,,,0.95,,874,Percent of total billed charges,,,0.97,,892.4,Percent of total billed charges,,,0.96,,883.2,Percent of total billed charges,,,0.95,,874,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,874,Percent of total billed charges,,874,901.6,
HC PR 58611 Ligate Oviduct(S) Add-On,PX-97511107,CDM,58611,CPT,975,RC,,inpatient,,,209,188.1,,0.95,,198.55,Percent of total billed charges,,,0.98,,204.82,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.96,,200.64,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,198.55,Percent of total billed charges,,198.55,204.82,
HC PR 58611 Ligate Oviduct(S) Add-On,PX-97511107,CDM,58611,CPT,975,RC,,outpatient,,,209,188.1,,0.95,,198.55,Percent of total billed charges,,,0.98,,204.82,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.96,,200.64,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,198.55,Percent of total billed charges,,198.55,204.82,
HC PR 58660 Laparoscopy Lysis,PX-97511109,CDM,58660,CPT,975,RC,,inpatient,,,1691,1521.9,,0.95,,1606.45,Percent of total billed charges,,,0.98,,1657.18,Percent of total billed charges,,,0.95,,1606.45,Percent of total billed charges,,,0.97,,1640.27,Percent of total billed charges,,,0.97,,1640.27,Percent of total billed charges,,,0.96,,1623.36,Percent of total billed charges,,,0.95,,1606.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1606.45,Percent of total billed charges,,1606.45,1657.18,
HC PR 58660 Laparoscopy Lysis,PX-97511109,CDM,58660,CPT,975,RC,,outpatient,,,1691,1521.9,,0.95,,1606.45,Percent of total billed charges,,,0.98,,1657.18,Percent of total billed charges,,,0.95,,1606.45,Percent of total billed charges,,,0.95,,1606.45,Percent of total billed charges,,,0.97,,1640.27,Percent of total billed charges,,,0.96,,1623.36,Percent of total billed charges,,,0.95,,1606.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1606.45,Percent of total billed charges,,1606.45,1657.18,
HC PR 58661 Laparoscopy Remove Adnexa,PX-97511110,CDM,58661,CPT,975,RC,,inpatient,,,1658,1492.2,,0.95,,1575.1,Percent of total billed charges,,,0.98,,1624.84,Percent of total billed charges,,,0.95,,1575.1,Percent of total billed charges,,,0.97,,1608.26,Percent of total billed charges,,,0.97,,1608.26,Percent of total billed charges,,,0.96,,1591.68,Percent of total billed charges,,,0.95,,1575.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1575.1,Percent of total billed charges,,1575.1,1624.84,
HC PR 58661 Laparoscopy Remove Adnexa,PX-97511110,CDM,58661,CPT,975,RC,,outpatient,,,1658,1492.2,,0.95,,1575.1,Percent of total billed charges,,,0.98,,1624.84,Percent of total billed charges,,,0.95,,1575.1,Percent of total billed charges,,,0.95,,1575.1,Percent of total billed charges,,,0.97,,1608.26,Percent of total billed charges,,,0.96,,1591.68,Percent of total billed charges,,,0.95,,1575.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1575.1,Percent of total billed charges,,1575.1,1624.84,
HC PR 58670 Laparoscopy Tubal Cautery,PX-97511112,CDM,58670,CPT,975,RC,,inpatient,,,978,880.2,,0.95,,929.1,Percent of total billed charges,,,0.98,,958.44,Percent of total billed charges,,,0.95,,929.1,Percent of total billed charges,,,0.97,,948.66,Percent of total billed charges,,,0.97,,948.66,Percent of total billed charges,,,0.96,,938.88,Percent of total billed charges,,,0.95,,929.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,929.1,Percent of total billed charges,,929.1,958.44,
HC PR 58670 Laparoscopy Tubal Cautery,PX-97511112,CDM,58670,CPT,975,RC,,outpatient,,,978,880.2,,0.95,,929.1,Percent of total billed charges,,,0.98,,958.44,Percent of total billed charges,,,0.95,,929.1,Percent of total billed charges,,,0.95,,929.1,Percent of total billed charges,,,0.97,,948.66,Percent of total billed charges,,,0.96,,938.88,Percent of total billed charges,,,0.95,,929.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,929.1,Percent of total billed charges,,929.1,958.44,
HC PR 58671 Laparoscopy Tubal Block,PX-97511113,CDM,58671,CPT,975,RC,,inpatient,,,921,828.9,,0.95,,874.95,Percent of total billed charges,,,0.98,,902.58,Percent of total billed charges,,,0.95,,874.95,Percent of total billed charges,,,0.97,,893.37,Percent of total billed charges,,,0.97,,893.37,Percent of total billed charges,,,0.96,,884.16,Percent of total billed charges,,,0.95,,874.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,874.95,Percent of total billed charges,,874.95,902.58,
HC PR 58671 Laparoscopy Tubal Block,PX-97511113,CDM,58671,CPT,975,RC,,outpatient,,,921,828.9,,0.95,,874.95,Percent of total billed charges,,,0.98,,902.58,Percent of total billed charges,,,0.95,,874.95,Percent of total billed charges,,,0.95,,874.95,Percent of total billed charges,,,0.97,,893.37,Percent of total billed charges,,,0.96,,884.16,Percent of total billed charges,,,0.95,,874.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,874.95,Percent of total billed charges,,874.95,902.58,
HC PR 58700 Removal of Fallopian Tube,PX-97511115,CDM,58700,CPT,975,RC,,inpatient,,,1730,1557,,0.95,,1643.5,Percent of total billed charges,,,0.98,,1695.4,Percent of total billed charges,,,0.95,,1643.5,Percent of total billed charges,,,0.97,,1678.1,Percent of total billed charges,,,0.97,,1678.1,Percent of total billed charges,,,0.96,,1660.8,Percent of total billed charges,,,0.95,,1643.5,Percent of total billed charges,,,,,,,,,0.95,,1643.5,Percent of total billed charges,,1643.5,1695.4,
HC PR 58700 Removal of Fallopian Tube,PX-97511115,CDM,58700,CPT,975,RC,,outpatient,,,1730,1557,,0.95,,1643.5,Percent of total billed charges,,,0.98,,1695.4,Percent of total billed charges,,,0.95,,1643.5,Percent of total billed charges,,,0.95,,1643.5,Percent of total billed charges,,,0.97,,1678.1,Percent of total billed charges,,,0.96,,1660.8,Percent of total billed charges,,,0.95,,1643.5,Percent of total billed charges,,,,,,,,,0.95,,1643.5,Percent of total billed charges,,1643.5,1695.4,
HC PR 58720 Removal of Ovary/Tube(S),PX-97511116,CDM,58720,CPT,975,RC,,inpatient,,,1880,1692,,0.95,,1786,Percent of total billed charges,,,0.98,,1842.4,Percent of total billed charges,,,0.95,,1786,Percent of total billed charges,,,0.97,,1823.6,Percent of total billed charges,,,0.97,,1823.6,Percent of total billed charges,,,0.96,,1804.8,Percent of total billed charges,,,0.95,,1786,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1786,Percent of total billed charges,,1786,1842.4,
HC PR 58720 Removal of Ovary/Tube(S),PX-97511116,CDM,58720,CPT,975,RC,,outpatient,,,1880,1692,,0.95,,1786,Percent of total billed charges,,,0.98,,1842.4,Percent of total billed charges,,,0.95,,1786,Percent of total billed charges,,,0.95,,1786,Percent of total billed charges,,,0.97,,1823.6,Percent of total billed charges,,,0.96,,1804.8,Percent of total billed charges,,,0.95,,1786,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1786,Percent of total billed charges,,1786,1842.4,
HC PR 58940 Removal of Ovary(S),PX-97511117,CDM,58940,CPT,975,RC,,inpatient,,,1376,1238.4,,0.95,,1307.2,Percent of total billed charges,,,0.98,,1348.48,Percent of total billed charges,,,0.95,,1307.2,Percent of total billed charges,,,0.97,,1334.72,Percent of total billed charges,,,0.97,,1334.72,Percent of total billed charges,,,0.96,,1320.96,Percent of total billed charges,,,0.95,,1307.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1307.2,Percent of total billed charges,,1307.2,1348.48,
HC PR 58940 Removal of Ovary(S),PX-97511117,CDM,58940,CPT,975,RC,,outpatient,,,1376,1238.4,,0.95,,1307.2,Percent of total billed charges,,,0.98,,1348.48,Percent of total billed charges,,,0.95,,1307.2,Percent of total billed charges,,,0.95,,1307.2,Percent of total billed charges,,,0.97,,1334.72,Percent of total billed charges,,,0.96,,1320.96,Percent of total billed charges,,,0.95,,1307.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1307.2,Percent of total billed charges,,1307.2,1348.48,
HC PR 60100 Biopsy of Thyroid,PX-97511121,CDM,60100,CPT,975,RC,,inpatient,,,414,372.6,,0.95,,393.3,Percent of total billed charges,,,0.98,,405.72,Percent of total billed charges,,,0.95,,393.3,Percent of total billed charges,,,0.97,,401.58,Percent of total billed charges,,,0.97,,401.58,Percent of total billed charges,,,0.96,,397.44,Percent of total billed charges,,,0.95,,393.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,393.3,Percent of total billed charges,,393.3,405.72,
HC PR 60100 Biopsy of Thyroid,PX-97511121,CDM,60100,CPT,975,RC,,outpatient,,,414,372.6,,0.95,,393.3,Percent of total billed charges,,,0.98,,405.72,Percent of total billed charges,,,0.95,,393.3,Percent of total billed charges,,,0.95,,393.3,Percent of total billed charges,,,0.97,,401.58,Percent of total billed charges,,,0.96,,397.44,Percent of total billed charges,,,0.95,,393.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,393.3,Percent of total billed charges,,393.3,405.72,
HC PR 60240 Removal of Thyroid,PX-97511127,CDM,60240,CPT,975,RC,,inpatient,,,2285,2056.5,,0.95,,2170.75,Percent of total billed charges,,,0.98,,2239.3,Percent of total billed charges,,,0.95,,2170.75,Percent of total billed charges,,,0.97,,2216.45,Percent of total billed charges,,,0.97,,2216.45,Percent of total billed charges,,,0.96,,2193.6,Percent of total billed charges,,,0.95,,2170.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2170.75,Percent of total billed charges,,2170.75,2239.3,
HC PR 60240 Removal of Thyroid,PX-97511127,CDM,60240,CPT,975,RC,,outpatient,,,2285,2056.5,,0.95,,2170.75,Percent of total billed charges,,,0.98,,2239.3,Percent of total billed charges,,,0.95,,2170.75,Percent of total billed charges,,,0.95,,2170.75,Percent of total billed charges,,,0.97,,2216.45,Percent of total billed charges,,,0.96,,2193.6,Percent of total billed charges,,,0.95,,2170.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2170.75,Percent of total billed charges,,2170.75,2239.3,
HC PR ED 62270 Spinal Fluid Tap Diagnostic Cdm,PX-98110812,CDM,62270,CPT,981,RC,,inpatient,,,516,464.4,,0.95,,490.2,Percent of total billed charges,,,0.98,,505.68,Percent of total billed charges,,,0.95,,490.2,Percent of total billed charges,,,0.97,,500.52,Percent of total billed charges,,,0.97,,500.52,Percent of total billed charges,,,0.96,,495.36,Percent of total billed charges,,,0.95,,490.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,490.2,Percent of total billed charges,,490.2,505.68,
HC PR ED 62270 Spinal Fluid Tap Diagnostic Cdm,PX-98110812,CDM,62270,CPT,981,RC,,outpatient,,,516,464.4,,0.95,,490.2,Percent of total billed charges,,,0.98,,505.68,Percent of total billed charges,,,0.95,,490.2,Percent of total billed charges,,,0.95,,490.2,Percent of total billed charges,,,0.97,,500.52,Percent of total billed charges,,,0.96,,495.36,Percent of total billed charges,,,0.95,,490.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,490.2,Percent of total billed charges,,490.2,505.68,
HC PR ED 62272 Drain Cerebro Spinal Fluid Cdm,PX-98110813,CDM,62272,CPT,981,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR ED 62272 Drain Cerebro Spinal Fluid Cdm,PX-98110813,CDM,62272,CPT,981,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR ED 64400 Nerve Block Inj Trigeminal Cdm,PX-98110814,CDM,64400,CPT,981,RC,,inpatient,,,186,167.4,,0.95,,176.7,Percent of total billed charges,,,0.98,,182.28,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.96,,178.56,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,176.7,Percent of total billed charges,,176.7,182.28,
HC PR ED 64400 Nerve Block Inj Trigeminal Cdm,PX-98110814,CDM,64400,CPT,981,RC,,outpatient,,,186,167.4,,0.95,,176.7,Percent of total billed charges,,,0.98,,182.28,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.96,,178.56,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,176.7,Percent of total billed charges,,176.7,182.28,
HC PR 23515 Open Tx Clavicular Fracture Internal Fixation,PX-97511303,CDM,23515,CPT,975,RC,,inpatient,,,1796,1616.4,,0.95,,1706.2,Percent of total billed charges,,,0.98,,1760.08,Percent of total billed charges,,,0.95,,1706.2,Percent of total billed charges,,,0.97,,1742.12,Percent of total billed charges,,,0.97,,1742.12,Percent of total billed charges,,,0.96,,1724.16,Percent of total billed charges,,,0.95,,1706.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1706.2,Percent of total billed charges,,1706.2,1760.08,
HC PR 23515 Open Tx Clavicular Fracture Internal Fixation,PX-97511303,CDM,23515,CPT,975,RC,,outpatient,,,1796,1616.4,,0.95,,1706.2,Percent of total billed charges,,,0.98,,1760.08,Percent of total billed charges,,,0.95,,1706.2,Percent of total billed charges,,,0.95,,1706.2,Percent of total billed charges,,,0.97,,1742.12,Percent of total billed charges,,,0.96,,1724.16,Percent of total billed charges,,,0.95,,1706.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1706.2,Percent of total billed charges,,1706.2,1760.08,
HC PR 29826 Arthroscopy Shoulder W/Coracoacrm Ligmnt Release,PX-97511311,CDM,29826,CPT,975,RC,,inpatient,,,418,376.2,,0.95,,397.1,Percent of total billed charges,,,0.98,,409.64,Percent of total billed charges,,,0.95,,397.1,Percent of total billed charges,,,0.97,,405.46,Percent of total billed charges,,,0.97,,405.46,Percent of total billed charges,,,0.96,,401.28,Percent of total billed charges,,,0.95,,397.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,397.1,Percent of total billed charges,,397.1,409.64,
HC PR 29826 Arthroscopy Shoulder W/Coracoacrm Ligmnt Release,PX-97511311,CDM,29826,CPT,975,RC,,outpatient,,,418,376.2,,0.95,,397.1,Percent of total billed charges,,,0.98,,409.64,Percent of total billed charges,,,0.95,,397.1,Percent of total billed charges,,,0.95,,397.1,Percent of total billed charges,,,0.97,,405.46,Percent of total billed charges,,,0.96,,401.28,Percent of total billed charges,,,0.95,,397.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,397.1,Percent of total billed charges,,397.1,409.64,
HC PR 59812 Tx Incomplete Abortion Any Trimester Surgical,PX-97511317,CDM,59812,CPT,975,RC,,inpatient,,,791,711.9,,0.95,,751.45,Percent of total billed charges,,,0.98,,775.18,Percent of total billed charges,,,0.95,,751.45,Percent of total billed charges,,,0.97,,767.27,Percent of total billed charges,,,0.97,,767.27,Percent of total billed charges,,,0.96,,759.36,Percent of total billed charges,,,0.95,,751.45,Percent of total billed charges,,,,,,,,,0.95,,751.45,Percent of total billed charges,,751.45,775.18,
HC PR 59812 Tx Incomplete Abortion Any Trimester Surgical,PX-97511317,CDM,59812,CPT,975,RC,,outpatient,,,791,711.9,,0.95,,751.45,Percent of total billed charges,,,0.98,,775.18,Percent of total billed charges,,,0.95,,751.45,Percent of total billed charges,,,0.95,,751.45,Percent of total billed charges,,,0.97,,767.27,Percent of total billed charges,,,0.96,,759.36,Percent of total billed charges,,,0.95,,751.45,Percent of total billed charges,,,,,,,,,0.95,,751.45,Percent of total billed charges,,751.45,775.18,
HC PR 59820 Tx Missed Abortion First Trimester Surgical,PX-97511318,CDM,59820,CPT,975,RC,,inpatient,,,1095,985.5,,0.95,,1040.25,Percent of total billed charges,,,0.98,,1073.1,Percent of total billed charges,,,0.95,,1040.25,Percent of total billed charges,,,0.97,,1062.15,Percent of total billed charges,,,0.97,,1062.15,Percent of total billed charges,,,0.96,,1051.2,Percent of total billed charges,,,0.95,,1040.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1040.25,Percent of total billed charges,,1040.25,1073.1,
HC PR 59820 Tx Missed Abortion First Trimester Surgical,PX-97511318,CDM,59820,CPT,975,RC,,outpatient,,,1095,985.5,,0.95,,1040.25,Percent of total billed charges,,,0.98,,1073.1,Percent of total billed charges,,,0.95,,1040.25,Percent of total billed charges,,,0.95,,1040.25,Percent of total billed charges,,,0.97,,1062.15,Percent of total billed charges,,,0.96,,1051.2,Percent of total billed charges,,,0.95,,1040.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1040.25,Percent of total billed charges,,1040.25,1073.1,
HC PR 64721 Carpal Tunnel Surgery,PX-96910862,CDM,64721,CPT,983,RC,,inpatient,,,1114,1002.6,,0.95,,1058.3,Percent of total billed charges,,,0.98,,1091.72,Percent of total billed charges,,,0.95,,1058.3,Percent of total billed charges,,,0.97,,1080.58,Percent of total billed charges,,,0.97,,1080.58,Percent of total billed charges,,,0.96,,1069.44,Percent of total billed charges,,,0.95,,1058.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1058.3,Percent of total billed charges,,1058.3,1091.72,
HC PR 64721 Carpal Tunnel Surgery,PX-96910862,CDM,64721,CPT,983,RC,,outpatient,,,1114,1002.6,,0.95,,1058.3,Percent of total billed charges,,,0.98,,1091.72,Percent of total billed charges,,,0.95,,1058.3,Percent of total billed charges,,,0.95,,1058.3,Percent of total billed charges,,,0.97,,1080.58,Percent of total billed charges,,,0.96,,1069.44,Percent of total billed charges,,,0.95,,1058.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1058.3,Percent of total billed charges,,1058.3,1091.72,
HC PR 24342 Rinsj Rptd Biceps/Triceps Tdn Dstl W/WO Tdn Grf,PX-97511321,CDM,24342,CPT,975,RC,,inpatient,,,1925,1732.5,,0.95,,1828.75,Percent of total billed charges,,,0.98,,1886.5,Percent of total billed charges,,,0.95,,1828.75,Percent of total billed charges,,,0.97,,1867.25,Percent of total billed charges,,,0.97,,1867.25,Percent of total billed charges,,,0.96,,1848,Percent of total billed charges,,,0.95,,1828.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1828.75,Percent of total billed charges,,1828.75,1886.5,
HC PR 24342 Rinsj Rptd Biceps/Triceps Tdn Dstl W/WO Tdn Grf,PX-97511321,CDM,24342,CPT,975,RC,,outpatient,,,1925,1732.5,,0.95,,1828.75,Percent of total billed charges,,,0.98,,1886.5,Percent of total billed charges,,,0.95,,1828.75,Percent of total billed charges,,,0.95,,1828.75,Percent of total billed charges,,,0.97,,1867.25,Percent of total billed charges,,,0.96,,1848,Percent of total billed charges,,,0.95,,1828.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1828.75,Percent of total billed charges,,1828.75,1886.5,
HC PR 64722 Relieve Pressure on Nerve(S),PX-97511173,CDM,64722,CPT,975,RC,,inpatient,,,926,833.4,,0.95,,879.7,Percent of total billed charges,,,0.98,,907.48,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,0.97,,898.22,Percent of total billed charges,,,0.97,,898.22,Percent of total billed charges,,,0.96,,888.96,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,879.7,Percent of total billed charges,,879.7,907.48,
HC PR 64722 Relieve Pressure on Nerve(S),PX-97511173,CDM,64722,CPT,975,RC,,outpatient,,,926,833.4,,0.95,,879.7,Percent of total billed charges,,,0.98,,907.48,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,0.97,,898.22,Percent of total billed charges,,,0.96,,888.96,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,879.7,Percent of total billed charges,,879.7,907.48,
HC PR 64774 Exc Neuroma Cutan Nrv Surgly Identifiable Cdm,PX-97511174,CDM,64774,CPT,975,RC,,inpatient,,,975,877.5,,0.95,,926.25,Percent of total billed charges,,,0.98,,955.5,Percent of total billed charges,,,0.95,,926.25,Percent of total billed charges,,,0.97,,945.75,Percent of total billed charges,,,0.97,,945.75,Percent of total billed charges,,,0.96,,936,Percent of total billed charges,,,0.95,,926.25,Percent of total billed charges,,,,,,,,,0.95,,926.25,Percent of total billed charges,,926.25,955.5,
HC PR 64774 Exc Neuroma Cutan Nrv Surgly Identifiable Cdm,PX-97511174,CDM,64774,CPT,975,RC,,outpatient,,,975,877.5,,0.95,,926.25,Percent of total billed charges,,,0.98,,955.5,Percent of total billed charges,,,0.95,,926.25,Percent of total billed charges,,,0.95,,926.25,Percent of total billed charges,,,0.97,,945.75,Percent of total billed charges,,,0.96,,936,Percent of total billed charges,,,0.95,,926.25,Percent of total billed charges,,,,,,,,,0.95,,926.25,Percent of total billed charges,,926.25,955.5,
HC PR 25606 Perq Skel Fixj Distal Radial Fx/Epiphysl Sep,PX-97511323,CDM,25606,CPT,975,RC,,inpatient,,,1677,1509.3,,0.95,,1593.15,Percent of total billed charges,,,0.98,,1643.46,Percent of total billed charges,,,0.95,,1593.15,Percent of total billed charges,,,0.97,,1626.69,Percent of total billed charges,,,0.97,,1626.69,Percent of total billed charges,,,0.96,,1609.92,Percent of total billed charges,,,0.95,,1593.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1593.15,Percent of total billed charges,,1593.15,1643.46,
HC PR 25606 Perq Skel Fixj Distal Radial Fx/Epiphysl Sep,PX-97511323,CDM,25606,CPT,975,RC,,outpatient,,,1677,1509.3,,0.95,,1593.15,Percent of total billed charges,,,0.98,,1643.46,Percent of total billed charges,,,0.95,,1593.15,Percent of total billed charges,,,0.95,,1593.15,Percent of total billed charges,,,0.97,,1626.69,Percent of total billed charges,,,0.96,,1609.92,Percent of total billed charges,,,0.95,,1593.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1593.15,Percent of total billed charges,,1593.15,1643.46,
HC PR 26160 Exc Lesion Tdn Shth/Jt Capsl Hand/Fngr,PX-97511324,CDM,26160,CPT,975,RC,,inpatient,,,1273,1145.7,,0.95,,1209.35,Percent of total billed charges,,,0.98,,1247.54,Percent of total billed charges,,,0.95,,1209.35,Percent of total billed charges,,,0.97,,1234.81,Percent of total billed charges,,,0.97,,1234.81,Percent of total billed charges,,,0.96,,1222.08,Percent of total billed charges,,,0.95,,1209.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1209.35,Percent of total billed charges,,1209.35,1247.54,
HC PR 26160 Exc Lesion Tdn Shth/Jt Capsl Hand/Fngr,PX-97511324,CDM,26160,CPT,975,RC,,outpatient,,,1273,1145.7,,0.95,,1209.35,Percent of total billed charges,,,0.98,,1247.54,Percent of total billed charges,,,0.95,,1209.35,Percent of total billed charges,,,0.95,,1209.35,Percent of total billed charges,,,0.97,,1234.81,Percent of total billed charges,,,0.96,,1222.08,Percent of total billed charges,,,0.95,,1209.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1209.35,Percent of total billed charges,,1209.35,1247.54,
HC PR ED 65205 Remove Foreign Body From Eye Superficial Cdm,PX-98110818,CDM,65205,CPT,981,RC,,inpatient,,,171,153.9,,0.95,,162.45,Percent of total billed charges,,,0.98,,167.58,Percent of total billed charges,,,0.95,,162.45,Percent of total billed charges,,,0.97,,165.87,Percent of total billed charges,,,0.97,,165.87,Percent of total billed charges,,,0.96,,164.16,Percent of total billed charges,,,0.95,,162.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,162.45,Percent of total billed charges,,162.45,167.58,
HC PR ED 65205 Remove Foreign Body From Eye Superficial Cdm,PX-98110818,CDM,65205,CPT,981,RC,,outpatient,,,171,153.9,,0.95,,162.45,Percent of total billed charges,,,0.98,,167.58,Percent of total billed charges,,,0.95,,162.45,Percent of total billed charges,,,0.95,,162.45,Percent of total billed charges,,,0.97,,165.87,Percent of total billed charges,,,0.96,,164.16,Percent of total billed charges,,,0.95,,162.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,162.45,Percent of total billed charges,,162.45,167.58,
HC PR ED 65210 Remove Foreign Body From Eye Embedded Cdm,PX-98110819,CDM,65210,CPT,981,RC,,inpatient,,,356,320.4,,0.95,,338.2,Percent of total billed charges,,,0.98,,348.88,Percent of total billed charges,,,0.95,,338.2,Percent of total billed charges,,,0.97,,345.32,Percent of total billed charges,,,0.97,,345.32,Percent of total billed charges,,,0.96,,341.76,Percent of total billed charges,,,0.95,,338.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,338.2,Percent of total billed charges,,338.2,348.88,
HC PR ED 65210 Remove Foreign Body From Eye Embedded Cdm,PX-98110819,CDM,65210,CPT,981,RC,,outpatient,,,356,320.4,,0.95,,338.2,Percent of total billed charges,,,0.98,,348.88,Percent of total billed charges,,,0.95,,338.2,Percent of total billed charges,,,0.95,,338.2,Percent of total billed charges,,,0.97,,345.32,Percent of total billed charges,,,0.96,,341.76,Percent of total billed charges,,,0.95,,338.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,338.2,Percent of total billed charges,,338.2,348.88,
HC PR ED 65220 Remove Foreign Body From Eye Corneal W/O Slit Lamp Cdm,PX-98110820,CDM,65220,CPT,981,RC,,inpatient,,,130,117,,0.95,,123.5,Percent of total billed charges,,,0.98,,127.4,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.96,,124.8,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,123.5,Percent of total billed charges,,123.5,127.4,
HC PR ED 65220 Remove Foreign Body From Eye Corneal W/O Slit Lamp Cdm,PX-98110820,CDM,65220,CPT,981,RC,,outpatient,,,130,117,,0.95,,123.5,Percent of total billed charges,,,0.98,,127.4,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.96,,124.8,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,123.5,Percent of total billed charges,,123.5,127.4,
HC PR ED 65222 Remove Foreign Body From Eye Corneal W/ Slit Lamp Cdm,PX-98110821,CDM,65222,CPT,981,RC,,inpatient,,,337,303.3,,0.95,,320.15,Percent of total billed charges,,,0.98,,330.26,Percent of total billed charges,,,0.95,,320.15,Percent of total billed charges,,,0.97,,326.89,Percent of total billed charges,,,0.97,,326.89,Percent of total billed charges,,,0.96,,323.52,Percent of total billed charges,,,0.95,,320.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,320.15,Percent of total billed charges,,320.15,330.26,
HC PR ED 65222 Remove Foreign Body From Eye Corneal W/ Slit Lamp Cdm,PX-98110821,CDM,65222,CPT,981,RC,,outpatient,,,337,303.3,,0.95,,320.15,Percent of total billed charges,,,0.98,,330.26,Percent of total billed charges,,,0.95,,320.15,Percent of total billed charges,,,0.95,,320.15,Percent of total billed charges,,,0.97,,326.89,Percent of total billed charges,,,0.96,,323.52,Percent of total billed charges,,,0.95,,320.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,320.15,Percent of total billed charges,,320.15,330.26,
HC PR 27236 Optx Fem Fx Prox End Nck Int Fixj/Prostc Rplcmt,PX-97511327,CDM,27236,CPT,975,RC,,inpatient,,,2947,2652.3,,0.95,,2799.65,Percent of total billed charges,,,0.98,,2888.06,Percent of total billed charges,,,0.95,,2799.65,Percent of total billed charges,,,0.97,,2858.59,Percent of total billed charges,,,0.97,,2858.59,Percent of total billed charges,,,0.96,,2829.12,Percent of total billed charges,,,0.95,,2799.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2799.65,Percent of total billed charges,,2799.65,2888.06,
HC PR 27236 Optx Fem Fx Prox End Nck Int Fixj/Prostc Rplcmt,PX-97511327,CDM,27236,CPT,975,RC,,outpatient,,,2947,2652.3,,0.95,,2799.65,Percent of total billed charges,,,0.98,,2888.06,Percent of total billed charges,,,0.95,,2799.65,Percent of total billed charges,,,0.95,,2799.65,Percent of total billed charges,,,0.97,,2858.59,Percent of total billed charges,,,0.96,,2829.12,Percent of total billed charges,,,0.95,,2799.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2799.65,Percent of total billed charges,,2799.65,2888.06,
HC PR 27447 Arthrp Kne Condyle&Platu Medial&Lat Compartments,PX-97511328,CDM,27447,CPT,975,RC,,inpatient,,,3158,2842.2,,0.95,,3000.1,Percent of total billed charges,,,0.98,,3094.84,Percent of total billed charges,,,0.95,,3000.1,Percent of total billed charges,,,0.97,,3063.26,Percent of total billed charges,,,0.97,,3063.26,Percent of total billed charges,,,0.96,,3031.68,Percent of total billed charges,,,0.95,,3000.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3000.1,Percent of total billed charges,,3000.1,3094.84,
HC PR 27447 Arthrp Kne Condyle&Platu Medial&Lat Compartments,PX-97511328,CDM,27447,CPT,975,RC,,outpatient,,,3158,2842.2,,0.95,,3000.1,Percent of total billed charges,,,0.98,,3094.84,Percent of total billed charges,,,0.95,,3000.1,Percent of total billed charges,,,0.95,,3000.1,Percent of total billed charges,,,0.97,,3063.26,Percent of total billed charges,,,0.96,,3031.68,Percent of total billed charges,,,0.95,,3000.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3000.1,Percent of total billed charges,,3000.1,3094.84,
HC PR ED 67938 Remove Eyelid Foreign Body Cdm,PX-98110826,CDM,67938,CPT,981,RC,,inpatient,,,908,817.2,,0.95,,862.6,Percent of total billed charges,,,0.98,,889.84,Percent of total billed charges,,,0.95,,862.6,Percent of total billed charges,,,0.97,,880.76,Percent of total billed charges,,,0.97,,880.76,Percent of total billed charges,,,0.96,,871.68,Percent of total billed charges,,,0.95,,862.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,862.6,Percent of total billed charges,,862.6,889.84,
HC PR ED 67938 Remove Eyelid Foreign Body Cdm,PX-98110826,CDM,67938,CPT,981,RC,,outpatient,,,908,817.2,,0.95,,862.6,Percent of total billed charges,,,0.98,,889.84,Percent of total billed charges,,,0.95,,862.6,Percent of total billed charges,,,0.95,,862.6,Percent of total billed charges,,,0.97,,880.76,Percent of total billed charges,,,0.96,,871.68,Percent of total billed charges,,,0.95,,862.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,862.6,Percent of total billed charges,,862.6,889.84,
HC PR 27792 Open Tx Distal Fibular Fracture Lat Malleolus,PX-97511334,CDM,27792,CPT,975,RC,,inpatient,,,1607,1446.3,,0.95,,1526.65,Percent of total billed charges,,,0.98,,1574.86,Percent of total billed charges,,,0.95,,1526.65,Percent of total billed charges,,,0.97,,1558.79,Percent of total billed charges,,,0.97,,1558.79,Percent of total billed charges,,,0.96,,1542.72,Percent of total billed charges,,,0.95,,1526.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1526.65,Percent of total billed charges,,1526.65,1574.86,
HC PR 27792 Open Tx Distal Fibular Fracture Lat Malleolus,PX-97511334,CDM,27792,CPT,975,RC,,outpatient,,,1607,1446.3,,0.95,,1526.65,Percent of total billed charges,,,0.98,,1574.86,Percent of total billed charges,,,0.95,,1526.65,Percent of total billed charges,,,0.95,,1526.65,Percent of total billed charges,,,0.97,,1558.79,Percent of total billed charges,,,0.96,,1542.72,Percent of total billed charges,,,0.95,,1526.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1526.65,Percent of total billed charges,,1526.65,1574.86,
HC PR ED 69200 Clear Outer Ear Canal W/O General Anesthesia Cdm,PX-98110830,CDM,69200,CPT,981,RC,,inpatient,,,264,237.6,,0.95,,250.8,Percent of total billed charges,,,0.98,,258.72,Percent of total billed charges,,,0.95,,250.8,Percent of total billed charges,,,0.97,,256.08,Percent of total billed charges,,,0.97,,256.08,Percent of total billed charges,,,0.96,,253.44,Percent of total billed charges,,,0.95,,250.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,250.8,Percent of total billed charges,,250.8,258.72,
HC PR ED 69200 Clear Outer Ear Canal W/O General Anesthesia Cdm,PX-98110830,CDM,69200,CPT,981,RC,,outpatient,,,264,237.6,,0.95,,250.8,Percent of total billed charges,,,0.98,,258.72,Percent of total billed charges,,,0.95,,250.8,Percent of total billed charges,,,0.95,,250.8,Percent of total billed charges,,,0.97,,256.08,Percent of total billed charges,,,0.96,,253.44,Percent of total billed charges,,,0.95,,250.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,250.8,Percent of total billed charges,,250.8,258.72,
Clear Outer Ear Canal W/ General Anesthesia,PX-97511187,CDM,69205,CPT,975,RC,,inpatient,,,710,639,,0.95,,674.5,Percent of total billed charges,,,0.98,,695.8,Percent of total billed charges,,,0.95,,674.5,Percent of total billed charges,,,0.97,,688.7,Percent of total billed charges,,,0.97,,688.7,Percent of total billed charges,,,0.96,,681.6,Percent of total billed charges,,,0.95,,674.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,674.5,Percent of total billed charges,,674.5,695.8,
Clear Outer Ear Canal W/ General Anesthesia,PX-97511187,CDM,69205,CPT,975,RC,,outpatient,,,710,639,,0.95,,674.5,Percent of total billed charges,,,0.98,,695.8,Percent of total billed charges,,,0.95,,674.5,Percent of total billed charges,,,0.95,,674.5,Percent of total billed charges,,,0.97,,688.7,Percent of total billed charges,,,0.96,,681.6,Percent of total billed charges,,,0.95,,674.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,674.5,Percent of total billed charges,,674.5,695.8,
HC PR ED 69210 Remove Impacted Ear Wax Cdm,PX-98110831,CDM,69210,CPT,981,RC,,inpatient,,,151,135.9,,0.95,,143.45,Percent of total billed charges,,,0.98,,147.98,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,0.97,,146.47,Percent of total billed charges,,,0.97,,146.47,Percent of total billed charges,,,0.96,,144.96,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,143.45,Percent of total billed charges,,143.45,147.98,
HC PR ED 69210 Remove Impacted Ear Wax Cdm,PX-98110831,CDM,69210,CPT,981,RC,,outpatient,,,151,135.9,,0.95,,143.45,Percent of total billed charges,,,0.98,,147.98,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,0.97,,146.47,Percent of total billed charges,,,0.96,,144.96,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,143.45,Percent of total billed charges,,143.45,147.98,
HC PR 28485 Open Treatment Metatarsal Fracture Each,PX-97511344,CDM,28485,CPT,975,RC,,inpatient,,,1800,1620,,0.95,,1710,Percent of total billed charges,,,0.98,,1764,Percent of total billed charges,,,0.95,,1710,Percent of total billed charges,,,0.97,,1746,Percent of total billed charges,,,0.97,,1746,Percent of total billed charges,,,0.96,,1728,Percent of total billed charges,,,0.95,,1710,Percent of total billed charges,,,,,,,,,0.95,,1710,Percent of total billed charges,,1710,1764,
HC PR 28485 Open Treatment Metatarsal Fracture Each,PX-97511344,CDM,28485,CPT,975,RC,,outpatient,,,1800,1620,,0.95,,1710,Percent of total billed charges,,,0.98,,1764,Percent of total billed charges,,,0.95,,1710,Percent of total billed charges,,,0.95,,1710,Percent of total billed charges,,,0.97,,1746,Percent of total billed charges,,,0.96,,1728,Percent of total billed charges,,,0.95,,1710,Percent of total billed charges,,,,,,,,,0.95,,1710,Percent of total billed charges,,1710,1764,
HC PR 28805 Amputation Foot Transmetarsal,PX-97511345,CDM,28805,CPT,975,RC,,inpatient,,,1513,1361.7,,0.95,,1437.35,Percent of total billed charges,,,0.98,,1482.74,Percent of total billed charges,,,0.95,,1437.35,Percent of total billed charges,,,0.97,,1467.61,Percent of total billed charges,,,0.97,,1467.61,Percent of total billed charges,,,0.96,,1452.48,Percent of total billed charges,,,0.95,,1437.35,Percent of total billed charges,,,,,,,,,0.95,,1437.35,Percent of total billed charges,,1437.35,1482.74,
HC PR 28805 Amputation Foot Transmetarsal,PX-97511345,CDM,28805,CPT,975,RC,,outpatient,,,1513,1361.7,,0.95,,1437.35,Percent of total billed charges,,,0.98,,1482.74,Percent of total billed charges,,,0.95,,1437.35,Percent of total billed charges,,,0.95,,1437.35,Percent of total billed charges,,,0.97,,1467.61,Percent of total billed charges,,,0.96,,1452.48,Percent of total billed charges,,,0.95,,1437.35,Percent of total billed charges,,,,,,,,,0.95,,1437.35,Percent of total billed charges,,1437.35,1482.74,
HC PR 28820 Amputation Toe Metatarsophalangeal Joint,PX-97511347,CDM,28820,CPT,975,RC,,inpatient,,,1388,1249.2,,0.95,,1318.6,Percent of total billed charges,,,0.98,,1360.24,Percent of total billed charges,,,0.95,,1318.6,Percent of total billed charges,,,0.97,,1346.36,Percent of total billed charges,,,0.97,,1346.36,Percent of total billed charges,,,0.96,,1332.48,Percent of total billed charges,,,0.95,,1318.6,Percent of total billed charges,,,,,,,,,0.95,,1318.6,Percent of total billed charges,,1318.6,1360.24,
HC PR 28820 Amputation Toe Metatarsophalangeal Joint,PX-97511347,CDM,28820,CPT,975,RC,,outpatient,,,1388,1249.2,,0.95,,1318.6,Percent of total billed charges,,,0.98,,1360.24,Percent of total billed charges,,,0.95,,1318.6,Percent of total billed charges,,,0.95,,1318.6,Percent of total billed charges,,,0.97,,1346.36,Percent of total billed charges,,,0.96,,1332.48,Percent of total billed charges,,,0.95,,1318.6,Percent of total billed charges,,,,,,,,,0.95,,1318.6,Percent of total billed charges,,1318.6,1360.24,
HC PR 29880 Arthrs Knee W/Meniscectomy Med&Lat W/Shaving,PX-97511348,CDM,29880,CPT,975,RC,,inpatient,,,1402,1261.8,,0.95,,1331.9,Percent of total billed charges,,,0.98,,1373.96,Percent of total billed charges,,,0.95,,1331.9,Percent of total billed charges,,,0.97,,1359.94,Percent of total billed charges,,,0.97,,1359.94,Percent of total billed charges,,,0.96,,1345.92,Percent of total billed charges,,,0.95,,1331.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1331.9,Percent of total billed charges,,1331.9,1373.96,
HC PR 29880 Arthrs Knee W/Meniscectomy Med&Lat W/Shaving,PX-97511348,CDM,29880,CPT,975,RC,,outpatient,,,1402,1261.8,,0.95,,1331.9,Percent of total billed charges,,,0.98,,1373.96,Percent of total billed charges,,,0.95,,1331.9,Percent of total billed charges,,,0.95,,1331.9,Percent of total billed charges,,,0.97,,1359.94,Percent of total billed charges,,,0.96,,1345.92,Percent of total billed charges,,,0.95,,1331.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1331.9,Percent of total billed charges,,1331.9,1373.96,
HC PR 45390 Colonoscopy Flx W/Endoscopic Mucosal Resection,PX-97511352,CDM,45390,CPT,975,RC,,inpatient,,,802,721.8,,0.95,,761.9,Percent of total billed charges,,,0.98,,785.96,Percent of total billed charges,,,0.95,,761.9,Percent of total billed charges,,,0.97,,777.94,Percent of total billed charges,,,0.97,,777.94,Percent of total billed charges,,,0.96,,769.92,Percent of total billed charges,,,0.95,,761.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,761.9,Percent of total billed charges,,761.9,785.96,
HC PR 45390 Colonoscopy Flx W/Endoscopic Mucosal Resection,PX-97511352,CDM,45390,CPT,975,RC,,outpatient,,,802,721.8,,0.95,,761.9,Percent of total billed charges,,,0.98,,785.96,Percent of total billed charges,,,0.95,,761.9,Percent of total billed charges,,,0.95,,761.9,Percent of total billed charges,,,0.97,,777.94,Percent of total billed charges,,,0.96,,769.92,Percent of total billed charges,,,0.95,,761.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,761.9,Percent of total billed charges,,761.9,785.96,
HC PR Rx Naltrexone Inj 1 Mg,PX-63610263,CDM,J2315,HCPCS,636,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
HC PR Rx Naltrexone Inj 1 Mg,PX-63610263,CDM,J2315,HCPCS,636,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
HC PR Rx Normal Saline Infusion 1000 Ml,PX-63610333,CDM,J7030,HCPCS,636,RC,,inpatient,,,16,14.4,,0.95,,15.2,Percent of total billed charges,,,0.98,,15.68,Percent of total billed charges,,,0.95,,15.2,Percent of total billed charges,,,0.97,,15.52,Percent of total billed charges,,,0.97,,15.52,Percent of total billed charges,,,0.96,,15.36,Percent of total billed charges,,,0.95,,15.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,15.2,Percent of total billed charges,,15.2,15.68,
HC PR Rx Normal Saline Infusion 1000 Ml,PX-63610333,CDM,J7030,HCPCS,636,RC,,outpatient,,,16,14.4,,0.95,,15.2,Percent of total billed charges,,,0.98,,15.68,Percent of total billed charges,,,0.95,,15.2,Percent of total billed charges,,,0.95,,15.2,Percent of total billed charges,,,0.97,,15.52,Percent of total billed charges,,,0.96,,15.36,Percent of total billed charges,,,0.95,,15.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,15.2,Percent of total billed charges,,15.2,15.68,
HC PR Rx Levonorgestrel (Skyla) Iud 13.5 Mg,PX-63610334,CDM,J7301,HCPCS,636,RC,,inpatient,,,1100,990,,0.95,,1045,Percent of total billed charges,,,0.98,,1078,Percent of total billed charges,,,0.95,,1045,Percent of total billed charges,,,0.97,,1067,Percent of total billed charges,,,0.97,,1067,Percent of total billed charges,,,0.96,,1056,Percent of total billed charges,,,0.95,,1045,Percent of total billed charges,,,,,,,,,0.95,,1045,Percent of total billed charges,,1045,1078,
HC PR Rx Levonorgestrel (Skyla) Iud 13.5 Mg,PX-63610334,CDM,J7301,HCPCS,636,RC,,outpatient,,,1100,990,,0.95,,1045,Percent of total billed charges,,,0.98,,1078,Percent of total billed charges,,,0.95,,1045,Percent of total billed charges,,,0.95,,1045,Percent of total billed charges,,,0.97,,1067,Percent of total billed charges,,,0.96,,1056,Percent of total billed charges,,,0.95,,1045,Percent of total billed charges,,,,,,,,,0.95,,1045,Percent of total billed charges,,1045,1078,
HC PR Rx Etonogestrel Implant 1 Ea,PX-63610335,CDM,J7307,HCPCS,636,RC,,inpatient,,,1858,1672.2,,0.95,,1765.1,Percent of total billed charges,,,0.98,,1820.84,Percent of total billed charges,,,0.95,,1765.1,Percent of total billed charges,,,0.97,,1802.26,Percent of total billed charges,,,0.97,,1802.26,Percent of total billed charges,,,0.96,,1783.68,Percent of total billed charges,,,0.95,,1765.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1765.1,Percent of total billed charges,,1765.1,1820.84,
HC PR Rx Etonogestrel Implant 1 Ea,PX-63610335,CDM,J7307,HCPCS,636,RC,,outpatient,,,1858,1672.2,,0.95,,1765.1,Percent of total billed charges,,,0.98,,1820.84,Percent of total billed charges,,,0.95,,1765.1,Percent of total billed charges,,,0.95,,1765.1,Percent of total billed charges,,,0.97,,1802.26,Percent of total billed charges,,,0.96,,1783.68,Percent of total billed charges,,,0.95,,1765.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1765.1,Percent of total billed charges,,1765.1,1820.84,
HC PR Rx Hyaluronan or Derivative (Euflexxa) Inj 1 Ea,PX-63610336,CDM,J7323,HCPCS,636,RC,,inpatient,,,2727,2454.3,,0.95,,2590.65,Percent of total billed charges,,,0.98,,2672.46,Percent of total billed charges,,,0.95,,2590.65,Percent of total billed charges,,,0.97,,2645.19,Percent of total billed charges,,,0.97,,2645.19,Percent of total billed charges,,,0.96,,2617.92,Percent of total billed charges,,,0.95,,2590.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2590.65,Percent of total billed charges,,2590.65,2672.46,
HC PR Rx Hyaluronan or Derivative (Euflexxa) Inj 1 Ea,PX-63610336,CDM,J7323,HCPCS,636,RC,,outpatient,,,2727,2454.3,,0.95,,2590.65,Percent of total billed charges,,,0.98,,2672.46,Percent of total billed charges,,,0.95,,2590.65,Percent of total billed charges,,,0.95,,2590.65,Percent of total billed charges,,,0.97,,2645.19,Percent of total billed charges,,,0.96,,2617.92,Percent of total billed charges,,,0.95,,2590.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2590.65,Percent of total billed charges,,2590.65,2672.46,
HC PR Rx Hyaluronan or Derivative (Orthovisc) Inj 1 Ea,PX-63610337,CDM,J7324,HCPCS,636,RC,,inpatient,,,1304,1173.6,,0.95,,1238.8,Percent of total billed charges,,,0.98,,1277.92,Percent of total billed charges,,,0.95,,1238.8,Percent of total billed charges,,,0.97,,1264.88,Percent of total billed charges,,,0.97,,1264.88,Percent of total billed charges,,,0.96,,1251.84,Percent of total billed charges,,,0.95,,1238.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1238.8,Percent of total billed charges,,1238.8,1277.92,
HC PR Rx Hyaluronan or Derivative (Orthovisc) Inj 1 Ea,PX-63610337,CDM,J7324,HCPCS,636,RC,,outpatient,,,1304,1173.6,,0.95,,1238.8,Percent of total billed charges,,,0.98,,1277.92,Percent of total billed charges,,,0.95,,1238.8,Percent of total billed charges,,,0.95,,1238.8,Percent of total billed charges,,,0.97,,1264.88,Percent of total billed charges,,,0.96,,1251.84,Percent of total billed charges,,,0.95,,1238.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1238.8,Percent of total billed charges,,1238.8,1277.92,
HC PR Rx Prochlorperazine Inj 10 Mg,PX-63610355,CDM,J0780,HCPCS,636,RC,,inpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
HC PR Rx Prochlorperazine Inj 10 Mg,PX-63610355,CDM,J0780,HCPCS,636,RC,,outpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
HC PR 51040 Cystostomy Cystotomy W/Drainage Cdm,PX-97511487,CDM,51040,CPT,975,RC,,inpatient,,,721,648.9,,0.95,,684.95,Percent of total billed charges,,,0.98,,706.58,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,0.97,,699.37,Percent of total billed charges,,,0.97,,699.37,Percent of total billed charges,,,0.96,,692.16,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,684.95,Percent of total billed charges,,684.95,706.58,
HC PR 51040 Cystostomy Cystotomy W/Drainage Cdm,PX-97511487,CDM,51040,CPT,975,RC,,outpatient,,,721,648.9,,0.95,,684.95,Percent of total billed charges,,,0.98,,706.58,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,0.97,,699.37,Percent of total billed charges,,,0.96,,692.16,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,684.95,Percent of total billed charges,,684.95,706.58,
HC PR 51102 Aspiration Bladder Insert Suprapubic Catheter Cdm,PX-97511493,CDM,51102,CPT,975,RC,,inpatient,,,587,528.3,,0.95,,557.65,Percent of total billed charges,,,0.98,,575.26,Percent of total billed charges,,,0.95,,557.65,Percent of total billed charges,,,0.97,,569.39,Percent of total billed charges,,,0.97,,569.39,Percent of total billed charges,,,0.96,,563.52,Percent of total billed charges,,,0.95,,557.65,Percent of total billed charges,,,,,,,,,0.95,,557.65,Percent of total billed charges,,557.65,575.26,
HC PR 51102 Aspiration Bladder Insert Suprapubic Catheter Cdm,PX-97511493,CDM,51102,CPT,975,RC,,outpatient,,,587,528.3,,0.95,,557.65,Percent of total billed charges,,,0.98,,575.26,Percent of total billed charges,,,0.95,,557.65,Percent of total billed charges,,,0.95,,557.65,Percent of total billed charges,,,0.97,,569.39,Percent of total billed charges,,,0.96,,563.52,Percent of total billed charges,,,0.95,,557.65,Percent of total billed charges,,,,,,,,,0.95,,557.65,Percent of total billed charges,,557.65,575.26,
HC PR 54056 Dstrj Lesion Penis Simple Cryosurgery Cdm,PX-97513890,CDM,54056,CPT,975,RC,,inpatient,,,359,323.1,,0.95,,341.05,Percent of total billed charges,,,0.98,,351.82,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,0.97,,348.23,Percent of total billed charges,,,0.97,,348.23,Percent of total billed charges,,,0.96,,344.64,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,341.05,Percent of total billed charges,,341.05,351.82,
HC PR 54056 Dstrj Lesion Penis Simple Cryosurgery Cdm,PX-97513890,CDM,54056,CPT,975,RC,,outpatient,,,359,323.1,,0.95,,341.05,Percent of total billed charges,,,0.98,,351.82,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,0.97,,348.23,Percent of total billed charges,,,0.96,,344.64,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,341.05,Percent of total billed charges,,341.05,351.82,
Amplifed DNA or RNA probe of (Covid-19) antigen,PX-30610482,CDM,87635,CPT,306,RC,,inpatient,,,136,122.4,,0.95,,129.2,Percent of total billed charges,,,0.98,,133.28,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,0.97,,131.92,Percent of total billed charges,,,0.97,,131.92,Percent of total billed charges,,,0.96,,130.56,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,129.2,Percent of total billed charges,,129.2,133.28,
Amplifed DNA or RNA probe of (Covid-19) antigen,PX-30610482,CDM,87635,CPT,306,RC,,outpatient,,,136,122.4,,0.95,,129.2,Percent of total billed charges,,,0.98,,133.28,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,0.97,,131.92,Percent of total billed charges,,,0.96,,130.56,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,129.2,Percent of total billed charges,,129.2,133.28,
HC PR G0071 Telephone/Evisit Svcs by Rhc/FQHC 5 Min,PX-52110008,CDM,G0071,HCPCS,521,RC,,inpatient,,,209,188.1,,0.95,,198.55,Percent of total billed charges,,,0.98,,204.82,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.96,,200.64,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,198.55,Percent of total billed charges,,198.55,204.82,
HC PR G0071 Telephone/Evisit Svcs by Rhc/FQHC 5 Min,PX-52110008,CDM,G0071,HCPCS,521,RC,,outpatient,,,209,188.1,,0.95,,198.55,Percent of total billed charges,,,0.98,,204.82,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.96,,200.64,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,198.55,Percent of total billed charges,,198.55,204.82,
HC Pacu Acuity Lvl 5 per Min,PX-71010358,CDM,71010358,LOCAL,710,RC,,inpatient,,,12,10.8,,0.95,,11.4,Percent of total billed charges,,,0.98,,11.76,Percent of total billed charges,,,0.95,,11.4,Percent of total billed charges,,,0.97,,11.64,Percent of total billed charges,,,0.97,,11.64,Percent of total billed charges,,,0.96,,11.52,Percent of total billed charges,,,0.95,,11.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,11.4,Percent of total billed charges,,11.4,11.76,
HC Pacu Acuity Lvl 5 per Min,PX-71010358,CDM,71010358,LOCAL,710,RC,,outpatient,,,12,10.8,,0.95,,11.4,Percent of total billed charges,,,0.98,,11.76,Percent of total billed charges,,,0.95,,11.4,Percent of total billed charges,,,0.95,,11.4,Percent of total billed charges,,,0.97,,11.64,Percent of total billed charges,,,0.96,,11.52,Percent of total billed charges,,,0.95,,11.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,11.4,Percent of total billed charges,,11.4,11.76,
HC Anesthesia Gen by Min Cdm,PX-37010116,CDM,37010116,LOCAL,370,RC,,inpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
HC Anesthesia Gen by Min Cdm,PX-37010116,CDM,37010116,LOCAL,370,RC,,outpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
HC Anesthesia Mac by Min Cdm,PX-37010118,CDM,37010118,LOCAL,370,RC,,inpatient,,,18,16.2,,0.95,,17.1,Percent of total billed charges,,,0.98,,17.64,Percent of total billed charges,,,0.95,,17.1,Percent of total billed charges,,,0.97,,17.46,Percent of total billed charges,,,0.97,,17.46,Percent of total billed charges,,,0.96,,17.28,Percent of total billed charges,,,0.95,,17.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,17.1,Percent of total billed charges,,17.1,17.64,
HC Anesthesia Mac by Min Cdm,PX-37010118,CDM,37010118,LOCAL,370,RC,,outpatient,,,18,16.2,,0.95,,17.1,Percent of total billed charges,,,0.98,,17.64,Percent of total billed charges,,,0.95,,17.1,Percent of total billed charges,,,0.95,,17.1,Percent of total billed charges,,,0.97,,17.46,Percent of total billed charges,,,0.96,,17.28,Percent of total billed charges,,,0.95,,17.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,17.1,Percent of total billed charges,,17.1,17.64,
HC Anesthesia Regional by Min Cdm,PX-37010120,CDM,37010120,LOCAL,370,RC,,inpatient,,,18,16.2,,0.95,,17.1,Percent of total billed charges,,,0.98,,17.64,Percent of total billed charges,,,0.95,,17.1,Percent of total billed charges,,,0.97,,17.46,Percent of total billed charges,,,0.97,,17.46,Percent of total billed charges,,,0.96,,17.28,Percent of total billed charges,,,0.95,,17.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,17.1,Percent of total billed charges,,17.1,17.64,
HC Anesthesia Regional by Min Cdm,PX-37010120,CDM,37010120,LOCAL,370,RC,,outpatient,,,18,16.2,,0.95,,17.1,Percent of total billed charges,,,0.98,,17.64,Percent of total billed charges,,,0.95,,17.1,Percent of total billed charges,,,0.95,,17.1,Percent of total billed charges,,,0.97,,17.46,Percent of total billed charges,,,0.96,,17.28,Percent of total billed charges,,,0.95,,17.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,17.1,Percent of total billed charges,,17.1,17.64,
"Psychotherapy, 30 minutes",PX-91410052,CDM,90832,CPT,914,RC,,inpatient,,,168,151.2,,0.95,,159.6,Percent of total billed charges,,,0.98,,164.64,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,0.97,,162.96,Percent of total billed charges,,,0.97,,162.96,Percent of total billed charges,,,0.96,,161.28,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,159.6,Percent of total billed charges,,159.6,164.64,
"Psychotherapy, 30 minutes",PX-91410052,CDM,90832,CPT,914,RC,,outpatient,,,168,151.2,,0.95,,159.6,Percent of total billed charges,,,0.98,,164.64,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,0.97,,162.96,Percent of total billed charges,,,0.96,,161.28,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,159.6,Percent of total billed charges,,159.6,164.64,
"Psychotherapy, 45 minutes",PX-91410053,CDM,90834,CPT,914,RC,,inpatient,,,308,277.2,,0.95,,292.6,Percent of total billed charges,,,0.98,,301.84,Percent of total billed charges,,,0.95,,292.6,Percent of total billed charges,,,0.97,,298.76,Percent of total billed charges,,,0.97,,298.76,Percent of total billed charges,,,0.96,,295.68,Percent of total billed charges,,,0.95,,292.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,292.6,Percent of total billed charges,,292.6,301.84,
"Psychotherapy, 45 minutes",PX-91410053,CDM,90834,CPT,914,RC,,outpatient,,,308,277.2,,0.95,,292.6,Percent of total billed charges,,,0.98,,301.84,Percent of total billed charges,,,0.95,,292.6,Percent of total billed charges,,,0.95,,292.6,Percent of total billed charges,,,0.97,,298.76,Percent of total billed charges,,,0.96,,295.68,Percent of total billed charges,,,0.95,,292.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,292.6,Percent of total billed charges,,292.6,301.84,
"Psychotherapy, 1 hour",PX-91410054,CDM,90837,CPT,914,RC,,inpatient,,,328,295.2,,0.95,,311.6,Percent of total billed charges,,,0.98,,321.44,Percent of total billed charges,,,0.95,,311.6,Percent of total billed charges,,,0.97,,318.16,Percent of total billed charges,,,0.97,,318.16,Percent of total billed charges,,,0.96,,314.88,Percent of total billed charges,,,0.95,,311.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,311.6,Percent of total billed charges,,311.6,321.44,
"Psychotherapy, 1 hour",PX-91410054,CDM,90837,CPT,914,RC,,outpatient,,,328,295.2,,0.95,,311.6,Percent of total billed charges,,,0.98,,321.44,Percent of total billed charges,,,0.95,,311.6,Percent of total billed charges,,,0.95,,311.6,Percent of total billed charges,,,0.97,,318.16,Percent of total billed charges,,,0.96,,314.88,Percent of total billed charges,,,0.95,,311.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,311.6,Percent of total billed charges,,311.6,321.44,
HC Wrist Splint/Velcro,PX-27410120,CDM,L3807,HCPCS,274,RC,,inpatient,,,127,114.3,,0.95,,120.65,Percent of total billed charges,,,0.98,,124.46,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,0.97,,123.19,Percent of total billed charges,,,0.97,,123.19,Percent of total billed charges,,,0.96,,121.92,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,120.65,Percent of total billed charges,,120.65,124.46,
HC Wrist Splint/Velcro,PX-27410120,CDM,L3807,HCPCS,274,RC,,outpatient,,,127,114.3,,0.95,,120.65,Percent of total billed charges,,,0.98,,124.46,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,0.97,,123.19,Percent of total billed charges,,,0.96,,121.92,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,120.65,Percent of total billed charges,,120.65,124.46,
Measurerement of (Covid-19) antibody,PX-30210241,CDM,86769,CPT,302,RC,,inpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
Measurerement of (Covid-19) antibody,PX-30210241,CDM,86769,CPT,302,RC,,outpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
Remove stabilizing device from head,PX-36112019,CDM,20665,CPT,361,RC,,inpatient,,,603,542.7,,0.95,,572.85,Percent of total billed charges,,,0.98,,590.94,Percent of total billed charges,,,0.95,,572.85,Percent of total billed charges,,,0.97,,584.91,Percent of total billed charges,,,0.97,,584.91,Percent of total billed charges,,,0.96,,578.88,Percent of total billed charges,,,0.95,,572.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,572.85,Percent of total billed charges,,572.85,590.94,
Remove stabilizing device from head,PX-36112019,CDM,20665,CPT,361,RC,,outpatient,,,603,542.7,,0.95,,572.85,Percent of total billed charges,,,0.98,,590.94,Percent of total billed charges,,,0.95,,572.85,Percent of total billed charges,,,0.95,,572.85,Percent of total billed charges,,,0.97,,584.91,Percent of total billed charges,,,0.96,,578.88,Percent of total billed charges,,,0.95,,572.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,572.85,Percent of total billed charges,,572.85,590.94,
"Uric acid level, blood",PX-30110570,CDM,84550,CPT,301,RC,,inpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
"Uric acid level, blood",PX-30110570,CDM,84550,CPT,301,RC,,outpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
"RBC sedimentation rate, to detect inflammation no automated",PX-30510011,CDM,85651,CPT,305,RC,,inpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19,Percent of total billed charges,,19,19.6,
"RBC sedimentation rate, to detect inflammation no automated",PX-30510011,CDM,85651,CPT,305,RC,,outpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19,Percent of total billed charges,,19,19.6,
Screening test for autoimmune disorder,PX-30210244,CDM,86038,CPT,302,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
Screening test for autoimmune disorder,PX-30210244,CDM,86038,CPT,302,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
Rheumatoid factor level,PX-30210245,CDM,86431,CPT,302,RC,,inpatient,,,31,27.9,,0.95,,29.45,Percent of total billed charges,,,0.98,,30.38,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.96,,29.76,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,29.45,Percent of total billed charges,,29.45,30.38,
Rheumatoid factor level,PX-30210245,CDM,86431,CPT,302,RC,,outpatient,,,31,27.9,,0.95,,29.45,Percent of total billed charges,,,0.98,,30.38,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.96,,29.76,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,29.45,Percent of total billed charges,,29.45,30.38,
Protoporphyrin (metabolism substance) level,PX-30110797,CDM,84202,CPT,301,RC,,inpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Protoporphyrin (metabolism substance) level,PX-30110797,CDM,84202,CPT,301,RC,,outpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
HC PR 10080 Incision & Drainage Pilonidal Cyst Simple Rhc,PX-52120002,CDM,10080,CPT,521,RC,,inpatient,,,546,491.4,,0.95,,518.7,Percent of total billed charges,,,0.98,,535.08,Percent of total billed charges,,,0.95,,518.7,Percent of total billed charges,,,0.97,,529.62,Percent of total billed charges,,,0.97,,529.62,Percent of total billed charges,,,0.96,,524.16,Percent of total billed charges,,,0.95,,518.7,Percent of total billed charges,,,,,,,,,0.95,,518.7,Percent of total billed charges,,518.7,535.08,
HC PR 10080 Incision & Drainage Pilonidal Cyst Simple Rhc,PX-52120002,CDM,10080,CPT,521,RC,,outpatient,,,546,491.4,,0.95,,518.7,Percent of total billed charges,,,0.98,,535.08,Percent of total billed charges,,,0.95,,518.7,Percent of total billed charges,,,0.95,,518.7,Percent of total billed charges,,,0.97,,529.62,Percent of total billed charges,,,0.96,,524.16,Percent of total billed charges,,,0.95,,518.7,Percent of total billed charges,,,,,,,,,0.95,,518.7,Percent of total billed charges,,518.7,535.08,
"Test by nucleic acid for clostridium difficile, amplified",PX-30016255,CDM,87493,CPT,306,RC,,inpatient,,,183,164.7,,0.95,,173.85,Percent of total billed charges,,,0.98,,179.34,Percent of total billed charges,,,0.95,,173.85,Percent of total billed charges,,,0.97,,177.51,Percent of total billed charges,,,0.97,,177.51,Percent of total billed charges,,,0.96,,175.68,Percent of total billed charges,,,0.95,,173.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,173.85,Percent of total billed charges,,173.85,179.34,
"Test by nucleic acid for clostridium difficile, amplified",PX-30016255,CDM,87493,CPT,306,RC,,outpatient,,,183,164.7,,0.95,,173.85,Percent of total billed charges,,,0.98,,179.34,Percent of total billed charges,,,0.95,,173.85,Percent of total billed charges,,,0.95,,173.85,Percent of total billed charges,,,0.97,,177.51,Percent of total billed charges,,,0.96,,175.68,Percent of total billed charges,,,0.95,,173.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,173.85,Percent of total billed charges,,173.85,179.34,
Heavy metal level,PX-30016272,CDM,83018,CPT,301,RC,,inpatient,,,96,86.4,,0.95,,91.2,Percent of total billed charges,,,0.98,,94.08,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.96,,92.16,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,91.2,Percent of total billed charges,,91.2,94.08,
Heavy metal level,PX-30016272,CDM,83018,CPT,301,RC,,outpatient,,,96,86.4,,0.95,,91.2,Percent of total billed charges,,,0.98,,94.08,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.96,,92.16,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,91.2,Percent of total billed charges,,91.2,94.08,
Creatinine level to test for kidney function/muscle injury,PX-30016275,CDM,82570,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Creatinine level to test for kidney function/muscle injury,PX-30016275,CDM,82570,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Chromium level to test for poisoning or deficiency,PX-30016280,CDM,82495,CPT,301,RC,,inpatient,,,120,108,,0.95,,114,Percent of total billed charges,,,0.98,,117.6,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.96,,115.2,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114,Percent of total billed charges,,114,117.6,
Chromium level to test for poisoning or deficiency,PX-30016280,CDM,82495,CPT,301,RC,,outpatient,,,120,108,,0.95,,114,Percent of total billed charges,,,0.98,,117.6,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.96,,115.2,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114,Percent of total billed charges,,114,117.6,
"Measure antibody to allergic, crude allergen extract, each",PX-30016288,CDM,86003,CPT,302,RC,,inpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
"Measure antibody to allergic, crude allergen extract, each",PX-30016288,CDM,86003,CPT,302,RC,,outpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
Artery puncture collection of blood sample,PX-41010006,CDM,36600,CPT,410,RC,,inpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
Artery puncture collection of blood sample,PX-41010006,CDM,36600,CPT,410,RC,,outpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
Manual attempt to restore blood circulation and breathing,PX-41010007,CDM,92950,CPT,410,RC,,inpatient,,,773,695.7,,0.95,,734.35,Percent of total billed charges,,,0.98,,757.54,Percent of total billed charges,,,0.95,,734.35,Percent of total billed charges,,,0.97,,749.81,Percent of total billed charges,,,0.97,,749.81,Percent of total billed charges,,,0.96,,742.08,Percent of total billed charges,,,0.95,,734.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,734.35,Percent of total billed charges,,734.35,757.54,
Manual attempt to restore blood circulation and breathing,PX-41010007,CDM,92950,CPT,410,RC,,outpatient,,,773,695.7,,0.95,,734.35,Percent of total billed charges,,,0.98,,757.54,Percent of total billed charges,,,0.95,,734.35,Percent of total billed charges,,,0.95,,734.35,Percent of total billed charges,,,0.97,,749.81,Percent of total billed charges,,,0.96,,742.08,Percent of total billed charges,,,0.95,,734.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,734.35,Percent of total billed charges,,734.35,757.54,
Measure total volume of air exhaled after inhaling,PX-46010090,CDM,94150,CPT,460,RC,,inpatient,,,85,76.5,,0.95,,80.75,Percent of total billed charges,,,0.98,,83.3,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.96,,81.6,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,80.75,Percent of total billed charges,,80.75,83.3,
Measure total volume of air exhaled after inhaling,PX-46010090,CDM,94150,CPT,460,RC,,outpatient,,,85,76.5,,0.95,,80.75,Percent of total billed charges,,,0.98,,83.3,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.96,,81.6,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,80.75,Percent of total billed charges,,80.75,83.3,
Inhalation for airway obstruction or sputum production,PX-41210004,CDM,94640,CPT,410,RC,,inpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
Inhalation for airway obstruction or sputum production,PX-41210004,CDM,94640,CPT,410,RC,,outpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
Inhalation for airway obstruction or sputum production,PX-41210006,CDM,94640,CPT,410,RC,,inpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
Inhalation for airway obstruction or sputum production,PX-41210006,CDM,94640,CPT,410,RC,,outpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
"Inhalation treatment for acute airway obstruction, 1st hr",PX-41210008,CDM,94644,CPT,410,RC,,inpatient,,,153,137.7,,0.95,,145.35,Percent of total billed charges,,,0.98,,149.94,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.96,,146.88,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,145.35,Percent of total billed charges,,145.35,149.94,
"Inhalation treatment for acute airway obstruction, 1st hr",PX-41210008,CDM,94644,CPT,410,RC,,outpatient,,,153,137.7,,0.95,,145.35,Percent of total billed charges,,,0.98,,149.94,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.96,,146.88,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,145.35,Percent of total billed charges,,145.35,149.94,
Evaluation of use of breathing device,PX-41210009,CDM,94664,CPT,410,RC,,inpatient,,,107,96.3,,0.95,,101.65,Percent of total billed charges,,,0.98,,104.86,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.96,,102.72,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,101.65,Percent of total billed charges,,101.65,104.86,
Evaluation of use of breathing device,PX-41210009,CDM,94664,CPT,410,RC,,outpatient,,,107,96.3,,0.95,,101.65,Percent of total billed charges,,,0.98,,104.86,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.96,,102.72,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,101.65,Percent of total billed charges,,101.65,104.86,
Patient Convenience Items - General,PX-41010011,CDM,41010011,LOCAL,460,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Patient Convenience Items - General,PX-41010011,CDM,41010011,LOCAL,460,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Measure oxygen level in blood using ear or finger device,PX-41010012,CDM,94761,CPT,410,RC,,inpatient,,,120,108,,0.95,,114,Percent of total billed charges,,,0.98,,117.6,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.96,,115.2,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114,Percent of total billed charges,,114,117.6,
Measure oxygen level in blood using ear or finger device,PX-41010012,CDM,94761,CPT,410,RC,,outpatient,,,120,108,,0.95,,114,Percent of total billed charges,,,0.98,,117.6,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.96,,115.2,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114,Percent of total billed charges,,114,117.6,
Measure oxygen level in blood using ear or finger device,PX-41010013,CDM,94762,CPT,460,RC,,inpatient,,,221,198.9,,0.95,,209.95,Percent of total billed charges,,,0.98,,216.58,Percent of total billed charges,,,0.95,,209.95,Percent of total billed charges,,,0.97,,214.37,Percent of total billed charges,,,0.97,,214.37,Percent of total billed charges,,,0.96,,212.16,Percent of total billed charges,,,0.95,,209.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,209.95,Percent of total billed charges,,209.95,216.58,
Measure oxygen level in blood using ear or finger device,PX-41010013,CDM,94762,CPT,460,RC,,outpatient,,,221,198.9,,0.95,,209.95,Percent of total billed charges,,,0.98,,216.58,Percent of total billed charges,,,0.95,,209.95,Percent of total billed charges,,,0.95,,209.95,Percent of total billed charges,,,0.97,,214.37,Percent of total billed charges,,,0.96,,212.16,Percent of total billed charges,,,0.95,,209.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,209.95,Percent of total billed charges,,209.95,216.58,
Electrocardiogram (ECG) up to 30 days continuous,PX-48210017,CDM,93268,CPT,482,RC,,inpatient,,,686,617.4,,0.95,,651.7,Percent of total billed charges,,,0.98,,672.28,Percent of total billed charges,,,0.95,,651.7,Percent of total billed charges,,,0.97,,665.42,Percent of total billed charges,,,0.97,,665.42,Percent of total billed charges,,,0.96,,658.56,Percent of total billed charges,,,0.95,,651.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,651.7,Percent of total billed charges,,651.7,672.28,
Electrocardiogram (ECG) up to 30 days continuous,PX-48210017,CDM,93268,CPT,482,RC,,outpatient,,,686,617.4,,0.95,,651.7,Percent of total billed charges,,,0.98,,672.28,Percent of total billed charges,,,0.95,,651.7,Percent of total billed charges,,,0.95,,651.7,Percent of total billed charges,,,0.97,,665.42,Percent of total billed charges,,,0.96,,658.56,Percent of total billed charges,,,0.95,,651.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,651.7,Percent of total billed charges,,651.7,672.28,
Electrocardiogram up to 30 days continuous,PX-48210019,CDM,93270,CPT,730,RC,,inpatient,,,326,293.4,,0.95,,309.7,Percent of total billed charges,,,0.98,,319.48,Percent of total billed charges,,,0.95,,309.7,Percent of total billed charges,,,0.97,,316.22,Percent of total billed charges,,,0.97,,316.22,Percent of total billed charges,,,0.96,,312.96,Percent of total billed charges,,,0.95,,309.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,309.7,Percent of total billed charges,,309.7,319.48,
Electrocardiogram up to 30 days continuous,PX-48210019,CDM,93270,CPT,730,RC,,outpatient,,,326,293.4,,0.95,,309.7,Percent of total billed charges,,,0.98,,319.48,Percent of total billed charges,,,0.95,,309.7,Percent of total billed charges,,,0.95,,309.7,Percent of total billed charges,,,0.97,,316.22,Percent of total billed charges,,,0.96,,312.96,Percent of total billed charges,,,0.95,,309.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,309.7,Percent of total billed charges,,309.7,319.48,
HC PR 11306 Shaving Skin Lesion 1 S/N/H/F/G Diam 0.6-1.0 Cm Cdm Cdm,PX-97514000,CDM,11306,CPT,975,RC,,inpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,286.9,Percent of total billed charges,,286.9,295.96,
HC PR 11306 Shaving Skin Lesion 1 S/N/H/F/G Diam 0.6-1.0 Cm Cdm Cdm,PX-97514000,CDM,11306,CPT,975,RC,,outpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,286.9,Percent of total billed charges,,286.9,295.96,
HC PR 11406 Exc B9 Lesion Mrgn Xcp Sk Tg T/a/L >4.0 Cm Cdm Cdm,PX-97514003,CDM,11406,CPT,975,RC,,inpatient,,,688,619.2,,0.95,,653.6,Percent of total billed charges,,,0.98,,674.24,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,0.97,,667.36,Percent of total billed charges,,,0.97,,667.36,Percent of total billed charges,,,0.96,,660.48,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,,,,,,,0.95,,653.6,Percent of total billed charges,,653.6,674.24,
HC PR 11406 Exc B9 Lesion Mrgn Xcp Sk Tg T/a/L >4.0 Cm Cdm Cdm,PX-97514003,CDM,11406,CPT,975,RC,,outpatient,,,688,619.2,,0.95,,653.6,Percent of total billed charges,,,0.98,,674.24,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,0.97,,667.36,Percent of total billed charges,,,0.96,,660.48,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,,,,,,,0.95,,653.6,Percent of total billed charges,,653.6,674.24,
HC PR 11424 Exc B9 Lesion Mrgn Xcp Sk Tg S/N/H/F/G 3.1-4.0cm Cdm Cdm,PX-97514005,CDM,11424,CPT,975,RC,,inpatient,,,588,529.2,,0.95,,558.6,Percent of total billed charges,,,0.98,,576.24,Percent of total billed charges,,,0.95,,558.6,Percent of total billed charges,,,0.97,,570.36,Percent of total billed charges,,,0.97,,570.36,Percent of total billed charges,,,0.96,,564.48,Percent of total billed charges,,,0.95,,558.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,558.6,Percent of total billed charges,,558.6,576.24,
HC PR 11424 Exc B9 Lesion Mrgn Xcp Sk Tg S/N/H/F/G 3.1-4.0cm Cdm Cdm,PX-97514005,CDM,11424,CPT,975,RC,,outpatient,,,588,529.2,,0.95,,558.6,Percent of total billed charges,,,0.98,,576.24,Percent of total billed charges,,,0.95,,558.6,Percent of total billed charges,,,0.95,,558.6,Percent of total billed charges,,,0.97,,570.36,Percent of total billed charges,,,0.96,,564.48,Percent of total billed charges,,,0.95,,558.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,558.6,Percent of total billed charges,,558.6,576.24,
HC PR 13121 Repair Complex Scalp/Arm/Leg 2.6-7.5 Cm Cdm Cdm,PX-97514017,CDM,13121,CPT,975,RC,,inpatient,,,1045,940.5,,0.95,,992.75,Percent of total billed charges,,,0.98,,1024.1,Percent of total billed charges,,,0.95,,992.75,Percent of total billed charges,,,0.97,,1013.65,Percent of total billed charges,,,0.97,,1013.65,Percent of total billed charges,,,0.96,,1003.2,Percent of total billed charges,,,0.95,,992.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,992.75,Percent of total billed charges,,992.75,1024.1,
HC PR 13121 Repair Complex Scalp/Arm/Leg 2.6-7.5 Cm Cdm Cdm,PX-97514017,CDM,13121,CPT,975,RC,,outpatient,,,1045,940.5,,0.95,,992.75,Percent of total billed charges,,,0.98,,1024.1,Percent of total billed charges,,,0.95,,992.75,Percent of total billed charges,,,0.95,,992.75,Percent of total billed charges,,,0.97,,1013.65,Percent of total billed charges,,,0.96,,1003.2,Percent of total billed charges,,,0.95,,992.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,992.75,Percent of total billed charges,,992.75,1024.1,
HC PR 13122 Repair Complex Scalp/Arm/Leg Ea Addl 5 Cm/< Cdm Cdm,PX-97514018,CDM,13122,CPT,975,RC,,inpatient,,,312,280.8,,0.95,,296.4,Percent of total billed charges,,,0.98,,305.76,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,0.97,,302.64,Percent of total billed charges,,,0.97,,302.64,Percent of total billed charges,,,0.96,,299.52,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,296.4,Percent of total billed charges,,296.4,305.76,
HC PR 13122 Repair Complex Scalp/Arm/Leg Ea Addl 5 Cm/< Cdm Cdm,PX-97514018,CDM,13122,CPT,975,RC,,outpatient,,,312,280.8,,0.95,,296.4,Percent of total billed charges,,,0.98,,305.76,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,0.97,,302.64,Percent of total billed charges,,,0.96,,299.52,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,296.4,Percent of total billed charges,,296.4,305.76,
HC PR 20680 Removal Implant Deep Cdm Cdm,PX-97514030,CDM,20680,CPT,975,RC,,inpatient,,,1483,1334.7,,0.95,,1408.85,Percent of total billed charges,,,0.98,,1453.34,Percent of total billed charges,,,0.95,,1408.85,Percent of total billed charges,,,0.97,,1438.51,Percent of total billed charges,,,0.97,,1438.51,Percent of total billed charges,,,0.96,,1423.68,Percent of total billed charges,,,0.95,,1408.85,Percent of total billed charges,,,,,,,,,0.95,,1408.85,Percent of total billed charges,,1408.85,1453.34,
HC PR 20680 Removal Implant Deep Cdm Cdm,PX-97514030,CDM,20680,CPT,975,RC,,outpatient,,,1483,1334.7,,0.95,,1408.85,Percent of total billed charges,,,0.98,,1453.34,Percent of total billed charges,,,0.95,,1408.85,Percent of total billed charges,,,0.95,,1408.85,Percent of total billed charges,,,0.97,,1438.51,Percent of total billed charges,,,0.96,,1423.68,Percent of total billed charges,,,0.95,,1408.85,Percent of total billed charges,,,,,,,,,0.95,,1408.85,Percent of total billed charges,,1408.85,1453.34,
HC PR 21501 I&D Deep Absc/Hmtma Soft Tissue Neck/Thorax Cdm Cdm,PX-97514033,CDM,21501,CPT,975,RC,,inpatient,,,1209,1088.1,,0.95,,1148.55,Percent of total billed charges,,,0.98,,1184.82,Percent of total billed charges,,,0.95,,1148.55,Percent of total billed charges,,,0.97,,1172.73,Percent of total billed charges,,,0.97,,1172.73,Percent of total billed charges,,,0.96,,1160.64,Percent of total billed charges,,,0.95,,1148.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1148.55,Percent of total billed charges,,1148.55,1184.82,
HC PR 21501 I&D Deep Absc/Hmtma Soft Tissue Neck/Thorax Cdm Cdm,PX-97514033,CDM,21501,CPT,975,RC,,outpatient,,,1209,1088.1,,0.95,,1148.55,Percent of total billed charges,,,0.98,,1184.82,Percent of total billed charges,,,0.95,,1148.55,Percent of total billed charges,,,0.95,,1148.55,Percent of total billed charges,,,0.97,,1172.73,Percent of total billed charges,,,0.96,,1160.64,Percent of total billed charges,,,0.95,,1148.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1148.55,Percent of total billed charges,,1148.55,1184.82,
HC PR 21933 Exc Tumor Soft Tiss Back/Flank Subfascial 5 Cm/> Cdm Cdm,PX-97514034,CDM,21933,CPT,975,RC,,inpatient,,,1595,1435.5,,0.95,,1515.25,Percent of total billed charges,,,0.98,,1563.1,Percent of total billed charges,,,0.95,,1515.25,Percent of total billed charges,,,0.97,,1547.15,Percent of total billed charges,,,0.97,,1547.15,Percent of total billed charges,,,0.96,,1531.2,Percent of total billed charges,,,0.95,,1515.25,Percent of total billed charges,,,,,,,,,0.95,,1515.25,Percent of total billed charges,,1515.25,1563.1,
HC PR 21933 Exc Tumor Soft Tiss Back/Flank Subfascial 5 Cm/> Cdm Cdm,PX-97514034,CDM,21933,CPT,975,RC,,outpatient,,,1595,1435.5,,0.95,,1515.25,Percent of total billed charges,,,0.98,,1563.1,Percent of total billed charges,,,0.95,,1515.25,Percent of total billed charges,,,0.95,,1515.25,Percent of total billed charges,,,0.97,,1547.15,Percent of total billed charges,,,0.96,,1531.2,Percent of total billed charges,,,0.95,,1515.25,Percent of total billed charges,,,,,,,,,0.95,,1515.25,Percent of total billed charges,,1515.25,1563.1,
HC PR 23071 Excision Tumor Soft Tissue Shoulder Subq 3 Cm/> Cdm Cdm,PX-97514035,CDM,23071,CPT,975,RC,,inpatient,,,1045,940.5,,0.95,,992.75,Percent of total billed charges,,,0.98,,1024.1,Percent of total billed charges,,,0.95,,992.75,Percent of total billed charges,,,0.97,,1013.65,Percent of total billed charges,,,0.97,,1013.65,Percent of total billed charges,,,0.96,,1003.2,Percent of total billed charges,,,0.95,,992.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,992.75,Percent of total billed charges,,992.75,1024.1,
HC PR 23071 Excision Tumor Soft Tissue Shoulder Subq 3 Cm/> Cdm Cdm,PX-97514035,CDM,23071,CPT,975,RC,,outpatient,,,1045,940.5,,0.95,,992.75,Percent of total billed charges,,,0.98,,1024.1,Percent of total billed charges,,,0.95,,992.75,Percent of total billed charges,,,0.95,,992.75,Percent of total billed charges,,,0.97,,1013.65,Percent of total billed charges,,,0.96,,1003.2,Percent of total billed charges,,,0.95,,992.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,992.75,Percent of total billed charges,,992.75,1024.1,
HC PR 27337 Excison Tumor Soft Tissue Thigh/Knee Subq 3 Cm/> Cdm Cdm,PX-97514041,CDM,27337,CPT,975,RC,,inpatient,,,1043,938.7,,0.95,,990.85,Percent of total billed charges,,,0.98,,1022.14,Percent of total billed charges,,,0.95,,990.85,Percent of total billed charges,,,0.97,,1011.71,Percent of total billed charges,,,0.97,,1011.71,Percent of total billed charges,,,0.96,,1001.28,Percent of total billed charges,,,0.95,,990.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,990.85,Percent of total billed charges,,990.85,1022.14,
HC PR 27337 Excison Tumor Soft Tissue Thigh/Knee Subq 3 Cm/> Cdm Cdm,PX-97514041,CDM,27337,CPT,975,RC,,outpatient,,,1043,938.7,,0.95,,990.85,Percent of total billed charges,,,0.98,,1022.14,Percent of total billed charges,,,0.95,,990.85,Percent of total billed charges,,,0.95,,990.85,Percent of total billed charges,,,0.97,,1011.71,Percent of total billed charges,,,0.96,,1001.28,Percent of total billed charges,,,0.95,,990.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,990.85,Percent of total billed charges,,990.85,1022.14,
HC PR 36556 Insj Non-Tunneled Central Venous Cath Age 5 Yr/> Cdm Cdm,PX-97514056,CDM,36556,CPT,975,RC,,inpatient,,,520,468,,0.95,,494,Percent of total billed charges,,,0.98,,509.6,Percent of total billed charges,,,0.95,,494,Percent of total billed charges,,,0.97,,504.4,Percent of total billed charges,,,0.97,,504.4,Percent of total billed charges,,,0.96,,499.2,Percent of total billed charges,,,0.95,,494,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,494,Percent of total billed charges,,494,509.6,
HC PR 36556 Insj Non-Tunneled Central Venous Cath Age 5 Yr/> Cdm Cdm,PX-97514056,CDM,36556,CPT,975,RC,,outpatient,,,520,468,,0.95,,494,Percent of total billed charges,,,0.98,,509.6,Percent of total billed charges,,,0.95,,494,Percent of total billed charges,,,0.95,,494,Percent of total billed charges,,,0.97,,504.4,Percent of total billed charges,,,0.96,,499.2,Percent of total billed charges,,,0.95,,494,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,494,Percent of total billed charges,,494,509.6,
HC PR 49521 Rpr Recrt Ingun Hernia Any Age Incarcerated Cdm Cdm,PX-97514080,CDM,49521,CPT,975,RC,,inpatient,,,1770,1593,,0.95,,1681.5,Percent of total billed charges,,,0.98,,1734.6,Percent of total billed charges,,,0.95,,1681.5,Percent of total billed charges,,,0.97,,1716.9,Percent of total billed charges,,,0.97,,1716.9,Percent of total billed charges,,,0.96,,1699.2,Percent of total billed charges,,,0.95,,1681.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1681.5,Percent of total billed charges,,1681.5,1734.6,
HC PR 49521 Rpr Recrt Ingun Hernia Any Age Incarcerated Cdm Cdm,PX-97514080,CDM,49521,CPT,975,RC,,outpatient,,,1770,1593,,0.95,,1681.5,Percent of total billed charges,,,0.98,,1734.6,Percent of total billed charges,,,0.95,,1681.5,Percent of total billed charges,,,0.95,,1681.5,Percent of total billed charges,,,0.97,,1716.9,Percent of total billed charges,,,0.96,,1699.2,Percent of total billed charges,,,0.95,,1681.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1681.5,Percent of total billed charges,,1681.5,1734.6,
Measurement of infliximab,PX-30110807,CDM,80230,CPT,301,RC,,inpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
Measurement of infliximab,PX-30110807,CDM,80230,CPT,301,RC,,outpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
HC PR G2025 Telehealth Visit Distant Site Fee Cdm,PX-98311378,CDM,G2025,HCPCS,521,RC,,inpatient,,,299,269.1,,0.95,,284.05,Percent of total billed charges,,,0.98,,293.02,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,0.97,,290.03,Percent of total billed charges,,,0.97,,290.03,Percent of total billed charges,,,0.96,,287.04,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,284.05,Percent of total billed charges,,284.05,293.02,
HC PR G2025 Telehealth Visit Distant Site Fee Cdm,PX-98311378,CDM,G2025,HCPCS,521,RC,,outpatient,,,299,269.1,,0.95,,284.05,Percent of total billed charges,,,0.98,,293.02,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,0.97,,290.03,Percent of total billed charges,,,0.96,,287.04,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,284.05,Percent of total billed charges,,284.05,293.02,
HC PR 10081 Incision & Drainage Pilonidal Cyst Complicated Cdm,PX-97514150,CDM,10081,CPT,975,RC,,inpatient,,,675,607.5,,0.95,,641.25,Percent of total billed charges,,,0.98,,661.5,Percent of total billed charges,,,0.95,,641.25,Percent of total billed charges,,,0.97,,654.75,Percent of total billed charges,,,0.97,,654.75,Percent of total billed charges,,,0.96,,648,Percent of total billed charges,,,0.95,,641.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,641.25,Percent of total billed charges,,641.25,661.5,
HC PR 10081 Incision & Drainage Pilonidal Cyst Complicated Cdm,PX-97514150,CDM,10081,CPT,975,RC,,outpatient,,,675,607.5,,0.95,,641.25,Percent of total billed charges,,,0.98,,661.5,Percent of total billed charges,,,0.95,,641.25,Percent of total billed charges,,,0.95,,641.25,Percent of total billed charges,,,0.97,,654.75,Percent of total billed charges,,,0.96,,648,Percent of total billed charges,,,0.95,,641.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,641.25,Percent of total billed charges,,641.25,661.5,
HC PR 28825 Amputation Toe Interphalangeal Joint Cdm,PX-97514151,CDM,28825,CPT,975,RC,,inpatient,,,717,645.3,,0.95,,681.15,Percent of total billed charges,,,0.98,,702.66,Percent of total billed charges,,,0.95,,681.15,Percent of total billed charges,,,0.97,,695.49,Percent of total billed charges,,,0.97,,695.49,Percent of total billed charges,,,0.96,,688.32,Percent of total billed charges,,,0.95,,681.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,681.15,Percent of total billed charges,,681.15,702.66,
HC PR 28825 Amputation Toe Interphalangeal Joint Cdm,PX-97514151,CDM,28825,CPT,975,RC,,outpatient,,,717,645.3,,0.95,,681.15,Percent of total billed charges,,,0.98,,702.66,Percent of total billed charges,,,0.95,,681.15,Percent of total billed charges,,,0.95,,681.15,Percent of total billed charges,,,0.97,,695.49,Percent of total billed charges,,,0.96,,688.32,Percent of total billed charges,,,0.95,,681.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,681.15,Percent of total billed charges,,681.15,702.66,
HC PR 64450 Injection Anes Other Peripheral Nerve/Branch Cdm,PX-98311386,CDM,64450,CPT,983,RC,,inpatient,,,186,167.4,,0.95,,176.7,Percent of total billed charges,,,0.98,,182.28,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.96,,178.56,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,176.7,Percent of total billed charges,,176.7,182.28,
HC PR 64450 Injection Anes Other Peripheral Nerve/Branch Cdm,PX-98311386,CDM,64450,CPT,983,RC,,outpatient,,,186,167.4,,0.95,,176.7,Percent of total billed charges,,,0.98,,182.28,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.96,,178.56,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,176.7,Percent of total billed charges,,176.7,182.28,
Simple drainage of abscess of finger,PX-45014005,CDM,26010,CPT,450,RC,,inpatient,,,578,520.2,,0.95,,549.1,Percent of total billed charges,,,0.98,,566.44,Percent of total billed charges,,,0.95,,549.1,Percent of total billed charges,,,0.97,,560.66,Percent of total billed charges,,,0.97,,560.66,Percent of total billed charges,,,0.96,,554.88,Percent of total billed charges,,,0.95,,549.1,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,549.1,Percent of total billed charges,,549.1,3950,
Simple drainage of abscess of finger,PX-45014005,CDM,26010,CPT,450,RC,,outpatient,,,578,520.2,,0.95,,549.1,Percent of total billed charges,,,0.98,,566.44,Percent of total billed charges,,,0.95,,549.1,Percent of total billed charges,,,0.95,,549.1,Percent of total billed charges,,,0.97,,560.66,Percent of total billed charges,,,0.96,,554.88,Percent of total billed charges,,,0.95,,549.1,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,549.1,Percent of total billed charges,,549.1,3950,
Analysis for antibody to Rubeola (measles virus),PX-30017035,CDM,86765,CPT,302,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Analysis for antibody to Rubeola (measles virus),PX-30017035,CDM,86765,CPT,302,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
HC Pain Room Services Level 2,PX-36010002,CDM,36010002,LOCAL,360,RC,,inpatient,,,720,648,,0.95,,684,Percent of total billed charges,,,0.98,,705.6,Percent of total billed charges,,,0.95,,684,Percent of total billed charges,,,0.97,,698.4,Percent of total billed charges,,,0.97,,698.4,Percent of total billed charges,,,0.96,,691.2,Percent of total billed charges,,,0.95,,684,Percent of total billed charges,,,,,,,,,0.95,,684,Percent of total billed charges,,684,705.6,
HC Pain Room Services Level 2,PX-36010002,CDM,36010002,LOCAL,360,RC,,outpatient,,,720,648,,0.95,,684,Percent of total billed charges,,,0.98,,705.6,Percent of total billed charges,,,0.95,,684,Percent of total billed charges,,,0.95,,684,Percent of total billed charges,,,0.97,,698.4,Percent of total billed charges,,,0.96,,691.2,Percent of total billed charges,,,0.95,,684,Percent of total billed charges,,,,,,,,,0.95,,684,Percent of total billed charges,,684,705.6,
HC Pain Room Services Level 3,PX-36010003,CDM,36010003,LOCAL,360,RC,,inpatient,,,946,851.4,,0.95,,898.7,Percent of total billed charges,,,0.98,,927.08,Percent of total billed charges,,,0.95,,898.7,Percent of total billed charges,,,0.97,,917.62,Percent of total billed charges,,,0.97,,917.62,Percent of total billed charges,,,0.96,,908.16,Percent of total billed charges,,,0.95,,898.7,Percent of total billed charges,,,,,,,,,0.95,,898.7,Percent of total billed charges,,898.7,927.08,
HC Pain Room Services Level 3,PX-36010003,CDM,36010003,LOCAL,360,RC,,outpatient,,,946,851.4,,0.95,,898.7,Percent of total billed charges,,,0.98,,927.08,Percent of total billed charges,,,0.95,,898.7,Percent of total billed charges,,,0.95,,898.7,Percent of total billed charges,,,0.97,,917.62,Percent of total billed charges,,,0.96,,908.16,Percent of total billed charges,,,0.95,,898.7,Percent of total billed charges,,,,,,,,,0.95,,898.7,Percent of total billed charges,,898.7,927.08,
Test by immunoassay for severe ARS coronavirus,PX-30600007,CDM,87426,CPT,306,RC,,inpatient,,,55,49.5,,0.95,,52.25,Percent of total billed charges,,,0.98,,53.9,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.96,,52.8,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,52.25,Percent of total billed charges,,52.25,53.9,
Test by immunoassay for severe ARS coronavirus,PX-30600007,CDM,87426,CPT,306,RC,,outpatient,,,55,49.5,,0.95,,52.25,Percent of total billed charges,,,0.98,,53.9,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.96,,52.8,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,52.25,Percent of total billed charges,,52.25,53.9,
Drainage of fluid from abdominal cavity,PX-45014046,CDM,49082,CPT,450,RC,,inpatient,,,705,634.5,,0.95,,669.75,Percent of total billed charges,,,0.98,,690.9,Percent of total billed charges,,,0.95,,669.75,Percent of total billed charges,,,0.97,,683.85,Percent of total billed charges,,,0.97,,683.85,Percent of total billed charges,,,0.96,,676.8,Percent of total billed charges,,,0.95,,669.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,669.75,Percent of total billed charges,,669.75,3950,
Drainage of fluid from abdominal cavity,PX-45014046,CDM,49082,CPT,450,RC,,outpatient,,,705,634.5,,0.95,,669.75,Percent of total billed charges,,,0.98,,690.9,Percent of total billed charges,,,0.95,,669.75,Percent of total billed charges,,,0.95,,669.75,Percent of total billed charges,,,0.97,,683.85,Percent of total billed charges,,,0.96,,676.8,Percent of total billed charges,,,0.95,,669.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,669.75,Percent of total billed charges,,669.75,3950,
HC PR ED 49082 Abd Paracent W/O Imag Guid Cdm,PX-98110907,CDM,49082,CPT,981,RC,,inpatient,,,609,548.1,,0.95,,578.55,Percent of total billed charges,,,0.98,,596.82,Percent of total billed charges,,,0.95,,578.55,Percent of total billed charges,,,0.97,,590.73,Percent of total billed charges,,,0.97,,590.73,Percent of total billed charges,,,0.96,,584.64,Percent of total billed charges,,,0.95,,578.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,578.55,Percent of total billed charges,,578.55,596.82,
HC PR ED 49082 Abd Paracent W/O Imag Guid Cdm,PX-98110907,CDM,49082,CPT,981,RC,,outpatient,,,609,548.1,,0.95,,578.55,Percent of total billed charges,,,0.98,,596.82,Percent of total billed charges,,,0.95,,578.55,Percent of total billed charges,,,0.95,,578.55,Percent of total billed charges,,,0.97,,590.73,Percent of total billed charges,,,0.96,,584.64,Percent of total billed charges,,,0.95,,578.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,578.55,Percent of total billed charges,,578.55,596.82,
Drainage of fluid from abdominal cavity,PX-45014047,CDM,49083,CPT,450,RC,,inpatient,,,1415,1273.5,,0.95,,1344.25,Percent of total billed charges,,,0.98,,1386.7,Percent of total billed charges,,,0.95,,1344.25,Percent of total billed charges,,,0.97,,1372.55,Percent of total billed charges,,,0.97,,1372.55,Percent of total billed charges,,,0.96,,1358.4,Percent of total billed charges,,,0.95,,1344.25,Percent of total billed charges,,,,,,,,,0.95,,1344.25,Percent of total billed charges,,1344.25,1386.7,
Drainage of fluid from abdominal cavity,PX-45014047,CDM,49083,CPT,450,RC,,outpatient,,,1415,1273.5,,0.95,,1344.25,Percent of total billed charges,,,0.98,,1386.7,Percent of total billed charges,,,0.95,,1344.25,Percent of total billed charges,,,0.95,,1344.25,Percent of total billed charges,,,0.97,,1372.55,Percent of total billed charges,,,0.96,,1358.4,Percent of total billed charges,,,0.95,,1344.25,Percent of total billed charges,,,,,,,,,0.95,,1344.25,Percent of total billed charges,,1344.25,1386.7,
HC PR ED 49083 Abd Paracent W/Imag Guidance Cdm,PX-98110908,CDM,49083,CPT,981,RC,,inpatient,,,384,345.6,,0.95,,364.8,Percent of total billed charges,,,0.98,,376.32,Percent of total billed charges,,,0.95,,364.8,Percent of total billed charges,,,0.97,,372.48,Percent of total billed charges,,,0.97,,372.48,Percent of total billed charges,,,0.96,,368.64,Percent of total billed charges,,,0.95,,364.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,364.8,Percent of total billed charges,,364.8,376.32,
HC PR ED 49083 Abd Paracent W/Imag Guidance Cdm,PX-98110908,CDM,49083,CPT,981,RC,,outpatient,,,384,345.6,,0.95,,364.8,Percent of total billed charges,,,0.98,,376.32,Percent of total billed charges,,,0.95,,364.8,Percent of total billed charges,,,0.95,,364.8,Percent of total billed charges,,,0.97,,372.48,Percent of total billed charges,,,0.96,,368.64,Percent of total billed charges,,,0.95,,364.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,364.8,Percent of total billed charges,,364.8,376.32,
Test by nucleic acid for multiple types influenza virus,PX-30211511,CDM,87502,CPT,300,RC,,inpatient,,,258,232.2,,0.95,,245.1,Percent of total billed charges,,,0.98,,252.84,Percent of total billed charges,,,0.95,,245.1,Percent of total billed charges,,,0.97,,250.26,Percent of total billed charges,,,0.97,,250.26,Percent of total billed charges,,,0.96,,247.68,Percent of total billed charges,,,0.95,,245.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,245.1,Percent of total billed charges,,245.1,252.84,
Test by nucleic acid for multiple types influenza virus,PX-30211511,CDM,87502,CPT,300,RC,,outpatient,,,258,232.2,,0.95,,245.1,Percent of total billed charges,,,0.98,,252.84,Percent of total billed charges,,,0.95,,245.1,Percent of total billed charges,,,0.95,,245.1,Percent of total billed charges,,,0.97,,250.26,Percent of total billed charges,,,0.96,,247.68,Percent of total billed charges,,,0.95,,245.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,245.1,Percent of total billed charges,,245.1,252.84,
Test for screening hearing using a probe,PX-47110105,CDM,92558,CPT,471,RC,,inpatient,,,216,194.4,,0.95,,205.2,Percent of total billed charges,,,0.98,,211.68,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,0.97,,209.52,Percent of total billed charges,,,0.97,,209.52,Percent of total billed charges,,,0.96,,207.36,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,205.2,Percent of total billed charges,,205.2,211.68,
Test for screening hearing using a probe,PX-47110105,CDM,92558,CPT,471,RC,,outpatient,,,216,194.4,,0.95,,205.2,Percent of total billed charges,,,0.98,,211.68,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,0.97,,209.52,Percent of total billed charges,,,0.96,,207.36,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,205.2,Percent of total billed charges,,205.2,211.68,
Measurement of substance using immunoassay technique,PX-30100018,CDM,83520,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Measurement of substance using immunoassay technique,PX-30100018,CDM,83520,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Measure substance using immunoassay technique,PX-30100019,CDM,83520,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Measure substance using immunoassay technique,PX-30100019,CDM,83520,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Wrist-hand-finger orthotic,PX-27410241,CDM,L3808,HCPCS,274,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
Wrist-hand-finger orthotic,PX-27410241,CDM,L3808,HCPCS,274,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
Finger orthotic,PX-27410246,CDM,L3933,HCPCS,274,RC,,inpatient,,,216,194.4,,0.95,,205.2,Percent of total billed charges,,,0.98,,211.68,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,0.97,,209.52,Percent of total billed charges,,,0.97,,209.52,Percent of total billed charges,,,0.96,,207.36,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,205.2,Percent of total billed charges,,205.2,211.68,
Finger orthotic,PX-27410246,CDM,L3933,HCPCS,274,RC,,outpatient,,,216,194.4,,0.95,,205.2,Percent of total billed charges,,,0.98,,211.68,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,0.97,,209.52,Percent of total billed charges,,,0.96,,207.36,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,205.2,Percent of total billed charges,,205.2,211.68,
HC PR 64612 Chemodnrvtj Musc Musc Innervated Facial Nrv Unil Cdm,PX-98300111,CDM,64612,CPT,983,RC,,inpatient,,,200,180,,0.95,,190,Percent of total billed charges,,,0.98,,196,Percent of total billed charges,,,0.95,,190,Percent of total billed charges,,,0.97,,194,Percent of total billed charges,,,0.97,,194,Percent of total billed charges,,,0.96,,192,Percent of total billed charges,,,0.95,,190,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,190,Percent of total billed charges,,190,196,
HC PR 64612 Chemodnrvtj Musc Musc Innervated Facial Nrv Unil Cdm,PX-98300111,CDM,64612,CPT,983,RC,,outpatient,,,200,180,,0.95,,190,Percent of total billed charges,,,0.98,,196,Percent of total billed charges,,,0.95,,190,Percent of total billed charges,,,0.95,,190,Percent of total billed charges,,,0.97,,194,Percent of total billed charges,,,0.96,,192,Percent of total billed charges,,,0.95,,190,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,190,Percent of total billed charges,,190,196,
HC PR 64615 Chemodervate Facial/Trigem/Cerv Musc Migraine Cdm,PX-98300112,CDM,64615,CPT,983,RC,,inpatient,,,269,242.1,,0.95,,255.55,Percent of total billed charges,,,0.98,,263.62,Percent of total billed charges,,,0.95,,255.55,Percent of total billed charges,,,0.97,,260.93,Percent of total billed charges,,,0.97,,260.93,Percent of total billed charges,,,0.96,,258.24,Percent of total billed charges,,,0.95,,255.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,255.55,Percent of total billed charges,,255.55,263.62,
HC PR 64615 Chemodervate Facial/Trigem/Cerv Musc Migraine Cdm,PX-98300112,CDM,64615,CPT,983,RC,,outpatient,,,269,242.1,,0.95,,255.55,Percent of total billed charges,,,0.98,,263.62,Percent of total billed charges,,,0.95,,255.55,Percent of total billed charges,,,0.95,,255.55,Percent of total billed charges,,,0.97,,260.93,Percent of total billed charges,,,0.96,,258.24,Percent of total billed charges,,,0.95,,255.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,255.55,Percent of total billed charges,,255.55,263.62,
HC PR 64616 Chemodenervation Muscle Neck Unilat for Dystonia Cdm,PX-98300113,CDM,64616,CPT,983,RC,,inpatient,,,269,242.1,,0.95,,255.55,Percent of total billed charges,,,0.98,,263.62,Percent of total billed charges,,,0.95,,255.55,Percent of total billed charges,,,0.97,,260.93,Percent of total billed charges,,,0.97,,260.93,Percent of total billed charges,,,0.96,,258.24,Percent of total billed charges,,,0.95,,255.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,255.55,Percent of total billed charges,,255.55,263.62,
HC PR 64616 Chemodenervation Muscle Neck Unilat for Dystonia Cdm,PX-98300113,CDM,64616,CPT,983,RC,,outpatient,,,269,242.1,,0.95,,255.55,Percent of total billed charges,,,0.98,,263.62,Percent of total billed charges,,,0.95,,255.55,Percent of total billed charges,,,0.95,,255.55,Percent of total billed charges,,,0.97,,260.93,Percent of total billed charges,,,0.96,,258.24,Percent of total billed charges,,,0.95,,255.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,255.55,Percent of total billed charges,,255.55,263.62,
"Evacuation, Subungual Hematoma",PX-98300143,CDM,11740,CPT,983,RC,,inpatient,,,143,128.7,,0.95,,135.85,Percent of total billed charges,,,0.98,,140.14,Percent of total billed charges,,,0.95,,135.85,Percent of total billed charges,,,0.97,,138.71,Percent of total billed charges,,,0.97,,138.71,Percent of total billed charges,,,0.96,,137.28,Percent of total billed charges,,,0.95,,135.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,135.85,Percent of total billed charges,,135.85,140.14,
"Evacuation, Subungual Hematoma",PX-98300143,CDM,11740,CPT,983,RC,,outpatient,,,143,128.7,,0.95,,135.85,Percent of total billed charges,,,0.98,,140.14,Percent of total billed charges,,,0.95,,135.85,Percent of total billed charges,,,0.95,,135.85,Percent of total billed charges,,,0.97,,138.71,Percent of total billed charges,,,0.96,,137.28,Percent of total billed charges,,,0.95,,135.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,135.85,Percent of total billed charges,,135.85,140.14,
HC PR 29540 Strapping Ankle &/Foot Cdm,PX-98300147,CDM,29540,CPT,983,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
HC PR 29540 Strapping Ankle &/Foot Cdm,PX-98300147,CDM,29540,CPT,983,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Blood creatinine level,PX-30100021,CDM,82565,CPT,301,RC,,inpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
Blood creatinine level,PX-30100021,CDM,82565,CPT,301,RC,,outpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
Care management services - behavioral health issue,PX-90000004,CDM,99484,CPT,900,RC,,inpatient,,,108,97.2,,0.95,,102.6,Percent of total billed charges,,,0.98,,105.84,Percent of total billed charges,,,0.95,,102.6,Percent of total billed charges,,,0.97,,104.76,Percent of total billed charges,,,0.97,,104.76,Percent of total billed charges,,,0.96,,103.68,Percent of total billed charges,,,0.95,,102.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,102.6,Percent of total billed charges,,102.6,105.84,
Care management services - behavioral health issue,PX-90000004,CDM,99484,CPT,900,RC,,outpatient,,,108,97.2,,0.95,,102.6,Percent of total billed charges,,,0.98,,105.84,Percent of total billed charges,,,0.95,,102.6,Percent of total billed charges,,,0.95,,102.6,Percent of total billed charges,,,0.97,,104.76,Percent of total billed charges,,,0.96,,103.68,Percent of total billed charges,,,0.95,,102.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,102.6,Percent of total billed charges,,102.6,105.84,
HC PR 27818 Closed Rx Trimalleolar Fx Manip Cdm,PX-97500037,CDM,27818,CPT,975,RC,,inpatient,,,1254,1128.6,,0.95,,1191.3,Percent of total billed charges,,,0.98,,1228.92,Percent of total billed charges,,,0.95,,1191.3,Percent of total billed charges,,,0.97,,1216.38,Percent of total billed charges,,,0.97,,1216.38,Percent of total billed charges,,,0.96,,1203.84,Percent of total billed charges,,,0.95,,1191.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1191.3,Percent of total billed charges,,1191.3,1228.92,
HC PR 27818 Closed Rx Trimalleolar Fx Manip Cdm,PX-97500037,CDM,27818,CPT,975,RC,,outpatient,,,1254,1128.6,,0.95,,1191.3,Percent of total billed charges,,,0.98,,1228.92,Percent of total billed charges,,,0.95,,1191.3,Percent of total billed charges,,,0.95,,1191.3,Percent of total billed charges,,,0.97,,1216.38,Percent of total billed charges,,,0.96,,1203.84,Percent of total billed charges,,,0.95,,1191.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1191.3,Percent of total billed charges,,1191.3,1228.92,
"HC PR 25609 Open Rx Distal Radius Fx, Intra-Articular, 3+ Frag [25609] Cdm",PX-97500046,CDM,25609,CPT,975,RC,,inpatient,,,2245,2020.5,,0.95,,2132.75,Percent of total billed charges,,,0.98,,2200.1,Percent of total billed charges,,,0.95,,2132.75,Percent of total billed charges,,,0.97,,2177.65,Percent of total billed charges,,,0.97,,2177.65,Percent of total billed charges,,,0.96,,2155.2,Percent of total billed charges,,,0.95,,2132.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2132.75,Percent of total billed charges,,2132.75,2200.1,
"HC PR 25609 Open Rx Distal Radius Fx, Intra-Articular, 3+ Frag [25609] Cdm",PX-97500046,CDM,25609,CPT,975,RC,,outpatient,,,2245,2020.5,,0.95,,2132.75,Percent of total billed charges,,,0.98,,2200.1,Percent of total billed charges,,,0.95,,2132.75,Percent of total billed charges,,,0.95,,2132.75,Percent of total billed charges,,,0.97,,2177.65,Percent of total billed charges,,,0.96,,2155.2,Percent of total billed charges,,,0.95,,2132.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2132.75,Percent of total billed charges,,2132.75,2200.1,
HC PR 26055 Incise Finger Tendon Sheath [26055] Cdm,PX-97500047,CDM,26055,CPT,975,RC,,inpatient,,,1458,1312.2,,0.95,,1385.1,Percent of total billed charges,,,0.98,,1428.84,Percent of total billed charges,,,0.95,,1385.1,Percent of total billed charges,,,0.97,,1414.26,Percent of total billed charges,,,0.97,,1414.26,Percent of total billed charges,,,0.96,,1399.68,Percent of total billed charges,,,0.95,,1385.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1385.1,Percent of total billed charges,,1385.1,1428.84,
HC PR 26055 Incise Finger Tendon Sheath [26055] Cdm,PX-97500047,CDM,26055,CPT,975,RC,,outpatient,,,1458,1312.2,,0.95,,1385.1,Percent of total billed charges,,,0.98,,1428.84,Percent of total billed charges,,,0.95,,1385.1,Percent of total billed charges,,,0.95,,1385.1,Percent of total billed charges,,,0.97,,1414.26,Percent of total billed charges,,,0.96,,1399.68,Percent of total billed charges,,,0.95,,1385.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1385.1,Percent of total billed charges,,1385.1,1428.84,
HC PR 45398 Colonoscopy Flexible With Band Ligation(S) [45398] Cdm,PX-97500052,CDM,45398,CPT,975,RC,,inpatient,,,2008,1807.2,,0.95,,1907.6,Percent of total billed charges,,,0.98,,1967.84,Percent of total billed charges,,,0.95,,1907.6,Percent of total billed charges,,,0.97,,1947.76,Percent of total billed charges,,,0.97,,1947.76,Percent of total billed charges,,,0.96,,1927.68,Percent of total billed charges,,,0.95,,1907.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1907.6,Percent of total billed charges,,1907.6,1967.84,
HC PR 45398 Colonoscopy Flexible With Band Ligation(S) [45398] Cdm,PX-97500052,CDM,45398,CPT,975,RC,,outpatient,,,2008,1807.2,,0.95,,1907.6,Percent of total billed charges,,,0.98,,1967.84,Percent of total billed charges,,,0.95,,1907.6,Percent of total billed charges,,,0.95,,1907.6,Percent of total billed charges,,,0.97,,1947.76,Percent of total billed charges,,,0.96,,1927.68,Percent of total billed charges,,,0.95,,1907.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1907.6,Percent of total billed charges,,1907.6,1967.84,
HC PR ED 17250 Chemical Cauterization of Granulation Tissue Cdm,PX-98100002,CDM,17250,CPT,981,RC,,inpatient,,,215,193.5,,0.95,,204.25,Percent of total billed charges,,,0.98,,210.7,Percent of total billed charges,,,0.95,,204.25,Percent of total billed charges,,,0.97,,208.55,Percent of total billed charges,,,0.97,,208.55,Percent of total billed charges,,,0.96,,206.4,Percent of total billed charges,,,0.95,,204.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,204.25,Percent of total billed charges,,204.25,210.7,
HC PR ED 17250 Chemical Cauterization of Granulation Tissue Cdm,PX-98100002,CDM,17250,CPT,981,RC,,outpatient,,,215,193.5,,0.95,,204.25,Percent of total billed charges,,,0.98,,210.7,Percent of total billed charges,,,0.95,,204.25,Percent of total billed charges,,,0.95,,204.25,Percent of total billed charges,,,0.97,,208.55,Percent of total billed charges,,,0.96,,206.4,Percent of total billed charges,,,0.95,,204.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,204.25,Percent of total billed charges,,204.25,210.7,
Measurement of acetaminophen,PX-30100039,CDM,80143,CPT,301,RC,,inpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
Measurement of acetaminophen,PX-30100039,CDM,80143,CPT,301,RC,,outpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
Measurement of amiodarone,PX-30100040,CDM,80151,CPT,301,RC,,inpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
Measurement of amiodarone,PX-30100040,CDM,80151,CPT,301,RC,,outpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
"Measurement of carbamazepine-10,11-epoxide",PX-30100041,CDM,80161,CPT,301,RC,,inpatient,,,161,144.9,,0.95,,152.95,Percent of total billed charges,,,0.98,,157.78,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.96,,154.56,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,152.95,Percent of total billed charges,,152.95,157.78,
"Measurement of carbamazepine-10,11-epoxide",PX-30100041,CDM,80161,CPT,301,RC,,outpatient,,,161,144.9,,0.95,,152.95,Percent of total billed charges,,,0.98,,157.78,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.96,,154.56,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,152.95,Percent of total billed charges,,152.95,157.78,
Measurement of felbamate,PX-30100042,CDM,80167,CPT,301,RC,,inpatient,,,178,160.2,,0.95,,169.1,Percent of total billed charges,,,0.98,,174.44,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,0.97,,172.66,Percent of total billed charges,,,0.97,,172.66,Percent of total billed charges,,,0.96,,170.88,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,169.1,Percent of total billed charges,,169.1,174.44,
Measurement of felbamate,PX-30100042,CDM,80167,CPT,301,RC,,outpatient,,,178,160.2,,0.95,,169.1,Percent of total billed charges,,,0.98,,174.44,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,0.97,,172.66,Percent of total billed charges,,,0.96,,170.88,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,169.1,Percent of total billed charges,,169.1,174.44,
Measurement of salicylate,PX-30100043,CDM,80179,CPT,301,RC,,inpatient,,,125,112.5,,0.95,,118.75,Percent of total billed charges,,,0.98,,122.5,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.96,,120,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,118.75,Percent of total billed charges,,118.75,122.5,
Measurement of salicylate,PX-30100043,CDM,80179,CPT,301,RC,,outpatient,,,125,112.5,,0.95,,118.75,Percent of total billed charges,,,0.98,,122.5,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.96,,120,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,118.75,Percent of total billed charges,,118.75,122.5,
Measurement of flecainide,PX-30100044,CDM,80181,CPT,301,RC,,inpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
Measurement of flecainide,PX-30100044,CDM,80181,CPT,301,RC,,outpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
Measurement of itraconazole,PX-30100045,CDM,80189,CPT,301,RC,,inpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
Measurement of itraconazole,PX-30100045,CDM,80189,CPT,301,RC,,outpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
Measurement of leflunomide,PX-30100046,CDM,80193,CPT,301,RC,,inpatient,,,63,56.7,,0.95,,59.85,Percent of total billed charges,,,0.98,,61.74,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.96,,60.48,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,59.85,Percent of total billed charges,,59.85,61.74,
Measurement of leflunomide,PX-30100046,CDM,80193,CPT,301,RC,,outpatient,,,63,56.7,,0.95,,59.85,Percent of total billed charges,,,0.98,,61.74,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.96,,60.48,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,59.85,Percent of total billed charges,,59.85,61.74,
Measurement of methotrexate,PX-30100047,CDM,80204,CPT,301,RC,,inpatient,,,117,105.3,,0.95,,111.15,Percent of total billed charges,,,0.98,,114.66,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.96,,112.32,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,111.15,Percent of total billed charges,,111.15,114.66,
Measurement of methotrexate,PX-30100047,CDM,80204,CPT,301,RC,,outpatient,,,117,105.3,,0.95,,111.15,Percent of total billed charges,,,0.98,,114.66,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.96,,112.32,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,111.15,Percent of total billed charges,,111.15,114.66,
Measurement of rufinamide,PX-30100048,CDM,80210,CPT,301,RC,,inpatient,,,117,105.3,,0.95,,111.15,Percent of total billed charges,,,0.98,,114.66,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.96,,112.32,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,111.15,Percent of total billed charges,,111.15,114.66,
Measurement of rufinamide,PX-30100048,CDM,80210,CPT,301,RC,,outpatient,,,117,105.3,,0.95,,111.15,Percent of total billed charges,,,0.98,,114.66,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.96,,112.32,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,111.15,Percent of total billed charges,,111.15,114.66,
Measure alcohol level in specimen other than breath/urine,PX-30100049,CDM,82077,CPT,301,RC,,inpatient,,,158,142.2,,0.95,,150.1,Percent of total billed charges,,,0.98,,154.84,Percent of total billed charges,,,0.95,,150.1,Percent of total billed charges,,,0.97,,153.26,Percent of total billed charges,,,0.97,,153.26,Percent of total billed charges,,,0.96,,151.68,Percent of total billed charges,,,0.95,,150.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,150.1,Percent of total billed charges,,150.1,154.84,
Measure alcohol level in specimen other than breath/urine,PX-30100049,CDM,82077,CPT,301,RC,,outpatient,,,158,142.2,,0.95,,150.1,Percent of total billed charges,,,0.98,,154.84,Percent of total billed charges,,,0.95,,150.1,Percent of total billed charges,,,0.95,,150.1,Percent of total billed charges,,,0.97,,153.26,Percent of total billed charges,,,0.96,,151.68,Percent of total billed charges,,,0.95,,150.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,150.1,Percent of total billed charges,,150.1,154.84,
Direct measurement of free estradiol (hormone),PX-30100050,CDM,82681,CPT,301,RC,,inpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
Direct measurement of free estradiol (hormone),PX-30100050,CDM,82681,CPT,301,RC,,outpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
Screening test for Covid-19 neutralizing antibody,PX-30200048,CDM,86408,CPT,302,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Screening test for Covid-19 neutralizing antibody,PX-30200048,CDM,86408,CPT,302,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Measure of neutralizing antibody to (COVID-19),PX-30200049,CDM,86409,CPT,302,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Measure of neutralizing antibody to (COVID-19),PX-30200049,CDM,86409,CPT,302,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Low dose CT scan of chest for lung cancer screening,PX-35200001,CDM,71271,CPT,352,RC,,inpatient,,,1853,1667.7,,0.95,,1760.35,Percent of total billed charges,,,0.98,,1815.94,Percent of total billed charges,,,0.95,,1760.35,Percent of total billed charges,,,0.97,,1797.41,Percent of total billed charges,,,0.97,,1797.41,Percent of total billed charges,,,0.96,,1778.88,Percent of total billed charges,,,0.95,,1760.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1760.35,Percent of total billed charges,,1760.35,1815.94,
Low dose CT scan of chest for lung cancer screening,PX-35200001,CDM,71271,CPT,352,RC,,outpatient,,,1853,1667.7,,0.95,,1760.35,Percent of total billed charges,,,0.98,,1815.94,Percent of total billed charges,,,0.95,,1760.35,Percent of total billed charges,,,0.95,,1760.35,Percent of total billed charges,,,0.97,,1797.41,Percent of total billed charges,,,0.96,,1778.88,Percent of total billed charges,,,0.95,,1760.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1760.35,Percent of total billed charges,,1760.35,1815.94,
VEMP testing of lower branch of inner ear nerve,PX-47100001,CDM,92517,CPT,471,RC,,inpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
VEMP testing of lower branch of inner ear nerve,PX-47100001,CDM,92517,CPT,471,RC,,outpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
VEMP testing of upper branch of inner ear nerve,PX-47100002,CDM,92518,CPT,471,RC,,inpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
VEMP testing of upper branch of inner ear nerve,PX-47100002,CDM,92518,CPT,471,RC,,outpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
VEMP test upper and lower branches of inner ear nerve,PX-47100003,CDM,92519,CPT,471,RC,,inpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
VEMP test upper and lower branches of inner ear nerve,PX-47100003,CDM,92519,CPT,471,RC,,outpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
Evaluate brain response to sound for hearing status,PX-47100004,CDM,92651,CPT,471,RC,,inpatient,,,244,219.6,,0.95,,231.8,Percent of total billed charges,,,0.98,,239.12,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,0.97,,236.68,Percent of total billed charges,,,0.97,,236.68,Percent of total billed charges,,,0.96,,234.24,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,231.8,Percent of total billed charges,,231.8,239.12,
Evaluate brain response to sound for hearing status,PX-47100004,CDM,92651,CPT,471,RC,,outpatient,,,244,219.6,,0.95,,231.8,Percent of total billed charges,,,0.98,,239.12,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,0.97,,236.68,Percent of total billed charges,,,0.96,,234.24,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,231.8,Percent of total billed charges,,231.8,239.12,
Evaluate brain response to sound for hearing threshold,PX-47100005,CDM,92652,CPT,471,RC,,inpatient,,,276,248.4,,0.95,,262.2,Percent of total billed charges,,,0.98,,270.48,Percent of total billed charges,,,0.95,,262.2,Percent of total billed charges,,,0.97,,267.72,Percent of total billed charges,,,0.97,,267.72,Percent of total billed charges,,,0.96,,264.96,Percent of total billed charges,,,0.95,,262.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,262.2,Percent of total billed charges,,262.2,270.48,
Evaluate brain response to sound for hearing threshold,PX-47100005,CDM,92652,CPT,471,RC,,outpatient,,,276,248.4,,0.95,,262.2,Percent of total billed charges,,,0.98,,270.48,Percent of total billed charges,,,0.95,,262.2,Percent of total billed charges,,,0.95,,262.2,Percent of total billed charges,,,0.97,,267.72,Percent of total billed charges,,,0.96,,264.96,Percent of total billed charges,,,0.95,,262.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,262.2,Percent of total billed charges,,262.2,270.48,
"Evaluate brain response to sound, nervous system disorder",PX-47100006,CDM,92653,CPT,471,RC,,inpatient,,,244,219.6,,0.95,,231.8,Percent of total billed charges,,,0.98,,239.12,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,0.97,,236.68,Percent of total billed charges,,,0.97,,236.68,Percent of total billed charges,,,0.96,,234.24,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,231.8,Percent of total billed charges,,231.8,239.12,
"Evaluate brain response to sound, nervous system disorder",PX-47100006,CDM,92653,CPT,471,RC,,outpatient,,,244,219.6,,0.95,,231.8,Percent of total billed charges,,,0.98,,239.12,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,0.97,,236.68,Percent of total billed charges,,,0.96,,234.24,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,231.8,Percent of total billed charges,,231.8,239.12,
HC PR 93245 External Ecg Rec>7d<15d Scan Alys Report R&I Rhc,PX-52100019,CDM,93245,CPT,521,RC,,inpatient,,,126,113.4,,0.95,,119.7,Percent of total billed charges,,,0.98,,123.48,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.96,,120.96,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,119.7,Percent of total billed charges,,119.7,123.48,
HC PR 93245 External Ecg Rec>7d<15d Scan Alys Report R&I Rhc,PX-52100019,CDM,93245,CPT,521,RC,,outpatient,,,126,113.4,,0.95,,119.7,Percent of total billed charges,,,0.98,,123.48,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.96,,120.96,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,119.7,Percent of total billed charges,,119.7,123.48,
Heart rhythm recording of continous EKG > 8-15 days,PX-73100001,CDM,93246,CPT,731,RC,,inpatient,,,449,404.1,,0.95,,426.55,Percent of total billed charges,,,0.98,,440.02,Percent of total billed charges,,,0.95,,426.55,Percent of total billed charges,,,0.97,,435.53,Percent of total billed charges,,,0.97,,435.53,Percent of total billed charges,,,0.96,,431.04,Percent of total billed charges,,,0.95,,426.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,426.55,Percent of total billed charges,,426.55,440.02,
Heart rhythm recording of continous EKG > 8-15 days,PX-73100001,CDM,93246,CPT,731,RC,,outpatient,,,449,404.1,,0.95,,426.55,Percent of total billed charges,,,0.98,,440.02,Percent of total billed charges,,,0.95,,426.55,Percent of total billed charges,,,0.95,,426.55,Percent of total billed charges,,,0.97,,435.53,Percent of total billed charges,,,0.96,,431.04,Percent of total billed charges,,,0.95,,426.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,426.55,Percent of total billed charges,,426.55,440.02,
Heart rhythm analysis/report of continous EKG > 8-15 days,PX-73100002,CDM,93247,CPT,731,RC,,inpatient,,,577,519.3,,0.95,,548.15,Percent of total billed charges,,,0.98,,565.46,Percent of total billed charges,,,0.95,,548.15,Percent of total billed charges,,,0.97,,559.69,Percent of total billed charges,,,0.97,,559.69,Percent of total billed charges,,,0.96,,553.92,Percent of total billed charges,,,0.95,,548.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,548.15,Percent of total billed charges,,548.15,565.46,
Heart rhythm analysis/report of continous EKG > 8-15 days,PX-73100002,CDM,93247,CPT,731,RC,,outpatient,,,577,519.3,,0.95,,548.15,Percent of total billed charges,,,0.98,,565.46,Percent of total billed charges,,,0.95,,548.15,Percent of total billed charges,,,0.95,,548.15,Percent of total billed charges,,,0.97,,559.69,Percent of total billed charges,,,0.96,,553.92,Percent of total billed charges,,,0.95,,548.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,548.15,Percent of total billed charges,,548.15,565.46,
HC PR 93248 External Ecg Rec>7d<15d Review & Interpretation Rhc,PX-52100020,CDM,93248,CPT,521,RC,,inpatient,,,126,113.4,,0.95,,119.7,Percent of total billed charges,,,0.98,,123.48,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.96,,120.96,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,119.7,Percent of total billed charges,,119.7,123.48,
HC PR 93248 External Ecg Rec>7d<15d Review & Interpretation Rhc,PX-52100020,CDM,93248,CPT,521,RC,,outpatient,,,126,113.4,,0.95,,119.7,Percent of total billed charges,,,0.98,,123.48,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.96,,120.96,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,119.7,Percent of total billed charges,,119.7,123.48,
Exercise test for spasm of lung airways,PX-46000001,CDM,94619,CPT,460,RC,,inpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
Exercise test for spasm of lung airways,PX-46000001,CDM,94619,CPT,460,RC,,outpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
HC PR 99417 Prolonged Outpatient E/M Service Each 15 Minutes Rhc,PX-52100021,CDM,99417,CPT,521,RC,,inpatient,,,76,68.4,,0.95,,72.2,Percent of total billed charges,,,0.98,,74.48,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,0.97,,73.72,Percent of total billed charges,,,0.97,,73.72,Percent of total billed charges,,,0.96,,72.96,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,72.2,Percent of total billed charges,,72.2,74.48,
HC PR 99417 Prolonged Outpatient E/M Service Each 15 Minutes Rhc,PX-52100021,CDM,99417,CPT,521,RC,,outpatient,,,76,68.4,,0.95,,72.2,Percent of total billed charges,,,0.98,,74.48,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,0.97,,73.72,Percent of total billed charges,,,0.96,,72.96,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,72.2,Percent of total billed charges,,72.2,74.48,
HC PR 99439 CHRONIC CARE MGMT SRVCS EA ADDL 20 MIN p/ CALENDAR MONTH RHC,PX-52100022,CDM,99439,CPT,521,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
HC PR 99439 CHRONIC CARE MGMT SRVCS EA ADDL 20 MIN p/ CALENDAR MONTH RHC,PX-52100022,CDM,99439,CPT,521,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Evaluate brain response to sound with automated analysis,PX-47100007,CDM,92650,CPT,471,RC,,inpatient,,,244,219.6,,0.95,,231.8,Percent of total billed charges,,,0.98,,239.12,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,0.97,,236.68,Percent of total billed charges,,,0.97,,236.68,Percent of total billed charges,,,0.96,,234.24,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,231.8,Percent of total billed charges,,231.8,239.12,
Evaluate brain response to sound with automated analysis,PX-47100007,CDM,92650,CPT,471,RC,,outpatient,,,244,219.6,,0.95,,231.8,Percent of total billed charges,,,0.98,,239.12,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,0.97,,236.68,Percent of total billed charges,,,0.96,,234.24,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,231.8,Percent of total billed charges,,231.8,239.12,
HC PR 93241 External Ecg Rec>48hr<7d Scan Alys Report R&I Rhc,PX-52100023,CDM,93241,CPT,521,RC,,inpatient,,,126,113.4,,0.95,,119.7,Percent of total billed charges,,,0.98,,123.48,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.96,,120.96,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,119.7,Percent of total billed charges,,119.7,123.48,
HC PR 93241 External Ecg Rec>48hr<7d Scan Alys Report R&I Rhc,PX-52100023,CDM,93241,CPT,521,RC,,outpatient,,,126,113.4,,0.95,,119.7,Percent of total billed charges,,,0.98,,123.48,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.96,,120.96,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,119.7,Percent of total billed charges,,119.7,123.48,
HC PR 93242 External Ecg Rec>48hr<7d Recording Cdm,PX-98300188,CDM,93242,CPT,983,RC,,inpatient,,,120,108,,0.95,,114,Percent of total billed charges,,,0.98,,117.6,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.96,,115.2,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114,Percent of total billed charges,,114,117.6,
HC PR 93242 External Ecg Rec>48hr<7d Recording Cdm,PX-98300188,CDM,93242,CPT,983,RC,,outpatient,,,120,108,,0.95,,114,Percent of total billed charges,,,0.98,,117.6,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.96,,115.2,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114,Percent of total billed charges,,114,117.6,
Heart rhythm recording EKG >48 hrs up to 7 days,PX-73100003,CDM,93242,CPT,731,RC,,inpatient,,,449,404.1,,0.95,,426.55,Percent of total billed charges,,,0.98,,440.02,Percent of total billed charges,,,0.95,,426.55,Percent of total billed charges,,,0.97,,435.53,Percent of total billed charges,,,0.97,,435.53,Percent of total billed charges,,,0.96,,431.04,Percent of total billed charges,,,0.95,,426.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,426.55,Percent of total billed charges,,426.55,440.02,
Heart rhythm recording EKG >48 hrs up to 7 days,PX-73100003,CDM,93242,CPT,731,RC,,outpatient,,,449,404.1,,0.95,,426.55,Percent of total billed charges,,,0.98,,440.02,Percent of total billed charges,,,0.95,,426.55,Percent of total billed charges,,,0.95,,426.55,Percent of total billed charges,,,0.97,,435.53,Percent of total billed charges,,,0.96,,431.04,Percent of total billed charges,,,0.95,,426.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,426.55,Percent of total billed charges,,426.55,440.02,
Heart rhythm analysis/report of EKG >48 hrs up to 7 days,PX-73100004,CDM,93243,CPT,731,RC,,inpatient,,,550,495,,0.95,,522.5,Percent of total billed charges,,,0.98,,539,Percent of total billed charges,,,0.95,,522.5,Percent of total billed charges,,,0.97,,533.5,Percent of total billed charges,,,0.97,,533.5,Percent of total billed charges,,,0.96,,528,Percent of total billed charges,,,0.95,,522.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,522.5,Percent of total billed charges,,522.5,539,
Heart rhythm analysis/report of EKG >48 hrs up to 7 days,PX-73100004,CDM,93243,CPT,731,RC,,outpatient,,,550,495,,0.95,,522.5,Percent of total billed charges,,,0.98,,539,Percent of total billed charges,,,0.95,,522.5,Percent of total billed charges,,,0.95,,522.5,Percent of total billed charges,,,0.97,,533.5,Percent of total billed charges,,,0.96,,528,Percent of total billed charges,,,0.95,,522.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,522.5,Percent of total billed charges,,522.5,539,
HC PR 93244 External Ecg Rec>48hr<7d Review & Interpretation Rhc,PX-52100024,CDM,93244,CPT,521,RC,,inpatient,,,126,113.4,,0.95,,119.7,Percent of total billed charges,,,0.98,,123.48,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.96,,120.96,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,119.7,Percent of total billed charges,,119.7,123.48,
HC PR 93244 External Ecg Rec>48hr<7d Review & Interpretation Rhc,PX-52100024,CDM,93244,CPT,521,RC,,outpatient,,,126,113.4,,0.95,,119.7,Percent of total billed charges,,,0.98,,123.48,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.96,,120.96,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,119.7,Percent of total billed charges,,119.7,123.48,
HC PR Q0144 Azithromycin Dihydrate Oral-Capsule-Powder 1 Gm,PX-96910904,CDM,Q0144,HCPCS,983,RC,,inpatient,,,4,3.6,,0.95,,3.8,Percent of total billed charges,,,0.98,,3.92,Percent of total billed charges,,,0.95,,3.8,Percent of total billed charges,,,0.97,,3.88,Percent of total billed charges,,,0.97,,3.88,Percent of total billed charges,,,0.96,,3.84,Percent of total billed charges,,,0.95,,3.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3.8,Percent of total billed charges,,3.8,3.92,
HC PR Q0144 Azithromycin Dihydrate Oral-Capsule-Powder 1 Gm,PX-96910904,CDM,Q0144,HCPCS,983,RC,,outpatient,,,4,3.6,,0.95,,3.8,Percent of total billed charges,,,0.98,,3.92,Percent of total billed charges,,,0.95,,3.8,Percent of total billed charges,,,0.95,,3.8,Percent of total billed charges,,,0.97,,3.88,Percent of total billed charges,,,0.96,,3.84,Percent of total billed charges,,,0.95,,3.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3.8,Percent of total billed charges,,3.8,3.92,
"Test of car seat or bed (1 year or younger), 1 hr",PX-76110233,CDM,94780,CPT,410,RC,,inpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
"Test of car seat or bed (1 year or younger), 1 hr",PX-76110233,CDM,94780,CPT,410,RC,,outpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
"Test car seat or bed <=1yr, each additional 30 m",PX-76110234,CDM,94781,CPT,410,RC,,inpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
"Test car seat or bed <=1yr, each additional 30 m",PX-76110234,CDM,94781,CPT,410,RC,,outpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
HC PR 99477 Init Day Neonate Care,PX-98310451,CDM,99477,CPT,983,RC,,inpatient,,,961,864.9,,0.95,,912.95,Percent of total billed charges,,,0.98,,941.78,Percent of total billed charges,,,0.95,,912.95,Percent of total billed charges,,,0.97,,932.17,Percent of total billed charges,,,0.97,,932.17,Percent of total billed charges,,,0.96,,922.56,Percent of total billed charges,,,0.95,,912.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,912.95,Percent of total billed charges,,912.95,941.78,
HC PR 99477 Init Day Neonate Care,PX-98310451,CDM,99477,CPT,983,RC,,outpatient,,,961,864.9,,0.95,,912.95,Percent of total billed charges,,,0.98,,941.78,Percent of total billed charges,,,0.95,,912.95,Percent of total billed charges,,,0.95,,912.95,Percent of total billed charges,,,0.97,,932.17,Percent of total billed charges,,,0.96,,922.56,Percent of total billed charges,,,0.95,,912.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,912.95,Percent of total billed charges,,912.95,941.78,
HC PR 76813 US OB Nuchal Measurement 1 Gest,PX-98310458,CDM,76813,CPT,983,RC,,inpatient,,,285,256.5,,0.95,,270.75,Percent of total billed charges,,,0.98,,279.3,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.96,,273.6,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,270.75,Percent of total billed charges,,270.75,279.3,
HC PR 76813 US OB Nuchal Measurement 1 Gest,PX-98310458,CDM,76813,CPT,983,RC,,outpatient,,,285,256.5,,0.95,,270.75,Percent of total billed charges,,,0.98,,279.3,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.96,,273.6,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,270.75,Percent of total billed charges,,270.75,279.3,
HC Operating Room Services Level 1 1st 30 Mins,PX-36010146,CDM,36010146,LOCAL,360,RC,,inpatient,,,1715,1543.5,,0.95,,1629.25,Percent of total billed charges,,,0.98,,1680.7,Percent of total billed charges,,,0.95,,1629.25,Percent of total billed charges,,,0.97,,1663.55,Percent of total billed charges,,,0.97,,1663.55,Percent of total billed charges,,,0.96,,1646.4,Percent of total billed charges,,,0.95,,1629.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1629.25,Percent of total billed charges,,1629.25,1680.7,
HC Operating Room Services Level 1 1st 30 Mins,PX-36010146,CDM,36010146,LOCAL,360,RC,,outpatient,,,1715,1543.5,,0.95,,1629.25,Percent of total billed charges,,,0.98,,1680.7,Percent of total billed charges,,,0.95,,1629.25,Percent of total billed charges,,,0.95,,1629.25,Percent of total billed charges,,,0.97,,1663.55,Percent of total billed charges,,,0.96,,1646.4,Percent of total billed charges,,,0.95,,1629.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1629.25,Percent of total billed charges,,1629.25,1680.7,
HC Operating Room Services Level 2 1st 30 Mins,PX-36010147,CDM,36010147,LOCAL,360,RC,,inpatient,,,2750,2475,,0.95,,2612.5,Percent of total billed charges,,,0.98,,2695,Percent of total billed charges,,,0.95,,2612.5,Percent of total billed charges,,,0.97,,2667.5,Percent of total billed charges,,,0.97,,2667.5,Percent of total billed charges,,,0.96,,2640,Percent of total billed charges,,,0.95,,2612.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2612.5,Percent of total billed charges,,2612.5,2695,
HC Operating Room Services Level 2 1st 30 Mins,PX-36010147,CDM,36010147,LOCAL,360,RC,,outpatient,,,2750,2475,,0.95,,2612.5,Percent of total billed charges,,,0.98,,2695,Percent of total billed charges,,,0.95,,2612.5,Percent of total billed charges,,,0.95,,2612.5,Percent of total billed charges,,,0.97,,2667.5,Percent of total billed charges,,,0.96,,2640,Percent of total billed charges,,,0.95,,2612.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2612.5,Percent of total billed charges,,2612.5,2695,
HC Operating Room Services Level 3 1st 30 Mins,PX-36010148,CDM,36010148,LOCAL,360,RC,,inpatient,,,3465,3118.5,,0.95,,3291.75,Percent of total billed charges,,,0.98,,3395.7,Percent of total billed charges,,,0.95,,3291.75,Percent of total billed charges,,,0.97,,3361.05,Percent of total billed charges,,,0.97,,3361.05,Percent of total billed charges,,,0.96,,3326.4,Percent of total billed charges,,,0.95,,3291.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3291.75,Percent of total billed charges,,3291.75,3395.7,
HC Operating Room Services Level 3 1st 30 Mins,PX-36010148,CDM,36010148,LOCAL,360,RC,,outpatient,,,3465,3118.5,,0.95,,3291.75,Percent of total billed charges,,,0.98,,3395.7,Percent of total billed charges,,,0.95,,3291.75,Percent of total billed charges,,,0.95,,3291.75,Percent of total billed charges,,,0.97,,3361.05,Percent of total billed charges,,,0.96,,3326.4,Percent of total billed charges,,,0.95,,3291.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3291.75,Percent of total billed charges,,3291.75,3395.7,
HC Operating Room Services Level 4 1st 30 Mins,PX-36010149,CDM,36010149,LOCAL,360,RC,,inpatient,,,4125,3712.5,,0.95,,3918.75,Percent of total billed charges,,,0.98,,4042.5,Percent of total billed charges,,,0.95,,3918.75,Percent of total billed charges,,,0.97,,4001.25,Percent of total billed charges,,,0.97,,4001.25,Percent of total billed charges,,,0.96,,3960,Percent of total billed charges,,,0.95,,3918.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3918.75,Percent of total billed charges,,3918.75,4042.5,
HC Operating Room Services Level 4 1st 30 Mins,PX-36010149,CDM,36010149,LOCAL,360,RC,,outpatient,,,4125,3712.5,,0.95,,3918.75,Percent of total billed charges,,,0.98,,4042.5,Percent of total billed charges,,,0.95,,3918.75,Percent of total billed charges,,,0.95,,3918.75,Percent of total billed charges,,,0.97,,4001.25,Percent of total billed charges,,,0.96,,3960,Percent of total billed charges,,,0.95,,3918.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3918.75,Percent of total billed charges,,3918.75,4042.5,
HC Operating Room Services Level 5 1st 30 Mins,PX-36010150,CDM,36010150,LOCAL,360,RC,,inpatient,,,4785,4306.5,,0.95,,4545.75,Percent of total billed charges,,,0.98,,4689.3,Percent of total billed charges,,,0.95,,4545.75,Percent of total billed charges,,,0.97,,4641.45,Percent of total billed charges,,,0.97,,4641.45,Percent of total billed charges,,,0.96,,4593.6,Percent of total billed charges,,,0.95,,4545.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4545.75,Percent of total billed charges,,4545.75,4689.3,
HC Operating Room Services Level 5 1st 30 Mins,PX-36010150,CDM,36010150,LOCAL,360,RC,,outpatient,,,4785,4306.5,,0.95,,4545.75,Percent of total billed charges,,,0.98,,4689.3,Percent of total billed charges,,,0.95,,4545.75,Percent of total billed charges,,,0.95,,4545.75,Percent of total billed charges,,,0.97,,4641.45,Percent of total billed charges,,,0.96,,4593.6,Percent of total billed charges,,,0.95,,4545.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4545.75,Percent of total billed charges,,4545.75,4689.3,
HC Operating Room Services Level 6 1st 30 Mins,PX-36010151,CDM,36010151,LOCAL,360,RC,,inpatient,,,5445,4900.5,,0.95,,5172.75,Percent of total billed charges,,,0.98,,5336.1,Percent of total billed charges,,,0.95,,5172.75,Percent of total billed charges,,,0.97,,5281.65,Percent of total billed charges,,,0.97,,5281.65,Percent of total billed charges,,,0.96,,5227.2,Percent of total billed charges,,,0.95,,5172.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,5172.75,Percent of total billed charges,,5172.75,5336.1,
HC Operating Room Services Level 6 1st 30 Mins,PX-36010151,CDM,36010151,LOCAL,360,RC,,outpatient,,,5445,4900.5,,0.95,,5172.75,Percent of total billed charges,,,0.98,,5336.1,Percent of total billed charges,,,0.95,,5172.75,Percent of total billed charges,,,0.95,,5172.75,Percent of total billed charges,,,0.97,,5281.65,Percent of total billed charges,,,0.96,,5227.2,Percent of total billed charges,,,0.95,,5172.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,5172.75,Percent of total billed charges,,5172.75,5336.1,
HC Operating Room Services Level 7 1st 30 Mins,PX-36010152,CDM,36010152,LOCAL,360,RC,,inpatient,,,6105,5494.5,,0.95,,5799.75,Percent of total billed charges,,,0.98,,5982.9,Percent of total billed charges,,,0.95,,5799.75,Percent of total billed charges,,,0.97,,5921.85,Percent of total billed charges,,,0.97,,5921.85,Percent of total billed charges,,,0.96,,5860.8,Percent of total billed charges,,,0.95,,5799.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,5799.75,Percent of total billed charges,,5799.75,5982.9,
HC Operating Room Services Level 7 1st 30 Mins,PX-36010152,CDM,36010152,LOCAL,360,RC,,outpatient,,,6105,5494.5,,0.95,,5799.75,Percent of total billed charges,,,0.98,,5982.9,Percent of total billed charges,,,0.95,,5799.75,Percent of total billed charges,,,0.95,,5799.75,Percent of total billed charges,,,0.97,,5921.85,Percent of total billed charges,,,0.96,,5860.8,Percent of total billed charges,,,0.95,,5799.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,5799.75,Percent of total billed charges,,5799.75,5982.9,
HC PR ED 36416 Capillary Blood Draw Cdm,PX-98110910,CDM,36416,CPT,981,RC,,inpatient,,,120,108,,0.95,,114,Percent of total billed charges,,,0.98,,117.6,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.96,,115.2,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114,Percent of total billed charges,,114,117.6,
HC PR ED 36416 Capillary Blood Draw Cdm,PX-98110910,CDM,36416,CPT,981,RC,,outpatient,,,120,108,,0.95,,114,Percent of total billed charges,,,0.98,,117.6,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.96,,115.2,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114,Percent of total billed charges,,114,117.6,
HC PR 90474 Immune Admin Oral/Nasal Addl,PX-98110911,CDM,90474,CPT,771,RC,,inpatient,,,66,59.4,,0.95,,62.7,Percent of total billed charges,,,0.98,,64.68,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,0.97,,64.02,Percent of total billed charges,,,0.97,,64.02,Percent of total billed charges,,,0.96,,63.36,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,62.7,Percent of total billed charges,,62.7,64.68,
HC PR 90474 Immune Admin Oral/Nasal Addl,PX-98110911,CDM,90474,CPT,771,RC,,outpatient,,,66,59.4,,0.95,,62.7,Percent of total billed charges,,,0.98,,64.68,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,0.97,,64.02,Percent of total billed charges,,,0.96,,63.36,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,62.7,Percent of total billed charges,,62.7,64.68,
HC PR Rx Td Vaccine Pf 7 Yrs or Older Im 0.5 Ml,PX-63610038,CDM,90714,HCPCS,636,RC,,inpatient,,,174,156.6,,0.95,,165.3,Percent of total billed charges,,,0.98,,170.52,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,0.97,,168.78,Percent of total billed charges,,,0.97,,168.78,Percent of total billed charges,,,0.96,,167.04,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,165.3,Percent of total billed charges,,165.3,170.52,
HC PR Rx Td Vaccine Pf 7 Yrs or Older Im 0.5 Ml,PX-63610038,CDM,90714,HCPCS,636,RC,,outpatient,,,174,156.6,,0.95,,165.3,Percent of total billed charges,,,0.98,,170.52,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,0.97,,168.78,Percent of total billed charges,,,0.96,,167.04,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,165.3,Percent of total billed charges,,165.3,170.52,
HC PR 23430 Repair Tenodesis of Bicep,PX-97510467,CDM,23430,CPT,975,RC,,inpatient,,,1853,1667.7,,0.95,,1760.35,Percent of total billed charges,,,0.98,,1815.94,Percent of total billed charges,,,0.95,,1760.35,Percent of total billed charges,,,0.97,,1797.41,Percent of total billed charges,,,0.97,,1797.41,Percent of total billed charges,,,0.96,,1778.88,Percent of total billed charges,,,0.95,,1760.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1760.35,Percent of total billed charges,,1760.35,1815.94,
HC PR 23430 Repair Tenodesis of Bicep,PX-97510467,CDM,23430,CPT,975,RC,,outpatient,,,1853,1667.7,,0.95,,1760.35,Percent of total billed charges,,,0.98,,1815.94,Percent of total billed charges,,,0.95,,1760.35,Percent of total billed charges,,,0.95,,1760.35,Percent of total billed charges,,,0.97,,1797.41,Percent of total billed charges,,,0.96,,1778.88,Percent of total billed charges,,,0.95,,1760.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1760.35,Percent of total billed charges,,1760.35,1815.94,
HC PR 27345 Removal of Knee Cyst,PX-97510472,CDM,27345,CPT,975,RC,,inpatient,,,1220,1098,,0.95,,1159,Percent of total billed charges,,,0.98,,1195.6,Percent of total billed charges,,,0.95,,1159,Percent of total billed charges,,,0.97,,1183.4,Percent of total billed charges,,,0.97,,1183.4,Percent of total billed charges,,,0.96,,1171.2,Percent of total billed charges,,,0.95,,1159,Percent of total billed charges,,,,,,,,,0.95,,1159,Percent of total billed charges,,1159,1195.6,
HC PR 27345 Removal of Knee Cyst,PX-97510472,CDM,27345,CPT,975,RC,,outpatient,,,1220,1098,,0.95,,1159,Percent of total billed charges,,,0.98,,1195.6,Percent of total billed charges,,,0.95,,1159,Percent of total billed charges,,,0.95,,1159,Percent of total billed charges,,,0.97,,1183.4,Percent of total billed charges,,,0.96,,1171.2,Percent of total billed charges,,,0.95,,1159,Percent of total billed charges,,,,,,,,,0.95,,1159,Percent of total billed charges,,1159,1195.6,
HC PR 27524 Open Tx Patllr Fx W/Int Fixj/Patllc&Soft Tiss Repair Cdm,PX-97510484,CDM,27524,CPT,975,RC,,inpatient,,,1874,1686.6,,0.95,,1780.3,Percent of total billed charges,,,0.98,,1836.52,Percent of total billed charges,,,0.95,,1780.3,Percent of total billed charges,,,0.97,,1817.78,Percent of total billed charges,,,0.97,,1817.78,Percent of total billed charges,,,0.96,,1799.04,Percent of total billed charges,,,0.95,,1780.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1780.3,Percent of total billed charges,,1780.3,1836.52,
HC PR 27524 Open Tx Patllr Fx W/Int Fixj/Patllc&Soft Tiss Repair Cdm,PX-97510484,CDM,27524,CPT,975,RC,,outpatient,,,1874,1686.6,,0.95,,1780.3,Percent of total billed charges,,,0.98,,1836.52,Percent of total billed charges,,,0.95,,1780.3,Percent of total billed charges,,,0.95,,1780.3,Percent of total billed charges,,,0.97,,1817.78,Percent of total billed charges,,,0.96,,1799.04,Percent of total billed charges,,,0.95,,1780.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1780.3,Percent of total billed charges,,1780.3,1836.52,
HC R&B-Semi-Private Med Surg W/ Tele,PX-12010009,CDM,12010009,LOCAL,120,RC,,inpatient,,,2732,2458.8,,0.95,,2595.4,Percent of total billed charges,,,0.98,,2677.36,Percent of total billed charges,,,0.95,,2595.4,Percent of total billed charges,,,0.97,,2650.04,Percent of total billed charges,,,0.97,,2650.04,Percent of total billed charges,,,0.96,,2622.72,Percent of total billed charges,,,0.95,,2595.4,Percent of total billed charges,,,,,,,,,0.95,,2595.4,Percent of total billed charges,,2595.4,2677.36,
HC R&B-Semi-Private Med Surg W/ Tele,PX-12010009,CDM,12010009,LOCAL,120,RC,,outpatient,,,2732,2458.8,,0.95,,2595.4,Percent of total billed charges,,,0.98,,2677.36,Percent of total billed charges,,,0.95,,2595.4,Percent of total billed charges,,,0.95,,2595.4,Percent of total billed charges,,,0.97,,2650.04,Percent of total billed charges,,,0.96,,2622.72,Percent of total billed charges,,,0.95,,2595.4,Percent of total billed charges,,,,,,,,,0.95,,2595.4,Percent of total billed charges,,2595.4,2677.36,
"Test by nucleic acid for multiple respiratory virus, 3-5",PX-30010260,CDM,87631,CPT,306,RC,,inpatient,,,444,399.6,,0.95,,421.8,Percent of total billed charges,,,0.98,,435.12,Percent of total billed charges,,,0.95,,421.8,Percent of total billed charges,,,0.97,,430.68,Percent of total billed charges,,,0.97,,430.68,Percent of total billed charges,,,0.96,,426.24,Percent of total billed charges,,,0.95,,421.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,421.8,Percent of total billed charges,,421.8,435.12,
"Test by nucleic acid for multiple respiratory virus, 3-5",PX-30010260,CDM,87631,CPT,306,RC,,outpatient,,,444,399.6,,0.95,,421.8,Percent of total billed charges,,,0.98,,435.12,Percent of total billed charges,,,0.95,,421.8,Percent of total billed charges,,,0.95,,421.8,Percent of total billed charges,,,0.97,,430.68,Percent of total billed charges,,,0.96,,426.24,Percent of total billed charges,,,0.95,,421.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,421.8,Percent of total billed charges,,421.8,435.12,
Aspiration of fluid from chest cavity,PX-36111124,CDM,32554,CPT,361,RC,,inpatient,,,1390,1251,,0.95,,1320.5,Percent of total billed charges,,,0.98,,1362.2,Percent of total billed charges,,,0.95,,1320.5,Percent of total billed charges,,,0.97,,1348.3,Percent of total billed charges,,,0.97,,1348.3,Percent of total billed charges,,,0.96,,1334.4,Percent of total billed charges,,,0.95,,1320.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1320.5,Percent of total billed charges,,1320.5,1362.2,
Aspiration of fluid from chest cavity,PX-36111124,CDM,32554,CPT,361,RC,,outpatient,,,1390,1251,,0.95,,1320.5,Percent of total billed charges,,,0.98,,1362.2,Percent of total billed charges,,,0.95,,1320.5,Percent of total billed charges,,,0.95,,1320.5,Percent of total billed charges,,,0.97,,1348.3,Percent of total billed charges,,,0.96,,1334.4,Percent of total billed charges,,,0.95,,1320.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1320.5,Percent of total billed charges,,1320.5,1362.2,
Aspiration of fluid from chest cavity,PX-36111125,CDM,32555,CPT,361,RC,,inpatient,,,976,878.4,,0.95,,927.2,Percent of total billed charges,,,0.98,,956.48,Percent of total billed charges,,,0.95,,927.2,Percent of total billed charges,,,0.97,,946.72,Percent of total billed charges,,,0.97,,946.72,Percent of total billed charges,,,0.96,,936.96,Percent of total billed charges,,,0.95,,927.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,927.2,Percent of total billed charges,,927.2,956.48,
Aspiration of fluid from chest cavity,PX-36111125,CDM,32555,CPT,361,RC,,outpatient,,,976,878.4,,0.95,,927.2,Percent of total billed charges,,,0.98,,956.48,Percent of total billed charges,,,0.95,,927.2,Percent of total billed charges,,,0.95,,927.2,Percent of total billed charges,,,0.97,,946.72,Percent of total billed charges,,,0.96,,936.96,Percent of total billed charges,,,0.95,,927.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,927.2,Percent of total billed charges,,927.2,956.48,
Drain fluid from chest cavity w/ Insert indwelling tube,PX-36111126,CDM,32556,CPT,361,RC,,inpatient,,,1806,1625.4,,0.95,,1715.7,Percent of total billed charges,,,0.98,,1769.88,Percent of total billed charges,,,0.95,,1715.7,Percent of total billed charges,,,0.97,,1751.82,Percent of total billed charges,,,0.97,,1751.82,Percent of total billed charges,,,0.96,,1733.76,Percent of total billed charges,,,0.95,,1715.7,Percent of total billed charges,,,,,,,,,0.95,,1715.7,Percent of total billed charges,,1715.7,1769.88,
Drain fluid from chest cavity w/ Insert indwelling tube,PX-36111126,CDM,32556,CPT,361,RC,,outpatient,,,1806,1625.4,,0.95,,1715.7,Percent of total billed charges,,,0.98,,1769.88,Percent of total billed charges,,,0.95,,1715.7,Percent of total billed charges,,,0.95,,1715.7,Percent of total billed charges,,,0.97,,1751.82,Percent of total billed charges,,,0.96,,1733.76,Percent of total billed charges,,,0.95,,1715.7,Percent of total billed charges,,,,,,,,,0.95,,1715.7,Percent of total billed charges,,1715.7,1769.88,
Drain fluid from chest cavity w/insert indwelling tube,PX-36111127,CDM,32557,CPT,361,RC,,inpatient,,,539,485.1,,0.95,,512.05,Percent of total billed charges,,,0.98,,528.22,Percent of total billed charges,,,0.95,,512.05,Percent of total billed charges,,,0.97,,522.83,Percent of total billed charges,,,0.97,,522.83,Percent of total billed charges,,,0.96,,517.44,Percent of total billed charges,,,0.95,,512.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,512.05,Percent of total billed charges,,512.05,528.22,
Drain fluid from chest cavity w/insert indwelling tube,PX-36111127,CDM,32557,CPT,361,RC,,outpatient,,,539,485.1,,0.95,,512.05,Percent of total billed charges,,,0.98,,528.22,Percent of total billed charges,,,0.95,,512.05,Percent of total billed charges,,,0.95,,512.05,Percent of total billed charges,,,0.97,,522.83,Percent of total billed charges,,,0.96,,517.44,Percent of total billed charges,,,0.95,,512.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,512.05,Percent of total billed charges,,512.05,528.22,
Psychiatric diagnostic evaluation with medical services,PX-90010036,CDM,90792,CPT,900,RC,,inpatient,,,477,429.3,,0.95,,453.15,Percent of total billed charges,,,0.98,,467.46,Percent of total billed charges,,,0.95,,453.15,Percent of total billed charges,,,0.97,,462.69,Percent of total billed charges,,,0.97,,462.69,Percent of total billed charges,,,0.96,,457.92,Percent of total billed charges,,,0.95,,453.15,Percent of total billed charges,,,,,,,,,0.95,,453.15,Percent of total billed charges,,453.15,467.46,
Psychiatric diagnostic evaluation with medical services,PX-90010036,CDM,90792,CPT,900,RC,,outpatient,,,477,429.3,,0.95,,453.15,Percent of total billed charges,,,0.98,,467.46,Percent of total billed charges,,,0.95,,453.15,Percent of total billed charges,,,0.95,,453.15,Percent of total billed charges,,,0.97,,462.69,Percent of total billed charges,,,0.96,,457.92,Percent of total billed charges,,,0.95,,453.15,Percent of total billed charges,,,,,,,,,0.95,,453.15,Percent of total billed charges,,453.15,467.46,
Psychiatric diagnostic evaluation,PX-90010042,CDM,90791,CPT,900,RC,,inpatient,,,319,287.1,,0.95,,303.05,Percent of total billed charges,,,0.98,,312.62,Percent of total billed charges,,,0.95,,303.05,Percent of total billed charges,,,0.97,,309.43,Percent of total billed charges,,,0.97,,309.43,Percent of total billed charges,,,0.96,,306.24,Percent of total billed charges,,,0.95,,303.05,Percent of total billed charges,,,,,,,,,0.95,,303.05,Percent of total billed charges,,303.05,312.62,
Psychiatric diagnostic evaluation,PX-90010042,CDM,90791,CPT,900,RC,,outpatient,,,319,287.1,,0.95,,303.05,Percent of total billed charges,,,0.98,,312.62,Percent of total billed charges,,,0.95,,303.05,Percent of total billed charges,,,0.95,,303.05,Percent of total billed charges,,,0.97,,309.43,Percent of total billed charges,,,0.96,,306.24,Percent of total billed charges,,,0.95,,303.05,Percent of total billed charges,,,,,,,,,0.95,,303.05,Percent of total billed charges,,303.05,312.62,
"Psychotherapy, 30 minutes",PX-90010043,CDM,90832,CPT,900,RC,,inpatient,,,193,173.7,,0.95,,183.35,Percent of total billed charges,,,0.98,,189.14,Percent of total billed charges,,,0.95,,183.35,Percent of total billed charges,,,0.97,,187.21,Percent of total billed charges,,,0.97,,187.21,Percent of total billed charges,,,0.96,,185.28,Percent of total billed charges,,,0.95,,183.35,Percent of total billed charges,,,,,,,,,0.95,,183.35,Percent of total billed charges,,183.35,189.14,
"Psychotherapy, 30 minutes",PX-90010043,CDM,90832,CPT,900,RC,,outpatient,,,193,173.7,,0.95,,183.35,Percent of total billed charges,,,0.98,,189.14,Percent of total billed charges,,,0.95,,183.35,Percent of total billed charges,,,0.95,,183.35,Percent of total billed charges,,,0.97,,187.21,Percent of total billed charges,,,0.96,,185.28,Percent of total billed charges,,,0.95,,183.35,Percent of total billed charges,,,,,,,,,0.95,,183.35,Percent of total billed charges,,183.35,189.14,
"Psychotherapy, 45 minutes",PX-90010044,CDM,90834,CPT,900,RC,,inpatient,,,308,277.2,,0.95,,292.6,Percent of total billed charges,,,0.98,,301.84,Percent of total billed charges,,,0.95,,292.6,Percent of total billed charges,,,0.97,,298.76,Percent of total billed charges,,,0.97,,298.76,Percent of total billed charges,,,0.96,,295.68,Percent of total billed charges,,,0.95,,292.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,292.6,Percent of total billed charges,,292.6,301.84,
"Psychotherapy, 45 minutes",PX-90010044,CDM,90834,CPT,900,RC,,outpatient,,,308,277.2,,0.95,,292.6,Percent of total billed charges,,,0.98,,301.84,Percent of total billed charges,,,0.95,,292.6,Percent of total billed charges,,,0.95,,292.6,Percent of total billed charges,,,0.97,,298.76,Percent of total billed charges,,,0.96,,295.68,Percent of total billed charges,,,0.95,,292.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,292.6,Percent of total billed charges,,292.6,301.84,
"Psychotherapy, 1 hour",PX-90010045,CDM,90837,CPT,900,RC,,inpatient,,,375,337.5,,0.95,,356.25,Percent of total billed charges,,,0.98,,367.5,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.96,,360,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,,,,,,,0.95,,356.25,Percent of total billed charges,,356.25,367.5,
"Psychotherapy, 1 hour",PX-90010045,CDM,90837,CPT,900,RC,,outpatient,,,375,337.5,,0.95,,356.25,Percent of total billed charges,,,0.98,,367.5,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.96,,360,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,,,,,,,0.95,,356.25,Percent of total billed charges,,356.25,367.5,
HC PR 95018 Allg Test Perq & Ic Drug/Biol Immed React W/ I&R,PX-96010044,CDM,95018,CPT,960,RC,,inpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC PR 95018 Allg Test Perq & Ic Drug/Biol Immed React W/ I&R,PX-96010044,CDM,95018,CPT,960,RC,,outpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC PR 95076 Ingestion Challenge Test Initial 120 Minutes,PX-96010045,CDM,95076,CPT,960,RC,,inpatient,,,403,362.7,,0.95,,382.85,Percent of total billed charges,,,0.98,,394.94,Percent of total billed charges,,,0.95,,382.85,Percent of total billed charges,,,0.97,,390.91,Percent of total billed charges,,,0.97,,390.91,Percent of total billed charges,,,0.96,,386.88,Percent of total billed charges,,,0.95,,382.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,382.85,Percent of total billed charges,,382.85,394.94,
HC PR 95076 Ingestion Challenge Test Initial 120 Minutes,PX-96010045,CDM,95076,CPT,960,RC,,outpatient,,,403,362.7,,0.95,,382.85,Percent of total billed charges,,,0.98,,394.94,Percent of total billed charges,,,0.95,,382.85,Percent of total billed charges,,,0.95,,382.85,Percent of total billed charges,,,0.97,,390.91,Percent of total billed charges,,,0.96,,386.88,Percent of total billed charges,,,0.95,,382.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,382.85,Percent of total billed charges,,382.85,394.94,
HC PR 95079 Ingestion Challenge Test Each Addl 60 Minutes,PX-96010046,CDM,95079,CPT,960,RC,,inpatient,,,303,272.7,,0.95,,287.85,Percent of total billed charges,,,0.98,,296.94,Percent of total billed charges,,,0.95,,287.85,Percent of total billed charges,,,0.97,,293.91,Percent of total billed charges,,,0.97,,293.91,Percent of total billed charges,,,0.96,,290.88,Percent of total billed charges,,,0.95,,287.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,287.85,Percent of total billed charges,,287.85,296.94,
HC PR 95079 Ingestion Challenge Test Each Addl 60 Minutes,PX-96010046,CDM,95079,CPT,960,RC,,outpatient,,,303,272.7,,0.95,,287.85,Percent of total billed charges,,,0.98,,296.94,Percent of total billed charges,,,0.95,,287.85,Percent of total billed charges,,,0.95,,287.85,Percent of total billed charges,,,0.97,,293.91,Percent of total billed charges,,,0.96,,290.88,Percent of total billed charges,,,0.95,,287.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,287.85,Percent of total billed charges,,287.85,296.94,
HC PR 99495 Transj Care Mgmt Mod Mdm F2f 14 Cal D Discharge Cdm,PX-96010047,CDM,99495,CPT,960,RC,,inpatient,,,509,458.1,,0.95,,483.55,Percent of total billed charges,,,0.98,,498.82,Percent of total billed charges,,,0.95,,483.55,Percent of total billed charges,,,0.97,,493.73,Percent of total billed charges,,,0.97,,493.73,Percent of total billed charges,,,0.96,,488.64,Percent of total billed charges,,,0.95,,483.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,483.55,Percent of total billed charges,,483.55,498.82,
HC PR 99495 Transj Care Mgmt Mod Mdm F2f 14 Cal D Discharge Cdm,PX-96010047,CDM,99495,CPT,960,RC,,outpatient,,,509,458.1,,0.95,,483.55,Percent of total billed charges,,,0.98,,498.82,Percent of total billed charges,,,0.95,,483.55,Percent of total billed charges,,,0.95,,483.55,Percent of total billed charges,,,0.97,,493.73,Percent of total billed charges,,,0.96,,488.64,Percent of total billed charges,,,0.95,,483.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,483.55,Percent of total billed charges,,483.55,498.82,
HC PR 99496 Transj Care Mgmt High Mdm F2f 7 Cal D Discharge Cdm,PX-96010048,CDM,99496,CPT,960,RC,,inpatient,,,688,619.2,,0.95,,653.6,Percent of total billed charges,,,0.98,,674.24,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,0.97,,667.36,Percent of total billed charges,,,0.97,,667.36,Percent of total billed charges,,,0.96,,660.48,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,653.6,Percent of total billed charges,,653.6,674.24,
HC PR 99496 Transj Care Mgmt High Mdm F2f 7 Cal D Discharge Cdm,PX-96010048,CDM,99496,CPT,960,RC,,outpatient,,,688,619.2,,0.95,,653.6,Percent of total billed charges,,,0.98,,674.24,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,0.97,,667.36,Percent of total billed charges,,,0.96,,660.48,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,653.6,Percent of total billed charges,,653.6,674.24,
Translocation analysis (BCR/ABL1) major breakpoint,PX-30010266,CDM,81206,CPT,310,RC,,inpatient,,,510,459,,0.95,,484.5,Percent of total billed charges,,,0.98,,499.8,Percent of total billed charges,,,0.95,,484.5,Percent of total billed charges,,,0.97,,494.7,Percent of total billed charges,,,0.97,,494.7,Percent of total billed charges,,,0.96,,489.6,Percent of total billed charges,,,0.95,,484.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,484.5,Percent of total billed charges,,484.5,499.8,
Translocation analysis (BCR/ABL1) major breakpoint,PX-30010266,CDM,81206,CPT,310,RC,,outpatient,,,510,459,,0.95,,484.5,Percent of total billed charges,,,0.98,,499.8,Percent of total billed charges,,,0.95,,484.5,Percent of total billed charges,,,0.95,,484.5,Percent of total billed charges,,,0.97,,494.7,Percent of total billed charges,,,0.96,,489.6,Percent of total billed charges,,,0.95,,484.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,484.5,Percent of total billed charges,,484.5,499.8,
"Gene analysis, prothrombin, A variant",PX-30010267,CDM,81240,CPT,310,RC,,inpatient,,,248,223.2,,0.95,,235.6,Percent of total billed charges,,,0.98,,243.04,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,0.97,,240.56,Percent of total billed charges,,,0.97,,240.56,Percent of total billed charges,,,0.96,,238.08,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,235.6,Percent of total billed charges,,235.6,243.04,
"Gene analysis, prothrombin, A variant",PX-30010267,CDM,81240,CPT,310,RC,,outpatient,,,248,223.2,,0.95,,235.6,Percent of total billed charges,,,0.98,,243.04,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,0.97,,240.56,Percent of total billed charges,,,0.96,,238.08,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,235.6,Percent of total billed charges,,235.6,243.04,
Gene analysis (Janus kinase 2) variant,PX-30010269,CDM,81270,CPT,310,RC,,inpatient,,,558,502.2,,0.95,,530.1,Percent of total billed charges,,,0.98,,546.84,Percent of total billed charges,,,0.95,,530.1,Percent of total billed charges,,,0.97,,541.26,Percent of total billed charges,,,0.97,,541.26,Percent of total billed charges,,,0.96,,535.68,Percent of total billed charges,,,0.95,,530.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,530.1,Percent of total billed charges,,530.1,546.84,
Gene analysis (Janus kinase 2) variant,PX-30010269,CDM,81270,CPT,310,RC,,outpatient,,,558,502.2,,0.95,,530.1,Percent of total billed charges,,,0.98,,546.84,Percent of total billed charges,,,0.95,,530.1,Percent of total billed charges,,,0.95,,530.1,Percent of total billed charges,,,0.97,,541.26,Percent of total billed charges,,,0.96,,535.68,Percent of total billed charges,,,0.95,,530.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,530.1,Percent of total billed charges,,530.1,546.84,
Gene analysis common variants,PX-30010270,CDM,81291,CPT,310,RC,,inpatient,,,212,190.8,,0.95,,201.4,Percent of total billed charges,,,0.98,,207.76,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,0.97,,205.64,Percent of total billed charges,,,0.97,,205.64,Percent of total billed charges,,,0.96,,203.52,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,201.4,Percent of total billed charges,,201.4,207.76,
Gene analysis common variants,PX-30010270,CDM,81291,CPT,310,RC,,outpatient,,,212,190.8,,0.95,,201.4,Percent of total billed charges,,,0.98,,207.76,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,0.97,,205.64,Percent of total billed charges,,,0.96,,203.52,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,201.4,Percent of total billed charges,,201.4,207.76,
Translocation analysis (BCR/ABL1) minor breakpoint,PX-30010271,CDM,81207,CPT,310,RC,,inpatient,,,460,414,,0.95,,437,Percent of total billed charges,,,0.98,,450.8,Percent of total billed charges,,,0.95,,437,Percent of total billed charges,,,0.97,,446.2,Percent of total billed charges,,,0.97,,446.2,Percent of total billed charges,,,0.96,,441.6,Percent of total billed charges,,,0.95,,437,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,437,Percent of total billed charges,,437,450.8,
Translocation analysis (BCR/ABL1) minor breakpoint,PX-30010271,CDM,81207,CPT,310,RC,,outpatient,,,460,414,,0.95,,437,Percent of total billed charges,,,0.98,,450.8,Percent of total billed charges,,,0.95,,437,Percent of total billed charges,,,0.95,,437,Percent of total billed charges,,,0.97,,446.2,Percent of total billed charges,,,0.96,,441.6,Percent of total billed charges,,,0.95,,437,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,437,Percent of total billed charges,,437,450.8,
Gene analysis (coagulation factor V) Leiden variant,PX-30010272,CDM,81241,CPT,310,RC,,inpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
Gene analysis (coagulation factor V) Leiden variant,PX-30010272,CDM,81241,CPT,310,RC,,outpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
Gene analysis common variants,PX-30010274,CDM,81226,CPT,310,RC,,inpatient,,,845,760.5,,0.95,,802.75,Percent of total billed charges,,,0.98,,828.1,Percent of total billed charges,,,0.95,,802.75,Percent of total billed charges,,,0.97,,819.65,Percent of total billed charges,,,0.97,,819.65,Percent of total billed charges,,,0.96,,811.2,Percent of total billed charges,,,0.95,,802.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,802.75,Percent of total billed charges,,802.75,828.1,
Gene analysis common variants,PX-30010274,CDM,81226,CPT,310,RC,,outpatient,,,845,760.5,,0.95,,802.75,Percent of total billed charges,,,0.98,,828.1,Percent of total billed charges,,,0.95,,802.75,Percent of total billed charges,,,0.95,,802.75,Percent of total billed charges,,,0.97,,819.65,Percent of total billed charges,,,0.96,,811.2,Percent of total billed charges,,,0.95,,802.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,802.75,Percent of total billed charges,,802.75,828.1,
Gene analysis (hemochromatosis) common variants,PX-30010279,CDM,81256,CPT,310,RC,,inpatient,,,165,148.5,,0.95,,156.75,Percent of total billed charges,,,0.98,,161.7,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.96,,158.4,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,156.75,Percent of total billed charges,,156.75,161.7,
Gene analysis (hemochromatosis) common variants,PX-30010279,CDM,81256,CPT,310,RC,,outpatient,,,165,148.5,,0.95,,156.75,Percent of total billed charges,,,0.98,,161.7,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.96,,158.4,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,156.75,Percent of total billed charges,,156.75,161.7,
HC PR 90792 Psychiatric Diagnostic Eval W/Medical Services,PX-96110070,CDM,90792,CPT,961,RC,,inpatient,,,477,429.3,,0.95,,453.15,Percent of total billed charges,,,0.98,,467.46,Percent of total billed charges,,,0.95,,453.15,Percent of total billed charges,,,0.97,,462.69,Percent of total billed charges,,,0.97,,462.69,Percent of total billed charges,,,0.96,,457.92,Percent of total billed charges,,,0.95,,453.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,453.15,Percent of total billed charges,,453.15,467.46,
HC PR 90792 Psychiatric Diagnostic Eval W/Medical Services,PX-96110070,CDM,90792,CPT,961,RC,,outpatient,,,477,429.3,,0.95,,453.15,Percent of total billed charges,,,0.98,,467.46,Percent of total billed charges,,,0.95,,453.15,Percent of total billed charges,,,0.95,,453.15,Percent of total billed charges,,,0.97,,462.69,Percent of total billed charges,,,0.96,,457.92,Percent of total billed charges,,,0.95,,453.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,453.15,Percent of total billed charges,,453.15,467.46,
HC PR 26075 Explore & Treat Metacarpo-Phal Jt,PX-97510621,CDM,26075,CPT,975,RC,,inpatient,,,854,768.6,,0.95,,811.3,Percent of total billed charges,,,0.98,,836.92,Percent of total billed charges,,,0.95,,811.3,Percent of total billed charges,,,0.97,,828.38,Percent of total billed charges,,,0.97,,828.38,Percent of total billed charges,,,0.96,,819.84,Percent of total billed charges,,,0.95,,811.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,811.3,Percent of total billed charges,,811.3,836.92,
HC PR 26075 Explore & Treat Metacarpo-Phal Jt,PX-97510621,CDM,26075,CPT,975,RC,,outpatient,,,854,768.6,,0.95,,811.3,Percent of total billed charges,,,0.98,,836.92,Percent of total billed charges,,,0.95,,811.3,Percent of total billed charges,,,0.95,,811.3,Percent of total billed charges,,,0.97,,828.38,Percent of total billed charges,,,0.96,,819.84,Percent of total billed charges,,,0.95,,811.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,811.3,Percent of total billed charges,,811.3,836.92,
"HC PR 26357 Repair Flex Tendon,Zone 2,Secon,Hand,Ea",PX-97510623,CDM,26357,CPT,975,RC,,inpatient,,,2223,2000.7,,0.95,,2111.85,Percent of total billed charges,,,0.98,,2178.54,Percent of total billed charges,,,0.95,,2111.85,Percent of total billed charges,,,0.97,,2156.31,Percent of total billed charges,,,0.97,,2156.31,Percent of total billed charges,,,0.96,,2134.08,Percent of total billed charges,,,0.95,,2111.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2111.85,Percent of total billed charges,,2111.85,2178.54,
"HC PR 26357 Repair Flex Tendon,Zone 2,Secon,Hand,Ea",PX-97510623,CDM,26357,CPT,975,RC,,outpatient,,,2223,2000.7,,0.95,,2111.85,Percent of total billed charges,,,0.98,,2178.54,Percent of total billed charges,,,0.95,,2111.85,Percent of total billed charges,,,0.95,,2111.85,Percent of total billed charges,,,0.97,,2156.31,Percent of total billed charges,,,0.96,,2134.08,Percent of total billed charges,,,0.95,,2111.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2111.85,Percent of total billed charges,,2111.85,2178.54,
HC PR 26989 Hand/Finger Surgery Unlisted,PX-97510626,CDM,26989,CPT,975,RC,,inpatient,,,485,436.5,,0.95,,460.75,Percent of total billed charges,,,0.98,,475.3,Percent of total billed charges,,,0.95,,460.75,Percent of total billed charges,,,0.97,,470.45,Percent of total billed charges,,,0.97,,470.45,Percent of total billed charges,,,0.96,,465.6,Percent of total billed charges,,,0.95,,460.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,460.75,Percent of total billed charges,,460.75,475.3,
HC PR 26989 Hand/Finger Surgery Unlisted,PX-97510626,CDM,26989,CPT,975,RC,,outpatient,,,485,436.5,,0.95,,460.75,Percent of total billed charges,,,0.98,,475.3,Percent of total billed charges,,,0.95,,460.75,Percent of total billed charges,,,0.95,,460.75,Percent of total billed charges,,,0.97,,470.45,Percent of total billed charges,,,0.96,,465.6,Percent of total billed charges,,,0.95,,460.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,460.75,Percent of total billed charges,,460.75,475.3,
"HC PR 27427 Ligmt Revision,Knee,Extra-Artic",PX-97510634,CDM,27427,CPT,975,RC,,inpatient,,,1765,1588.5,,0.95,,1676.75,Percent of total billed charges,,,0.98,,1729.7,Percent of total billed charges,,,0.95,,1676.75,Percent of total billed charges,,,0.97,,1712.05,Percent of total billed charges,,,0.97,,1712.05,Percent of total billed charges,,,0.96,,1694.4,Percent of total billed charges,,,0.95,,1676.75,Percent of total billed charges,,,,,,,,,0.95,,1676.75,Percent of total billed charges,,1676.75,1729.7,
"HC PR 27427 Ligmt Revision,Knee,Extra-Artic",PX-97510634,CDM,27427,CPT,975,RC,,outpatient,,,1765,1588.5,,0.95,,1676.75,Percent of total billed charges,,,0.98,,1729.7,Percent of total billed charges,,,0.95,,1676.75,Percent of total billed charges,,,0.95,,1676.75,Percent of total billed charges,,,0.97,,1712.05,Percent of total billed charges,,,0.96,,1694.4,Percent of total billed charges,,,0.95,,1676.75,Percent of total billed charges,,,,,,,,,0.95,,1676.75,Percent of total billed charges,,1676.75,1729.7,
"HC PR 28730 Fusion Foot Bones,Midtarsal,Multi",PX-97510646,CDM,28730,CPT,975,RC,,inpatient,,,1966,1769.4,,0.95,,1867.7,Percent of total billed charges,,,0.98,,1926.68,Percent of total billed charges,,,0.95,,1867.7,Percent of total billed charges,,,0.97,,1907.02,Percent of total billed charges,,,0.97,,1907.02,Percent of total billed charges,,,0.96,,1887.36,Percent of total billed charges,,,0.95,,1867.7,Percent of total billed charges,,,,,,,,,0.95,,1867.7,Percent of total billed charges,,1867.7,1926.68,
"HC PR 28730 Fusion Foot Bones,Midtarsal,Multi",PX-97510646,CDM,28730,CPT,975,RC,,outpatient,,,1966,1769.4,,0.95,,1867.7,Percent of total billed charges,,,0.98,,1926.68,Percent of total billed charges,,,0.95,,1867.7,Percent of total billed charges,,,0.95,,1867.7,Percent of total billed charges,,,0.97,,1907.02,Percent of total billed charges,,,0.96,,1887.36,Percent of total billed charges,,,0.95,,1867.7,Percent of total billed charges,,,,,,,,,0.95,,1867.7,Percent of total billed charges,,1867.7,1926.68,
HC PR 29828 Arthroscopy Shoulder Surgical Biceps Tenodesis,PX-97510648,CDM,29828,CPT,975,RC,,inpatient,,,2269,2042.1,,0.95,,2155.55,Percent of total billed charges,,,0.98,,2223.62,Percent of total billed charges,,,0.95,,2155.55,Percent of total billed charges,,,0.97,,2200.93,Percent of total billed charges,,,0.97,,2200.93,Percent of total billed charges,,,0.96,,2178.24,Percent of total billed charges,,,0.95,,2155.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2155.55,Percent of total billed charges,,2155.55,2223.62,
HC PR 29828 Arthroscopy Shoulder Surgical Biceps Tenodesis,PX-97510648,CDM,29828,CPT,975,RC,,outpatient,,,2269,2042.1,,0.95,,2155.55,Percent of total billed charges,,,0.98,,2223.62,Percent of total billed charges,,,0.95,,2155.55,Percent of total billed charges,,,0.95,,2155.55,Percent of total billed charges,,,0.97,,2200.93,Percent of total billed charges,,,0.96,,2178.24,Percent of total billed charges,,,0.95,,2155.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2155.55,Percent of total billed charges,,2155.55,2223.62,
HC PR 64455 Inject Plantar Common Digital Nerve,PX-97510667,CDM,64455,CPT,975,RC,,inpatient,,,176,158.4,,0.95,,167.2,Percent of total billed charges,,,0.98,,172.48,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,0.97,,170.72,Percent of total billed charges,,,0.97,,170.72,Percent of total billed charges,,,0.96,,168.96,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,167.2,Percent of total billed charges,,167.2,172.48,
HC PR 64455 Inject Plantar Common Digital Nerve,PX-97510667,CDM,64455,CPT,975,RC,,outpatient,,,176,158.4,,0.95,,167.2,Percent of total billed charges,,,0.98,,172.48,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,0.97,,170.72,Percent of total billed charges,,,0.96,,168.96,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,167.2,Percent of total billed charges,,167.2,172.48,
HC PR 67840 Remove Eyelid Lesn (Not Chalazion),PX-97510670,CDM,67840,CPT,975,RC,,inpatient,,,686,617.4,,0.95,,651.7,Percent of total billed charges,,,0.98,,672.28,Percent of total billed charges,,,0.95,,651.7,Percent of total billed charges,,,0.97,,665.42,Percent of total billed charges,,,0.97,,665.42,Percent of total billed charges,,,0.96,,658.56,Percent of total billed charges,,,0.95,,651.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,651.7,Percent of total billed charges,,651.7,672.28,
HC PR 67840 Remove Eyelid Lesn (Not Chalazion),PX-97510670,CDM,67840,CPT,975,RC,,outpatient,,,686,617.4,,0.95,,651.7,Percent of total billed charges,,,0.98,,672.28,Percent of total billed charges,,,0.95,,651.7,Percent of total billed charges,,,0.95,,651.7,Percent of total billed charges,,,0.97,,665.42,Percent of total billed charges,,,0.96,,658.56,Percent of total billed charges,,,0.95,,651.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,651.7,Percent of total billed charges,,651.7,672.28,
"HC PR 90473 Immuniz Admin,Intranasal/Oral,1 Vac/Tox",PX-96910639,CDM,90473,CPT,983,RC,,inpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
"HC PR 90473 Immuniz Admin,Intranasal/Oral,1 Vac/Tox",PX-96910639,CDM,90473,CPT,983,RC,,outpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
HC PR 96523 Irrig Implanted Drug Delivery Device,PX-96910641,CDM,96523,CPT,983,RC,,inpatient,,,66,59.4,,0.95,,62.7,Percent of total billed charges,,,0.98,,64.68,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,0.97,,64.02,Percent of total billed charges,,,0.97,,64.02,Percent of total billed charges,,,0.96,,63.36,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,62.7,Percent of total billed charges,,62.7,64.68,
HC PR 96523 Irrig Implanted Drug Delivery Device,PX-96910641,CDM,96523,CPT,983,RC,,outpatient,,,66,59.4,,0.95,,62.7,Percent of total billed charges,,,0.98,,64.68,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,0.97,,64.02,Percent of total billed charges,,,0.96,,63.36,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,62.7,Percent of total billed charges,,62.7,64.68,
HC PR Q4012 Cast Sup Sht Arm Ped Fbrglas,PX-96910696,CDM,Q4012,HCPCS,983,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC PR Q4012 Cast Sup Sht Arm Ped Fbrglas,PX-96910696,CDM,Q4012,HCPCS,983,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC PR 27530 Cltx Tibial Fx Proximal W/O Manipulation,PX-97510673,CDM,27530,CPT,975,RC,,inpatient,,,1529,1376.1,,0.95,,1452.55,Percent of total billed charges,,,0.98,,1498.42,Percent of total billed charges,,,0.95,,1452.55,Percent of total billed charges,,,0.97,,1483.13,Percent of total billed charges,,,0.97,,1483.13,Percent of total billed charges,,,0.96,,1467.84,Percent of total billed charges,,,0.95,,1452.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1452.55,Percent of total billed charges,,1452.55,1498.42,
HC PR 27530 Cltx Tibial Fx Proximal W/O Manipulation,PX-97510673,CDM,27530,CPT,975,RC,,outpatient,,,1529,1376.1,,0.95,,1452.55,Percent of total billed charges,,,0.98,,1498.42,Percent of total billed charges,,,0.95,,1452.55,Percent of total billed charges,,,0.95,,1452.55,Percent of total billed charges,,,0.97,,1483.13,Percent of total billed charges,,,0.96,,1467.84,Percent of total billed charges,,,0.95,,1452.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1452.55,Percent of total billed charges,,1452.55,1498.42,
"HC PR 29807 Shldr Arthroscop,Surg,Repair,Slap Lesion",PX-97510675,CDM,29807,CPT,975,RC,,inpatient,,,2560,2304,,0.95,,2432,Percent of total billed charges,,,0.98,,2508.8,Percent of total billed charges,,,0.95,,2432,Percent of total billed charges,,,0.97,,2483.2,Percent of total billed charges,,,0.97,,2483.2,Percent of total billed charges,,,0.96,,2457.6,Percent of total billed charges,,,0.95,,2432,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2432,Percent of total billed charges,,2432,2508.8,
"HC PR 29807 Shldr Arthroscop,Surg,Repair,Slap Lesion",PX-97510675,CDM,29807,CPT,975,RC,,outpatient,,,2560,2304,,0.95,,2432,Percent of total billed charges,,,0.98,,2508.8,Percent of total billed charges,,,0.95,,2432,Percent of total billed charges,,,0.95,,2432,Percent of total billed charges,,,0.97,,2483.2,Percent of total billed charges,,,0.96,,2457.6,Percent of total billed charges,,,0.95,,2432,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2432,Percent of total billed charges,,2432,2508.8,
"HC PR 29827 Shldr Arthroscop,Surg,W/Rotat Cuff Repr",PX-97510676,CDM,29827,CPT,975,RC,,inpatient,,,2641,2376.9,,0.95,,2508.95,Percent of total billed charges,,,0.98,,2588.18,Percent of total billed charges,,,0.95,,2508.95,Percent of total billed charges,,,0.97,,2561.77,Percent of total billed charges,,,0.97,,2561.77,Percent of total billed charges,,,0.96,,2535.36,Percent of total billed charges,,,0.95,,2508.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2508.95,Percent of total billed charges,,2508.95,2588.18,
"HC PR 29827 Shldr Arthroscop,Surg,W/Rotat Cuff Repr",PX-97510676,CDM,29827,CPT,975,RC,,outpatient,,,2641,2376.9,,0.95,,2508.95,Percent of total billed charges,,,0.98,,2588.18,Percent of total billed charges,,,0.95,,2508.95,Percent of total billed charges,,,0.95,,2508.95,Percent of total billed charges,,,0.97,,2561.77,Percent of total billed charges,,,0.96,,2535.36,Percent of total billed charges,,,0.95,,2508.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2508.95,Percent of total billed charges,,2508.95,2588.18,
"HC PR 29888 Knee Scope,Aid Ant Cruciate Repair",PX-97510677,CDM,29888,CPT,975,RC,,inpatient,,,2409,2168.1,,0.95,,2288.55,Percent of total billed charges,,,0.98,,2360.82,Percent of total billed charges,,,0.95,,2288.55,Percent of total billed charges,,,0.97,,2336.73,Percent of total billed charges,,,0.97,,2336.73,Percent of total billed charges,,,0.96,,2312.64,Percent of total billed charges,,,0.95,,2288.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2288.55,Percent of total billed charges,,2288.55,2360.82,
"HC PR 29888 Knee Scope,Aid Ant Cruciate Repair",PX-97510677,CDM,29888,CPT,975,RC,,outpatient,,,2409,2168.1,,0.95,,2288.55,Percent of total billed charges,,,0.98,,2360.82,Percent of total billed charges,,,0.95,,2288.55,Percent of total billed charges,,,0.95,,2288.55,Percent of total billed charges,,,0.97,,2336.73,Percent of total billed charges,,,0.96,,2312.64,Percent of total billed charges,,,0.95,,2288.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2288.55,Percent of total billed charges,,2288.55,2360.82,
HC PR 29325 Application of Hip Casts,PX-96910918,CDM,29325,CPT,983,RC,,inpatient,,,694,624.6,,0.95,,659.3,Percent of total billed charges,,,0.98,,680.12,Percent of total billed charges,,,0.95,,659.3,Percent of total billed charges,,,0.97,,673.18,Percent of total billed charges,,,0.97,,673.18,Percent of total billed charges,,,0.96,,666.24,Percent of total billed charges,,,0.95,,659.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,659.3,Percent of total billed charges,,659.3,680.12,
HC PR 29325 Application of Hip Casts,PX-96910918,CDM,29325,CPT,983,RC,,outpatient,,,694,624.6,,0.95,,659.3,Percent of total billed charges,,,0.98,,680.12,Percent of total billed charges,,,0.95,,659.3,Percent of total billed charges,,,0.95,,659.3,Percent of total billed charges,,,0.97,,673.18,Percent of total billed charges,,,0.96,,666.24,Percent of total billed charges,,,0.95,,659.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,659.3,Percent of total billed charges,,659.3,680.12,
HC PR 26785 Treat Finger Dislocation,PX-97511308,CDM,26785,CPT,975,RC,,inpatient,,,1458,1312.2,,0.95,,1385.1,Percent of total billed charges,,,0.98,,1428.84,Percent of total billed charges,,,0.95,,1385.1,Percent of total billed charges,,,0.97,,1414.26,Percent of total billed charges,,,0.97,,1414.26,Percent of total billed charges,,,0.96,,1399.68,Percent of total billed charges,,,0.95,,1385.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1385.1,Percent of total billed charges,,1385.1,1428.84,
HC PR 26785 Treat Finger Dislocation,PX-97511308,CDM,26785,CPT,975,RC,,outpatient,,,1458,1312.2,,0.95,,1385.1,Percent of total billed charges,,,0.98,,1428.84,Percent of total billed charges,,,0.95,,1385.1,Percent of total billed charges,,,0.95,,1385.1,Percent of total billed charges,,,0.97,,1414.26,Percent of total billed charges,,,0.96,,1399.68,Percent of total billed charges,,,0.95,,1385.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1385.1,Percent of total billed charges,,1385.1,1428.84,
HC PR 29819 Shoulder Arthroscopy/Surgery,PX-97511402,CDM,29819,CPT,975,RC,,inpatient,,,1463,1316.7,,0.95,,1389.85,Percent of total billed charges,,,0.98,,1433.74,Percent of total billed charges,,,0.95,,1389.85,Percent of total billed charges,,,0.97,,1419.11,Percent of total billed charges,,,0.97,,1419.11,Percent of total billed charges,,,0.96,,1404.48,Percent of total billed charges,,,0.95,,1389.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1389.85,Percent of total billed charges,,1389.85,1433.74,
HC PR 29819 Shoulder Arthroscopy/Surgery,PX-97511402,CDM,29819,CPT,975,RC,,outpatient,,,1463,1316.7,,0.95,,1389.85,Percent of total billed charges,,,0.98,,1433.74,Percent of total billed charges,,,0.95,,1389.85,Percent of total billed charges,,,0.95,,1389.85,Percent of total billed charges,,,0.97,,1419.11,Percent of total billed charges,,,0.96,,1404.48,Percent of total billed charges,,,0.95,,1389.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1389.85,Percent of total billed charges,,1389.85,1433.74,
HC PR 29825 Surgical Arthroscopy Shoulder W/Lss & Rescj Ads Cdm,PX-97511403,CDM,29825,CPT,975,RC,,inpatient,,,1460,1314,,0.95,,1387,Percent of total billed charges,,,0.98,,1430.8,Percent of total billed charges,,,0.95,,1387,Percent of total billed charges,,,0.97,,1416.2,Percent of total billed charges,,,0.97,,1416.2,Percent of total billed charges,,,0.96,,1401.6,Percent of total billed charges,,,0.95,,1387,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1387,Percent of total billed charges,,1387,1430.8,
HC PR 29825 Surgical Arthroscopy Shoulder W/Lss & Rescj Ads Cdm,PX-97511403,CDM,29825,CPT,975,RC,,outpatient,,,1460,1314,,0.95,,1387,Percent of total billed charges,,,0.98,,1430.8,Percent of total billed charges,,,0.95,,1387,Percent of total billed charges,,,0.95,,1387,Percent of total billed charges,,,0.97,,1416.2,Percent of total billed charges,,,0.96,,1401.6,Percent of total billed charges,,,0.95,,1387,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1387,Percent of total billed charges,,1387,1430.8,
HC PR 32554 Thorancentesis Needle/Cath Pleura W/O Imaging,PX-97511404,CDM,32554,CPT,975,RC,,inpatient,,,574,516.6,,0.95,,545.3,Percent of total billed charges,,,0.98,,562.52,Percent of total billed charges,,,0.95,,545.3,Percent of total billed charges,,,0.97,,556.78,Percent of total billed charges,,,0.97,,556.78,Percent of total billed charges,,,0.96,,551.04,Percent of total billed charges,,,0.95,,545.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,545.3,Percent of total billed charges,,545.3,562.52,
HC PR 32554 Thorancentesis Needle/Cath Pleura W/O Imaging,PX-97511404,CDM,32554,CPT,975,RC,,outpatient,,,574,516.6,,0.95,,545.3,Percent of total billed charges,,,0.98,,562.52,Percent of total billed charges,,,0.95,,545.3,Percent of total billed charges,,,0.95,,545.3,Percent of total billed charges,,,0.97,,556.78,Percent of total billed charges,,,0.96,,551.04,Percent of total billed charges,,,0.95,,545.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,545.3,Percent of total billed charges,,545.3,562.52,
HC R&B-Semi-Private Isolation,PX-12010011,CDM,12010011,LOCAL,120,RC,,inpatient,,,5403,4862.7,,0.95,,5132.85,Percent of total billed charges,,,0.98,,5294.94,Percent of total billed charges,,,0.95,,5132.85,Percent of total billed charges,,,0.97,,5240.91,Percent of total billed charges,,,0.97,,5240.91,Percent of total billed charges,,,0.96,,5186.88,Percent of total billed charges,,,0.95,,5132.85,Percent of total billed charges,,,,,,,,,0.95,,5132.85,Percent of total billed charges,,5132.85,5294.94,
HC R&B-Semi-Private Isolation,PX-12010011,CDM,12010011,LOCAL,120,RC,,outpatient,,,5403,4862.7,,0.95,,5132.85,Percent of total billed charges,,,0.98,,5294.94,Percent of total billed charges,,,0.95,,5132.85,Percent of total billed charges,,,0.95,,5132.85,Percent of total billed charges,,,0.97,,5240.91,Percent of total billed charges,,,0.96,,5186.88,Percent of total billed charges,,,0.95,,5132.85,Percent of total billed charges,,,,,,,,,0.95,,5132.85,Percent of total billed charges,,5132.85,5294.94,
HC PR 90471 Vfc Immunization Admin Initial,PX-96910338,CDM,90471,CPT,771,RC,,inpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,0.01,Percent of total billed charges,,0.01,0.01,
HC PR 90471 Vfc Immunization Admin Initial,PX-96910338,CDM,90471,CPT,771,RC,,outpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,0.01,Percent of total billed charges,,0.01,0.01,
HC PR 90472 Vfc Immunization Admin Each Addl,PX-96910339,CDM,90472,CPT,771,RC,,inpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,0.01,Percent of total billed charges,,0.01,0.01,
HC PR 90472 Vfc Immunization Admin Each Addl,PX-96910339,CDM,90472,CPT,771,RC,,outpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,0.01,Percent of total billed charges,,0.01,0.01,
HC PR 90473 Vfc Immune Admin Oral/Nasal Initial,PX-96910340,CDM,90473,HCPCS,983,RC,,inpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,0.01,Percent of total billed charges,,0.01,0.01,
HC PR 90473 Vfc Immune Admin Oral/Nasal Initial,PX-96910340,CDM,90473,HCPCS,983,RC,,outpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,0.01,Percent of total billed charges,,0.01,0.01,
HC PR 90474 Vfc Immune Admin Oral/Nasal Addl,PX-96910341,CDM,90474,HCPCS,983,RC,,inpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,0.01,Percent of total billed charges,,0.01,0.01,
HC PR 90474 Vfc Immune Admin Oral/Nasal Addl,PX-96910341,CDM,90474,HCPCS,983,RC,,outpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,0.01,Percent of total billed charges,,0.01,0.01,
HC PR G0008 Medicare Admin Influenza Virus Vac,PX-96910343,CDM,G0008,HCPCS,771,RC,,inpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
HC PR G0008 Medicare Admin Influenza Virus Vac,PX-96910343,CDM,G0008,HCPCS,771,RC,,outpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
HC PR G0009 Medicare Admin Pneumococcal Vaccine,PX-96910344,CDM,G0009,HCPCS,771,RC,,inpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
HC PR G0009 Medicare Admin Pneumococcal Vaccine,PX-96910344,CDM,G0009,HCPCS,771,RC,,outpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
HC PR 93888 Transcranial Doppler Ltd,PX-97210041,CDM,93888,CPT,972,RC,,inpatient,,,393,353.7,,0.95,,373.35,Percent of total billed charges,,,0.98,,385.14,Percent of total billed charges,,,0.95,,373.35,Percent of total billed charges,,,0.97,,381.21,Percent of total billed charges,,,0.97,,381.21,Percent of total billed charges,,,0.96,,377.28,Percent of total billed charges,,,0.95,,373.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,373.35,Percent of total billed charges,,373.35,385.14,
HC PR 93888 Transcranial Doppler Ltd,PX-97210041,CDM,93888,CPT,972,RC,,outpatient,,,393,353.7,,0.95,,373.35,Percent of total billed charges,,,0.98,,385.14,Percent of total billed charges,,,0.95,,373.35,Percent of total billed charges,,,0.95,,373.35,Percent of total billed charges,,,0.97,,381.21,Percent of total billed charges,,,0.96,,377.28,Percent of total billed charges,,,0.95,,373.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,373.35,Percent of total billed charges,,373.35,385.14,
Pleural drainage w/ insertion of catheter; w/o imaging guidance,PX-98110929,CDM,32556,CPT,981,RC,,inpatient,,,293,263.7,,0.95,,278.35,Percent of total billed charges,,,0.98,,287.14,Percent of total billed charges,,,0.95,,278.35,Percent of total billed charges,,,0.97,,284.21,Percent of total billed charges,,,0.97,,284.21,Percent of total billed charges,,,0.96,,281.28,Percent of total billed charges,,,0.95,,278.35,Percent of total billed charges,,,,,,,,,0.95,,278.35,Percent of total billed charges,,278.35,287.14,
Pleural drainage w/ insertion of catheter; w/o imaging guidance,PX-98110929,CDM,32556,CPT,981,RC,,outpatient,,,293,263.7,,0.95,,278.35,Percent of total billed charges,,,0.98,,287.14,Percent of total billed charges,,,0.95,,278.35,Percent of total billed charges,,,0.95,,278.35,Percent of total billed charges,,,0.97,,284.21,Percent of total billed charges,,,0.96,,281.28,Percent of total billed charges,,,0.95,,278.35,Percent of total billed charges,,,,,,,,,0.95,,278.35,Percent of total billed charges,,278.35,287.14,
HC PR ED 32555 Thoracentesis/Aspir W Img Gd Cdm,PX-98110930,CDM,32555,CPT,981,RC,,inpatient,,,254,228.6,,0.95,,241.3,Percent of total billed charges,,,0.98,,248.92,Percent of total billed charges,,,0.95,,241.3,Percent of total billed charges,,,0.97,,246.38,Percent of total billed charges,,,0.97,,246.38,Percent of total billed charges,,,0.96,,243.84,Percent of total billed charges,,,0.95,,241.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,241.3,Percent of total billed charges,,241.3,248.92,
HC PR ED 32555 Thoracentesis/Aspir W Img Gd Cdm,PX-98110930,CDM,32555,CPT,981,RC,,outpatient,,,254,228.6,,0.95,,241.3,Percent of total billed charges,,,0.98,,248.92,Percent of total billed charges,,,0.95,,241.3,Percent of total billed charges,,,0.95,,241.3,Percent of total billed charges,,,0.97,,246.38,Percent of total billed charges,,,0.96,,243.84,Percent of total billed charges,,,0.95,,241.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,241.3,Percent of total billed charges,,241.3,248.92,
HC PR ED 32554 Thoracentesis/Aspir W/O Img Gd Cdm,PX-98110931,CDM,32554,CPT,981,RC,,inpatient,,,259,233.1,,0.95,,246.05,Percent of total billed charges,,,0.98,,253.82,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,0.97,,251.23,Percent of total billed charges,,,0.97,,251.23,Percent of total billed charges,,,0.96,,248.64,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,246.05,Percent of total billed charges,,246.05,253.82,
HC PR ED 32554 Thoracentesis/Aspir W/O Img Gd Cdm,PX-98110931,CDM,32554,CPT,981,RC,,outpatient,,,259,233.1,,0.95,,246.05,Percent of total billed charges,,,0.98,,253.82,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,0.97,,251.23,Percent of total billed charges,,,0.96,,248.64,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,246.05,Percent of total billed charges,,246.05,253.82,
Genome-wide microarray analysis,PX-31010606,CDM,81229,CPT,310,RC,,inpatient,,,3141,2826.9,,0.95,,2983.95,Percent of total billed charges,,,0.98,,3078.18,Percent of total billed charges,,,0.95,,2983.95,Percent of total billed charges,,,0.97,,3046.77,Percent of total billed charges,,,0.97,,3046.77,Percent of total billed charges,,,0.96,,3015.36,Percent of total billed charges,,,0.95,,2983.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2983.95,Percent of total billed charges,,2983.95,3078.18,
Genome-wide microarray analysis,PX-31010606,CDM,81229,CPT,310,RC,,outpatient,,,3141,2826.9,,0.95,,2983.95,Percent of total billed charges,,,0.98,,3078.18,Percent of total billed charges,,,0.95,,2983.95,Percent of total billed charges,,,0.95,,2983.95,Percent of total billed charges,,,0.97,,3046.77,Percent of total billed charges,,,0.96,,3015.36,Percent of total billed charges,,,0.95,,2983.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2983.95,Percent of total billed charges,,2983.95,3078.18,
HC PR 97810 Acupunct W/O Elec Stimul 15 Min,PX-96010104,CDM,97810,CPT,960,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 97810 Acupunct W/O Elec Stimul 15 Min,PX-96010104,CDM,97810,CPT,960,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 97811 Acupunct W/O Elec Stimul Addl 15m,PX-96010105,CDM,97811,CPT,960,RC,,inpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
HC PR 97811 Acupunct W/O Elec Stimul Addl 15m,PX-96010105,CDM,97811,CPT,960,RC,,outpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
HC PR 97813 Acupunct W/ Elec Stimul 15 Min,PX-96010106,CDM,97813,CPT,960,RC,,inpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
HC PR 97813 Acupunct W/ Elec Stimul 15 Min,PX-96010106,CDM,97813,CPT,960,RC,,outpatient,,,116,104.4,,0.95,,110.2,Percent of total billed charges,,,0.98,,113.68,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,0.97,,112.52,Percent of total billed charges,,,0.96,,111.36,Percent of total billed charges,,,0.95,,110.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,110.2,Percent of total billed charges,,110.2,113.68,
HC PR 97814 Acupunct W/ Elec Stimul Addl 15m,PX-96010107,CDM,97814,CPT,960,RC,,inpatient,,,98,88.2,,0.95,,93.1,Percent of total billed charges,,,0.98,,96.04,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,0.97,,95.06,Percent of total billed charges,,,0.97,,95.06,Percent of total billed charges,,,0.96,,94.08,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,93.1,Percent of total billed charges,,93.1,96.04,
HC PR 97814 Acupunct W/ Elec Stimul Addl 15m,PX-96010107,CDM,97814,CPT,960,RC,,outpatient,,,98,88.2,,0.95,,93.1,Percent of total billed charges,,,0.98,,96.04,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,0.97,,95.06,Percent of total billed charges,,,0.96,,94.08,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,93.1,Percent of total billed charges,,93.1,96.04,
HC Misc Supply,PX-27110047,CDM,27110047,LOCAL,271,RC,,inpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
HC Misc Supply,PX-27110047,CDM,27110047,LOCAL,271,RC,,outpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
HC PR ED 29086 ER Cast Finger Cdm,PX-98110936,CDM,29086,CPT,981,RC,,inpatient,,,199,179.1,,0.95,,189.05,Percent of total billed charges,,,0.98,,195.02,Percent of total billed charges,,,0.95,,189.05,Percent of total billed charges,,,0.97,,193.03,Percent of total billed charges,,,0.97,,193.03,Percent of total billed charges,,,0.96,,191.04,Percent of total billed charges,,,0.95,,189.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,189.05,Percent of total billed charges,,189.05,195.02,
HC PR ED 29086 ER Cast Finger Cdm,PX-98110936,CDM,29086,CPT,981,RC,,outpatient,,,199,179.1,,0.95,,189.05,Percent of total billed charges,,,0.98,,195.02,Percent of total billed charges,,,0.95,,189.05,Percent of total billed charges,,,0.95,,189.05,Percent of total billed charges,,,0.97,,193.03,Percent of total billed charges,,,0.96,,191.04,Percent of total billed charges,,,0.95,,189.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,189.05,Percent of total billed charges,,189.05,195.02,
"HC PR ED 27767 ER Closed Tx Posterior Malleous Fx, W/O Cdm",PX-98110939,CDM,27767,CPT,981,RC,,inpatient,,,1241,1116.9,,0.95,,1178.95,Percent of total billed charges,,,0.98,,1216.18,Percent of total billed charges,,,0.95,,1178.95,Percent of total billed charges,,,0.97,,1203.77,Percent of total billed charges,,,0.97,,1203.77,Percent of total billed charges,,,0.96,,1191.36,Percent of total billed charges,,,0.95,,1178.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1178.95,Percent of total billed charges,,1178.95,1216.18,
"HC PR ED 27767 ER Closed Tx Posterior Malleous Fx, W/O Cdm",PX-98110939,CDM,27767,CPT,981,RC,,outpatient,,,1241,1116.9,,0.95,,1178.95,Percent of total billed charges,,,0.98,,1216.18,Percent of total billed charges,,,0.95,,1178.95,Percent of total billed charges,,,0.95,,1178.95,Percent of total billed charges,,,0.97,,1203.77,Percent of total billed charges,,,0.96,,1191.36,Percent of total billed charges,,,0.95,,1178.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1178.95,Percent of total billed charges,,1178.95,1216.18,
HC PR ED 28635 Treat Toe Dislocation W/Manipulation W/Anesth Cdm,PX-98110941,CDM,28635,CPT,981,RC,,inpatient,,,479,431.1,,0.95,,455.05,Percent of total billed charges,,,0.98,,469.42,Percent of total billed charges,,,0.95,,455.05,Percent of total billed charges,,,0.97,,464.63,Percent of total billed charges,,,0.97,,464.63,Percent of total billed charges,,,0.96,,459.84,Percent of total billed charges,,,0.95,,455.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,455.05,Percent of total billed charges,,455.05,469.42,
HC PR ED 28635 Treat Toe Dislocation W/Manipulation W/Anesth Cdm,PX-98110941,CDM,28635,CPT,981,RC,,outpatient,,,479,431.1,,0.95,,455.05,Percent of total billed charges,,,0.98,,469.42,Percent of total billed charges,,,0.95,,455.05,Percent of total billed charges,,,0.95,,455.05,Percent of total billed charges,,,0.97,,464.63,Percent of total billed charges,,,0.96,,459.84,Percent of total billed charges,,,0.95,,455.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,455.05,Percent of total billed charges,,455.05,469.42,
Treatment of spontaneous dislocated hip under anesthesia,PX-45010622,CDM,27257,CPT,450,RC,,inpatient,,,1880,1692,,0.95,,1786,Percent of total billed charges,,,0.98,,1842.4,Percent of total billed charges,,,0.95,,1786,Percent of total billed charges,,,0.97,,1823.6,Percent of total billed charges,,,0.97,,1823.6,Percent of total billed charges,,,0.96,,1804.8,Percent of total billed charges,,,0.95,,1786,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1786,Percent of total billed charges,,1786,3950,
Treatment of spontaneous dislocated hip under anesthesia,PX-45010622,CDM,27257,CPT,450,RC,,outpatient,,,1880,1692,,0.95,,1786,Percent of total billed charges,,,0.98,,1842.4,Percent of total billed charges,,,0.95,,1786,Percent of total billed charges,,,0.95,,1786,Percent of total billed charges,,,0.97,,1823.6,Percent of total billed charges,,,0.96,,1804.8,Percent of total billed charges,,,0.95,,1786,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1786,Percent of total billed charges,,1786,3950,
HC Telehealth Facility Fee Q3014 Cdm,PX-78010001,CDM,Q3014,HCPCS,780,RC,,inpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
HC Telehealth Facility Fee Q3014 Cdm,PX-78010001,CDM,Q3014,HCPCS,780,RC,,outpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
HC PR 27331 Explore/Treat Knee Joint,PX-98210074,CDM,27331,CPT,982,RC,,inpatient,,,1196,1076.4,,0.95,,1136.2,Percent of total billed charges,,,0.98,,1172.08,Percent of total billed charges,,,0.95,,1136.2,Percent of total billed charges,,,0.97,,1160.12,Percent of total billed charges,,,0.97,,1160.12,Percent of total billed charges,,,0.96,,1148.16,Percent of total billed charges,,,0.95,,1136.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1136.2,Percent of total billed charges,,1136.2,1172.08,
HC PR 27331 Explore/Treat Knee Joint,PX-98210074,CDM,27331,CPT,982,RC,,outpatient,,,1196,1076.4,,0.95,,1136.2,Percent of total billed charges,,,0.98,,1172.08,Percent of total billed charges,,,0.95,,1136.2,Percent of total billed charges,,,0.95,,1136.2,Percent of total billed charges,,,0.97,,1160.12,Percent of total billed charges,,,0.96,,1148.16,Percent of total billed charges,,,0.95,,1136.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1136.2,Percent of total billed charges,,1136.2,1172.08,
HC PR 29999 Arthroscopy of Joint,PX-98210087,CDM,29999,CPT,982,RC,,inpatient,,,5749,5174.1,,0.95,,5461.55,Percent of total billed charges,,,0.98,,5634.02,Percent of total billed charges,,,0.95,,5461.55,Percent of total billed charges,,,0.97,,5576.53,Percent of total billed charges,,,0.97,,5576.53,Percent of total billed charges,,,0.96,,5519.04,Percent of total billed charges,,,0.95,,5461.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,5461.55,Percent of total billed charges,,5461.55,5634.02,
HC PR 29999 Arthroscopy of Joint,PX-98210087,CDM,29999,CPT,982,RC,,outpatient,,,5749,5174.1,,0.95,,5461.55,Percent of total billed charges,,,0.98,,5634.02,Percent of total billed charges,,,0.95,,5461.55,Percent of total billed charges,,,0.95,,5461.55,Percent of total billed charges,,,0.97,,5576.53,Percent of total billed charges,,,0.96,,5519.04,Percent of total billed charges,,,0.95,,5461.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,5461.55,Percent of total billed charges,,5461.55,5634.02,
HC PR 84703 Chorionic Gonadotropin Assay,PX-98310386,CDM,84703,CPT,983,RC,,inpatient,,,108,97.2,,0.95,,102.6,Percent of total billed charges,,,0.98,,105.84,Percent of total billed charges,,,0.95,,102.6,Percent of total billed charges,,,0.97,,104.76,Percent of total billed charges,,,0.97,,104.76,Percent of total billed charges,,,0.96,,103.68,Percent of total billed charges,,,0.95,,102.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,102.6,Percent of total billed charges,,102.6,105.84,
HC PR 84703 Chorionic Gonadotropin Assay,PX-98310386,CDM,84703,CPT,983,RC,,outpatient,,,108,97.2,,0.95,,102.6,Percent of total billed charges,,,0.98,,105.84,Percent of total billed charges,,,0.95,,102.6,Percent of total billed charges,,,0.95,,102.6,Percent of total billed charges,,,0.97,,104.76,Percent of total billed charges,,,0.96,,103.68,Percent of total billed charges,,,0.95,,102.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,102.6,Percent of total billed charges,,102.6,105.84,
HC PR G0403 Ekg for Initial Prevent Exam,PX-98310523,CDM,G0403,HCPCS,983,RC,,inpatient,,,43,38.7,,0.95,,40.85,Percent of total billed charges,,,0.98,,42.14,Percent of total billed charges,,,0.95,,40.85,Percent of total billed charges,,,0.97,,41.71,Percent of total billed charges,,,0.97,,41.71,Percent of total billed charges,,,0.96,,41.28,Percent of total billed charges,,,0.95,,40.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,40.85,Percent of total billed charges,,40.85,42.14,
HC PR G0403 Ekg for Initial Prevent Exam,PX-98310523,CDM,G0403,HCPCS,983,RC,,outpatient,,,43,38.7,,0.95,,40.85,Percent of total billed charges,,,0.98,,42.14,Percent of total billed charges,,,0.95,,40.85,Percent of total billed charges,,,0.95,,40.85,Percent of total billed charges,,,0.97,,41.71,Percent of total billed charges,,,0.96,,41.28,Percent of total billed charges,,,0.95,,40.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,40.85,Percent of total billed charges,,40.85,42.14,
HC Optime Shell 636,PX-63610041,CDM,63610041,LOCAL,636,RC,,inpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,0.01,Percent of total billed charges,,0.01,0.01,
HC Optime Shell 636,PX-63610041,CDM,63610041,LOCAL,636,RC,,outpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,0.01,Percent of total billed charges,,0.01,0.01,
Removal of cataract by inserting prosthetic lens,PX-36010172,CDM,66984,CPT,360,RC,,inpatient,,,3933,3539.7,,0.95,,3736.35,Percent of total billed charges,,,0.98,,3854.34,Percent of total billed charges,,,0.95,,3736.35,Percent of total billed charges,,,0.97,,3815.01,Percent of total billed charges,,,0.97,,3815.01,Percent of total billed charges,,,0.96,,3775.68,Percent of total billed charges,,,0.95,,3736.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3736.35,Percent of total billed charges,,3736.35,3854.34,
Removal of cataract by inserting prosthetic lens,PX-36010172,CDM,66984,CPT,360,RC,,outpatient,,,3933,3539.7,,0.95,,3736.35,Percent of total billed charges,,,0.98,,3854.34,Percent of total billed charges,,,0.95,,3736.35,Percent of total billed charges,,,0.95,,3736.35,Percent of total billed charges,,,0.97,,3815.01,Percent of total billed charges,,,0.96,,3775.68,Percent of total billed charges,,,0.95,,3736.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3736.35,Percent of total billed charges,,3736.35,3854.34,
Methylation analysis,PX-30010044,CDM,81331,CPT,310,RC,,inpatient,,,194,174.6,,0.95,,184.3,Percent of total billed charges,,,0.98,,190.12,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,0.97,,188.18,Percent of total billed charges,,,0.97,,188.18,Percent of total billed charges,,,0.96,,186.24,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,184.3,Percent of total billed charges,,184.3,190.12,
Methylation analysis,PX-30010044,CDM,81331,CPT,310,RC,,outpatient,,,194,174.6,,0.95,,184.3,Percent of total billed charges,,,0.98,,190.12,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,0.97,,188.18,Percent of total billed charges,,,0.96,,186.24,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,184.3,Percent of total billed charges,,184.3,190.12,
HC PR 64450 Nerve Block Other Peripheral Separate Proc,PX-96310215,CDM,64450,CPT,963,RC,,inpatient,,,269,242.1,,0.95,,255.55,Percent of total billed charges,,,0.98,,263.62,Percent of total billed charges,,,0.95,,255.55,Percent of total billed charges,,,0.97,,260.93,Percent of total billed charges,,,0.97,,260.93,Percent of total billed charges,,,0.96,,258.24,Percent of total billed charges,,,0.95,,255.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,255.55,Percent of total billed charges,,255.55,263.62,
HC PR 64450 Nerve Block Other Peripheral Separate Proc,PX-96310215,CDM,64450,CPT,963,RC,,outpatient,,,269,242.1,,0.95,,255.55,Percent of total billed charges,,,0.98,,263.62,Percent of total billed charges,,,0.95,,255.55,Percent of total billed charges,,,0.95,,255.55,Percent of total billed charges,,,0.97,,260.93,Percent of total billed charges,,,0.96,,258.24,Percent of total billed charges,,,0.95,,255.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,255.55,Percent of total billed charges,,255.55,263.62,
HC PR 62273 Inject Epidural Patch,PX-96310216,CDM,62273,CPT,963,RC,,inpatient,,,2233,2009.7,,0.95,,2121.35,Percent of total billed charges,,,0.98,,2188.34,Percent of total billed charges,,,0.95,,2121.35,Percent of total billed charges,,,0.97,,2166.01,Percent of total billed charges,,,0.97,,2166.01,Percent of total billed charges,,,0.96,,2143.68,Percent of total billed charges,,,0.95,,2121.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2121.35,Percent of total billed charges,,2121.35,2188.34,
HC PR 62273 Inject Epidural Patch,PX-96310216,CDM,62273,CPT,963,RC,,outpatient,,,2233,2009.7,,0.95,,2121.35,Percent of total billed charges,,,0.98,,2188.34,Percent of total billed charges,,,0.95,,2121.35,Percent of total billed charges,,,0.95,,2121.35,Percent of total billed charges,,,0.97,,2166.01,Percent of total billed charges,,,0.96,,2143.68,Percent of total billed charges,,,0.95,,2121.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2121.35,Percent of total billed charges,,2121.35,2188.34,
HC PR 31500 Intubation W/Bronchoscope,PX-96310220,CDM,31500,CPT,963,RC,,inpatient,,,723,650.7,,0.95,,686.85,Percent of total billed charges,,,0.98,,708.54,Percent of total billed charges,,,0.95,,686.85,Percent of total billed charges,,,0.97,,701.31,Percent of total billed charges,,,0.97,,701.31,Percent of total billed charges,,,0.96,,694.08,Percent of total billed charges,,,0.95,,686.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,686.85,Percent of total billed charges,,686.85,708.54,
HC PR 31500 Intubation W/Bronchoscope,PX-96310220,CDM,31500,CPT,963,RC,,outpatient,,,723,650.7,,0.95,,686.85,Percent of total billed charges,,,0.98,,708.54,Percent of total billed charges,,,0.95,,686.85,Percent of total billed charges,,,0.95,,686.85,Percent of total billed charges,,,0.97,,701.31,Percent of total billed charges,,,0.96,,694.08,Percent of total billed charges,,,0.95,,686.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,686.85,Percent of total billed charges,,686.85,708.54,
HC PR 36400 Anes/Venipuncture < Age 3,PX-96310221,CDM,36400,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 36400 Anes/Venipuncture < Age 3,PX-96310221,CDM,36400,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 36620 Anes/Arterial Cath/Cannula,PX-96310223,CDM,36620,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 36620 Anes/Arterial Cath/Cannula,PX-96310223,CDM,36620,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 62270 Anes/Spinal Punc,PX-96310224,CDM,62270,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 62270 Anes/Spinal Punc,PX-96310224,CDM,62270,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 49905 Omental Flap Extea Abdom,PX-97511522,CDM,49905,CPT,975,RC,,inpatient,,,858,772.2,,0.95,,815.1,Percent of total billed charges,,,0.98,,840.84,Percent of total billed charges,,,0.95,,815.1,Percent of total billed charges,,,0.97,,832.26,Percent of total billed charges,,,0.97,,832.26,Percent of total billed charges,,,0.96,,823.68,Percent of total billed charges,,,0.95,,815.1,Percent of total billed charges,,,,,,,,,0.95,,815.1,Percent of total billed charges,,815.1,840.84,
HC PR 49905 Omental Flap Extea Abdom,PX-97511522,CDM,49905,CPT,975,RC,,outpatient,,,858,772.2,,0.95,,815.1,Percent of total billed charges,,,0.98,,840.84,Percent of total billed charges,,,0.95,,815.1,Percent of total billed charges,,,0.95,,815.1,Percent of total billed charges,,,0.97,,832.26,Percent of total billed charges,,,0.96,,823.68,Percent of total billed charges,,,0.95,,815.1,Percent of total billed charges,,,,,,,,,0.95,,815.1,Percent of total billed charges,,815.1,840.84,
HC PR 26111 Exc Tum Hand/Fgr >1.5 Cm,PX-96910357,CDM,26111,CPT,983,RC,,inpatient,,,1041,936.9,,0.95,,988.95,Percent of total billed charges,,,0.98,,1020.18,Percent of total billed charges,,,0.95,,988.95,Percent of total billed charges,,,0.97,,1009.77,Percent of total billed charges,,,0.97,,1009.77,Percent of total billed charges,,,0.96,,999.36,Percent of total billed charges,,,0.95,,988.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,988.95,Percent of total billed charges,,988.95,1020.18,
HC PR 26111 Exc Tum Hand/Fgr >1.5 Cm,PX-96910357,CDM,26111,CPT,983,RC,,outpatient,,,1041,936.9,,0.95,,988.95,Percent of total billed charges,,,0.98,,1020.18,Percent of total billed charges,,,0.95,,988.95,Percent of total billed charges,,,0.95,,988.95,Percent of total billed charges,,,0.97,,1009.77,Percent of total billed charges,,,0.96,,999.36,Percent of total billed charges,,,0.95,,988.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,988.95,Percent of total billed charges,,988.95,1020.18,
HC PR 25071 Exc Tumor Arm/Wrst 3cm,PX-97511530,CDM,25071,CPT,975,RC,,inpatient,,,919,827.1,,0.95,,873.05,Percent of total billed charges,,,0.98,,900.62,Percent of total billed charges,,,0.95,,873.05,Percent of total billed charges,,,0.97,,891.43,Percent of total billed charges,,,0.97,,891.43,Percent of total billed charges,,,0.96,,882.24,Percent of total billed charges,,,0.95,,873.05,Percent of total billed charges,,,,,,,,,0.95,,873.05,Percent of total billed charges,,873.05,900.62,
HC PR 25071 Exc Tumor Arm/Wrst 3cm,PX-97511530,CDM,25071,CPT,975,RC,,outpatient,,,919,827.1,,0.95,,873.05,Percent of total billed charges,,,0.98,,900.62,Percent of total billed charges,,,0.95,,873.05,Percent of total billed charges,,,0.95,,873.05,Percent of total billed charges,,,0.97,,891.43,Percent of total billed charges,,,0.96,,882.24,Percent of total billed charges,,,0.95,,873.05,Percent of total billed charges,,,,,,,,,0.95,,873.05,Percent of total billed charges,,873.05,900.62,
HC PR 27043 Exc Tumor Hip Sq >3cm,PX-97511534,CDM,27043,CPT,975,RC,,inpatient,,,1165,1048.5,,0.95,,1106.75,Percent of total billed charges,,,0.98,,1141.7,Percent of total billed charges,,,0.95,,1106.75,Percent of total billed charges,,,0.97,,1130.05,Percent of total billed charges,,,0.97,,1130.05,Percent of total billed charges,,,0.96,,1118.4,Percent of total billed charges,,,0.95,,1106.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1106.75,Percent of total billed charges,,1106.75,1141.7,
HC PR 27043 Exc Tumor Hip Sq >3cm,PX-97511534,CDM,27043,CPT,975,RC,,outpatient,,,1165,1048.5,,0.95,,1106.75,Percent of total billed charges,,,0.98,,1141.7,Percent of total billed charges,,,0.95,,1106.75,Percent of total billed charges,,,0.95,,1106.75,Percent of total billed charges,,,0.97,,1130.05,Percent of total billed charges,,,0.96,,1118.4,Percent of total billed charges,,,0.95,,1106.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1106.75,Percent of total billed charges,,1106.75,1141.7,
HC PR 49418 Insert Perit Cath Comp,PX-97511555,CDM,49418,CPT,975,RC,,inpatient,,,2368,2131.2,,0.95,,2249.6,Percent of total billed charges,,,0.98,,2320.64,Percent of total billed charges,,,0.95,,2249.6,Percent of total billed charges,,,0.97,,2296.96,Percent of total billed charges,,,0.97,,2296.96,Percent of total billed charges,,,0.96,,2273.28,Percent of total billed charges,,,0.95,,2249.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2249.6,Percent of total billed charges,,2249.6,2320.64,
HC PR 49418 Insert Perit Cath Comp,PX-97511555,CDM,49418,CPT,975,RC,,outpatient,,,2368,2131.2,,0.95,,2249.6,Percent of total billed charges,,,0.98,,2320.64,Percent of total billed charges,,,0.95,,2249.6,Percent of total billed charges,,,0.95,,2249.6,Percent of total billed charges,,,0.97,,2296.96,Percent of total billed charges,,,0.96,,2273.28,Percent of total billed charges,,,0.95,,2249.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2249.6,Percent of total billed charges,,2249.6,2320.64,
HC PR 44005 Lysis of Peritoneal Adhesions,PX-98310744,CDM,44005,CPT,983,RC,,inpatient,,,2678,2410.2,,0.95,,2544.1,Percent of total billed charges,,,0.98,,2624.44,Percent of total billed charges,,,0.95,,2544.1,Percent of total billed charges,,,0.97,,2597.66,Percent of total billed charges,,,0.97,,2597.66,Percent of total billed charges,,,0.96,,2570.88,Percent of total billed charges,,,0.95,,2544.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2544.1,Percent of total billed charges,,2544.1,2624.44,
HC PR 44005 Lysis of Peritoneal Adhesions,PX-98310744,CDM,44005,CPT,983,RC,,outpatient,,,2678,2410.2,,0.95,,2544.1,Percent of total billed charges,,,0.98,,2624.44,Percent of total billed charges,,,0.95,,2544.1,Percent of total billed charges,,,0.95,,2544.1,Percent of total billed charges,,,0.97,,2597.66,Percent of total billed charges,,,0.96,,2570.88,Percent of total billed charges,,,0.95,,2544.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2544.1,Percent of total billed charges,,2544.1,2624.44,
HC PR 23073 Exc Shoulder Tum Deep 5 Cm/>,PX-97511560,CDM,23073,CPT,975,RC,,inpatient,,,1728,1555.2,,0.95,,1641.6,Percent of total billed charges,,,0.98,,1693.44,Percent of total billed charges,,,0.95,,1641.6,Percent of total billed charges,,,0.97,,1676.16,Percent of total billed charges,,,0.97,,1676.16,Percent of total billed charges,,,0.96,,1658.88,Percent of total billed charges,,,0.95,,1641.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1641.6,Percent of total billed charges,,1641.6,1693.44,
HC PR 23073 Exc Shoulder Tum Deep 5 Cm/>,PX-97511560,CDM,23073,CPT,975,RC,,outpatient,,,1728,1555.2,,0.95,,1641.6,Percent of total billed charges,,,0.98,,1693.44,Percent of total billed charges,,,0.95,,1641.6,Percent of total billed charges,,,0.95,,1641.6,Percent of total billed charges,,,0.97,,1676.16,Percent of total billed charges,,,0.96,,1658.88,Percent of total billed charges,,,0.95,,1641.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1641.6,Percent of total billed charges,,1641.6,1693.44,
HC PR 58570 Tlh Uterus 250 G or Less,PX-97511561,CDM,58570,CPT,975,RC,,inpatient,,,2984,2685.6,,0.95,,2834.8,Percent of total billed charges,,,0.98,,2924.32,Percent of total billed charges,,,0.95,,2834.8,Percent of total billed charges,,,0.97,,2894.48,Percent of total billed charges,,,0.97,,2894.48,Percent of total billed charges,,,0.96,,2864.64,Percent of total billed charges,,,0.95,,2834.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2834.8,Percent of total billed charges,,2834.8,2924.32,
HC PR 58570 Tlh Uterus 250 G or Less,PX-97511561,CDM,58570,CPT,975,RC,,outpatient,,,2984,2685.6,,0.95,,2834.8,Percent of total billed charges,,,0.98,,2924.32,Percent of total billed charges,,,0.95,,2834.8,Percent of total billed charges,,,0.95,,2834.8,Percent of total billed charges,,,0.97,,2894.48,Percent of total billed charges,,,0.96,,2864.64,Percent of total billed charges,,,0.95,,2834.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2834.8,Percent of total billed charges,,2834.8,2924.32,
HC PR 58571 Tlh W/T/O 250 G or Less,PX-97511562,CDM,58571,CPT,975,RC,,inpatient,,,2413,2171.7,,0.95,,2292.35,Percent of total billed charges,,,0.98,,2364.74,Percent of total billed charges,,,0.95,,2292.35,Percent of total billed charges,,,0.97,,2340.61,Percent of total billed charges,,,0.97,,2340.61,Percent of total billed charges,,,0.96,,2316.48,Percent of total billed charges,,,0.95,,2292.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2292.35,Percent of total billed charges,,2292.35,2364.74,
HC PR 58571 Tlh W/T/O 250 G or Less,PX-97511562,CDM,58571,CPT,975,RC,,outpatient,,,2413,2171.7,,0.95,,2292.35,Percent of total billed charges,,,0.98,,2364.74,Percent of total billed charges,,,0.95,,2292.35,Percent of total billed charges,,,0.95,,2292.35,Percent of total billed charges,,,0.97,,2340.61,Percent of total billed charges,,,0.96,,2316.48,Percent of total billed charges,,,0.95,,2292.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2292.35,Percent of total billed charges,,2292.35,2364.74,
HC PR 36556 Insert Non-Tunnel Cv Cath > 5,PX-96310231,CDM,36556,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 36556 Insert Non-Tunnel Cv Cath > 5,PX-96310231,CDM,36556,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 36569 Insertion Picc W/O Img Gdn 5 Yr/>,PX-96310232,CDM,36569,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 36569 Insertion Picc W/O Img Gdn 5 Yr/>,PX-96310232,CDM,36569,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 36410 Non-Routine Bl Draw > 3 Yrs,PX-96310233,CDM,36410,CPT,963,RC,,inpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
HC PR 36410 Non-Routine Bl Draw > 3 Yrs,PX-96310233,CDM,36410,CPT,963,RC,,outpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
HC PR 64447 Injection Aa&/Strd Femoral Nerve W/Img Gdn Cdm,PX-96310238,CDM,64447,CPT,963,RC,,inpatient,,,727,654.3,,0.95,,690.65,Percent of total billed charges,,,0.98,,712.46,Percent of total billed charges,,,0.95,,690.65,Percent of total billed charges,,,0.97,,705.19,Percent of total billed charges,,,0.97,,705.19,Percent of total billed charges,,,0.96,,697.92,Percent of total billed charges,,,0.95,,690.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,690.65,Percent of total billed charges,,690.65,712.46,
HC PR 64447 Injection Aa&/Strd Femoral Nerve W/Img Gdn Cdm,PX-96310238,CDM,64447,CPT,963,RC,,outpatient,,,727,654.3,,0.95,,690.65,Percent of total billed charges,,,0.98,,712.46,Percent of total billed charges,,,0.95,,690.65,Percent of total billed charges,,,0.95,,690.65,Percent of total billed charges,,,0.97,,705.19,Percent of total billed charges,,,0.96,,697.92,Percent of total billed charges,,,0.95,,690.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,690.65,Percent of total billed charges,,690.65,712.46,
HC PR 64415 Injection Aa&/Strd Brachial Plexus W/Img Gdn Cdm,PX-96310243,CDM,64415,CPT,963,RC,,inpatient,,,900,810,,0.95,,855,Percent of total billed charges,,,0.98,,882,Percent of total billed charges,,,0.95,,855,Percent of total billed charges,,,0.97,,873,Percent of total billed charges,,,0.97,,873,Percent of total billed charges,,,0.96,,864,Percent of total billed charges,,,0.95,,855,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,855,Percent of total billed charges,,855,882,
HC PR 64415 Injection Aa&/Strd Brachial Plexus W/Img Gdn Cdm,PX-96310243,CDM,64415,CPT,963,RC,,outpatient,,,900,810,,0.95,,855,Percent of total billed charges,,,0.98,,882,Percent of total billed charges,,,0.95,,855,Percent of total billed charges,,,0.95,,855,Percent of total billed charges,,,0.97,,873,Percent of total billed charges,,,0.96,,864,Percent of total billed charges,,,0.95,,855,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,855,Percent of total billed charges,,855,882,
Repair finger tendon of under side of hand,PX-45010636,CDM,26350,CPT,450,RC,,inpatient,,,2084,1875.6,,0.95,,1979.8,Percent of total billed charges,,,0.98,,2042.32,Percent of total billed charges,,,0.95,,1979.8,Percent of total billed charges,,,0.97,,2021.48,Percent of total billed charges,,,0.97,,2021.48,Percent of total billed charges,,,0.96,,2000.64,Percent of total billed charges,,,0.95,,1979.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1979.8,Percent of total billed charges,,1979.8,3950,
Repair finger tendon of under side of hand,PX-45010636,CDM,26350,CPT,450,RC,,outpatient,,,2084,1875.6,,0.95,,1979.8,Percent of total billed charges,,,0.98,,2042.32,Percent of total billed charges,,,0.95,,1979.8,Percent of total billed charges,,,0.95,,1979.8,Percent of total billed charges,,,0.97,,2021.48,Percent of total billed charges,,,0.96,,2000.64,Percent of total billed charges,,,0.95,,1979.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1979.8,Percent of total billed charges,,1979.8,3950,
Molecular pathology procedure level 2,PX-31010608,CDM,81401,CPT,310,RC,,inpatient,,,490,441,,0.95,,465.5,Percent of total billed charges,,,0.98,,480.2,Percent of total billed charges,,,0.95,,465.5,Percent of total billed charges,,,0.97,,475.3,Percent of total billed charges,,,0.97,,475.3,Percent of total billed charges,,,0.96,,470.4,Percent of total billed charges,,,0.95,,465.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,465.5,Percent of total billed charges,,465.5,480.2,
Molecular pathology procedure level 2,PX-31010608,CDM,81401,CPT,310,RC,,outpatient,,,490,441,,0.95,,465.5,Percent of total billed charges,,,0.98,,480.2,Percent of total billed charges,,,0.95,,465.5,Percent of total billed charges,,,0.95,,465.5,Percent of total billed charges,,,0.97,,475.3,Percent of total billed charges,,,0.96,,470.4,Percent of total billed charges,,,0.95,,465.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,465.5,Percent of total billed charges,,465.5,480.2,
HC PR Rx Hepatitus a Vaccine Pediatric 2 Dose Im 0.5 Ml,PX-63610052,CDM,90633,HCPCS,636,RC,,inpatient,,,96,86.4,,0.95,,91.2,Percent of total billed charges,,,0.98,,94.08,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.96,,92.16,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,91.2,Percent of total billed charges,,91.2,94.08,
HC PR Rx Hepatitus a Vaccine Pediatric 2 Dose Im 0.5 Ml,PX-63610052,CDM,90633,HCPCS,636,RC,,outpatient,,,96,86.4,,0.95,,91.2,Percent of total billed charges,,,0.98,,94.08,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.96,,92.16,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,91.2,Percent of total billed charges,,91.2,94.08,
HC PR Rx Measles Mumps Rubella Vaccine Live Sq 1 Ea,PX-63610054,CDM,90707,HCPCS,636,RC,,inpatient,,,271,243.9,,0.95,,257.45,Percent of total billed charges,,,0.98,,265.58,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,0.97,,262.87,Percent of total billed charges,,,0.97,,262.87,Percent of total billed charges,,,0.96,,260.16,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,257.45,Percent of total billed charges,,257.45,265.58,
HC PR Rx Measles Mumps Rubella Vaccine Live Sq 1 Ea,PX-63610054,CDM,90707,HCPCS,636,RC,,outpatient,,,271,243.9,,0.95,,257.45,Percent of total billed charges,,,0.98,,265.58,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,0.97,,262.87,Percent of total billed charges,,,0.96,,260.16,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,257.45,Percent of total billed charges,,257.45,265.58,
HC PR Rx Poliovirus Vaccine Inactivated Sq/Im 0.5 Ml,PX-63610055,CDM,90713,HCPCS,636,RC,,inpatient,,,96,86.4,,0.95,,91.2,Percent of total billed charges,,,0.98,,94.08,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.96,,92.16,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,91.2,Percent of total billed charges,,91.2,94.08,
HC PR Rx Poliovirus Vaccine Inactivated Sq/Im 0.5 Ml,PX-63610055,CDM,90713,HCPCS,636,RC,,outpatient,,,96,86.4,,0.95,,91.2,Percent of total billed charges,,,0.98,,94.08,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.96,,92.16,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,91.2,Percent of total billed charges,,91.2,94.08,
HC PR Rx Tdap Vaccine 7 Yrs or Older Im 0.5 Ml,PX-63610056,CDM,90715,HCPCS,636,RC,,inpatient,,,191,171.9,,0.95,,181.45,Percent of total billed charges,,,0.98,,187.18,Percent of total billed charges,,,0.95,,181.45,Percent of total billed charges,,,0.97,,185.27,Percent of total billed charges,,,0.97,,185.27,Percent of total billed charges,,,0.96,,183.36,Percent of total billed charges,,,0.95,,181.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,181.45,Percent of total billed charges,,181.45,187.18,
HC PR Rx Tdap Vaccine 7 Yrs or Older Im 0.5 Ml,PX-63610056,CDM,90715,HCPCS,636,RC,,outpatient,,,191,171.9,,0.95,,181.45,Percent of total billed charges,,,0.98,,187.18,Percent of total billed charges,,,0.95,,181.45,Percent of total billed charges,,,0.95,,181.45,Percent of total billed charges,,,0.97,,185.27,Percent of total billed charges,,,0.96,,183.36,Percent of total billed charges,,,0.95,,181.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,181.45,Percent of total billed charges,,181.45,187.18,
HC PR Rx Varicella Vaccine Live Sq 0.5 Ml,PX-63610057,CDM,90716,HCPCS,636,RC,,inpatient,,,334,300.6,,0.95,,317.3,Percent of total billed charges,,,0.98,,327.32,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,0.97,,323.98,Percent of total billed charges,,,0.97,,323.98,Percent of total billed charges,,,0.96,,320.64,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,317.3,Percent of total billed charges,,317.3,327.32,
HC PR Rx Varicella Vaccine Live Sq 0.5 Ml,PX-63610057,CDM,90716,HCPCS,636,RC,,outpatient,,,334,300.6,,0.95,,317.3,Percent of total billed charges,,,0.98,,327.32,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,0.97,,323.98,Percent of total billed charges,,,0.96,,320.64,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,317.3,Percent of total billed charges,,317.3,327.32,
HC PR ED 49451 Replace Duod/Jej Tube Perc Cdm,PX-98110115,CDM,49451,CPT,981,RC,,inpatient,,,1629,1466.1,,0.95,,1547.55,Percent of total billed charges,,,0.98,,1596.42,Percent of total billed charges,,,0.95,,1547.55,Percent of total billed charges,,,0.97,,1580.13,Percent of total billed charges,,,0.97,,1580.13,Percent of total billed charges,,,0.96,,1563.84,Percent of total billed charges,,,0.95,,1547.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1547.55,Percent of total billed charges,,1547.55,1596.42,
HC PR ED 49451 Replace Duod/Jej Tube Perc Cdm,PX-98110115,CDM,49451,CPT,981,RC,,outpatient,,,1629,1466.1,,0.95,,1547.55,Percent of total billed charges,,,0.98,,1596.42,Percent of total billed charges,,,0.95,,1547.55,Percent of total billed charges,,,0.95,,1547.55,Percent of total billed charges,,,0.97,,1580.13,Percent of total billed charges,,,0.96,,1563.84,Percent of total billed charges,,,0.95,,1547.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1547.55,Percent of total billed charges,,1547.55,1596.42,
"Estrogen analysis, fractionated",PX-30012036,CDM,82671,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
"Estrogen analysis, fractionated",PX-30012036,CDM,82671,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Microscopic exam for white blood cells w/manual cell count,PX-30012071,CDM,85007,CPT,305,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Microscopic exam for white blood cells w/manual cell count,PX-30012071,CDM,85007,CPT,305,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
"Measure antibody to assess autoimmune disorder, any method",PX-30012120,CDM,86235,CPT,302,RC,,inpatient,,,87,78.3,,0.95,,82.65,Percent of total billed charges,,,0.98,,85.26,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.96,,83.52,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,82.65,Percent of total billed charges,,82.65,85.26,
"Measure antibody to assess autoimmune disorder, any method",PX-30012120,CDM,86235,CPT,302,RC,,outpatient,,,87,78.3,,0.95,,82.65,Percent of total billed charges,,,0.98,,85.26,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.96,,83.52,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,82.65,Percent of total billed charges,,82.65,85.26,
"Measure antibody to assess autoimmune disorder, any method",PX-30012126,CDM,86235,CPT,302,RC,,inpatient,,,87,78.3,,0.95,,82.65,Percent of total billed charges,,,0.98,,85.26,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.96,,83.52,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,82.65,Percent of total billed charges,,82.65,85.26,
"Measure antibody to assess autoimmune disorder, any method",PX-30012126,CDM,86235,CPT,302,RC,,outpatient,,,87,78.3,,0.95,,82.65,Percent of total billed charges,,,0.98,,85.26,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.96,,83.52,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,82.65,Percent of total billed charges,,82.65,85.26,
Confirmation test for antibody to Borrelia burgdorferi,PX-30012170,CDM,86617,CPT,302,RC,,inpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
Confirmation test for antibody to Borrelia burgdorferi,PX-30012170,CDM,86617,CPT,302,RC,,outpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
HC PR 17999 Skin Tissue Procedure,PX-97511694,CDM,17999,CPT,975,RC,,inpatient,,,1337,1203.3,,0.95,,1270.15,Percent of total billed charges,,,0.98,,1310.26,Percent of total billed charges,,,0.95,,1270.15,Percent of total billed charges,,,0.97,,1296.89,Percent of total billed charges,,,0.97,,1296.89,Percent of total billed charges,,,0.96,,1283.52,Percent of total billed charges,,,0.95,,1270.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1270.15,Percent of total billed charges,,1270.15,1310.26,
HC PR 17999 Skin Tissue Procedure,PX-97511694,CDM,17999,CPT,975,RC,,outpatient,,,1337,1203.3,,0.95,,1270.15,Percent of total billed charges,,,0.98,,1310.26,Percent of total billed charges,,,0.95,,1270.15,Percent of total billed charges,,,0.95,,1270.15,Percent of total billed charges,,,0.97,,1296.89,Percent of total billed charges,,,0.96,,1283.52,Percent of total billed charges,,,0.95,,1270.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1270.15,Percent of total billed charges,,1270.15,1310.26,
HC PR 20822 Replantation Digit Complete,PX-97511738,CDM,20822,CPT,975,RC,,inpatient,,,4509,4058.1,,0.95,,4283.55,Percent of total billed charges,,,0.98,,4418.82,Percent of total billed charges,,,0.95,,4283.55,Percent of total billed charges,,,0.97,,4373.73,Percent of total billed charges,,,0.97,,4373.73,Percent of total billed charges,,,0.96,,4328.64,Percent of total billed charges,,,0.95,,4283.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4283.55,Percent of total billed charges,,4283.55,4418.82,
HC PR 20822 Replantation Digit Complete,PX-97511738,CDM,20822,CPT,975,RC,,outpatient,,,4509,4058.1,,0.95,,4283.55,Percent of total billed charges,,,0.98,,4418.82,Percent of total billed charges,,,0.95,,4283.55,Percent of total billed charges,,,0.95,,4283.55,Percent of total billed charges,,,0.97,,4373.73,Percent of total billed charges,,,0.96,,4328.64,Percent of total billed charges,,,0.95,,4283.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4283.55,Percent of total billed charges,,4283.55,4418.82,
HC PR 20985 Cptr-Asst Dir Ms Px,PX-97511762,CDM,20985,CPT,975,RC,,inpatient,,,353,317.7,,0.95,,335.35,Percent of total billed charges,,,0.98,,345.94,Percent of total billed charges,,,0.95,,335.35,Percent of total billed charges,,,0.97,,342.41,Percent of total billed charges,,,0.97,,342.41,Percent of total billed charges,,,0.96,,338.88,Percent of total billed charges,,,0.95,,335.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,335.35,Percent of total billed charges,,335.35,345.94,
HC PR 20985 Cptr-Asst Dir Ms Px,PX-97511762,CDM,20985,CPT,975,RC,,outpatient,,,353,317.7,,0.95,,335.35,Percent of total billed charges,,,0.98,,345.94,Percent of total billed charges,,,0.95,,335.35,Percent of total billed charges,,,0.95,,335.35,Percent of total billed charges,,,0.97,,342.41,Percent of total billed charges,,,0.96,,338.88,Percent of total billed charges,,,0.95,,335.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,335.35,Percent of total billed charges,,335.35,345.94,
HC PR 21406 Opn Tx Orbit Fx W/O Implant,PX-97511883,CDM,21406,CPT,975,RC,,inpatient,,,2231,2007.9,,0.95,,2119.45,Percent of total billed charges,,,0.98,,2186.38,Percent of total billed charges,,,0.95,,2119.45,Percent of total billed charges,,,0.97,,2164.07,Percent of total billed charges,,,0.97,,2164.07,Percent of total billed charges,,,0.96,,2141.76,Percent of total billed charges,,,0.95,,2119.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2119.45,Percent of total billed charges,,2119.45,2186.38,
HC PR 21406 Opn Tx Orbit Fx W/O Implant,PX-97511883,CDM,21406,CPT,975,RC,,outpatient,,,2231,2007.9,,0.95,,2119.45,Percent of total billed charges,,,0.98,,2186.38,Percent of total billed charges,,,0.95,,2119.45,Percent of total billed charges,,,0.95,,2119.45,Percent of total billed charges,,,0.97,,2164.07,Percent of total billed charges,,,0.96,,2141.76,Percent of total billed charges,,,0.95,,2119.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2119.45,Percent of total billed charges,,2119.45,2186.38,
HC PR 25259 Manipulate Wrist W/Anesthes,PX-97512065,CDM,25259,CPT,975,RC,,inpatient,,,1646,1481.4,,0.95,,1563.7,Percent of total billed charges,,,0.98,,1613.08,Percent of total billed charges,,,0.95,,1563.7,Percent of total billed charges,,,0.97,,1596.62,Percent of total billed charges,,,0.97,,1596.62,Percent of total billed charges,,,0.96,,1580.16,Percent of total billed charges,,,0.95,,1563.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1563.7,Percent of total billed charges,,1563.7,1613.08,
HC PR 25259 Manipulate Wrist W/Anesthes,PX-97512065,CDM,25259,CPT,975,RC,,outpatient,,,1646,1481.4,,0.95,,1563.7,Percent of total billed charges,,,0.98,,1613.08,Percent of total billed charges,,,0.95,,1563.7,Percent of total billed charges,,,0.95,,1563.7,Percent of total billed charges,,,0.97,,1596.62,Percent of total billed charges,,,0.96,,1580.16,Percent of total billed charges,,,0.95,,1563.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1563.7,Percent of total billed charges,,1563.7,1613.08,
HC PR 27380 Repair of Kneecap Tendon,PX-97512272,CDM,27380,CPT,975,RC,,inpatient,,,1555,1399.5,,0.95,,1477.25,Percent of total billed charges,,,0.98,,1523.9,Percent of total billed charges,,,0.95,,1477.25,Percent of total billed charges,,,0.97,,1508.35,Percent of total billed charges,,,0.97,,1508.35,Percent of total billed charges,,,0.96,,1492.8,Percent of total billed charges,,,0.95,,1477.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1477.25,Percent of total billed charges,,1477.25,1523.9,
HC PR 27380 Repair of Kneecap Tendon,PX-97512272,CDM,27380,CPT,975,RC,,outpatient,,,1555,1399.5,,0.95,,1477.25,Percent of total billed charges,,,0.98,,1523.9,Percent of total billed charges,,,0.95,,1477.25,Percent of total billed charges,,,0.95,,1477.25,Percent of total billed charges,,,0.97,,1508.35,Percent of total billed charges,,,0.96,,1492.8,Percent of total billed charges,,,0.95,,1477.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1477.25,Percent of total billed charges,,1477.25,1523.9,
HC PR 27519 Treat Thigh Fx Growth Plate,PX-97512287,CDM,27519,CPT,975,RC,,inpatient,,,2198,1978.2,,0.95,,2088.1,Percent of total billed charges,,,0.98,,2154.04,Percent of total billed charges,,,0.95,,2088.1,Percent of total billed charges,,,0.97,,2132.06,Percent of total billed charges,,,0.97,,2132.06,Percent of total billed charges,,,0.96,,2110.08,Percent of total billed charges,,,0.95,,2088.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2088.1,Percent of total billed charges,,2088.1,2154.04,
HC PR 27519 Treat Thigh Fx Growth Plate,PX-97512287,CDM,27519,CPT,975,RC,,outpatient,,,2198,1978.2,,0.95,,2088.1,Percent of total billed charges,,,0.98,,2154.04,Percent of total billed charges,,,0.95,,2088.1,Percent of total billed charges,,,0.95,,2088.1,Percent of total billed charges,,,0.97,,2132.06,Percent of total billed charges,,,0.96,,2110.08,Percent of total billed charges,,,0.95,,2088.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2088.1,Percent of total billed charges,,2088.1,2154.04,
HC PR 28725 Fusion of Foot Bones,PX-97512348,CDM,28725,CPT,975,RC,,inpatient,,,2067,1860.3,,0.95,,1963.65,Percent of total billed charges,,,0.98,,2025.66,Percent of total billed charges,,,0.95,,1963.65,Percent of total billed charges,,,0.97,,2004.99,Percent of total billed charges,,,0.97,,2004.99,Percent of total billed charges,,,0.96,,1984.32,Percent of total billed charges,,,0.95,,1963.65,Percent of total billed charges,,,,,,,,,0.95,,1963.65,Percent of total billed charges,,1963.65,2025.66,
HC PR 28725 Fusion of Foot Bones,PX-97512348,CDM,28725,CPT,975,RC,,outpatient,,,2067,1860.3,,0.95,,1963.65,Percent of total billed charges,,,0.98,,2025.66,Percent of total billed charges,,,0.95,,1963.65,Percent of total billed charges,,,0.95,,1963.65,Percent of total billed charges,,,0.97,,2004.99,Percent of total billed charges,,,0.96,,1984.32,Percent of total billed charges,,,0.95,,1963.65,Percent of total billed charges,,,,,,,,,0.95,,1963.65,Percent of total billed charges,,1963.65,2025.66,
HC PR 28750 Fusion of Big Toe Joint,PX-97512351,CDM,28750,CPT,975,RC,,inpatient,,,2243,2018.7,,0.95,,2130.85,Percent of total billed charges,,,0.98,,2198.14,Percent of total billed charges,,,0.95,,2130.85,Percent of total billed charges,,,0.97,,2175.71,Percent of total billed charges,,,0.97,,2175.71,Percent of total billed charges,,,0.96,,2153.28,Percent of total billed charges,,,0.95,,2130.85,Percent of total billed charges,,,,,,,,,0.95,,2130.85,Percent of total billed charges,,2130.85,2198.14,
HC PR 28750 Fusion of Big Toe Joint,PX-97512351,CDM,28750,CPT,975,RC,,outpatient,,,2243,2018.7,,0.95,,2130.85,Percent of total billed charges,,,0.98,,2198.14,Percent of total billed charges,,,0.95,,2130.85,Percent of total billed charges,,,0.95,,2130.85,Percent of total billed charges,,,0.97,,2175.71,Percent of total billed charges,,,0.96,,2153.28,Percent of total billed charges,,,0.95,,2130.85,Percent of total billed charges,,,,,,,,,0.95,,2130.85,Percent of total billed charges,,2130.85,2198.14,
HC PR 29806 Shoulder Arthroscopy/Surgery,PX-97512354,CDM,29806,CPT,975,RC,,inpatient,,,2622,2359.8,,0.95,,2490.9,Percent of total billed charges,,,0.98,,2569.56,Percent of total billed charges,,,0.95,,2490.9,Percent of total billed charges,,,0.97,,2543.34,Percent of total billed charges,,,0.97,,2543.34,Percent of total billed charges,,,0.96,,2517.12,Percent of total billed charges,,,0.95,,2490.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2490.9,Percent of total billed charges,,2490.9,2569.56,
HC PR 29806 Shoulder Arthroscopy/Surgery,PX-97512354,CDM,29806,CPT,975,RC,,outpatient,,,2622,2359.8,,0.95,,2490.9,Percent of total billed charges,,,0.98,,2569.56,Percent of total billed charges,,,0.95,,2490.9,Percent of total billed charges,,,0.95,,2490.9,Percent of total billed charges,,,0.97,,2543.34,Percent of total billed charges,,,0.96,,2517.12,Percent of total billed charges,,,0.95,,2490.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2490.9,Percent of total billed charges,,2490.9,2569.56,
HC PR 36011 Place Catheter in Vein,PX-97512703,CDM,36011,CPT,975,RC,,inpatient,,,1964,1767.6,,0.95,,1865.8,Percent of total billed charges,,,0.98,,1924.72,Percent of total billed charges,,,0.95,,1865.8,Percent of total billed charges,,,0.97,,1905.08,Percent of total billed charges,,,0.97,,1905.08,Percent of total billed charges,,,0.96,,1885.44,Percent of total billed charges,,,0.95,,1865.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1865.8,Percent of total billed charges,,1865.8,1924.72,
HC PR 36011 Place Catheter in Vein,PX-97512703,CDM,36011,CPT,975,RC,,outpatient,,,1964,1767.6,,0.95,,1865.8,Percent of total billed charges,,,0.98,,1924.72,Percent of total billed charges,,,0.95,,1865.8,Percent of total billed charges,,,0.95,,1865.8,Percent of total billed charges,,,0.97,,1905.08,Percent of total billed charges,,,0.96,,1885.44,Percent of total billed charges,,,0.95,,1865.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1865.8,Percent of total billed charges,,1865.8,1924.72,
HC PR 38900 Io Map of Sent Lymph Node,PX-97512800,CDM,38900,CPT,975,RC,,inpatient,,,342,307.8,,0.95,,324.9,Percent of total billed charges,,,0.98,,335.16,Percent of total billed charges,,,0.95,,324.9,Percent of total billed charges,,,0.97,,331.74,Percent of total billed charges,,,0.97,,331.74,Percent of total billed charges,,,0.96,,328.32,Percent of total billed charges,,,0.95,,324.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,324.9,Percent of total billed charges,,324.9,335.16,
HC PR 38900 Io Map of Sent Lymph Node,PX-97512800,CDM,38900,CPT,975,RC,,outpatient,,,342,307.8,,0.95,,324.9,Percent of total billed charges,,,0.98,,335.16,Percent of total billed charges,,,0.95,,324.9,Percent of total billed charges,,,0.95,,324.9,Percent of total billed charges,,,0.97,,331.74,Percent of total billed charges,,,0.96,,328.32,Percent of total billed charges,,,0.95,,324.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,324.9,Percent of total billed charges,,324.9,335.16,
HC PR 44380 Ileoscopy Thru Stoma Dx W/Collj Spec When Prfmd Cdm,PX-97512947,CDM,44380,CPT,975,RC,,inpatient,,,484,435.6,,0.95,,459.8,Percent of total billed charges,,,0.98,,474.32,Percent of total billed charges,,,0.95,,459.8,Percent of total billed charges,,,0.97,,469.48,Percent of total billed charges,,,0.97,,469.48,Percent of total billed charges,,,0.96,,464.64,Percent of total billed charges,,,0.95,,459.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,459.8,Percent of total billed charges,,459.8,474.32,
HC PR 44380 Ileoscopy Thru Stoma Dx W/Collj Spec When Prfmd Cdm,PX-97512947,CDM,44380,CPT,975,RC,,outpatient,,,484,435.6,,0.95,,459.8,Percent of total billed charges,,,0.98,,474.32,Percent of total billed charges,,,0.95,,459.8,Percent of total billed charges,,,0.95,,459.8,Percent of total billed charges,,,0.97,,469.48,Percent of total billed charges,,,0.96,,464.64,Percent of total billed charges,,,0.95,,459.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,459.8,Percent of total billed charges,,459.8,474.32,
HC PR 44386 Endoscopy Bowel Pouch/Biop,PX-97512949,CDM,44386,CPT,975,RC,,inpatient,,,762,685.8,,0.95,,723.9,Percent of total billed charges,,,0.98,,746.76,Percent of total billed charges,,,0.95,,723.9,Percent of total billed charges,,,0.97,,739.14,Percent of total billed charges,,,0.97,,739.14,Percent of total billed charges,,,0.96,,731.52,Percent of total billed charges,,,0.95,,723.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,723.9,Percent of total billed charges,,723.9,746.76,
HC PR 44386 Endoscopy Bowel Pouch/Biop,PX-97512949,CDM,44386,CPT,975,RC,,outpatient,,,762,685.8,,0.95,,723.9,Percent of total billed charges,,,0.98,,746.76,Percent of total billed charges,,,0.95,,723.9,Percent of total billed charges,,,0.95,,723.9,Percent of total billed charges,,,0.97,,739.14,Percent of total billed charges,,,0.96,,731.52,Percent of total billed charges,,,0.95,,723.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,723.9,Percent of total billed charges,,723.9,746.76,
HC PR 45172 Exc Rect Tum Transanal Full,PX-97512961,CDM,45172,CPT,975,RC,,inpatient,,,2027,1824.3,,0.95,,1925.65,Percent of total billed charges,,,0.98,,1986.46,Percent of total billed charges,,,0.95,,1925.65,Percent of total billed charges,,,0.97,,1966.19,Percent of total billed charges,,,0.97,,1966.19,Percent of total billed charges,,,0.96,,1945.92,Percent of total billed charges,,,0.95,,1925.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1925.65,Percent of total billed charges,,1925.65,1986.46,
HC PR 45172 Exc Rect Tum Transanal Full,PX-97512961,CDM,45172,CPT,975,RC,,outpatient,,,2027,1824.3,,0.95,,1925.65,Percent of total billed charges,,,0.98,,1986.46,Percent of total billed charges,,,0.95,,1925.65,Percent of total billed charges,,,0.95,,1925.65,Percent of total billed charges,,,0.97,,1966.19,Percent of total billed charges,,,0.96,,1945.92,Percent of total billed charges,,,0.95,,1925.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1925.65,Percent of total billed charges,,1925.65,1986.46,
HC PR 45337 Sigmoidoscopy & Decompress,PX-97512963,CDM,45337,CPT,975,RC,,inpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
HC PR 45337 Sigmoidoscopy & Decompress,PX-97512963,CDM,45337,CPT,975,RC,,outpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
HC PR 45550 Repair Rectum/Remove Sigmoid,PX-97512973,CDM,45550,CPT,975,RC,,inpatient,,,3543,3188.7,,0.95,,3365.85,Percent of total billed charges,,,0.98,,3472.14,Percent of total billed charges,,,0.95,,3365.85,Percent of total billed charges,,,0.97,,3436.71,Percent of total billed charges,,,0.97,,3436.71,Percent of total billed charges,,,0.96,,3401.28,Percent of total billed charges,,,0.95,,3365.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3365.85,Percent of total billed charges,,3365.85,3472.14,
HC PR 45550 Repair Rectum/Remove Sigmoid,PX-97512973,CDM,45550,CPT,975,RC,,outpatient,,,3543,3188.7,,0.95,,3365.85,Percent of total billed charges,,,0.98,,3472.14,Percent of total billed charges,,,0.95,,3365.85,Percent of total billed charges,,,0.95,,3365.85,Percent of total billed charges,,,0.97,,3436.71,Percent of total billed charges,,,0.96,,3401.28,Percent of total billed charges,,,0.95,,3365.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3365.85,Percent of total billed charges,,3365.85,3472.14,
HC PR 46946 Remove by Ligat Int Hem Grps,PX-97512992,CDM,46946,CPT,975,RC,,inpatient,,,940,846,,0.95,,893,Percent of total billed charges,,,0.98,,921.2,Percent of total billed charges,,,0.95,,893,Percent of total billed charges,,,0.97,,911.8,Percent of total billed charges,,,0.97,,911.8,Percent of total billed charges,,,0.96,,902.4,Percent of total billed charges,,,0.95,,893,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,893,Percent of total billed charges,,893,921.2,
HC PR 46946 Remove by Ligat Int Hem Grps,PX-97512992,CDM,46946,CPT,975,RC,,outpatient,,,940,846,,0.95,,893,Percent of total billed charges,,,0.98,,921.2,Percent of total billed charges,,,0.95,,893,Percent of total billed charges,,,0.95,,893,Percent of total billed charges,,,0.97,,911.8,Percent of total billed charges,,,0.96,,902.4,Percent of total billed charges,,,0.95,,893,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,893,Percent of total billed charges,,893,921.2,
HC PR 51500 Removal of Bladder Cyst,PX-97513061,CDM,51500,CPT,975,RC,,inpatient,,,1574,1416.6,,0.95,,1495.3,Percent of total billed charges,,,0.98,,1542.52,Percent of total billed charges,,,0.95,,1495.3,Percent of total billed charges,,,0.97,,1526.78,Percent of total billed charges,,,0.97,,1526.78,Percent of total billed charges,,,0.96,,1511.04,Percent of total billed charges,,,0.95,,1495.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1495.3,Percent of total billed charges,,1495.3,1542.52,
HC PR 51500 Removal of Bladder Cyst,PX-97513061,CDM,51500,CPT,975,RC,,outpatient,,,1574,1416.6,,0.95,,1495.3,Percent of total billed charges,,,0.98,,1542.52,Percent of total billed charges,,,0.95,,1495.3,Percent of total billed charges,,,0.95,,1495.3,Percent of total billed charges,,,0.97,,1526.78,Percent of total billed charges,,,0.96,,1511.04,Percent of total billed charges,,,0.95,,1495.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1495.3,Percent of total billed charges,,1495.3,1542.52,
HC PR 54692 Laparoscopy Orchiopexy,PX-97513074,CDM,54692,CPT,975,RC,,inpatient,,,1846,1661.4,,0.95,,1753.7,Percent of total billed charges,,,0.98,,1809.08,Percent of total billed charges,,,0.95,,1753.7,Percent of total billed charges,,,0.97,,1790.62,Percent of total billed charges,,,0.97,,1790.62,Percent of total billed charges,,,0.96,,1772.16,Percent of total billed charges,,,0.95,,1753.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1753.7,Percent of total billed charges,,1753.7,1809.08,
HC PR 54692 Laparoscopy Orchiopexy,PX-97513074,CDM,54692,CPT,975,RC,,outpatient,,,1846,1661.4,,0.95,,1753.7,Percent of total billed charges,,,0.98,,1809.08,Percent of total billed charges,,,0.95,,1753.7,Percent of total billed charges,,,0.95,,1753.7,Percent of total billed charges,,,0.97,,1790.62,Percent of total billed charges,,,0.96,,1772.16,Percent of total billed charges,,,0.95,,1753.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1753.7,Percent of total billed charges,,1753.7,1809.08,
HC PR 58559 Hysteroscopy Lysis,PX-97513094,CDM,58559,CPT,975,RC,,inpatient,,,832,748.8,,0.95,,790.4,Percent of total billed charges,,,0.98,,815.36,Percent of total billed charges,,,0.95,,790.4,Percent of total billed charges,,,0.97,,807.04,Percent of total billed charges,,,0.97,,807.04,Percent of total billed charges,,,0.96,,798.72,Percent of total billed charges,,,0.95,,790.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,790.4,Percent of total billed charges,,790.4,815.36,
HC PR 58559 Hysteroscopy Lysis,PX-97513094,CDM,58559,CPT,975,RC,,outpatient,,,832,748.8,,0.95,,790.4,Percent of total billed charges,,,0.98,,815.36,Percent of total billed charges,,,0.95,,790.4,Percent of total billed charges,,,0.95,,790.4,Percent of total billed charges,,,0.97,,807.04,Percent of total billed charges,,,0.96,,798.72,Percent of total billed charges,,,0.95,,790.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,790.4,Percent of total billed charges,,790.4,815.36,
HC PR 64505 HC Injection Anes Agent Sphenopalatine Ganglion,PX-97513440,CDM,64505,CPT,975,RC,,inpatient,,,358,322.2,,0.95,,340.1,Percent of total billed charges,,,0.98,,350.84,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,0.97,,347.26,Percent of total billed charges,,,0.97,,347.26,Percent of total billed charges,,,0.96,,343.68,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,340.1,Percent of total billed charges,,340.1,350.84,
HC PR 64505 HC Injection Anes Agent Sphenopalatine Ganglion,PX-97513440,CDM,64505,CPT,975,RC,,outpatient,,,358,322.2,,0.95,,340.1,Percent of total billed charges,,,0.98,,350.84,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,0.97,,347.26,Percent of total billed charges,,,0.96,,343.68,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,340.1,Percent of total billed charges,,340.1,350.84,
HC PR 64650 Chemodenerv Eccrine Glands,PX-97513472,CDM,64650,CPT,975,RC,,inpatient,,,283,254.7,,0.95,,268.85,Percent of total billed charges,,,0.98,,277.34,Percent of total billed charges,,,0.95,,268.85,Percent of total billed charges,,,0.97,,274.51,Percent of total billed charges,,,0.97,,274.51,Percent of total billed charges,,,0.96,,271.68,Percent of total billed charges,,,0.95,,268.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,268.85,Percent of total billed charges,,268.85,277.34,
HC PR 64650 Chemodenerv Eccrine Glands,PX-97513472,CDM,64650,CPT,975,RC,,outpatient,,,283,254.7,,0.95,,268.85,Percent of total billed charges,,,0.98,,277.34,Percent of total billed charges,,,0.95,,268.85,Percent of total billed charges,,,0.95,,268.85,Percent of total billed charges,,,0.97,,274.51,Percent of total billed charges,,,0.96,,271.68,Percent of total billed charges,,,0.95,,268.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,268.85,Percent of total billed charges,,268.85,277.34,
HC PR 64653 Chemodenerv Eccrine Glands,PX-97513473,CDM,64653,CPT,975,RC,,inpatient,,,283,254.7,,0.95,,268.85,Percent of total billed charges,,,0.98,,277.34,Percent of total billed charges,,,0.95,,268.85,Percent of total billed charges,,,0.97,,274.51,Percent of total billed charges,,,0.97,,274.51,Percent of total billed charges,,,0.96,,271.68,Percent of total billed charges,,,0.95,,268.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,268.85,Percent of total billed charges,,268.85,277.34,
HC PR 64653 Chemodenerv Eccrine Glands,PX-97513473,CDM,64653,CPT,975,RC,,outpatient,,,283,254.7,,0.95,,268.85,Percent of total billed charges,,,0.98,,277.34,Percent of total billed charges,,,0.95,,268.85,Percent of total billed charges,,,0.95,,268.85,Percent of total billed charges,,,0.97,,274.51,Percent of total billed charges,,,0.96,,271.68,Percent of total billed charges,,,0.95,,268.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,268.85,Percent of total billed charges,,268.85,277.34,
Test by nucleic acid for multiple types respiratory virus,PX-30010068,CDM,87631,CPT,306,RC,,inpatient,,,444,399.6,,0.95,,421.8,Percent of total billed charges,,,0.98,,435.12,Percent of total billed charges,,,0.95,,421.8,Percent of total billed charges,,,0.97,,430.68,Percent of total billed charges,,,0.97,,430.68,Percent of total billed charges,,,0.96,,426.24,Percent of total billed charges,,,0.95,,421.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,421.8,Percent of total billed charges,,421.8,435.12,
Test by nucleic acid for multiple types respiratory virus,PX-30010068,CDM,87631,CPT,306,RC,,outpatient,,,444,399.6,,0.95,,421.8,Percent of total billed charges,,,0.98,,435.12,Percent of total billed charges,,,0.95,,421.8,Percent of total billed charges,,,0.95,,421.8,Percent of total billed charges,,,0.97,,430.68,Percent of total billed charges,,,0.96,,426.24,Percent of total billed charges,,,0.95,,421.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,421.8,Percent of total billed charges,,421.8,435.12,
HC PR 14350 Filleted Finger/Toe Flap,PX-96911020,CDM,14350,CPT,969,RC,,inpatient,,,2611,2349.9,,0.95,,2480.45,Percent of total billed charges,,,0.98,,2558.78,Percent of total billed charges,,,0.95,,2480.45,Percent of total billed charges,,,0.97,,2532.67,Percent of total billed charges,,,0.97,,2532.67,Percent of total billed charges,,,0.96,,2506.56,Percent of total billed charges,,,0.95,,2480.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2480.45,Percent of total billed charges,,2480.45,2558.78,
HC PR 14350 Filleted Finger/Toe Flap,PX-96911020,CDM,14350,CPT,969,RC,,outpatient,,,2611,2349.9,,0.95,,2480.45,Percent of total billed charges,,,0.98,,2558.78,Percent of total billed charges,,,0.95,,2480.45,Percent of total billed charges,,,0.95,,2480.45,Percent of total billed charges,,,0.97,,2532.67,Percent of total billed charges,,,0.96,,2506.56,Percent of total billed charges,,,0.95,,2480.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2480.45,Percent of total billed charges,,2480.45,2558.78,
HC PR Rx Onabotulinumtoxina Inj 1 Unit,PX-63610063,CDM,J0585,HCPCS,636,RC,,inpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19,Percent of total billed charges,,19,19.6,
HC PR Rx Onabotulinumtoxina Inj 1 Unit,PX-63610063,CDM,J0585,HCPCS,636,RC,,outpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19,Percent of total billed charges,,19,19.6,
"Administration of chemotherapy into vein, 1 hour or less",PX-33510017,CDM,96413,CPT,335,RC,,inpatient,,,604,543.6,,0.95,,573.8,Percent of total billed charges,,,0.98,,591.92,Percent of total billed charges,,,0.95,,573.8,Percent of total billed charges,,,0.97,,585.88,Percent of total billed charges,,,0.97,,585.88,Percent of total billed charges,,,0.96,,579.84,Percent of total billed charges,,,0.95,,573.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,573.8,Percent of total billed charges,,573.8,591.92,
"Administration of chemotherapy into vein, 1 hour or less",PX-33510017,CDM,96413,CPT,335,RC,,outpatient,,,604,543.6,,0.95,,573.8,Percent of total billed charges,,,0.98,,591.92,Percent of total billed charges,,,0.95,,573.8,Percent of total billed charges,,,0.95,,573.8,Percent of total billed charges,,,0.97,,585.88,Percent of total billed charges,,,0.96,,579.84,Percent of total billed charges,,,0.95,,573.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,573.8,Percent of total billed charges,,573.8,591.92,
"Give chemotherapy to vein, each additional hr",PX-33510018,CDM,96415,CPT,335,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Give chemotherapy to vein, each additional hr",PX-33510018,CDM,96415,CPT,335,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
HC PR 1111f Dschrg Med/Current Med Merge,PX-99013529,CDM,99013529,LOCAL,990,RC,,inpatient,,,147,132.3,,0.95,,139.65,Percent of total billed charges,,,0.98,,144.06,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,0.97,,142.59,Percent of total billed charges,,,0.97,,142.59,Percent of total billed charges,,,0.96,,141.12,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,139.65,Percent of total billed charges,,139.65,144.06,
HC PR 1111f Dschrg Med/Current Med Merge,PX-99013529,CDM,99013529,LOCAL,990,RC,,outpatient,,,147,132.3,,0.95,,139.65,Percent of total billed charges,,,0.98,,144.06,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,0.97,,142.59,Percent of total billed charges,,,0.96,,141.12,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,139.65,Percent of total billed charges,,139.65,144.06,
"Test by nucleic acid for Trichomonas vaginalis , amplified",PX-30010093,CDM,87661,CPT,306,RC,,inpatient,,,181,162.9,,0.95,,171.95,Percent of total billed charges,,,0.98,,177.38,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,0.97,,175.57,Percent of total billed charges,,,0.97,,175.57,Percent of total billed charges,,,0.96,,173.76,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,171.95,Percent of total billed charges,,171.95,177.38,
"Test by nucleic acid for Trichomonas vaginalis , amplified",PX-30010093,CDM,87661,CPT,306,RC,,outpatient,,,181,162.9,,0.95,,171.95,Percent of total billed charges,,,0.98,,177.38,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,0.97,,175.57,Percent of total billed charges,,,0.96,,173.76,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,171.95,Percent of total billed charges,,171.95,177.38,
Clozapine level,PX-30110128,CDM,80159,CPT,301,RC,,inpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
Clozapine level,PX-30110128,CDM,80159,CPT,301,RC,,outpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
Gabapentin level,PX-30110130,CDM,80171,CPT,301,RC,,inpatient,,,76,68.4,,0.95,,72.2,Percent of total billed charges,,,0.98,,74.48,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,0.97,,73.72,Percent of total billed charges,,,0.97,,73.72,Percent of total billed charges,,,0.96,,72.96,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,72.2,Percent of total billed charges,,72.2,74.48,
Gabapentin level,PX-30110130,CDM,80171,CPT,301,RC,,outpatient,,,76,68.4,,0.95,,72.2,Percent of total billed charges,,,0.98,,74.48,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,0.97,,73.72,Percent of total billed charges,,,0.96,,72.96,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,72.2,Percent of total billed charges,,72.2,74.48,
Lamotrigine level,PX-30110131,CDM,80175,CPT,301,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Lamotrigine level,PX-30110131,CDM,80175,CPT,301,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Levetiracetam level,PX-30110132,CDM,80177,CPT,301,RC,,inpatient,,,205,184.5,,0.95,,194.75,Percent of total billed charges,,,0.98,,200.9,Percent of total billed charges,,,0.95,,194.75,Percent of total billed charges,,,0.97,,198.85,Percent of total billed charges,,,0.97,,198.85,Percent of total billed charges,,,0.96,,196.8,Percent of total billed charges,,,0.95,,194.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,194.75,Percent of total billed charges,,194.75,200.9,
Levetiracetam level,PX-30110132,CDM,80177,CPT,301,RC,,outpatient,,,205,184.5,,0.95,,194.75,Percent of total billed charges,,,0.98,,200.9,Percent of total billed charges,,,0.95,,194.75,Percent of total billed charges,,,0.95,,194.75,Percent of total billed charges,,,0.97,,198.85,Percent of total billed charges,,,0.96,,196.8,Percent of total billed charges,,,0.95,,194.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,194.75,Percent of total billed charges,,194.75,200.9,
Oxcarbazepine level,PX-30110134,CDM,80183,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Oxcarbazepine level,PX-30110134,CDM,80183,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Zonisamide level,PX-30110136,CDM,80203,CPT,301,RC,,inpatient,,,117,105.3,,0.95,,111.15,Percent of total billed charges,,,0.98,,114.66,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.96,,112.32,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,111.15,Percent of total billed charges,,111.15,114.66,
Zonisamide level,PX-30110136,CDM,80203,CPT,301,RC,,outpatient,,,117,105.3,,0.95,,111.15,Percent of total billed charges,,,0.98,,114.66,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.96,,112.32,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,111.15,Percent of total billed charges,,111.15,114.66,
Drain fluid in soft tissue using imaging guidance,PX-36111182,CDM,10030,CPT,361,RC,,inpatient,,,856,770.4,,0.95,,813.2,Percent of total billed charges,,,0.98,,838.88,Percent of total billed charges,,,0.95,,813.2,Percent of total billed charges,,,0.97,,830.32,Percent of total billed charges,,,0.97,,830.32,Percent of total billed charges,,,0.96,,821.76,Percent of total billed charges,,,0.95,,813.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,813.2,Percent of total billed charges,,813.2,838.88,
Drain fluid in soft tissue using imaging guidance,PX-36111182,CDM,10030,CPT,361,RC,,outpatient,,,856,770.4,,0.95,,813.2,Percent of total billed charges,,,0.98,,838.88,Percent of total billed charges,,,0.95,,813.2,Percent of total billed charges,,,0.95,,813.2,Percent of total billed charges,,,0.97,,830.32,Percent of total billed charges,,,0.96,,821.76,Percent of total billed charges,,,0.95,,813.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,813.2,Percent of total billed charges,,813.2,838.88,
"Biopsy breast using ultrasound, first growth",PX-36111185,CDM,19083,CPT,361,RC,,inpatient,,,851,765.9,,0.95,,808.45,Percent of total billed charges,,,0.98,,833.98,Percent of total billed charges,,,0.95,,808.45,Percent of total billed charges,,,0.97,,825.47,Percent of total billed charges,,,0.97,,825.47,Percent of total billed charges,,,0.96,,816.96,Percent of total billed charges,,,0.95,,808.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,808.45,Percent of total billed charges,,808.45,833.98,
"Biopsy breast using ultrasound, first growth",PX-36111185,CDM,19083,CPT,361,RC,,outpatient,,,851,765.9,,0.95,,808.45,Percent of total billed charges,,,0.98,,833.98,Percent of total billed charges,,,0.95,,808.45,Percent of total billed charges,,,0.95,,808.45,Percent of total billed charges,,,0.97,,825.47,Percent of total billed charges,,,0.96,,816.96,Percent of total billed charges,,,0.95,,808.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,808.45,Percent of total billed charges,,808.45,833.98,
"Biopsy breast using ultrasound, each add growth",PX-36111186,CDM,19084,CPT,361,RC,,inpatient,,,831,747.9,,0.95,,789.45,Percent of total billed charges,,,0.98,,814.38,Percent of total billed charges,,,0.95,,789.45,Percent of total billed charges,,,0.97,,806.07,Percent of total billed charges,,,0.97,,806.07,Percent of total billed charges,,,0.96,,797.76,Percent of total billed charges,,,0.95,,789.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,789.45,Percent of total billed charges,,789.45,814.38,
"Biopsy breast using ultrasound, each add growth",PX-36111186,CDM,19084,CPT,361,RC,,outpatient,,,831,747.9,,0.95,,789.45,Percent of total billed charges,,,0.98,,814.38,Percent of total billed charges,,,0.95,,789.45,Percent of total billed charges,,,0.95,,789.45,Percent of total billed charges,,,0.97,,806.07,Percent of total billed charges,,,0.96,,797.76,Percent of total billed charges,,,0.95,,789.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,789.45,Percent of total billed charges,,789.45,814.38,
Place locating device in breast with imaging,PX-36111189,CDM,19281,CPT,361,RC,,inpatient,,,401,360.9,,0.95,,380.95,Percent of total billed charges,,,0.98,,392.98,Percent of total billed charges,,,0.95,,380.95,Percent of total billed charges,,,0.97,,388.97,Percent of total billed charges,,,0.97,,388.97,Percent of total billed charges,,,0.96,,384.96,Percent of total billed charges,,,0.95,,380.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,380.95,Percent of total billed charges,,380.95,392.98,
Place locating device in breast with imaging,PX-36111189,CDM,19281,CPT,361,RC,,outpatient,,,401,360.9,,0.95,,380.95,Percent of total billed charges,,,0.98,,392.98,Percent of total billed charges,,,0.95,,380.95,Percent of total billed charges,,,0.95,,380.95,Percent of total billed charges,,,0.97,,388.97,Percent of total billed charges,,,0.96,,384.96,Percent of total billed charges,,,0.95,,380.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,380.95,Percent of total billed charges,,380.95,392.98,
Place locating device in breast with ultrasound,PX-36111193,CDM,19285,CPT,361,RC,,inpatient,,,321,288.9,,0.95,,304.95,Percent of total billed charges,,,0.98,,314.58,Percent of total billed charges,,,0.95,,304.95,Percent of total billed charges,,,0.97,,311.37,Percent of total billed charges,,,0.97,,311.37,Percent of total billed charges,,,0.96,,308.16,Percent of total billed charges,,,0.95,,304.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,304.95,Percent of total billed charges,,304.95,314.58,
Place locating device in breast with ultrasound,PX-36111193,CDM,19285,CPT,361,RC,,outpatient,,,321,288.9,,0.95,,304.95,Percent of total billed charges,,,0.98,,314.58,Percent of total billed charges,,,0.95,,304.95,Percent of total billed charges,,,0.95,,304.95,Percent of total billed charges,,,0.97,,311.37,Percent of total billed charges,,,0.96,,308.16,Percent of total billed charges,,,0.95,,304.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,304.95,Percent of total billed charges,,304.95,314.58,
Therapy procedure to clear airway using an inflatable vest,PX-41010023,CDM,94669,CPT,410,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Therapy procedure to clear airway using an inflatable vest,PX-41010023,CDM,94669,CPT,410,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Evaluate sound production w/comprehension/expression,PX-44010126,CDM,92523,CPT,444,RC,,inpatient,,,593,533.7,,0.95,,563.35,Percent of total billed charges,,,0.98,,581.14,Percent of total billed charges,,,0.95,,563.35,Percent of total billed charges,,,0.97,,575.21,Percent of total billed charges,,,0.97,,575.21,Percent of total billed charges,,,0.96,,569.28,Percent of total billed charges,,,0.95,,563.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,563.35,Percent of total billed charges,,563.35,581.14,
Evaluate sound production w/comprehension/expression,PX-44010126,CDM,92523,CPT,444,RC,,outpatient,,,593,533.7,,0.95,,563.35,Percent of total billed charges,,,0.98,,581.14,Percent of total billed charges,,,0.95,,563.35,Percent of total billed charges,,,0.95,,563.35,Percent of total billed charges,,,0.97,,575.21,Percent of total billed charges,,,0.96,,569.28,Percent of total billed charges,,,0.95,,563.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,563.35,Percent of total billed charges,,563.35,581.14,
Behavioral and qualitative analysis of voice and resonance,PX-44010127,CDM,92524,CPT,444,RC,,inpatient,,,499,449.1,,0.95,,474.05,Percent of total billed charges,,,0.98,,489.02,Percent of total billed charges,,,0.95,,474.05,Percent of total billed charges,,,0.97,,484.03,Percent of total billed charges,,,0.97,,484.03,Percent of total billed charges,,,0.96,,479.04,Percent of total billed charges,,,0.95,,474.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,474.05,Percent of total billed charges,,474.05,489.02,
Behavioral and qualitative analysis of voice and resonance,PX-44010127,CDM,92524,CPT,444,RC,,outpatient,,,499,449.1,,0.95,,474.05,Percent of total billed charges,,,0.98,,489.02,Percent of total billed charges,,,0.95,,474.05,Percent of total billed charges,,,0.95,,474.05,Percent of total billed charges,,,0.97,,484.03,Percent of total billed charges,,,0.96,,479.04,Percent of total billed charges,,,0.95,,474.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,474.05,Percent of total billed charges,,474.05,489.02,
Evaluation of speech sound production,PX-44410064,CDM,92522,CPT,444,RC,,inpatient,,,437,393.3,,0.95,,415.15,Percent of total billed charges,,,0.98,,428.26,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,0.97,,423.89,Percent of total billed charges,,,0.97,,423.89,Percent of total billed charges,,,0.96,,419.52,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,415.15,Percent of total billed charges,,415.15,428.26,
Evaluation of speech sound production,PX-44410064,CDM,92522,CPT,444,RC,,outpatient,,,437,393.3,,0.95,,415.15,Percent of total billed charges,,,0.98,,428.26,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,0.97,,423.89,Percent of total billed charges,,,0.96,,419.52,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,415.15,Percent of total billed charges,,415.15,428.26,
HC PR 19081 Bx Breast 1st Lesion Stereo,PX-96910587,CDM,19081,CPT,983,RC,,inpatient,,,1687,1518.3,,0.95,,1602.65,Percent of total billed charges,,,0.98,,1653.26,Percent of total billed charges,,,0.95,,1602.65,Percent of total billed charges,,,0.97,,1636.39,Percent of total billed charges,,,0.97,,1636.39,Percent of total billed charges,,,0.96,,1619.52,Percent of total billed charges,,,0.95,,1602.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1602.65,Percent of total billed charges,,1602.65,1653.26,
HC PR 19081 Bx Breast 1st Lesion Stereo,PX-96910587,CDM,19081,CPT,983,RC,,outpatient,,,1687,1518.3,,0.95,,1602.65,Percent of total billed charges,,,0.98,,1653.26,Percent of total billed charges,,,0.95,,1602.65,Percent of total billed charges,,,0.95,,1602.65,Percent of total billed charges,,,0.97,,1636.39,Percent of total billed charges,,,0.96,,1619.52,Percent of total billed charges,,,0.95,,1602.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1602.65,Percent of total billed charges,,1602.65,1653.26,
HC PR 19083 Bx Breast 1st Lesion US Imag,PX-96910589,CDM,19083,CPT,983,RC,,inpatient,,,220,198,,0.95,,209,Percent of total billed charges,,,0.98,,215.6,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,0.97,,213.4,Percent of total billed charges,,,0.97,,213.4,Percent of total billed charges,,,0.96,,211.2,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,209,Percent of total billed charges,,209,215.6,
HC PR 19083 Bx Breast 1st Lesion US Imag,PX-96910589,CDM,19083,CPT,983,RC,,outpatient,,,220,198,,0.95,,209,Percent of total billed charges,,,0.98,,215.6,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,0.97,,213.4,Percent of total billed charges,,,0.96,,211.2,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,209,Percent of total billed charges,,209,215.6,
HC PR 19084 Bx Breast Add Lesion US Imag,PX-96910590,CDM,19084,CPT,983,RC,,inpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95,Percent of total billed charges,,95,98,
HC PR 19084 Bx Breast Add Lesion US Imag,PX-96910590,CDM,19084,CPT,983,RC,,outpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95,Percent of total billed charges,,95,98,
HC PR 19281 Perq Device Loc Breast 1st Imag,PX-96910593,CDM,19281,CPT,983,RC,,inpatient,,,591,531.9,,0.95,,561.45,Percent of total billed charges,,,0.98,,579.18,Percent of total billed charges,,,0.95,,561.45,Percent of total billed charges,,,0.97,,573.27,Percent of total billed charges,,,0.97,,573.27,Percent of total billed charges,,,0.96,,567.36,Percent of total billed charges,,,0.95,,561.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,561.45,Percent of total billed charges,,561.45,579.18,
HC PR 19281 Perq Device Loc Breast 1st Imag,PX-96910593,CDM,19281,CPT,983,RC,,outpatient,,,591,531.9,,0.95,,561.45,Percent of total billed charges,,,0.98,,579.18,Percent of total billed charges,,,0.95,,561.45,Percent of total billed charges,,,0.95,,561.45,Percent of total billed charges,,,0.97,,573.27,Percent of total billed charges,,,0.96,,567.36,Percent of total billed charges,,,0.95,,561.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,561.45,Percent of total billed charges,,561.45,579.18,
HC PR 19282 Perq Device Loc Breast Ea Imag,PX-96910594,CDM,19282,CPT,983,RC,,inpatient,,,418,376.2,,0.95,,397.1,Percent of total billed charges,,,0.98,,409.64,Percent of total billed charges,,,0.95,,397.1,Percent of total billed charges,,,0.97,,405.46,Percent of total billed charges,,,0.97,,405.46,Percent of total billed charges,,,0.96,,401.28,Percent of total billed charges,,,0.95,,397.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,397.1,Percent of total billed charges,,397.1,409.64,
HC PR 19282 Perq Device Loc Breast Ea Imag,PX-96910594,CDM,19282,CPT,983,RC,,outpatient,,,418,376.2,,0.95,,397.1,Percent of total billed charges,,,0.98,,409.64,Percent of total billed charges,,,0.95,,397.1,Percent of total billed charges,,,0.95,,397.1,Percent of total billed charges,,,0.97,,405.46,Percent of total billed charges,,,0.96,,401.28,Percent of total billed charges,,,0.95,,397.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,397.1,Percent of total billed charges,,397.1,409.64,
HC PR 19285 Perq Dev Loc Breast 1st US Imag,PX-96910597,CDM,19285,CPT,983,RC,,inpatient,,,964,867.6,,0.95,,915.8,Percent of total billed charges,,,0.98,,944.72,Percent of total billed charges,,,0.95,,915.8,Percent of total billed charges,,,0.97,,935.08,Percent of total billed charges,,,0.97,,935.08,Percent of total billed charges,,,0.96,,925.44,Percent of total billed charges,,,0.95,,915.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,915.8,Percent of total billed charges,,915.8,944.72,
HC PR 19285 Perq Dev Loc Breast 1st US Imag,PX-96910597,CDM,19285,CPT,983,RC,,outpatient,,,964,867.6,,0.95,,915.8,Percent of total billed charges,,,0.98,,944.72,Percent of total billed charges,,,0.95,,915.8,Percent of total billed charges,,,0.95,,915.8,Percent of total billed charges,,,0.97,,935.08,Percent of total billed charges,,,0.96,,925.44,Percent of total billed charges,,,0.95,,915.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,915.8,Percent of total billed charges,,915.8,944.72,
HC PR 43233 Egd Balloon Dil Esoph30 Mm/>,PX-97513603,CDM,43233,CPT,975,RC,,inpatient,,,297,267.3,,0.95,,282.15,Percent of total billed charges,,,0.98,,291.06,Percent of total billed charges,,,0.95,,282.15,Percent of total billed charges,,,0.97,,288.09,Percent of total billed charges,,,0.97,,288.09,Percent of total billed charges,,,0.96,,285.12,Percent of total billed charges,,,0.95,,282.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,282.15,Percent of total billed charges,,282.15,291.06,
HC PR 43233 Egd Balloon Dil Esoph30 Mm/>,PX-97513603,CDM,43233,CPT,975,RC,,outpatient,,,297,267.3,,0.95,,282.15,Percent of total billed charges,,,0.98,,291.06,Percent of total billed charges,,,0.95,,282.15,Percent of total billed charges,,,0.95,,282.15,Percent of total billed charges,,,0.97,,288.09,Percent of total billed charges,,,0.96,,285.12,Percent of total billed charges,,,0.95,,282.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,282.15,Percent of total billed charges,,282.15,291.06,
HC PR 64646 Chemodenerv Trunk Musc 1-5,PX-97513623,CDM,64646,CPT,975,RC,,inpatient,,,667,600.3,,0.95,,633.65,Percent of total billed charges,,,0.98,,653.66,Percent of total billed charges,,,0.95,,633.65,Percent of total billed charges,,,0.97,,646.99,Percent of total billed charges,,,0.97,,646.99,Percent of total billed charges,,,0.96,,640.32,Percent of total billed charges,,,0.95,,633.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,633.65,Percent of total billed charges,,633.65,653.66,
HC PR 64646 Chemodenerv Trunk Musc 1-5,PX-97513623,CDM,64646,CPT,975,RC,,outpatient,,,667,600.3,,0.95,,633.65,Percent of total billed charges,,,0.98,,653.66,Percent of total billed charges,,,0.95,,633.65,Percent of total billed charges,,,0.95,,633.65,Percent of total billed charges,,,0.97,,646.99,Percent of total billed charges,,,0.96,,640.32,Percent of total billed charges,,,0.95,,633.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,633.65,Percent of total billed charges,,633.65,653.66,
HC PR 64647 Chemodenerv Trunk Musc 6/>,PX-97513624,CDM,64647,CPT,975,RC,,inpatient,,,688,619.2,,0.95,,653.6,Percent of total billed charges,,,0.98,,674.24,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,0.97,,667.36,Percent of total billed charges,,,0.97,,667.36,Percent of total billed charges,,,0.96,,660.48,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,653.6,Percent of total billed charges,,653.6,674.24,
HC PR 64647 Chemodenerv Trunk Musc 6/>,PX-97513624,CDM,64647,CPT,975,RC,,outpatient,,,688,619.2,,0.95,,653.6,Percent of total billed charges,,,0.98,,674.24,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,0.97,,667.36,Percent of total billed charges,,,0.96,,660.48,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,653.6,Percent of total billed charges,,653.6,674.24,
HC PR 46930 Destruction of Internal Hemorroids by Thermal Energy,PX-97513626,CDM,46930,CPT,975,RC,,inpatient,,,534,480.6,,0.95,,507.3,Percent of total billed charges,,,0.98,,523.32,Percent of total billed charges,,,0.95,,507.3,Percent of total billed charges,,,0.97,,517.98,Percent of total billed charges,,,0.97,,517.98,Percent of total billed charges,,,0.96,,512.64,Percent of total billed charges,,,0.95,,507.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,507.3,Percent of total billed charges,,507.3,523.32,
HC PR 46930 Destruction of Internal Hemorroids by Thermal Energy,PX-97513626,CDM,46930,CPT,975,RC,,outpatient,,,534,480.6,,0.95,,507.3,Percent of total billed charges,,,0.98,,523.32,Percent of total billed charges,,,0.95,,507.3,Percent of total billed charges,,,0.95,,507.3,Percent of total billed charges,,,0.97,,517.98,Percent of total billed charges,,,0.96,,512.64,Percent of total billed charges,,,0.95,,507.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,507.3,Percent of total billed charges,,507.3,523.32,
HLA class II typing high resolution one allele/allele group,PX-30011990,CDM,81381,CPT,310,RC,,inpatient,,,553,497.7,,0.95,,525.35,Percent of total billed charges,,,0.98,,541.94,Percent of total billed charges,,,0.95,,525.35,Percent of total billed charges,,,0.97,,536.41,Percent of total billed charges,,,0.97,,536.41,Percent of total billed charges,,,0.96,,530.88,Percent of total billed charges,,,0.95,,525.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,525.35,Percent of total billed charges,,525.35,541.94,
HLA class II typing high resolution one allele/allele group,PX-30011990,CDM,81381,CPT,310,RC,,outpatient,,,553,497.7,,0.95,,525.35,Percent of total billed charges,,,0.98,,541.94,Percent of total billed charges,,,0.95,,525.35,Percent of total billed charges,,,0.95,,525.35,Percent of total billed charges,,,0.97,,536.41,Percent of total billed charges,,,0.96,,530.88,Percent of total billed charges,,,0.95,,525.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,525.35,Percent of total billed charges,,525.35,541.94,
HC PR 98968 Phone Assessment by Nonphysician 21-30 Min Cdm,PX-96910961,CDM,98968,CPT,983,RC,,inpatient,,,133,119.7,,0.95,,126.35,Percent of total billed charges,,,0.98,,130.34,Percent of total billed charges,,,0.95,,126.35,Percent of total billed charges,,,0.97,,129.01,Percent of total billed charges,,,0.97,,129.01,Percent of total billed charges,,,0.96,,127.68,Percent of total billed charges,,,0.95,,126.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,126.35,Percent of total billed charges,,126.35,130.34,
HC PR 98968 Phone Assessment by Nonphysician 21-30 Min Cdm,PX-96910961,CDM,98968,CPT,983,RC,,outpatient,,,133,119.7,,0.95,,126.35,Percent of total billed charges,,,0.98,,130.34,Percent of total billed charges,,,0.95,,126.35,Percent of total billed charges,,,0.95,,126.35,Percent of total billed charges,,,0.97,,129.01,Percent of total billed charges,,,0.96,,127.68,Percent of total billed charges,,,0.95,,126.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,126.35,Percent of total billed charges,,126.35,130.34,
Molecular pathology procedure,PX-30114290,CDM,81479,CPT,310,RC,,inpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Molecular pathology procedure,PX-30114290,CDM,81479,CPT,310,RC,,outpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Analysis for antibody to Coccidioides (bacteria),PX-30211518,CDM,86635,CPT,302,RC,,inpatient,,,58,52.2,,0.95,,55.1,Percent of total billed charges,,,0.98,,56.84,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,0.97,,56.26,Percent of total billed charges,,,0.97,,56.26,Percent of total billed charges,,,0.96,,55.68,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,55.1,Percent of total billed charges,,55.1,56.84,
Analysis for antibody to Coccidioides (bacteria),PX-30211518,CDM,86635,CPT,302,RC,,outpatient,,,58,52.2,,0.95,,55.1,Percent of total billed charges,,,0.98,,56.84,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,0.97,,56.26,Percent of total billed charges,,,0.96,,55.68,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,55.1,Percent of total billed charges,,55.1,56.84,
Detection test by immunoassay technique for other organism,PX-30610178,CDM,87449,CPT,306,RC,,inpatient,,,76,68.4,,0.95,,72.2,Percent of total billed charges,,,0.98,,74.48,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,0.97,,73.72,Percent of total billed charges,,,0.97,,73.72,Percent of total billed charges,,,0.96,,72.96,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,72.2,Percent of total billed charges,,72.2,74.48,
Detection test by immunoassay technique for other organism,PX-30610178,CDM,87449,CPT,306,RC,,outpatient,,,76,68.4,,0.95,,72.2,Percent of total billed charges,,,0.98,,74.48,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,0.97,,73.72,Percent of total billed charges,,,0.96,,72.96,Percent of total billed charges,,,0.95,,72.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,72.2,Percent of total billed charges,,72.2,74.48,
Removal of foreign body in eye or lens,PX-45010662,CDM,65235,CPT,450,RC,,inpatient,,,2525,2272.5,,0.95,,2398.75,Percent of total billed charges,,,0.98,,2474.5,Percent of total billed charges,,,0.95,,2398.75,Percent of total billed charges,,,0.97,,2449.25,Percent of total billed charges,,,0.97,,2449.25,Percent of total billed charges,,,0.96,,2424,Percent of total billed charges,,,0.95,,2398.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2398.75,Percent of total billed charges,,2398.75,3950,
Removal of foreign body in eye or lens,PX-45010662,CDM,65235,CPT,450,RC,,outpatient,,,2525,2272.5,,0.95,,2398.75,Percent of total billed charges,,,0.98,,2474.5,Percent of total billed charges,,,0.95,,2398.75,Percent of total billed charges,,,0.95,,2398.75,Percent of total billed charges,,,0.97,,2449.25,Percent of total billed charges,,,0.96,,2424,Percent of total billed charges,,,0.95,,2398.75,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2398.75,Percent of total billed charges,,2398.75,3950,
HC PR ED 29520 Strapping of Hip Cdm,PX-98110118,CDM,29520,CPT,981,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
HC PR ED 29520 Strapping of Hip Cdm,PX-98110118,CDM,29520,CPT,981,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Translocation analysis (BCR/ABL1) major breakpoint,PX-30012263,CDM,81206,CPT,310,RC,,inpatient,,,770,693,,0.95,,731.5,Percent of total billed charges,,,0.98,,754.6,Percent of total billed charges,,,0.95,,731.5,Percent of total billed charges,,,0.97,,746.9,Percent of total billed charges,,,0.97,,746.9,Percent of total billed charges,,,0.96,,739.2,Percent of total billed charges,,,0.95,,731.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,731.5,Percent of total billed charges,,731.5,754.6,
Translocation analysis (BCR/ABL1) major breakpoint,PX-30012263,CDM,81206,CPT,310,RC,,outpatient,,,770,693,,0.95,,731.5,Percent of total billed charges,,,0.98,,754.6,Percent of total billed charges,,,0.95,,731.5,Percent of total billed charges,,,0.95,,731.5,Percent of total billed charges,,,0.97,,746.9,Percent of total billed charges,,,0.96,,739.2,Percent of total billed charges,,,0.95,,731.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,731.5,Percent of total billed charges,,731.5,754.6,
Analysis for antibody to Ehrlichia,PX-30012282,CDM,86666,CPT,302,RC,,inpatient,,,40,36,,0.95,,38,Percent of total billed charges,,,0.98,,39.2,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.96,,38.4,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38,Percent of total billed charges,,38,39.2,
Analysis for antibody to Ehrlichia,PX-30012282,CDM,86666,CPT,302,RC,,outpatient,,,40,36,,0.95,,38,Percent of total billed charges,,,0.98,,39.2,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.96,,38.4,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38,Percent of total billed charges,,38,39.2,
HC PR G0442 Annual Alcohol Screen 15 Min Cdm,PX-98310916,CDM,G0442,HCPCS,983,RC,,inpatient,,,48,43.2,,0.95,,45.6,Percent of total billed charges,,,0.98,,47.04,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.96,,46.08,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,45.6,Percent of total billed charges,,45.6,47.04,
HC PR G0442 Annual Alcohol Screen 15 Min Cdm,PX-98310916,CDM,G0442,HCPCS,983,RC,,outpatient,,,48,43.2,,0.95,,45.6,Percent of total billed charges,,,0.98,,47.04,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.96,,46.08,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,45.6,Percent of total billed charges,,45.6,47.04,
"Training and education, 45 minutes or more",PX-94210113,CDM,G0177,HCPCS,942,RC,,inpatient,,,200,180,,0.95,,190,Percent of total billed charges,,,0.98,,196,Percent of total billed charges,,,0.95,,190,Percent of total billed charges,,,0.97,,194,Percent of total billed charges,,,0.97,,194,Percent of total billed charges,,,0.96,,192,Percent of total billed charges,,,0.95,,190,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,190,Percent of total billed charges,,190,196,
"Training and education, 45 minutes or more",PX-94210113,CDM,G0177,HCPCS,942,RC,,outpatient,,,200,180,,0.95,,190,Percent of total billed charges,,,0.98,,196,Percent of total billed charges,,,0.95,,190,Percent of total billed charges,,,0.95,,190,Percent of total billed charges,,,0.97,,194,Percent of total billed charges,,,0.96,,192,Percent of total billed charges,,,0.95,,190,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,190,Percent of total billed charges,,190,196,
HC R&B Hospice Respite,PX-65510001,CDM,65510001,LOCAL,655,RC,,inpatient,,,269,242.1,,0.95,,255.55,Percent of total billed charges,,,0.98,,263.62,Percent of total billed charges,,,0.95,,255.55,Percent of total billed charges,,,0.97,,260.93,Percent of total billed charges,,,0.97,,260.93,Percent of total billed charges,,,0.96,,258.24,Percent of total billed charges,,,0.95,,255.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,255.55,Percent of total billed charges,,255.55,263.62,
HC R&B Hospice Respite,PX-65510001,CDM,65510001,LOCAL,655,RC,,outpatient,,,269,242.1,,0.95,,255.55,Percent of total billed charges,,,0.98,,263.62,Percent of total billed charges,,,0.95,,255.55,Percent of total billed charges,,,0.95,,255.55,Percent of total billed charges,,,0.97,,260.93,Percent of total billed charges,,,0.96,,258.24,Percent of total billed charges,,,0.95,,255.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,255.55,Percent of total billed charges,,255.55,263.62,
"Evaluation of speech continuity, smoothness, rate, effort",PX-44010138,CDM,92521,CPT,440,RC,,inpatient,,,327,294.3,,0.95,,310.65,Percent of total billed charges,,,0.98,,320.46,Percent of total billed charges,,,0.95,,310.65,Percent of total billed charges,,,0.97,,317.19,Percent of total billed charges,,,0.97,,317.19,Percent of total billed charges,,,0.96,,313.92,Percent of total billed charges,,,0.95,,310.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,310.65,Percent of total billed charges,,310.65,320.46,
"Evaluation of speech continuity, smoothness, rate, effort",PX-44010138,CDM,92521,CPT,440,RC,,outpatient,,,327,294.3,,0.95,,310.65,Percent of total billed charges,,,0.98,,320.46,Percent of total billed charges,,,0.95,,310.65,Percent of total billed charges,,,0.95,,310.65,Percent of total billed charges,,,0.97,,317.19,Percent of total billed charges,,,0.96,,313.92,Percent of total billed charges,,,0.95,,310.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,310.65,Percent of total billed charges,,310.65,320.46,
HC PR Rx Influenza Quadrivalent Inh 0.2 Ml,PX-63610069,CDM,90672,HCPCS,636,RC,,inpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
HC PR Rx Influenza Quadrivalent Inh 0.2 Ml,PX-63610069,CDM,90672,HCPCS,636,RC,,outpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
HC PR 24300 Manipulate Elbow W/Anesth,PX-97513630,CDM,24300,CPT,975,RC,,inpatient,,,1458,1312.2,,0.95,,1385.1,Percent of total billed charges,,,0.98,,1428.84,Percent of total billed charges,,,0.95,,1385.1,Percent of total billed charges,,,0.97,,1414.26,Percent of total billed charges,,,0.97,,1414.26,Percent of total billed charges,,,0.96,,1399.68,Percent of total billed charges,,,0.95,,1385.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1385.1,Percent of total billed charges,,1385.1,1428.84,
HC PR 24300 Manipulate Elbow W/Anesth,PX-97513630,CDM,24300,CPT,975,RC,,outpatient,,,1458,1312.2,,0.95,,1385.1,Percent of total billed charges,,,0.98,,1428.84,Percent of total billed charges,,,0.95,,1385.1,Percent of total billed charges,,,0.95,,1385.1,Percent of total billed charges,,,0.97,,1414.26,Percent of total billed charges,,,0.96,,1399.68,Percent of total billed charges,,,0.95,,1385.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1385.1,Percent of total billed charges,,1385.1,1428.84,
HC PR 29581 Multilayer Wnd Compression,PX-98310855,CDM,29581,CPT,983,RC,,inpatient,,,217,195.3,,0.95,,206.15,Percent of total billed charges,,,0.98,,212.66,Percent of total billed charges,,,0.95,,206.15,Percent of total billed charges,,,0.97,,210.49,Percent of total billed charges,,,0.97,,210.49,Percent of total billed charges,,,0.96,,208.32,Percent of total billed charges,,,0.95,,206.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,206.15,Percent of total billed charges,,206.15,212.66,
HC PR 29581 Multilayer Wnd Compression,PX-98310855,CDM,29581,CPT,983,RC,,outpatient,,,217,195.3,,0.95,,206.15,Percent of total billed charges,,,0.98,,212.66,Percent of total billed charges,,,0.95,,206.15,Percent of total billed charges,,,0.95,,206.15,Percent of total billed charges,,,0.97,,210.49,Percent of total billed charges,,,0.96,,208.32,Percent of total billed charges,,,0.95,,206.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,206.15,Percent of total billed charges,,206.15,212.66,
HC PR 64417 Injection Aa&/Strd Axillary Nerve W/Img Gdn Cdm,PX-96310254,CDM,64417,CPT,963,RC,,inpatient,,,1950,1755,,0.95,,1852.5,Percent of total billed charges,,,0.98,,1911,Percent of total billed charges,,,0.95,,1852.5,Percent of total billed charges,,,0.97,,1891.5,Percent of total billed charges,,,0.97,,1891.5,Percent of total billed charges,,,0.96,,1872,Percent of total billed charges,,,0.95,,1852.5,Percent of total billed charges,,,,,,,,,0.95,,1852.5,Percent of total billed charges,,1852.5,1911,
HC PR 64417 Injection Aa&/Strd Axillary Nerve W/Img Gdn Cdm,PX-96310254,CDM,64417,CPT,963,RC,,outpatient,,,1950,1755,,0.95,,1852.5,Percent of total billed charges,,,0.98,,1911,Percent of total billed charges,,,0.95,,1852.5,Percent of total billed charges,,,0.95,,1852.5,Percent of total billed charges,,,0.97,,1891.5,Percent of total billed charges,,,0.96,,1872,Percent of total billed charges,,,0.95,,1852.5,Percent of total billed charges,,,,,,,,,0.95,,1852.5,Percent of total billed charges,,1852.5,1911,
HC PR 64421 Injection Aa&/Strd Intercostal Nrv Ea Addl Lvl,PX-96310255,CDM,64421,CPT,963,RC,,inpatient,,,1588,1429.2,,0.95,,1508.6,Percent of total billed charges,,,0.98,,1556.24,Percent of total billed charges,,,0.95,,1508.6,Percent of total billed charges,,,0.97,,1540.36,Percent of total billed charges,,,0.97,,1540.36,Percent of total billed charges,,,0.96,,1524.48,Percent of total billed charges,,,0.95,,1508.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1508.6,Percent of total billed charges,,1508.6,1556.24,
HC PR 64421 Injection Aa&/Strd Intercostal Nrv Ea Addl Lvl,PX-96310255,CDM,64421,CPT,963,RC,,outpatient,,,1588,1429.2,,0.95,,1508.6,Percent of total billed charges,,,0.98,,1556.24,Percent of total billed charges,,,0.95,,1508.6,Percent of total billed charges,,,0.95,,1508.6,Percent of total billed charges,,,0.97,,1540.36,Percent of total billed charges,,,0.96,,1524.48,Percent of total billed charges,,,0.95,,1508.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1508.6,Percent of total billed charges,,1508.6,1556.24,
HC PR 64445 Injection Aa&/Strd Sciatic Nerve W/Img Gdn Cdm,PX-96310256,CDM,64445,CPT,963,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR 64445 Injection Aa&/Strd Sciatic Nerve W/Img Gdn Cdm,PX-96310256,CDM,64445,CPT,963,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
Measurement of substance using immunoassay technique,PX-30011994,CDM,83520,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Measurement of substance using immunoassay technique,PX-30011994,CDM,83520,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Molecular pathology procedure level 6 genetic analysis,PX-31010140,CDM,81405,CPT,310,RC,,inpatient,,,1056,950.4,,0.95,,1003.2,Percent of total billed charges,,,0.98,,1034.88,Percent of total billed charges,,,0.95,,1003.2,Percent of total billed charges,,,0.97,,1024.32,Percent of total billed charges,,,0.97,,1024.32,Percent of total billed charges,,,0.96,,1013.76,Percent of total billed charges,,,0.95,,1003.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1003.2,Percent of total billed charges,,1003.2,1034.88,
Molecular pathology procedure level 6 genetic analysis,PX-31010140,CDM,81405,CPT,310,RC,,outpatient,,,1056,950.4,,0.95,,1003.2,Percent of total billed charges,,,0.98,,1034.88,Percent of total billed charges,,,0.95,,1003.2,Percent of total billed charges,,,0.95,,1003.2,Percent of total billed charges,,,0.97,,1024.32,Percent of total billed charges,,,0.96,,1013.76,Percent of total billed charges,,,0.95,,1003.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1003.2,Percent of total billed charges,,1003.2,1034.88,
"Remove growth under skin of back or lower sides, =>3.0 cm",PX-36010557,CDM,21931,CPT,360,RC,,inpatient,,,1167,1050.3,,0.95,,1108.65,Percent of total billed charges,,,0.98,,1143.66,Percent of total billed charges,,,0.95,,1108.65,Percent of total billed charges,,,0.97,,1131.99,Percent of total billed charges,,,0.97,,1131.99,Percent of total billed charges,,,0.96,,1120.32,Percent of total billed charges,,,0.95,,1108.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1108.65,Percent of total billed charges,,1108.65,1143.66,
"Remove growth under skin of back or lower sides, =>3.0 cm",PX-36010557,CDM,21931,CPT,360,RC,,outpatient,,,1167,1050.3,,0.95,,1108.65,Percent of total billed charges,,,0.98,,1143.66,Percent of total billed charges,,,0.95,,1108.65,Percent of total billed charges,,,0.95,,1108.65,Percent of total billed charges,,,0.97,,1131.99,Percent of total billed charges,,,0.96,,1120.32,Percent of total billed charges,,,0.95,,1108.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1108.65,Percent of total billed charges,,1108.65,1143.66,
"Remove growth under skin of forearm or wrist, <3.0 cm",PX-36010567,CDM,25075,CPT,361,RC,,inpatient,,,1257,1131.3,,0.95,,1194.15,Percent of total billed charges,,,0.98,,1231.86,Percent of total billed charges,,,0.95,,1194.15,Percent of total billed charges,,,0.97,,1219.29,Percent of total billed charges,,,0.97,,1219.29,Percent of total billed charges,,,0.96,,1206.72,Percent of total billed charges,,,0.95,,1194.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1194.15,Percent of total billed charges,,1194.15,1231.86,
"Remove growth under skin of forearm or wrist, <3.0 cm",PX-36010567,CDM,25075,CPT,361,RC,,outpatient,,,1257,1131.3,,0.95,,1194.15,Percent of total billed charges,,,0.98,,1231.86,Percent of total billed charges,,,0.95,,1194.15,Percent of total billed charges,,,0.95,,1194.15,Percent of total billed charges,,,0.97,,1219.29,Percent of total billed charges,,,0.96,,1206.72,Percent of total billed charges,,,0.95,,1194.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1194.15,Percent of total billed charges,,1194.15,1231.86,
Insertion of drug delivery implant into tissue,PX-36110100,CDM,11981,LOCAL,361,RC,,inpatient,,,347,312.3,,0.95,,329.65,Percent of total billed charges,,,0.98,,340.06,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,0.97,,336.59,Percent of total billed charges,,,0.97,,336.59,Percent of total billed charges,,,0.96,,333.12,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,329.65,Percent of total billed charges,,329.65,340.06,
Insertion of drug delivery implant into tissue,PX-36110100,CDM,11981,LOCAL,361,RC,,outpatient,,,347,312.3,,0.95,,329.65,Percent of total billed charges,,,0.98,,340.06,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,0.97,,336.59,Percent of total billed charges,,,0.96,,333.12,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,329.65,Percent of total billed charges,,329.65,340.06,
HC PR 20604 Drain/Inj Joint/Bursa Small W/US,PX-96911040,CDM,20604,CPT,983,RC,,inpatient,,,204,183.6,,0.95,,193.8,Percent of total billed charges,,,0.98,,199.92,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.96,,195.84,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,193.8,Percent of total billed charges,,193.8,199.92,
HC PR 20604 Drain/Inj Joint/Bursa Small W/US,PX-96911040,CDM,20604,CPT,983,RC,,outpatient,,,204,183.6,,0.95,,193.8,Percent of total billed charges,,,0.98,,199.92,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.96,,195.84,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,193.8,Percent of total billed charges,,193.8,199.92,
Reattachment of part of cutoff finger,PX-45010675,CDM,20822,CPT,450,RC,,inpatient,,,2258,2032.2,,0.95,,2145.1,Percent of total billed charges,,,0.98,,2212.84,Percent of total billed charges,,,0.95,,2145.1,Percent of total billed charges,,,0.97,,2190.26,Percent of total billed charges,,,0.97,,2190.26,Percent of total billed charges,,,0.96,,2167.68,Percent of total billed charges,,,0.95,,2145.1,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2145.1,Percent of total billed charges,,2145.1,3950,
Reattachment of part of cutoff finger,PX-45010675,CDM,20822,CPT,450,RC,,outpatient,,,2258,2032.2,,0.95,,2145.1,Percent of total billed charges,,,0.98,,2212.84,Percent of total billed charges,,,0.95,,2145.1,Percent of total billed charges,,,0.95,,2145.1,Percent of total billed charges,,,0.97,,2190.26,Percent of total billed charges,,,0.96,,2167.68,Percent of total billed charges,,,0.95,,2145.1,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,2145.1,Percent of total billed charges,,2145.1,3950,
HC PR Rx Influenza Quadrivalent (Iiv4) Pf Im 0.5 Ml,PX-63610082,CDM,90686,HCPCS,636,RC,,inpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
HC PR Rx Influenza Quadrivalent (Iiv4) Pf Im 0.5 Ml,PX-63610082,CDM,90686,HCPCS,636,RC,,outpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
HC PR Rx Influenza Quadrivalent (Iiv4) Pf Im 0.25 Ml,PX-63610083,CDM,90685,HCPCS,636,RC,,inpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
HC PR Rx Influenza Quadrivalent (Iiv4) Pf Im 0.25 Ml,PX-63610083,CDM,90685,HCPCS,636,RC,,outpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
CT scan of chest without contrast,PX-35210105,CDM,71250,CPT,352,RC,,inpatient,,,1890,1701,,0.95,,1795.5,Percent of total billed charges,,,0.98,,1852.2,Percent of total billed charges,,,0.95,,1795.5,Percent of total billed charges,,,0.97,,1833.3,Percent of total billed charges,,,0.97,,1833.3,Percent of total billed charges,,,0.96,,1814.4,Percent of total billed charges,,,0.95,,1795.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1795.5,Percent of total billed charges,,1795.5,1852.2,
CT scan of chest without contrast,PX-35210105,CDM,71250,CPT,352,RC,,outpatient,,,1890,1701,,0.95,,1795.5,Percent of total billed charges,,,0.98,,1852.2,Percent of total billed charges,,,0.95,,1795.5,Percent of total billed charges,,,0.95,,1795.5,Percent of total billed charges,,,0.97,,1833.3,Percent of total billed charges,,,0.96,,1814.4,Percent of total billed charges,,,0.95,,1795.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1795.5,Percent of total billed charges,,1795.5,1852.2,
HC PR Rx Vitamin B12 Inj 1000 Mcg,PX-63610135,CDM,J3420,HCPCS,636,RC,,inpatient,,,23,20.7,,0.95,,21.85,Percent of total billed charges,,,0.98,,22.54,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.96,,22.08,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,21.85,Percent of total billed charges,,21.85,22.54,
HC PR Rx Vitamin B12 Inj 1000 Mcg,PX-63610135,CDM,J3420,HCPCS,636,RC,,outpatient,,,23,20.7,,0.95,,21.85,Percent of total billed charges,,,0.98,,22.54,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.96,,22.08,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,21.85,Percent of total billed charges,,21.85,22.54,
HC US Breast Uni Complete,PX-40210136,CDM,76641,CPT,402,RC,,inpatient,,,573,515.7,,0.95,,544.35,Percent of total billed charges,,,0.98,,561.54,Percent of total billed charges,,,0.95,,544.35,Percent of total billed charges,,,0.97,,555.81,Percent of total billed charges,,,0.97,,555.81,Percent of total billed charges,,,0.96,,550.08,Percent of total billed charges,,,0.95,,544.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,544.35,Percent of total billed charges,,544.35,561.54,
HC US Breast Uni Complete,PX-40210136,CDM,76641,CPT,402,RC,,outpatient,,,573,515.7,,0.95,,544.35,Percent of total billed charges,,,0.98,,561.54,Percent of total billed charges,,,0.95,,544.35,Percent of total billed charges,,,0.95,,544.35,Percent of total billed charges,,,0.97,,555.81,Percent of total billed charges,,,0.96,,550.08,Percent of total billed charges,,,0.95,,544.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,544.35,Percent of total billed charges,,544.35,561.54,
Limited ultrasound scan of 1 breast,PX-40210137,CDM,76642,CPT,402,RC,,inpatient,,,556,500.4,,0.95,,528.2,Percent of total billed charges,,,0.98,,544.88,Percent of total billed charges,,,0.95,,528.2,Percent of total billed charges,,,0.97,,539.32,Percent of total billed charges,,,0.97,,539.32,Percent of total billed charges,,,0.96,,533.76,Percent of total billed charges,,,0.95,,528.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,528.2,Percent of total billed charges,,528.2,544.88,
Limited ultrasound scan of 1 breast,PX-40210137,CDM,76642,CPT,402,RC,,outpatient,,,556,500.4,,0.95,,528.2,Percent of total billed charges,,,0.98,,544.88,Percent of total billed charges,,,0.95,,528.2,Percent of total billed charges,,,0.95,,528.2,Percent of total billed charges,,,0.97,,539.32,Percent of total billed charges,,,0.96,,533.76,Percent of total billed charges,,,0.95,,528.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,528.2,Percent of total billed charges,,528.2,544.88,
Screening 3D breast mammography,PX-40110020,CDM,77063,CPT,403,RC,,inpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
Screening 3D breast mammography,PX-40110020,CDM,77063,CPT,403,RC,,outpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
Alcohols levels,PX-30110635,CDM,80320,CPT,301,RC,,inpatient,,,217,195.3,,0.95,,206.15,Percent of total billed charges,,,0.98,,212.66,Percent of total billed charges,,,0.95,,206.15,Percent of total billed charges,,,0.97,,210.49,Percent of total billed charges,,,0.97,,210.49,Percent of total billed charges,,,0.96,,208.32,Percent of total billed charges,,,0.95,,206.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,206.15,Percent of total billed charges,,206.15,212.66,
Alcohols levels,PX-30110635,CDM,80320,CPT,301,RC,,outpatient,,,217,195.3,,0.95,,206.15,Percent of total billed charges,,,0.98,,212.66,Percent of total billed charges,,,0.95,,206.15,Percent of total billed charges,,,0.95,,206.15,Percent of total billed charges,,,0.97,,210.49,Percent of total billed charges,,,0.96,,208.32,Percent of total billed charges,,,0.95,,206.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,206.15,Percent of total billed charges,,206.15,212.66,
Alkaloids levels,PX-30110638,CDM,80323,CPT,301,RC,,inpatient,,,167,150.3,,0.95,,158.65,Percent of total billed charges,,,0.98,,163.66,Percent of total billed charges,,,0.95,,158.65,Percent of total billed charges,,,0.97,,161.99,Percent of total billed charges,,,0.97,,161.99,Percent of total billed charges,,,0.96,,160.32,Percent of total billed charges,,,0.95,,158.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,158.65,Percent of total billed charges,,158.65,163.66,
Alkaloids levels,PX-30110638,CDM,80323,CPT,301,RC,,outpatient,,,167,150.3,,0.95,,158.65,Percent of total billed charges,,,0.98,,163.66,Percent of total billed charges,,,0.95,,158.65,Percent of total billed charges,,,0.95,,158.65,Percent of total billed charges,,,0.97,,161.99,Percent of total billed charges,,,0.96,,160.32,Percent of total billed charges,,,0.95,,158.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,158.65,Percent of total billed charges,,158.65,163.66,
"Analgesics levels, 1 or 2",PX-30110644,CDM,80329,CPT,301,RC,,inpatient,,,181,162.9,,0.95,,171.95,Percent of total billed charges,,,0.98,,177.38,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,0.97,,175.57,Percent of total billed charges,,,0.97,,175.57,Percent of total billed charges,,,0.96,,173.76,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,171.95,Percent of total billed charges,,171.95,177.38,
"Analgesics levels, 1 or 2",PX-30110644,CDM,80329,CPT,301,RC,,outpatient,,,181,162.9,,0.95,,171.95,Percent of total billed charges,,,0.98,,177.38,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,0.97,,175.57,Percent of total billed charges,,,0.96,,173.76,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,171.95,Percent of total billed charges,,171.95,177.38,
"Antidepressant levels, 1 or 2 (serotonergic class)",PX-30110647,CDM,80332,CPT,301,RC,,inpatient,,,841,756.9,,0.95,,798.95,Percent of total billed charges,,,0.98,,824.18,Percent of total billed charges,,,0.95,,798.95,Percent of total billed charges,,,0.97,,815.77,Percent of total billed charges,,,0.97,,815.77,Percent of total billed charges,,,0.96,,807.36,Percent of total billed charges,,,0.95,,798.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,798.95,Percent of total billed charges,,798.95,824.18,
"Antidepressant levels, 1 or 2 (serotonergic class)",PX-30110647,CDM,80332,CPT,301,RC,,outpatient,,,841,756.9,,0.95,,798.95,Percent of total billed charges,,,0.98,,824.18,Percent of total billed charges,,,0.95,,798.95,Percent of total billed charges,,,0.95,,798.95,Percent of total billed charges,,,0.97,,815.77,Percent of total billed charges,,,0.96,,807.36,Percent of total billed charges,,,0.95,,798.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,798.95,Percent of total billed charges,,798.95,824.18,
"Antiepileptics levels, 1-3",PX-30110654,CDM,80339,CPT,301,RC,,inpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
"Antiepileptics levels, 1-3",PX-30110654,CDM,80339,CPT,301,RC,,outpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
"Antipsychotics levels, 1-3",PX-30110657,CDM,80342,CPT,301,RC,,inpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
"Antipsychotics levels, 1-3",PX-30110657,CDM,80342,CPT,301,RC,,outpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
"Cannabinoids levels, natural",PX-30110664,CDM,80349,CPT,301,RC,,inpatient,,,90,81,,0.95,,85.5,Percent of total billed charges,,,0.98,,88.2,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,0.97,,87.3,Percent of total billed charges,,,0.97,,87.3,Percent of total billed charges,,,0.96,,86.4,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,85.5,Percent of total billed charges,,85.5,88.2,
"Cannabinoids levels, natural",PX-30110664,CDM,80349,CPT,301,RC,,outpatient,,,90,81,,0.95,,85.5,Percent of total billed charges,,,0.98,,88.2,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,0.97,,87.3,Percent of total billed charges,,,0.96,,86.4,Percent of total billed charges,,,0.95,,85.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,85.5,Percent of total billed charges,,85.5,88.2,
Methylphenidate level,PX-30110675,CDM,80360,CPT,301,RC,,inpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Methylphenidate level,PX-30110675,CDM,80360,CPT,301,RC,,outpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Test for detecting genes associated with colon cancer,PX-31010655,CDM,81435,CPT,310,RC,,inpatient,,,1994,1794.6,,0.95,,1894.3,Percent of total billed charges,,,0.98,,1954.12,Percent of total billed charges,,,0.95,,1894.3,Percent of total billed charges,,,0.97,,1934.18,Percent of total billed charges,,,0.97,,1934.18,Percent of total billed charges,,,0.96,,1914.24,Percent of total billed charges,,,0.95,,1894.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1894.3,Percent of total billed charges,,1894.3,1954.12,
Test for detecting genes associated with colon cancer,PX-31010655,CDM,81435,CPT,310,RC,,outpatient,,,1994,1794.6,,0.95,,1894.3,Percent of total billed charges,,,0.98,,1954.12,Percent of total billed charges,,,0.95,,1894.3,Percent of total billed charges,,,0.95,,1894.3,Percent of total billed charges,,,0.97,,1934.18,Percent of total billed charges,,,0.96,,1914.24,Percent of total billed charges,,,0.95,,1894.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1894.3,Percent of total billed charges,,1894.3,1954.12,
Test for detecting genes associated with colon cancer,PX-31010656,CDM,81436,CPT,310,RC,,inpatient,,,1994,1794.6,,0.95,,1894.3,Percent of total billed charges,,,0.98,,1954.12,Percent of total billed charges,,,0.95,,1894.3,Percent of total billed charges,,,0.97,,1934.18,Percent of total billed charges,,,0.97,,1934.18,Percent of total billed charges,,,0.96,,1914.24,Percent of total billed charges,,,0.95,,1894.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1894.3,Percent of total billed charges,,1894.3,1954.12,
Test for detecting genes associated with colon cancer,PX-31010656,CDM,81436,CPT,310,RC,,outpatient,,,1994,1794.6,,0.95,,1894.3,Percent of total billed charges,,,0.98,,1954.12,Percent of total billed charges,,,0.95,,1894.3,Percent of total billed charges,,,0.95,,1894.3,Percent of total billed charges,,,0.97,,1934.18,Percent of total billed charges,,,0.96,,1914.24,Percent of total billed charges,,,0.95,,1894.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1894.3,Percent of total billed charges,,1894.3,1954.12,
Special stained specimen slides to exam tissue each add,PX-31010667,CDM,88341,CPT,310,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Special stained specimen slides to exam tissue each add,PX-31010667,CDM,88341,CPT,310,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Special stained specimen slides to exam tissue each add,PX-31010668,CDM,88344,CPT,310,RC,,inpatient,,,176,158.4,,0.95,,167.2,Percent of total billed charges,,,0.98,,172.48,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,0.97,,170.72,Percent of total billed charges,,,0.97,,170.72,Percent of total billed charges,,,0.96,,168.96,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,,,,,,,0.95,,167.2,Percent of total billed charges,,167.2,172.48,
Special stained specimen slides to exam tissue each add,PX-31010668,CDM,88344,CPT,310,RC,,outpatient,,,176,158.4,,0.95,,167.2,Percent of total billed charges,,,0.98,,172.48,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,0.97,,170.72,Percent of total billed charges,,,0.96,,168.96,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,,,,,,,0.95,,167.2,Percent of total billed charges,,167.2,172.48,
Microscopic genetic analysis tissue manual multiplex,PX-31010674,CDM,88377,CPT,310,RC,,inpatient,,,1417,1275.3,,0.95,,1346.15,Percent of total billed charges,,,0.98,,1388.66,Percent of total billed charges,,,0.95,,1346.15,Percent of total billed charges,,,0.97,,1374.49,Percent of total billed charges,,,0.97,,1374.49,Percent of total billed charges,,,0.96,,1360.32,Percent of total billed charges,,,0.95,,1346.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1346.15,Percent of total billed charges,,1346.15,1388.66,
Microscopic genetic analysis tissue manual multiplex,PX-31010674,CDM,88377,CPT,310,RC,,outpatient,,,1417,1275.3,,0.95,,1346.15,Percent of total billed charges,,,0.98,,1388.66,Percent of total billed charges,,,0.95,,1346.15,Percent of total billed charges,,,0.95,,1346.15,Percent of total billed charges,,,0.97,,1374.49,Percent of total billed charges,,,0.96,,1360.32,Percent of total billed charges,,,0.95,,1346.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1346.15,Percent of total billed charges,,1346.15,1388.66,
HC PR Rx 9vhpv Vaccine 2/3 Dose Im 0.5 Ml,PX-63610089,CDM,90651,HCPCS,636,RC,,inpatient,,,475,427.5,,0.95,,451.25,Percent of total billed charges,,,0.98,,465.5,Percent of total billed charges,,,0.95,,451.25,Percent of total billed charges,,,0.97,,460.75,Percent of total billed charges,,,0.97,,460.75,Percent of total billed charges,,,0.96,,456,Percent of total billed charges,,,0.95,,451.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,451.25,Percent of total billed charges,,451.25,465.5,
HC PR Rx 9vhpv Vaccine 2/3 Dose Im 0.5 Ml,PX-63610089,CDM,90651,HCPCS,636,RC,,outpatient,,,475,427.5,,0.95,,451.25,Percent of total billed charges,,,0.98,,465.5,Percent of total billed charges,,,0.95,,451.25,Percent of total billed charges,,,0.95,,451.25,Percent of total billed charges,,,0.97,,460.75,Percent of total billed charges,,,0.96,,456,Percent of total billed charges,,,0.95,,451.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,451.25,Percent of total billed charges,,451.25,465.5,
HC PR 20606 Drain/Inj Joint/Bursa Intermediate W/US,PX-96911041,CDM,20606,CPT,983,RC,,inpatient,,,272,244.8,,0.95,,258.4,Percent of total billed charges,,,0.98,,266.56,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,0.97,,263.84,Percent of total billed charges,,,0.97,,263.84,Percent of total billed charges,,,0.96,,261.12,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,258.4,Percent of total billed charges,,258.4,266.56,
HC PR 20606 Drain/Inj Joint/Bursa Intermediate W/US,PX-96911041,CDM,20606,CPT,983,RC,,outpatient,,,272,244.8,,0.95,,258.4,Percent of total billed charges,,,0.98,,266.56,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,0.97,,263.84,Percent of total billed charges,,,0.96,,261.12,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,258.4,Percent of total billed charges,,258.4,266.56,
HC PR 20611 Drain/Inj Joint/Bursa Major W/US,PX-96911042,CDM,20611,CPT,975,RC,,inpatient,,,245,220.5,,0.95,,232.75,Percent of total billed charges,,,0.98,,240.1,Percent of total billed charges,,,0.95,,232.75,Percent of total billed charges,,,0.97,,237.65,Percent of total billed charges,,,0.97,,237.65,Percent of total billed charges,,,0.96,,235.2,Percent of total billed charges,,,0.95,,232.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,232.75,Percent of total billed charges,,232.75,240.1,
HC PR 20611 Drain/Inj Joint/Bursa Major W/US,PX-96911042,CDM,20611,CPT,975,RC,,outpatient,,,245,220.5,,0.95,,232.75,Percent of total billed charges,,,0.98,,240.1,Percent of total billed charges,,,0.95,,232.75,Percent of total billed charges,,,0.95,,232.75,Percent of total billed charges,,,0.97,,237.65,Percent of total billed charges,,,0.96,,235.2,Percent of total billed charges,,,0.95,,232.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,232.75,Percent of total billed charges,,232.75,240.1,
HC PR 45349 Sigmoidoscopy W/Resection,PX-96911101,CDM,45349,CPT,983,RC,,inpatient,,,514,462.6,,0.95,,488.3,Percent of total billed charges,,,0.98,,503.72,Percent of total billed charges,,,0.95,,488.3,Percent of total billed charges,,,0.97,,498.58,Percent of total billed charges,,,0.97,,498.58,Percent of total billed charges,,,0.96,,493.44,Percent of total billed charges,,,0.95,,488.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,488.3,Percent of total billed charges,,488.3,503.72,
HC PR 45349 Sigmoidoscopy W/Resection,PX-96911101,CDM,45349,CPT,983,RC,,outpatient,,,514,462.6,,0.95,,488.3,Percent of total billed charges,,,0.98,,503.72,Percent of total billed charges,,,0.95,,488.3,Percent of total billed charges,,,0.95,,488.3,Percent of total billed charges,,,0.97,,498.58,Percent of total billed charges,,,0.96,,493.44,Percent of total billed charges,,,0.95,,488.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,488.3,Percent of total billed charges,,488.3,503.72,
HC PR 45350 Sgmdsc W/Band Ligation,PX-96911102,CDM,45350,CPT,983,RC,,inpatient,,,1636,1472.4,,0.95,,1554.2,Percent of total billed charges,,,0.98,,1603.28,Percent of total billed charges,,,0.95,,1554.2,Percent of total billed charges,,,0.97,,1586.92,Percent of total billed charges,,,0.97,,1586.92,Percent of total billed charges,,,0.96,,1570.56,Percent of total billed charges,,,0.95,,1554.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1554.2,Percent of total billed charges,,1554.2,1603.28,
HC PR 45350 Sgmdsc W/Band Ligation,PX-96911102,CDM,45350,CPT,983,RC,,outpatient,,,1636,1472.4,,0.95,,1554.2,Percent of total billed charges,,,0.98,,1603.28,Percent of total billed charges,,,0.95,,1554.2,Percent of total billed charges,,,0.95,,1554.2,Percent of total billed charges,,,0.97,,1586.92,Percent of total billed charges,,,0.96,,1570.56,Percent of total billed charges,,,0.95,,1554.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1554.2,Percent of total billed charges,,1554.2,1603.28,
HC PR 45388 Colonoscopy W/Ablation,PX-96911103,CDM,45388,CPT,983,RC,,inpatient,,,7571,6813.9,,0.95,,7192.45,Percent of total billed charges,,,0.98,,7419.58,Percent of total billed charges,,,0.95,,7192.45,Percent of total billed charges,,,0.97,,7343.87,Percent of total billed charges,,,0.97,,7343.87,Percent of total billed charges,,,0.96,,7268.16,Percent of total billed charges,,,0.95,,7192.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,7192.45,Percent of total billed charges,,7192.45,7419.58,
HC PR 45388 Colonoscopy W/Ablation,PX-96911103,CDM,45388,CPT,983,RC,,outpatient,,,7571,6813.9,,0.95,,7192.45,Percent of total billed charges,,,0.98,,7419.58,Percent of total billed charges,,,0.95,,7192.45,Percent of total billed charges,,,0.95,,7192.45,Percent of total billed charges,,,0.97,,7343.87,Percent of total billed charges,,,0.96,,7268.16,Percent of total billed charges,,,0.95,,7192.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,7192.45,Percent of total billed charges,,7192.45,7419.58,
HC PR 45398 Colonoscopy W/Band Ligation,PX-96911107,CDM,45398,CPT,983,RC,,inpatient,,,2008,1807.2,,0.95,,1907.6,Percent of total billed charges,,,0.98,,1967.84,Percent of total billed charges,,,0.95,,1907.6,Percent of total billed charges,,,0.97,,1947.76,Percent of total billed charges,,,0.97,,1947.76,Percent of total billed charges,,,0.96,,1927.68,Percent of total billed charges,,,0.95,,1907.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1907.6,Percent of total billed charges,,1907.6,1967.84,
HC PR 45398 Colonoscopy W/Band Ligation,PX-96911107,CDM,45398,CPT,983,RC,,outpatient,,,2008,1807.2,,0.95,,1907.6,Percent of total billed charges,,,0.98,,1967.84,Percent of total billed charges,,,0.95,,1907.6,Percent of total billed charges,,,0.95,,1907.6,Percent of total billed charges,,,0.97,,1947.76,Percent of total billed charges,,,0.96,,1927.68,Percent of total billed charges,,,0.95,,1907.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1907.6,Percent of total billed charges,,1907.6,1967.84,
"HC Tomosynthesis, Mammo Uni or Bil Diagnostic",PX-40110021,CDM,G0279,HCPCS,401,RC,,inpatient,,,120,108,,0.95,,114,Percent of total billed charges,,,0.98,,117.6,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.96,,115.2,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114,Percent of total billed charges,,114,117.6,
"HC Tomosynthesis, Mammo Uni or Bil Diagnostic",PX-40110021,CDM,G0279,HCPCS,401,RC,,outpatient,,,120,108,,0.95,,114,Percent of total billed charges,,,0.98,,117.6,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.96,,115.2,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114,Percent of total billed charges,,114,117.6,
Rx Testosterone Cypionate Inj 1 Mg,PX-63610157,CDM,J1071,HCPCS,636,RC,,inpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,0.01,Percent of total billed charges,,0.01,0.01,
Rx Testosterone Cypionate Inj 1 Mg,PX-63610157,CDM,J1071,HCPCS,636,RC,,outpatient,,,0.01,0.01,,0.95,,0.01,Percent of total billed charges,,,0.98,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,0.97,,0.01,Percent of total billed charges,,,0.96,,0.01,Percent of total billed charges,,,0.95,,0.01,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,0.01,Percent of total billed charges,,0.01,0.01,
HC Iadna Streptococcus Group a Amplified Probe Tq,PX-30610056,CDM,87651,CPT,306,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
HC Iadna Streptococcus Group a Amplified Probe Tq,PX-30610056,CDM,87651,CPT,306,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
"Test by nucleic acid for HPV, high-risk types",PX-30114312,CDM,87624,CPT,300,RC,,inpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
"Test by nucleic acid for HPV, high-risk types",PX-30114312,CDM,87624,CPT,300,RC,,outpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
Gabapentin level non-blood,PX-30114343,CDM,80355,CPT,301,RC,,inpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
Gabapentin level non-blood,PX-30114343,CDM,80355,CPT,301,RC,,outpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
Methadone level,PX-30110694,CDM,80358,CPT,301,RC,,inpatient,,,156,140.4,,0.95,,148.2,Percent of total billed charges,,,0.98,,152.88,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,0.97,,151.32,Percent of total billed charges,,,0.97,,151.32,Percent of total billed charges,,,0.96,,149.76,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,148.2,Percent of total billed charges,,148.2,152.88,
Methadone level,PX-30110694,CDM,80358,CPT,301,RC,,outpatient,,,156,140.4,,0.95,,148.2,Percent of total billed charges,,,0.98,,152.88,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,0.97,,151.32,Percent of total billed charges,,,0.96,,149.76,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,148.2,Percent of total billed charges,,148.2,152.88,
"Tuberculosis test, enumeration of T-cells",PX-30012379,CDM,86481,CPT,302,RC,,inpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
"Tuberculosis test, enumeration of T-cells",PX-30012379,CDM,86481,CPT,302,RC,,outpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
HC PR Rx Betamethasone Acet&Sod Phosp Inj 3 Mg,PX-63610180,CDM,J0702,HCPCS,636,RC,,inpatient,,,340,306,,0.95,,323,Percent of total billed charges,,,0.98,,333.2,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.96,,326.4,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,323,Percent of total billed charges,,323,333.2,
HC PR Rx Betamethasone Acet&Sod Phosp Inj 3 Mg,PX-63610180,CDM,J0702,HCPCS,636,RC,,outpatient,,,340,306,,0.95,,323,Percent of total billed charges,,,0.98,,333.2,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.96,,326.4,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,323,Percent of total billed charges,,323,333.2,
Test by immunoassay w/direct observation for COVID-19,PX-30600089,CDM,87811,CPT,306,RC,,inpatient,,,55,49.5,,0.95,,52.25,Percent of total billed charges,,,0.98,,53.9,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.96,,52.8,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,52.25,Percent of total billed charges,,52.25,53.9,
Test by immunoassay w/direct observation for COVID-19,PX-30600089,CDM,87811,CPT,306,RC,,outpatient,,,55,49.5,,0.95,,52.25,Percent of total billed charges,,,0.98,,53.9,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.96,,52.8,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,52.25,Percent of total billed charges,,52.25,53.9,
Initial psych collaborative care 1st month 1st 70 m,PX-90000033,CDM,99492,CPT,900,RC,,inpatient,,,345,310.5,,0.95,,327.75,Percent of total billed charges,,,0.98,,338.1,Percent of total billed charges,,,0.95,,327.75,Percent of total billed charges,,,0.97,,334.65,Percent of total billed charges,,,0.97,,334.65,Percent of total billed charges,,,0.96,,331.2,Percent of total billed charges,,,0.95,,327.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,327.75,Percent of total billed charges,,327.75,338.1,
Initial psych collaborative care 1st month 1st 70 m,PX-90000033,CDM,99492,CPT,900,RC,,outpatient,,,345,310.5,,0.95,,327.75,Percent of total billed charges,,,0.98,,338.1,Percent of total billed charges,,,0.95,,327.75,Percent of total billed charges,,,0.95,,327.75,Percent of total billed charges,,,0.97,,334.65,Percent of total billed charges,,,0.96,,331.2,Percent of total billed charges,,,0.95,,327.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,327.75,Percent of total billed charges,,327.75,338.1,
"Follow-up psych collaborative care management, 1st 60m",PX-90000034,CDM,99493,CPT,900,RC,,inpatient,,,326,293.4,,0.95,,309.7,Percent of total billed charges,,,0.98,,319.48,Percent of total billed charges,,,0.95,,309.7,Percent of total billed charges,,,0.97,,316.22,Percent of total billed charges,,,0.97,,316.22,Percent of total billed charges,,,0.96,,312.96,Percent of total billed charges,,,0.95,,309.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,309.7,Percent of total billed charges,,309.7,319.48,
"Follow-up psych collaborative care management, 1st 60m",PX-90000034,CDM,99493,CPT,900,RC,,outpatient,,,326,293.4,,0.95,,309.7,Percent of total billed charges,,,0.98,,319.48,Percent of total billed charges,,,0.95,,309.7,Percent of total billed charges,,,0.95,,309.7,Percent of total billed charges,,,0.97,,316.22,Percent of total billed charges,,,0.96,,312.96,Percent of total billed charges,,,0.95,,309.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,309.7,Percent of total billed charges,,309.7,319.48,
"Psych collaborative care management each additional, 30 m",PX-90000035,CDM,99494,CPT,900,RC,,inpatient,,,132,118.8,,0.95,,125.4,Percent of total billed charges,,,0.98,,129.36,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.96,,126.72,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,125.4,Percent of total billed charges,,125.4,129.36,
"Psych collaborative care management each additional, 30 m",PX-90000035,CDM,99494,CPT,900,RC,,outpatient,,,132,118.8,,0.95,,125.4,Percent of total billed charges,,,0.98,,129.36,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.96,,126.72,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,125.4,Percent of total billed charges,,125.4,129.36,
HC PR 28060 Fasciectomy Plantar Fascia Partial Spx,PX-97500059,CDM,28060,CPT,975,RC,,inpatient,,,506,455.4,,0.95,,480.7,Percent of total billed charges,,,0.98,,495.88,Percent of total billed charges,,,0.95,,480.7,Percent of total billed charges,,,0.97,,490.82,Percent of total billed charges,,,0.97,,490.82,Percent of total billed charges,,,0.96,,485.76,Percent of total billed charges,,,0.95,,480.7,Percent of total billed charges,,,,,,,,,0.95,,480.7,Percent of total billed charges,,480.7,495.88,
HC PR 28060 Fasciectomy Plantar Fascia Partial Spx,PX-97500059,CDM,28060,CPT,975,RC,,outpatient,,,506,455.4,,0.95,,480.7,Percent of total billed charges,,,0.98,,495.88,Percent of total billed charges,,,0.95,,480.7,Percent of total billed charges,,,0.95,,480.7,Percent of total billed charges,,,0.97,,490.82,Percent of total billed charges,,,0.96,,485.76,Percent of total billed charges,,,0.95,,480.7,Percent of total billed charges,,,,,,,,,0.95,,480.7,Percent of total billed charges,,480.7,495.88,
Gene analysis (tumor protein 53) full sequence analysis,PX-31000044,CDM,81351,CPT,310,RC,,inpatient,,,1983,1784.7,,0.95,,1883.85,Percent of total billed charges,,,0.98,,1943.34,Percent of total billed charges,,,0.95,,1883.85,Percent of total billed charges,,,0.97,,1923.51,Percent of total billed charges,,,0.97,,1923.51,Percent of total billed charges,,,0.96,,1903.68,Percent of total billed charges,,,0.95,,1883.85,Percent of total billed charges,,,,,,,,,0.95,,1883.85,Percent of total billed charges,,1883.85,1943.34,
Gene analysis (tumor protein 53) full sequence analysis,PX-31000044,CDM,81351,CPT,310,RC,,outpatient,,,1983,1784.7,,0.95,,1883.85,Percent of total billed charges,,,0.98,,1943.34,Percent of total billed charges,,,0.95,,1883.85,Percent of total billed charges,,,0.95,,1883.85,Percent of total billed charges,,,0.97,,1923.51,Percent of total billed charges,,,0.96,,1903.68,Percent of total billed charges,,,0.95,,1883.85,Percent of total billed charges,,,,,,,,,0.95,,1883.85,Percent of total billed charges,,1883.85,1943.34,
Gene analysis (Janus kinase 2) targeted sequence analysis,PX-31000045,CDM,81279,CPT,310,RC,,inpatient,,,573,515.7,,0.95,,544.35,Percent of total billed charges,,,0.98,,561.54,Percent of total billed charges,,,0.95,,544.35,Percent of total billed charges,,,0.97,,555.81,Percent of total billed charges,,,0.97,,555.81,Percent of total billed charges,,,0.96,,550.08,Percent of total billed charges,,,0.95,,544.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,544.35,Percent of total billed charges,,544.35,561.54,
Gene analysis (Janus kinase 2) targeted sequence analysis,PX-31000045,CDM,81279,CPT,310,RC,,outpatient,,,573,515.7,,0.95,,544.35,Percent of total billed charges,,,0.98,,561.54,Percent of total billed charges,,,0.95,,544.35,Percent of total billed charges,,,0.95,,544.35,Percent of total billed charges,,,0.97,,555.81,Percent of total billed charges,,,0.96,,550.08,Percent of total billed charges,,,0.95,,544.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,544.35,Percent of total billed charges,,544.35,561.54,
Gene analysis of common variants,PX-31000046,CDM,81338,CPT,310,RC,,inpatient,,,465,418.5,,0.95,,441.75,Percent of total billed charges,,,0.98,,455.7,Percent of total billed charges,,,0.95,,441.75,Percent of total billed charges,,,0.97,,451.05,Percent of total billed charges,,,0.97,,451.05,Percent of total billed charges,,,0.96,,446.4,Percent of total billed charges,,,0.95,,441.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,441.75,Percent of total billed charges,,441.75,455.7,
Gene analysis of common variants,PX-31000046,CDM,81338,CPT,310,RC,,outpatient,,,465,418.5,,0.95,,441.75,Percent of total billed charges,,,0.98,,455.7,Percent of total billed charges,,,0.95,,441.75,Percent of total billed charges,,,0.95,,441.75,Percent of total billed charges,,,0.97,,451.05,Percent of total billed charges,,,0.96,,446.4,Percent of total billed charges,,,0.95,,441.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,441.75,Percent of total billed charges,,441.75,455.7,
HC PR G2212 Prolong Outpt/Office Vis Rhc,PX-52100099,CDM,G2212,CPT,521,RC,,inpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
HC PR G2212 Prolong Outpt/Office Vis Rhc,PX-52100099,CDM,G2212,CPT,521,RC,,outpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
Alkaloids levels,PX-30100117,CDM,80323,CPT,301,RC,,inpatient,,,167,150.3,,0.95,,158.65,Percent of total billed charges,,,0.98,,163.66,Percent of total billed charges,,,0.95,,158.65,Percent of total billed charges,,,0.97,,161.99,Percent of total billed charges,,,0.97,,161.99,Percent of total billed charges,,,0.96,,160.32,Percent of total billed charges,,,0.95,,158.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,158.65,Percent of total billed charges,,158.65,163.66,
Alkaloids levels,PX-30100117,CDM,80323,CPT,301,RC,,outpatient,,,167,150.3,,0.95,,158.65,Percent of total billed charges,,,0.98,,163.66,Percent of total billed charges,,,0.95,,158.65,Percent of total billed charges,,,0.95,,158.65,Percent of total billed charges,,,0.97,,161.99,Percent of total billed charges,,,0.96,,160.32,Percent of total billed charges,,,0.95,,158.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,158.65,Percent of total billed charges,,158.65,163.66,
Measurement of substance using immunoassay technique,PX-30100118,CDM,83520,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Measurement of substance using immunoassay technique,PX-30100118,CDM,83520,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
"Thyroid hormone, T3 measurement, total",PX-30100119,CDM,84480,CPT,301,RC,,inpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
"Thyroid hormone, T3 measurement, total",PX-30100119,CDM,84480,CPT,301,RC,,outpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
Measurement of substance using immunoassay technique,PX-30100121,CDM,83520,CPT,301,RC,,inpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
Measurement of substance using immunoassay technique,PX-30100121,CDM,83520,CPT,301,RC,,outpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
Alkaloids levels,PX-30100122,CDM,80323,CPT,301,RC,,inpatient,,,167,150.3,,0.95,,158.65,Percent of total billed charges,,,0.98,,163.66,Percent of total billed charges,,,0.95,,158.65,Percent of total billed charges,,,0.97,,161.99,Percent of total billed charges,,,0.97,,161.99,Percent of total billed charges,,,0.96,,160.32,Percent of total billed charges,,,0.95,,158.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,158.65,Percent of total billed charges,,158.65,163.66,
Alkaloids levels,PX-30100122,CDM,80323,CPT,301,RC,,outpatient,,,167,150.3,,0.95,,158.65,Percent of total billed charges,,,0.98,,163.66,Percent of total billed charges,,,0.95,,158.65,Percent of total billed charges,,,0.95,,158.65,Percent of total billed charges,,,0.97,,161.99,Percent of total billed charges,,,0.96,,160.32,Percent of total billed charges,,,0.95,,158.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,158.65,Percent of total billed charges,,158.65,163.66,
"Thyroid hormone, T3 measurement, free",PX-30100123,CDM,84481,CPT,301,RC,,inpatient,,,233,209.7,,0.95,,221.35,Percent of total billed charges,,,0.98,,228.34,Percent of total billed charges,,,0.95,,221.35,Percent of total billed charges,,,0.97,,226.01,Percent of total billed charges,,,0.97,,226.01,Percent of total billed charges,,,0.96,,223.68,Percent of total billed charges,,,0.95,,221.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,221.35,Percent of total billed charges,,221.35,228.34,
"Thyroid hormone, T3 measurement, free",PX-30100123,CDM,84481,CPT,301,RC,,outpatient,,,233,209.7,,0.95,,221.35,Percent of total billed charges,,,0.98,,228.34,Percent of total billed charges,,,0.95,,221.35,Percent of total billed charges,,,0.95,,221.35,Percent of total billed charges,,,0.97,,226.01,Percent of total billed charges,,,0.96,,223.68,Percent of total billed charges,,,0.95,,221.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,221.35,Percent of total billed charges,,221.35,228.34,
"Thyroid hormone, T3 measurement, total",PX-30100124,CDM,84480,CPT,301,RC,,inpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
"Thyroid hormone, T3 measurement, total",PX-30100124,CDM,84480,CPT,301,RC,,outpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
"Thyroid hormone, T3 measurement, free",PX-30100125,CDM,84481,CPT,301,RC,,inpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
"Thyroid hormone, T3 measurement, free",PX-30100125,CDM,84481,CPT,301,RC,,outpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
"Gonadotropin, chorionic (reproductive hormone) level",PX-30100126,CDM,84702,CPT,301,RC,,inpatient,,,185,166.5,,0.95,,175.75,Percent of total billed charges,,,0.98,,181.3,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,0.97,,179.45,Percent of total billed charges,,,0.97,,179.45,Percent of total billed charges,,,0.96,,177.6,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,175.75,Percent of total billed charges,,175.75,181.3,
"Gonadotropin, chorionic (reproductive hormone) level",PX-30100126,CDM,84702,CPT,301,RC,,outpatient,,,185,166.5,,0.95,,175.75,Percent of total billed charges,,,0.98,,181.3,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,0.97,,179.45,Percent of total billed charges,,,0.96,,177.6,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,175.75,Percent of total billed charges,,175.75,181.3,
"Alpha-fetoprotein (AFP) level, serum",PX-30100127,CDM,82105,CPT,301,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
"Alpha-fetoprotein (AFP) level, serum",PX-30100127,CDM,82105,CPT,301,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Estriol (hormone) level,PX-30100128,CDM,82677,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Estriol (hormone) level,PX-30100128,CDM,82677,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
"Gonadotropin, chorionic (reproductive hormone) level",PX-30100129,CDM,84702,CPT,301,RC,,inpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
"Gonadotropin, chorionic (reproductive hormone) level",PX-30100129,CDM,84702,CPT,301,RC,,outpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
IgE (immune system protein) level,PX-30100130,CDM,82785,CPT,301,RC,,inpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
IgE (immune system protein) level,PX-30100130,CDM,82785,CPT,301,RC,,outpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
"Cortisol (hormone) measurement, free",PX-30100131,CDM,82530,CPT,301,RC,,inpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
"Cortisol (hormone) measurement, free",PX-30100131,CDM,82530,CPT,301,RC,,outpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
Angiotensin l - converting enzyme (ACE) level,PX-30100132,CDM,82164,CPT,301,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Angiotensin l - converting enzyme (ACE) level,PX-30100132,CDM,82164,CPT,301,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Gammaglobulin test,PX-30100133,CDM,82784,CPT,301,RC,,inpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
Gammaglobulin test,PX-30100133,CDM,82784,CPT,301,RC,,outpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
Gammaglobulin test,PX-30100134,CDM,82784,CPT,301,RC,,inpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
Gammaglobulin test,PX-30100134,CDM,82784,CPT,301,RC,,outpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
Gammaglobulin test,PX-30100135,CDM,82784,CPT,301,RC,,inpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
Gammaglobulin test,PX-30100135,CDM,82784,CPT,301,RC,,outpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
Measurement of total estradiol (hormone),PX-30100136,CDM,82670,CPT,301,RC,,inpatient,,,206,185.4,,0.95,,195.7,Percent of total billed charges,,,0.98,,201.88,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.96,,197.76,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,195.7,Percent of total billed charges,,195.7,201.88,
Measurement of total estradiol (hormone),PX-30100136,CDM,82670,CPT,301,RC,,outpatient,,,206,185.4,,0.95,,195.7,Percent of total billed charges,,,0.98,,201.88,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.96,,197.76,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,195.7,Percent of total billed charges,,195.7,201.88,
"Gonadotropin, chorionic (reproductive hormone) level",PX-30100137,CDM,84702,CPT,301,RC,,inpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
"Gonadotropin, chorionic (reproductive hormone) level",PX-30100137,CDM,84702,CPT,301,RC,,outpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
Measurement of total estradiol (hormone),PX-30100138,CDM,82670,CPT,301,RC,,inpatient,,,243,218.7,,0.95,,230.85,Percent of total billed charges,,,0.98,,238.14,Percent of total billed charges,,,0.95,,230.85,Percent of total billed charges,,,0.97,,235.71,Percent of total billed charges,,,0.97,,235.71,Percent of total billed charges,,,0.96,,233.28,Percent of total billed charges,,,0.95,,230.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,230.85,Percent of total billed charges,,230.85,238.14,
Measurement of total estradiol (hormone),PX-30100138,CDM,82670,CPT,301,RC,,outpatient,,,243,218.7,,0.95,,230.85,Percent of total billed charges,,,0.98,,238.14,Percent of total billed charges,,,0.95,,230.85,Percent of total billed charges,,,0.95,,230.85,Percent of total billed charges,,,0.97,,235.71,Percent of total billed charges,,,0.96,,233.28,Percent of total billed charges,,,0.95,,230.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,230.85,Percent of total billed charges,,230.85,238.14,
IgE (immune system protein) level,PX-30100142,CDM,82785,CPT,301,RC,,inpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
IgE (immune system protein) level,PX-30100142,CDM,82785,CPT,301,RC,,outpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
"Cortisol (hormone) measurement, free",PX-30100144,CDM,82530,CPT,301,RC,,inpatient,,,112,100.8,,0.95,,106.4,Percent of total billed charges,,,0.98,,109.76,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.96,,107.52,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,106.4,Percent of total billed charges,,106.4,109.76,
"Cortisol (hormone) measurement, free",PX-30100144,CDM,82530,CPT,301,RC,,outpatient,,,112,100.8,,0.95,,106.4,Percent of total billed charges,,,0.98,,109.76,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.96,,107.52,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,106.4,Percent of total billed charges,,106.4,109.76,
Analysis for antibody to Toxoplasma (parasite),PX-30200108,CDM,86777,CPT,302,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Analysis for antibody to Toxoplasma (parasite),PX-30200108,CDM,86777,CPT,302,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Analysis for antibody to Coccidioides (bacteria),PX-30200109,CDM,86635,CPT,302,RC,,inpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Analysis for antibody to Coccidioides (bacteria),PX-30200109,CDM,86635,CPT,302,RC,,outpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Inhibin A (reproductive organ hormone) measurement,PX-30200110,CDM,86336,CPT,302,RC,,inpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Inhibin A (reproductive organ hormone) measurement,PX-30200110,CDM,86336,CPT,302,RC,,outpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Thyroglobulin (thyroid protein) antibody measurement,PX-30200113,CDM,86800,CPT,302,RC,,inpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
Thyroglobulin (thyroid protein) antibody measurement,PX-30200113,CDM,86800,CPT,302,RC,,outpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
Microsomal antibodies (autoantibody) measurement,PX-30200114,CDM,86376,CPT,302,RC,,inpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
Microsomal antibodies (autoantibody) measurement,PX-30200114,CDM,86376,CPT,302,RC,,outpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
Islet cell (pancreas) antibody measurement,PX-30200117,CDM,86341,CPT,302,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Islet cell (pancreas) antibody measurement,PX-30200117,CDM,86341,CPT,302,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Analysis for antibody to mumps virus,PX-30200118,CDM,86735,CPT,302,RC,,inpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
Analysis for antibody to mumps virus,PX-30200118,CDM,86735,CPT,302,RC,,outpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
Inhibin A (reproductive organ hormone) measurement,PX-30200120,CDM,86336,CPT,302,RC,,inpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Inhibin A (reproductive organ hormone) measurement,PX-30200120,CDM,86336,CPT,302,RC,,outpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
"Measure antibody to allergic, crude allergen extract, each",PX-30200123,CDM,86003,CPT,302,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
"Measure antibody to allergic, crude allergen extract, each",PX-30200123,CDM,86003,CPT,302,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
"Measure of complement (immune system proteins), antigen,",PX-30200124,CDM,86160,CPT,302,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
"Measure of complement (immune system proteins), antigen,",PX-30200124,CDM,86160,CPT,302,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
"Measure of complement (immune system proteins), antigen,",PX-30200125,CDM,86160,CPT,302,RC,,inpatient,,,55,49.5,,0.95,,52.25,Percent of total billed charges,,,0.98,,53.9,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.96,,52.8,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,52.25,Percent of total billed charges,,52.25,53.9,
"Measure of complement (immune system proteins), antigen,",PX-30200125,CDM,86160,CPT,302,RC,,outpatient,,,55,49.5,,0.95,,52.25,Percent of total billed charges,,,0.98,,53.9,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.96,,52.8,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,52.25,Percent of total billed charges,,52.25,53.9,
Measurement of Hepatitis A antibody,PX-30200126,CDM,86708,CPT,302,RC,,inpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
Measurement of Hepatitis A antibody,PX-30200126,CDM,86708,CPT,302,RC,,outpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
Measurement of Hepatitis A antibody,PX-30200127,CDM,86708,CPT,302,RC,,inpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Measurement of Hepatitis A antibody,PX-30200127,CDM,86708,CPT,302,RC,,outpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
"Analysis for antibody to Epstein-Barr, nuclear antigen",PX-30200128,CDM,86664,CPT,302,RC,,inpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
"Analysis for antibody to Epstein-Barr, nuclear antigen",PX-30200128,CDM,86664,CPT,302,RC,,outpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
"Analysis for antibody to Epstein-Barr virus , viral capsid",PX-30200129,CDM,86665,CPT,302,RC,,inpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
"Analysis for antibody to Epstein-Barr virus , viral capsid",PX-30200129,CDM,86665,CPT,302,RC,,outpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
Analysis for antibody to mumps virus,PX-30200130,CDM,86735,CPT,302,RC,,inpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
Analysis for antibody to mumps virus,PX-30200130,CDM,86735,CPT,302,RC,,outpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
Analysis for antibody to Coccidioides (bacteria),PX-30200131,CDM,86635,CPT,302,RC,,inpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Analysis for antibody to Coccidioides (bacteria),PX-30200131,CDM,86635,CPT,302,RC,,outpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Syphilis detection test,PX-30200132,CDM,86592,CPT,302,RC,,inpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
Syphilis detection test,PX-30200132,CDM,86592,CPT,302,RC,,outpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
Syphilis detection test,PX-30200133,CDM,86592,CPT,302,RC,,inpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
Syphilis detection test,PX-30200133,CDM,86592,CPT,302,RC,,outpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
Cardiolipin antibody (tissue antibody) measurement,PX-30200134,CDM,86147,CPT,302,RC,,inpatient,,,40,36,,0.95,,38,Percent of total billed charges,,,0.98,,39.2,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.96,,38.4,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38,Percent of total billed charges,,38,39.2,
Cardiolipin antibody (tissue antibody) measurement,PX-30200134,CDM,86147,CPT,302,RC,,outpatient,,,40,36,,0.95,,38,Percent of total billed charges,,,0.98,,39.2,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.96,,38.4,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38,Percent of total billed charges,,38,39.2,
"Measure antibody to allergic, crude allergen extract, each",PX-30200135,CDM,86003,CPT,302,RC,,inpatient,,,23,20.7,,0.95,,21.85,Percent of total billed charges,,,0.98,,22.54,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.96,,22.08,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,21.85,Percent of total billed charges,,21.85,22.54,
"Measure antibody to allergic, crude allergen extract, each",PX-30200135,CDM,86003,CPT,302,RC,,outpatient,,,23,20.7,,0.95,,21.85,Percent of total billed charges,,,0.98,,22.54,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.96,,22.08,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,21.85,Percent of total billed charges,,21.85,22.54,
"Measure of complement (immune system proteins), antigen,",PX-30200136,CDM,86160,CPT,302,RC,,inpatient,,,55,49.5,,0.95,,52.25,Percent of total billed charges,,,0.98,,53.9,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.96,,52.8,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,52.25,Percent of total billed charges,,52.25,53.9,
"Measure of complement (immune system proteins), antigen,",PX-30200136,CDM,86160,CPT,302,RC,,outpatient,,,55,49.5,,0.95,,52.25,Percent of total billed charges,,,0.98,,53.9,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.96,,52.8,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,52.25,Percent of total billed charges,,52.25,53.9,
Cardiolipin antibody (tissue antibody) measurement,PX-30200137,CDM,86147,CPT,302,RC,,inpatient,,,85,76.5,,0.95,,80.75,Percent of total billed charges,,,0.98,,83.3,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.96,,81.6,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,80.75,Percent of total billed charges,,80.75,83.3,
Cardiolipin antibody (tissue antibody) measurement,PX-30200137,CDM,86147,CPT,302,RC,,outpatient,,,85,76.5,,0.95,,80.75,Percent of total billed charges,,,0.98,,83.3,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.96,,81.6,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,80.75,Percent of total billed charges,,80.75,83.3,
Analysis for antibody (IgM) to Toxoplasma,PX-30200138,CDM,86778,CPT,302,RC,,inpatient,,,166,149.4,,0.95,,157.7,Percent of total billed charges,,,0.98,,162.68,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.96,,159.36,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,157.7,Percent of total billed charges,,157.7,162.68,
Analysis for antibody (IgM) to Toxoplasma,PX-30200138,CDM,86778,CPT,302,RC,,outpatient,,,166,149.4,,0.95,,157.7,Percent of total billed charges,,,0.98,,162.68,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.96,,159.36,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,157.7,Percent of total billed charges,,157.7,162.68,
"Analysis for antibody to Epstein-Barr virus , viral capsid",PX-30200139,CDM,86665,CPT,302,RC,,inpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
"Analysis for antibody to Epstein-Barr virus , viral capsid",PX-30200139,CDM,86665,CPT,302,RC,,outpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
"Analysis for antibody to Epstein-Barr virus , viral capsid",PX-30200140,CDM,86665,CPT,302,RC,,inpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
"Analysis for antibody to Epstein-Barr virus , viral capsid",PX-30200140,CDM,86665,CPT,302,RC,,outpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
"Analysis for antibody to Epstein-Barr, nuclear antigen",PX-30200141,CDM,86664,CPT,302,RC,,inpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
"Analysis for antibody to Epstein-Barr, nuclear antigen",PX-30200141,CDM,86664,CPT,302,RC,,outpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
Analysis for antibody to Toxoplasma (parasite),PX-30200142,CDM,86777,CPT,302,RC,,inpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
Analysis for antibody to Toxoplasma (parasite),PX-30200142,CDM,86777,CPT,302,RC,,outpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
Analysis for antibody (IgM) to Toxoplasma,PX-30200143,CDM,86778,CPT,302,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Analysis for antibody (IgM) to Toxoplasma,PX-30200143,CDM,86778,CPT,302,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Analysis for antibody to Coccidioides (bacteria),PX-30200144,CDM,86635,CPT,302,RC,,inpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Analysis for antibody to Coccidioides (bacteria),PX-30200144,CDM,86635,CPT,302,RC,,outpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
"Tuberculosis test, gamma interferon",PX-30200149,CDM,86480,CPT,302,RC,,inpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
"Tuberculosis test, gamma interferon",PX-30200149,CDM,86480,CPT,302,RC,,outpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
Virus isolation,PX-30600104,CDM,87255,CPT,306,RC,,inpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Virus isolation,PX-30600104,CDM,87255,CPT,306,RC,,outpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
"Test by nucleic acid for Neisseria gonorrhoeae , amplified",PX-30600106,CDM,87591,CPT,306,RC,,inpatient,,,84,75.6,,0.95,,79.8,Percent of total billed charges,,,0.98,,82.32,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,0.97,,81.48,Percent of total billed charges,,,0.97,,81.48,Percent of total billed charges,,,0.96,,80.64,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,79.8,Percent of total billed charges,,79.8,82.32,
"Test by nucleic acid for Neisseria gonorrhoeae , amplified",PX-30600106,CDM,87591,CPT,306,RC,,outpatient,,,84,75.6,,0.95,,79.8,Percent of total billed charges,,,0.98,,82.32,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,0.97,,81.48,Percent of total billed charges,,,0.96,,80.64,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,79.8,Percent of total billed charges,,79.8,82.32,
"Test by nucleic acid for Neisseria gonorrhoeae , amplified",PX-30600108,CDM,87591,CPT,306,RC,,inpatient,,,84,75.6,,0.95,,79.8,Percent of total billed charges,,,0.98,,82.32,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,0.97,,81.48,Percent of total billed charges,,,0.97,,81.48,Percent of total billed charges,,,0.96,,80.64,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,79.8,Percent of total billed charges,,79.8,82.32,
"Test by nucleic acid for Neisseria gonorrhoeae , amplified",PX-30600108,CDM,87591,CPT,306,RC,,outpatient,,,84,75.6,,0.95,,79.8,Percent of total billed charges,,,0.98,,82.32,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,0.97,,81.48,Percent of total billed charges,,,0.96,,80.64,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,79.8,Percent of total billed charges,,79.8,82.32,
"Test bynucleic acid for chlamydia trachomatis, amplified",PX-30600109,CDM,87491,CPT,306,RC,,inpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
"Test bynucleic acid for chlamydia trachomatis, amplified",PX-30600109,CDM,87491,CPT,306,RC,,outpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
Virus isolation,PX-30600111,CDM,87255,CPT,306,RC,,inpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Virus isolation,PX-30600111,CDM,87255,CPT,306,RC,,outpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
HC Feed Bag #70552h,PX-3254212WWM,CDM,3254212WWM,LOCAL,270,RC,,inpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
HC Feed Bag #70552h,PX-3254212WWM,CDM,3254212WWM,LOCAL,270,RC,,outpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
HC DRSG OPTIFOAM 6x6 #MSC1066EPZ,PX-3254213WWM,CDM,3254213WWM,LOCAL,270,RC,,inpatient,,,31,27.9,,0.95,,29.45,Percent of total billed charges,,,0.98,,30.38,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.96,,29.76,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,29.45,Percent of total billed charges,,29.45,30.38,
HC DRSG OPTIFOAM 6x6 #MSC1066EPZ,PX-3254213WWM,CDM,3254213WWM,LOCAL,270,RC,,outpatient,,,31,27.9,,0.95,,29.45,Percent of total billed charges,,,0.98,,30.38,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.96,,29.76,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,29.45,Percent of total billed charges,,29.45,30.38,
Body fluid cell count,PX-30000003,CDM,89050,CPT,300,RC,,inpatient,,,153,137.7,,0.95,,145.35,Percent of total billed charges,,,0.98,,149.94,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.96,,146.88,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,145.35,Percent of total billed charges,,145.35,149.94,
Body fluid cell count,PX-30000003,CDM,89050,CPT,300,RC,,outpatient,,,153,137.7,,0.95,,145.35,Percent of total billed charges,,,0.98,,149.94,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.96,,146.88,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,145.35,Percent of total billed charges,,145.35,149.94,
Body fluid cell count with cell identification,PX-30000004,CDM,89051,CPT,300,RC,,inpatient,,,152,136.8,,0.95,,144.4,Percent of total billed charges,,,0.98,,148.96,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,0.97,,147.44,Percent of total billed charges,,,0.97,,147.44,Percent of total billed charges,,,0.96,,145.92,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,144.4,Percent of total billed charges,,144.4,148.96,
Body fluid cell count with cell identification,PX-30000004,CDM,89051,CPT,300,RC,,outpatient,,,152,136.8,,0.95,,144.4,Percent of total billed charges,,,0.98,,148.96,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,0.97,,147.44,Percent of total billed charges,,,0.96,,145.92,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,144.4,Percent of total billed charges,,144.4,148.96,
Body fluid cell count,PX-30000007,CDM,89050,CPT,300,RC,,inpatient,,,153,137.7,,0.95,,145.35,Percent of total billed charges,,,0.98,,149.94,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.96,,146.88,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,145.35,Percent of total billed charges,,145.35,149.94,
Body fluid cell count,PX-30000007,CDM,89050,CPT,300,RC,,outpatient,,,153,137.7,,0.95,,145.35,Percent of total billed charges,,,0.98,,149.94,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.96,,146.88,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,145.35,Percent of total billed charges,,145.35,149.94,
Body fluid cell count with cell identification,PX-30000008,CDM,89051,CPT,300,RC,,inpatient,,,152,136.8,,0.95,,144.4,Percent of total billed charges,,,0.98,,148.96,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,0.97,,147.44,Percent of total billed charges,,,0.97,,147.44,Percent of total billed charges,,,0.96,,145.92,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,144.4,Percent of total billed charges,,144.4,148.96,
Body fluid cell count with cell identification,PX-30000008,CDM,89051,CPT,300,RC,,outpatient,,,152,136.8,,0.95,,144.4,Percent of total billed charges,,,0.98,,148.96,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,0.97,,147.44,Percent of total billed charges,,,0.96,,145.92,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,144.4,Percent of total billed charges,,144.4,148.96,
Crystal identification from tissue or body fluid,PX-30000006,CDM,89060,CPT,300,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Crystal identification from tissue or body fluid,PX-30000006,CDM,89060,CPT,300,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Body fluid cell count with cell identification,PX-30000010,CDM,89051,CPT,300,RC,,inpatient,,,152,136.8,,0.95,,144.4,Percent of total billed charges,,,0.98,,148.96,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,0.97,,147.44,Percent of total billed charges,,,0.97,,147.44,Percent of total billed charges,,,0.96,,145.92,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,144.4,Percent of total billed charges,,144.4,148.96,
Body fluid cell count with cell identification,PX-30000010,CDM,89051,CPT,300,RC,,outpatient,,,152,136.8,,0.95,,144.4,Percent of total billed charges,,,0.98,,148.96,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,0.97,,147.44,Percent of total billed charges,,,0.96,,145.92,Percent of total billed charges,,,0.95,,144.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,144.4,Percent of total billed charges,,144.4,148.96,
Body fluid cell count with cell identification,PX-30000011,CDM,89051,CPT,300,RC,,inpatient,,,153,137.7,,0.95,,145.35,Percent of total billed charges,,,0.98,,149.94,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.96,,146.88,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,145.35,Percent of total billed charges,,145.35,149.94,
Body fluid cell count with cell identification,PX-30000011,CDM,89051,CPT,300,RC,,outpatient,,,153,137.7,,0.95,,145.35,Percent of total billed charges,,,0.98,,149.94,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.96,,146.88,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,145.35,Percent of total billed charges,,145.35,149.94,
Microsomal antibodies (autoantibody) measurement,PX-30200152,CDM,86376,CPT,302,RC,,inpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
Microsomal antibodies (autoantibody) measurement,PX-30200152,CDM,86376,CPT,302,RC,,outpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
Measurement of Hepatitis A antibody (IgM),PX-30200153,CDM,86709,CPT,302,RC,,inpatient,,,40,36,,0.95,,38,Percent of total billed charges,,,0.98,,39.2,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.96,,38.4,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38,Percent of total billed charges,,38,39.2,
Measurement of Hepatitis A antibody (IgM),PX-30200153,CDM,86709,CPT,302,RC,,outpatient,,,40,36,,0.95,,38,Percent of total billed charges,,,0.98,,39.2,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.96,,38.4,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38,Percent of total billed charges,,38,39.2,
"Thrombin time, fibrinogen screening test, plasma",PX-30500038,CDM,85670,CPT,305,RC,,inpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
"Thrombin time, fibrinogen screening test, plasma",PX-30500038,CDM,85670,CPT,305,RC,,outpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
"HC PR 98961 Self-Mgmt Educ/Train, 2-4 Pt, Ea 30 Min Rhc",PX-52100034,CDM,98961,CPT,521,RC,,inpatient,,,37,33.3,,0.95,,35.15,Percent of total billed charges,,,0.98,,36.26,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.96,,35.52,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,35.15,Percent of total billed charges,,35.15,36.26,
"HC PR 98961 Self-Mgmt Educ/Train, 2-4 Pt, Ea 30 Min Rhc",PX-52100034,CDM,98961,CPT,521,RC,,outpatient,,,37,33.3,,0.95,,35.15,Percent of total billed charges,,,0.98,,36.26,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.96,,35.52,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,35.15,Percent of total billed charges,,35.15,36.26,
"HC PR 98962 Self-Mgmt Educ/Train, 5-8 Pt, Ea 30 Min Rhc",PX-52100035,CDM,98962,CPT,521,RC,,inpatient,,,28,25.2,,0.95,,26.6,Percent of total billed charges,,,0.98,,27.44,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.96,,26.88,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,26.6,Percent of total billed charges,,26.6,27.44,
"HC PR 98962 Self-Mgmt Educ/Train, 5-8 Pt, Ea 30 Min Rhc",PX-52100035,CDM,98962,CPT,521,RC,,outpatient,,,28,25.2,,0.95,,26.6,Percent of total billed charges,,,0.98,,27.44,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.96,,26.88,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,26.6,Percent of total billed charges,,26.6,27.44,
HC Needle Ez-Io 25mm (#9001-Vc-001),PX-3254151WWM,CDM,3254151WWM,LOCAL,270,RC,,inpatient,,,565,508.5,,0.95,,536.75,Percent of total billed charges,,,0.98,,553.7,Percent of total billed charges,,,0.95,,536.75,Percent of total billed charges,,,0.97,,548.05,Percent of total billed charges,,,0.97,,548.05,Percent of total billed charges,,,0.96,,542.4,Percent of total billed charges,,,0.95,,536.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,536.75,Percent of total billed charges,,536.75,553.7,
HC Needle Ez-Io 25mm (#9001-Vc-001),PX-3254151WWM,CDM,3254151WWM,LOCAL,270,RC,,outpatient,,,565,508.5,,0.95,,536.75,Percent of total billed charges,,,0.98,,553.7,Percent of total billed charges,,,0.95,,536.75,Percent of total billed charges,,,0.95,,536.75,Percent of total billed charges,,,0.97,,548.05,Percent of total billed charges,,,0.96,,542.4,Percent of total billed charges,,,0.95,,536.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,536.75,Percent of total billed charges,,536.75,553.7,
HC OB Koala Intra/Iupc/Cath,PX-3254216WWM,CDM,3254216WWM,LOCAL,270,RC,,inpatient,,,291,261.9,,0.95,,276.45,Percent of total billed charges,,,0.98,,285.18,Percent of total billed charges,,,0.95,,276.45,Percent of total billed charges,,,0.97,,282.27,Percent of total billed charges,,,0.97,,282.27,Percent of total billed charges,,,0.96,,279.36,Percent of total billed charges,,,0.95,,276.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,276.45,Percent of total billed charges,,276.45,285.18,
HC OB Koala Intra/Iupc/Cath,PX-3254216WWM,CDM,3254216WWM,LOCAL,270,RC,,outpatient,,,291,261.9,,0.95,,276.45,Percent of total billed charges,,,0.98,,285.18,Percent of total billed charges,,,0.95,,276.45,Percent of total billed charges,,,0.95,,276.45,Percent of total billed charges,,,0.97,,282.27,Percent of total billed charges,,,0.96,,279.36,Percent of total billed charges,,,0.95,,276.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,276.45,Percent of total billed charges,,276.45,285.18,
HC Sling Pelvic Med #556652,PX-3253500WWM,CDM,3253500WWM,LOCAL,270,RC,,inpatient,,,353,317.7,,0.95,,335.35,Percent of total billed charges,,,0.98,,345.94,Percent of total billed charges,,,0.95,,335.35,Percent of total billed charges,,,0.97,,342.41,Percent of total billed charges,,,0.97,,342.41,Percent of total billed charges,,,0.96,,338.88,Percent of total billed charges,,,0.95,,335.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,335.35,Percent of total billed charges,,335.35,345.94,
HC Sling Pelvic Med #556652,PX-3253500WWM,CDM,3253500WWM,LOCAL,270,RC,,outpatient,,,353,317.7,,0.95,,335.35,Percent of total billed charges,,,0.98,,345.94,Percent of total billed charges,,,0.95,,335.35,Percent of total billed charges,,,0.95,,335.35,Percent of total billed charges,,,0.97,,342.41,Percent of total billed charges,,,0.96,,338.88,Percent of total billed charges,,,0.95,,335.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,335.35,Percent of total billed charges,,335.35,345.94,
HC Ez-Io Stabilizer (#9066-Vc-005),PX-3254143WWM,CDM,3254143WWM,LOCAL,270,RC,,inpatient,,,123,110.7,,0.95,,116.85,Percent of total billed charges,,,0.98,,120.54,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.96,,118.08,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,116.85,Percent of total billed charges,,116.85,120.54,
HC Ez-Io Stabilizer (#9066-Vc-005),PX-3254143WWM,CDM,3254143WWM,LOCAL,270,RC,,outpatient,,,123,110.7,,0.95,,116.85,Percent of total billed charges,,,0.98,,120.54,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.96,,118.08,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,116.85,Percent of total billed charges,,116.85,120.54,
HC Medihoney.5oz (#788895),PX-3254214WWM,CDM,3254214WWM,LOCAL,270,RC,,inpatient,,,49,44.1,,0.95,,46.55,Percent of total billed charges,,,0.98,,48.02,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.96,,47.04,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,46.55,Percent of total billed charges,,46.55,48.02,
HC Medihoney.5oz (#788895),PX-3254214WWM,CDM,3254214WWM,LOCAL,270,RC,,outpatient,,,49,44.1,,0.95,,46.55,Percent of total billed charges,,,0.98,,48.02,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.96,,47.04,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,46.55,Percent of total billed charges,,46.55,48.02,
HC Splint Sam 4 1/4 X 36 (#37155),PX-3253095WWM,CDM,3253095WWM,LOCAL,270,RC,,inpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
HC Splint Sam 4 1/4 X 36 (#37155),PX-3253095WWM,CDM,3253095WWM,LOCAL,270,RC,,outpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
HC Sling Pelvic Lg #556653,PX-3253501WWM,CDM,3253501WWM,LOCAL,270,RC,,inpatient,,,493,443.7,,0.95,,468.35,Percent of total billed charges,,,0.98,,483.14,Percent of total billed charges,,,0.95,,468.35,Percent of total billed charges,,,0.97,,478.21,Percent of total billed charges,,,0.97,,478.21,Percent of total billed charges,,,0.96,,473.28,Percent of total billed charges,,,0.95,,468.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,468.35,Percent of total billed charges,,468.35,483.14,
HC Sling Pelvic Lg #556653,PX-3253501WWM,CDM,3253501WWM,LOCAL,270,RC,,outpatient,,,493,443.7,,0.95,,468.35,Percent of total billed charges,,,0.98,,483.14,Percent of total billed charges,,,0.95,,468.35,Percent of total billed charges,,,0.95,,468.35,Percent of total billed charges,,,0.97,,478.21,Percent of total billed charges,,,0.96,,473.28,Percent of total billed charges,,,0.95,,468.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,468.35,Percent of total billed charges,,468.35,483.14,
HC PR G2214 Init/Sub Psych Care M 1st 30 Minutes,PX-90000056,CDM,G2214,HCPCS,900,RC,,inpatient,,,141,126.9,,0.95,,133.95,Percent of total billed charges,,,0.98,,138.18,Percent of total billed charges,,,0.95,,133.95,Percent of total billed charges,,,0.97,,136.77,Percent of total billed charges,,,0.97,,136.77,Percent of total billed charges,,,0.96,,135.36,Percent of total billed charges,,,0.95,,133.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133.95,Percent of total billed charges,,133.95,138.18,
HC PR G2214 Init/Sub Psych Care M 1st 30 Minutes,PX-90000056,CDM,G2214,HCPCS,900,RC,,outpatient,,,141,126.9,,0.95,,133.95,Percent of total billed charges,,,0.98,,138.18,Percent of total billed charges,,,0.95,,133.95,Percent of total billed charges,,,0.95,,133.95,Percent of total billed charges,,,0.97,,136.77,Percent of total billed charges,,,0.96,,135.36,Percent of total billed charges,,,0.95,,133.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133.95,Percent of total billed charges,,133.95,138.18,
HC PR Rx Pneumococcal Conj 20 Valent Vaccine (Pcv20) Im 1 Ea,PX-63600095,CDM,90677,CPT,636,RC,,inpatient,,,506,455.4,,0.95,,480.7,Percent of total billed charges,,,0.98,,495.88,Percent of total billed charges,,,0.95,,480.7,Percent of total billed charges,,,0.97,,490.82,Percent of total billed charges,,,0.97,,490.82,Percent of total billed charges,,,0.96,,485.76,Percent of total billed charges,,,0.95,,480.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,480.7,Percent of total billed charges,,480.7,495.88,
HC PR Rx Pneumococcal Conj 20 Valent Vaccine (Pcv20) Im 1 Ea,PX-63600095,CDM,90677,CPT,636,RC,,outpatient,,,506,455.4,,0.95,,480.7,Percent of total billed charges,,,0.98,,495.88,Percent of total billed charges,,,0.95,,480.7,Percent of total billed charges,,,0.95,,480.7,Percent of total billed charges,,,0.97,,490.82,Percent of total billed charges,,,0.96,,485.76,Percent of total billed charges,,,0.95,,480.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,480.7,Percent of total billed charges,,480.7,495.88,
HC PR 99426 Principal Care Mgmt Svc 1st 30 Staff Cal Mo Rhc,PX-52100078,CDM,99426,CPT,521,RC,,inpatient,,,153,137.7,,0.95,,145.35,Percent of total billed charges,,,0.98,,149.94,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.96,,146.88,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,145.35,Percent of total billed charges,,145.35,149.94,
HC PR 99426 Principal Care Mgmt Svc 1st 30 Staff Cal Mo Rhc,PX-52100078,CDM,99426,CPT,521,RC,,outpatient,,,153,137.7,,0.95,,145.35,Percent of total billed charges,,,0.98,,149.94,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.96,,146.88,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,145.35,Percent of total billed charges,,145.35,149.94,
HC PR 99427 Principal Care Mgmt Svc Ea Addl 30 Staff Cal Mo Rhc,PX-52100079,CDM,99427,CPT,521,RC,,inpatient,,,117,105.3,,0.95,,111.15,Percent of total billed charges,,,0.98,,114.66,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.96,,112.32,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,111.15,Percent of total billed charges,,111.15,114.66,
HC PR 99427 Principal Care Mgmt Svc Ea Addl 30 Staff Cal Mo Rhc,PX-52100079,CDM,99427,CPT,521,RC,,outpatient,,,117,105.3,,0.95,,111.15,Percent of total billed charges,,,0.98,,114.66,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.96,,112.32,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,111.15,Percent of total billed charges,,111.15,114.66,
HC PR 99425 Principal Care Mgmt Svc Ea Adl 30 Phy/Qhp Cal Mo Rhc,PX-52100077,CDM,99425,CPT,521,RC,,inpatient,,,148,133.2,,0.95,,140.6,Percent of total billed charges,,,0.98,,145.04,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.96,,142.08,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,140.6,Percent of total billed charges,,140.6,145.04,
HC PR 99425 Principal Care Mgmt Svc Ea Adl 30 Phy/Qhp Cal Mo Rhc,PX-52100077,CDM,99425,CPT,521,RC,,outpatient,,,148,133.2,,0.95,,140.6,Percent of total billed charges,,,0.98,,145.04,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.96,,142.08,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,140.6,Percent of total billed charges,,140.6,145.04,
HC PR 99424 Principal Care Mgmt Svc 1st 30 Phys/Qhp Cal Mo Rhc,PX-52100076,CDM,99424,CPT,521,RC,,inpatient,,,204,183.6,,0.95,,193.8,Percent of total billed charges,,,0.98,,199.92,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.96,,195.84,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,193.8,Percent of total billed charges,,193.8,199.92,
HC PR 99424 Principal Care Mgmt Svc 1st 30 Phys/Qhp Cal Mo Rhc,PX-52100076,CDM,99424,CPT,521,RC,,outpatient,,,204,183.6,,0.95,,193.8,Percent of total billed charges,,,0.98,,199.92,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,0.97,,197.88,Percent of total billed charges,,,0.96,,195.84,Percent of total billed charges,,,0.95,,193.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,193.8,Percent of total billed charges,,193.8,199.92,
HC PR G0490 Home Visit Rn/Lpn by Rhc/Fq,PX-52710001,CDM,G0490,HCPCS,527,RC,,inpatient,,,82,73.8,,0.95,,77.9,Percent of total billed charges,,,0.98,,80.36,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,0.97,,79.54,Percent of total billed charges,,,0.97,,79.54,Percent of total billed charges,,,0.96,,78.72,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,77.9,Percent of total billed charges,,77.9,80.36,
HC PR G0490 Home Visit Rn/Lpn by Rhc/Fq,PX-52710001,CDM,G0490,HCPCS,527,RC,,outpatient,,,82,73.8,,0.95,,77.9,Percent of total billed charges,,,0.98,,80.36,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,0.97,,79.54,Percent of total billed charges,,,0.96,,78.72,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,77.9,Percent of total billed charges,,77.9,80.36,
HC Elastase Pancreatic Fecal Quantitative #,PX-30100376,CDM,82653,CPT,301,RC,,inpatient,,,72,64.8,,0.95,,68.4,Percent of total billed charges,,,0.98,,70.56,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.96,,69.12,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,68.4,Percent of total billed charges,,68.4,70.56,
HC Elastase Pancreatic Fecal Quantitative #,PX-30100376,CDM,82653,CPT,301,RC,,outpatient,,,72,64.8,,0.95,,68.4,Percent of total billed charges,,,0.98,,70.56,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.96,,69.12,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,68.4,Percent of total billed charges,,68.4,70.56,
Measurement of tissue transglutaminase,PX-30200295,CDM,86364,CPT,302,RC,,inpatient,,,37,33.3,,0.95,,35.15,Percent of total billed charges,,,0.98,,36.26,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.96,,35.52,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,35.15,Percent of total billed charges,,35.15,36.26,
Measurement of tissue transglutaminase,PX-30200295,CDM,86364,CPT,302,RC,,outpatient,,,37,33.3,,0.95,,35.15,Percent of total billed charges,,,0.98,,36.26,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.96,,35.52,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,35.15,Percent of total billed charges,,35.15,36.26,
CBA detection of MOG-IgG1 antibody,PX-30200319,CDM,86362,CPT,302,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
CBA detection of MOG-IgG1 antibody,PX-30200319,CDM,86362,CPT,302,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
ELISA detection of aquaporin-4 antibody,PX-30200304,CDM,86051,CPT,302,RC,,inpatient,,,37,33.3,,0.95,,35.15,Percent of total billed charges,,,0.98,,36.26,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.96,,35.52,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,35.15,Percent of total billed charges,,35.15,36.26,
ELISA detection of aquaporin-4 antibody,PX-30200304,CDM,86051,CPT,302,RC,,outpatient,,,37,33.3,,0.95,,35.15,Percent of total billed charges,,,0.98,,36.26,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.96,,35.52,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,35.15,Percent of total billed charges,,35.15,36.26,
Measurement of RNA of bacteria in vaginal fluid specimen,PX-31000098,CDM,81513,CPT,310,RC,,inpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,440.8,Percent of total billed charges,,440.8,454.72,
Measurement of RNA of bacteria in vaginal fluid specimen,PX-31000098,CDM,81513,CPT,310,RC,,outpatient,,,464,417.6,,0.95,,440.8,Percent of total billed charges,,,0.98,,454.72,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,0.97,,450.08,Percent of total billed charges,,,0.96,,445.44,Percent of total billed charges,,,0.95,,440.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,440.8,Percent of total billed charges,,440.8,454.72,
HC PR 95249 Cont Gluc Monitoring Patient Provided Equiptment Rhc,PX-52100139,CDM,95249,CPT,521,RC,,inpatient,,,161,144.9,,0.95,,152.95,Percent of total billed charges,,,0.98,,157.78,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.96,,154.56,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,152.95,Percent of total billed charges,,152.95,157.78,
HC PR 95249 Cont Gluc Monitoring Patient Provided Equiptment Rhc,PX-52100139,CDM,95249,CPT,521,RC,,outpatient,,,161,144.9,,0.95,,152.95,Percent of total billed charges,,,0.98,,157.78,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,0.97,,156.17,Percent of total billed charges,,,0.96,,154.56,Percent of total billed charges,,,0.95,,152.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,152.95,Percent of total billed charges,,152.95,157.78,
HC PR 76817 US Preg Uterus Real Time W/Image Dcmtn Transvag Rhc,PX-52100147,CDM,76817,CPT,521,RC,,inpatient,,,228,205.2,,0.95,,216.6,Percent of total billed charges,,,0.98,,223.44,Percent of total billed charges,,,0.95,,216.6,Percent of total billed charges,,,0.97,,221.16,Percent of total billed charges,,,0.97,,221.16,Percent of total billed charges,,,0.96,,218.88,Percent of total billed charges,,,0.95,,216.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,216.6,Percent of total billed charges,,216.6,223.44,
HC PR 76817 US Preg Uterus Real Time W/Image Dcmtn Transvag Rhc,PX-52100147,CDM,76817,CPT,521,RC,,outpatient,,,228,205.2,,0.95,,216.6,Percent of total billed charges,,,0.98,,223.44,Percent of total billed charges,,,0.95,,216.6,Percent of total billed charges,,,0.95,,216.6,Percent of total billed charges,,,0.97,,221.16,Percent of total billed charges,,,0.96,,218.88,Percent of total billed charges,,,0.95,,216.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,216.6,Percent of total billed charges,,216.6,223.44,
HC PR 64451 Injection Aa&/Strd Nerves Nrvtg Si Joint W/Img Cdm,PX-96300021,CDM,64451,CPT,963,RC,,inpatient,,,212,190.8,,0.95,,201.4,Percent of total billed charges,,,0.98,,207.76,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,0.97,,205.64,Percent of total billed charges,,,0.97,,205.64,Percent of total billed charges,,,0.96,,203.52,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,,,,,,,0.95,,201.4,Percent of total billed charges,,201.4,207.76,
HC PR 64451 Injection Aa&/Strd Nerves Nrvtg Si Joint W/Img Cdm,PX-96300021,CDM,64451,CPT,963,RC,,outpatient,,,212,190.8,,0.95,,201.4,Percent of total billed charges,,,0.98,,207.76,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,0.97,,205.64,Percent of total billed charges,,,0.96,,203.52,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,,,,,,,0.95,,201.4,Percent of total billed charges,,201.4,207.76,
HC PR G0108 Diab Manage Trn per Indiv Rhc,PX-52100157,CDM,G0108,HCPCS,521,RC,,inpatient,,,134,120.6,,0.95,,127.3,Percent of total billed charges,,,0.98,,131.32,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,0.97,,129.98,Percent of total billed charges,,,0.97,,129.98,Percent of total billed charges,,,0.96,,128.64,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,127.3,Percent of total billed charges,,127.3,131.32,
HC PR G0108 Diab Manage Trn per Indiv Rhc,PX-52100157,CDM,G0108,HCPCS,521,RC,,outpatient,,,134,120.6,,0.95,,127.3,Percent of total billed charges,,,0.98,,131.32,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,0.97,,129.98,Percent of total billed charges,,,0.96,,128.64,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,127.3,Percent of total billed charges,,127.3,131.32,
HC PR G0109 Diab Manage Trn Ind/Group Rhc,PX-52100158,CDM,G0109,HCPCS,521,RC,,inpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
HC PR G0109 Diab Manage Trn Ind/Group Rhc,PX-52100158,CDM,G0109,HCPCS,521,RC,,outpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
HC Mh Plan Not MD Cdm,PX-90000061,CDM,H0032,CPT,900,RC,,inpatient,,,82,73.8,,0.95,,77.9,Percent of total billed charges,,,0.98,,80.36,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,0.97,,79.54,Percent of total billed charges,,,0.97,,79.54,Percent of total billed charges,,,0.96,,78.72,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,77.9,Percent of total billed charges,,77.9,80.36,
HC Mh Plan Not MD Cdm,PX-90000061,CDM,H0032,CPT,900,RC,,outpatient,,,82,73.8,,0.95,,77.9,Percent of total billed charges,,,0.98,,80.36,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,0.97,,79.54,Percent of total billed charges,,,0.96,,78.72,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,77.9,Percent of total billed charges,,77.9,80.36,
HC PR 75989 Radiological Guidance Prq Drg W/Plmt Cath Rs&I Cdm,PX-97200052,CDM,75989,CPT,972,RC,,inpatient,,,274,246.6,,0.95,,260.3,Percent of total billed charges,,,0.98,,268.52,Percent of total billed charges,,,0.95,,260.3,Percent of total billed charges,,,0.97,,265.78,Percent of total billed charges,,,0.97,,265.78,Percent of total billed charges,,,0.96,,263.04,Percent of total billed charges,,,0.95,,260.3,Percent of total billed charges,,,,,,,,,0.95,,260.3,Percent of total billed charges,,260.3,268.52,
HC PR 75989 Radiological Guidance Prq Drg W/Plmt Cath Rs&I Cdm,PX-97200052,CDM,75989,CPT,972,RC,,outpatient,,,274,246.6,,0.95,,260.3,Percent of total billed charges,,,0.98,,268.52,Percent of total billed charges,,,0.95,,260.3,Percent of total billed charges,,,0.95,,260.3,Percent of total billed charges,,,0.97,,265.78,Percent of total billed charges,,,0.96,,263.04,Percent of total billed charges,,,0.95,,260.3,Percent of total billed charges,,,,,,,,,0.95,,260.3,Percent of total billed charges,,260.3,268.52,
Excision Olecranon Bursa,PX-97500230,CDM,24105,CPT,975,RC,,inpatient,,,911,819.9,,0.95,,865.45,Percent of total billed charges,,,0.98,,892.78,Percent of total billed charges,,,0.95,,865.45,Percent of total billed charges,,,0.97,,883.67,Percent of total billed charges,,,0.97,,883.67,Percent of total billed charges,,,0.96,,874.56,Percent of total billed charges,,,0.95,,865.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,865.45,Percent of total billed charges,,865.45,892.78,
Excision Olecranon Bursa,PX-97500230,CDM,24105,CPT,975,RC,,outpatient,,,911,819.9,,0.95,,865.45,Percent of total billed charges,,,0.98,,892.78,Percent of total billed charges,,,0.95,,865.45,Percent of total billed charges,,,0.95,,865.45,Percent of total billed charges,,,0.97,,883.67,Percent of total billed charges,,,0.96,,874.56,Percent of total billed charges,,,0.95,,865.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,865.45,Percent of total billed charges,,865.45,892.78,
HC PR 25000 Incision Extensor Tendon Sheath Wrist Cdm,PX-97500233,CDM,25000,CPT,975,RC,,inpatient,,,875,787.5,,0.95,,831.25,Percent of total billed charges,,,0.98,,857.5,Percent of total billed charges,,,0.95,,831.25,Percent of total billed charges,,,0.97,,848.75,Percent of total billed charges,,,0.97,,848.75,Percent of total billed charges,,,0.96,,840,Percent of total billed charges,,,0.95,,831.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,831.25,Percent of total billed charges,,831.25,857.5,
HC PR 25000 Incision Extensor Tendon Sheath Wrist Cdm,PX-97500233,CDM,25000,CPT,975,RC,,outpatient,,,875,787.5,,0.95,,831.25,Percent of total billed charges,,,0.98,,857.5,Percent of total billed charges,,,0.95,,831.25,Percent of total billed charges,,,0.95,,831.25,Percent of total billed charges,,,0.97,,848.75,Percent of total billed charges,,,0.96,,840,Percent of total billed charges,,,0.95,,831.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,831.25,Percent of total billed charges,,831.25,857.5,
HC PR 26123 Fasct Prtl Palmar 1 Dgt Prox Iphal Jt W/WO Rpr Cdm,PX-97500235,CDM,26123,CPT,975,RC,,inpatient,,,2091,1881.9,,0.95,,1986.45,Percent of total billed charges,,,0.98,,2049.18,Percent of total billed charges,,,0.95,,1986.45,Percent of total billed charges,,,0.97,,2028.27,Percent of total billed charges,,,0.97,,2028.27,Percent of total billed charges,,,0.96,,2007.36,Percent of total billed charges,,,0.95,,1986.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1986.45,Percent of total billed charges,,1986.45,2049.18,
HC PR 26123 Fasct Prtl Palmar 1 Dgt Prox Iphal Jt W/WO Rpr Cdm,PX-97500235,CDM,26123,CPT,975,RC,,outpatient,,,2091,1881.9,,0.95,,1986.45,Percent of total billed charges,,,0.98,,2049.18,Percent of total billed charges,,,0.95,,1986.45,Percent of total billed charges,,,0.95,,1986.45,Percent of total billed charges,,,0.97,,2028.27,Percent of total billed charges,,,0.96,,2007.36,Percent of total billed charges,,,0.95,,1986.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1986.45,Percent of total billed charges,,1986.45,2049.18,
HC PR 26418 Repair Extensor Tendon Finger W/O Graft Each Cdm,PX-97500238,CDM,26418,CPT,975,RC,,inpatient,,,1559,1403.1,,0.95,,1481.05,Percent of total billed charges,,,0.98,,1527.82,Percent of total billed charges,,,0.95,,1481.05,Percent of total billed charges,,,0.97,,1512.23,Percent of total billed charges,,,0.97,,1512.23,Percent of total billed charges,,,0.96,,1496.64,Percent of total billed charges,,,0.95,,1481.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1481.05,Percent of total billed charges,,1481.05,1527.82,
HC PR 26418 Repair Extensor Tendon Finger W/O Graft Each Cdm,PX-97500238,CDM,26418,CPT,975,RC,,outpatient,,,1559,1403.1,,0.95,,1481.05,Percent of total billed charges,,,0.98,,1527.82,Percent of total billed charges,,,0.95,,1481.05,Percent of total billed charges,,,0.95,,1481.05,Percent of total billed charges,,,0.97,,1512.23,Percent of total billed charges,,,0.96,,1496.64,Percent of total billed charges,,,0.95,,1481.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1481.05,Percent of total billed charges,,1481.05,1527.82,
HC PR 26951 Amp F/Th 1/2 Jt/Phalanx W/Neurect W/Dir Clsr Cdm,PX-97500244,CDM,26951,CPT,975,RC,,inpatient,,,1752,1576.8,,0.95,,1664.4,Percent of total billed charges,,,0.98,,1716.96,Percent of total billed charges,,,0.95,,1664.4,Percent of total billed charges,,,0.97,,1699.44,Percent of total billed charges,,,0.97,,1699.44,Percent of total billed charges,,,0.96,,1681.92,Percent of total billed charges,,,0.95,,1664.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1664.4,Percent of total billed charges,,1664.4,1716.96,
HC PR 26951 Amp F/Th 1/2 Jt/Phalanx W/Neurect W/Dir Clsr Cdm,PX-97500244,CDM,26951,CPT,975,RC,,outpatient,,,1752,1576.8,,0.95,,1664.4,Percent of total billed charges,,,0.98,,1716.96,Percent of total billed charges,,,0.95,,1664.4,Percent of total billed charges,,,0.95,,1664.4,Percent of total billed charges,,,0.97,,1699.44,Percent of total billed charges,,,0.96,,1681.92,Percent of total billed charges,,,0.95,,1664.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1664.4,Percent of total billed charges,,1664.4,1716.96,
HC PR 29875 Arthroscopy Knee Synovectomy Limited Spx Cdm,PX-97500250,CDM,29875,CPT,975,RC,,inpatient,,,1241,1116.9,,0.95,,1178.95,Percent of total billed charges,,,0.98,,1216.18,Percent of total billed charges,,,0.95,,1178.95,Percent of total billed charges,,,0.97,,1203.77,Percent of total billed charges,,,0.97,,1203.77,Percent of total billed charges,,,0.96,,1191.36,Percent of total billed charges,,,0.95,,1178.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1178.95,Percent of total billed charges,,1178.95,1216.18,
HC PR 29875 Arthroscopy Knee Synovectomy Limited Spx Cdm,PX-97500250,CDM,29875,CPT,975,RC,,outpatient,,,1241,1116.9,,0.95,,1178.95,Percent of total billed charges,,,0.98,,1216.18,Percent of total billed charges,,,0.95,,1178.95,Percent of total billed charges,,,0.95,,1178.95,Percent of total billed charges,,,0.97,,1203.77,Percent of total billed charges,,,0.96,,1191.36,Percent of total billed charges,,,0.95,,1178.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1178.95,Percent of total billed charges,,1178.95,1216.18,
Prolonged Inpatient/Observation Em Svc Ea 15 Min,PX-98300452,CDM,99418,CPT,987,RC,,inpatient,,,96,86.4,,0.95,,91.2,Percent of total billed charges,,,0.98,,94.08,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.96,,92.16,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,91.2,Percent of total billed charges,,91.2,94.08,
Prolonged Inpatient/Observation Em Svc Ea 15 Min,PX-98300452,CDM,99418,CPT,987,RC,,outpatient,,,96,86.4,,0.95,,91.2,Percent of total billed charges,,,0.98,,94.08,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.96,,92.16,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,91.2,Percent of total billed charges,,91.2,94.08,
HC PR 49592 Rpr Aa Hernia 1st < 3 Cm Ncrc8/Strangulated Cdm,PX-97500164,CDM,49592,CPT,975,RC,,inpatient,,,2204,1983.6,,0.95,,2093.8,Percent of total billed charges,,,0.98,,2159.92,Percent of total billed charges,,,0.95,,2093.8,Percent of total billed charges,,,0.97,,2137.88,Percent of total billed charges,,,0.97,,2137.88,Percent of total billed charges,,,0.96,,2115.84,Percent of total billed charges,,,0.95,,2093.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2093.8,Percent of total billed charges,,2093.8,2159.92,
HC PR 49592 Rpr Aa Hernia 1st < 3 Cm Ncrc8/Strangulated Cdm,PX-97500164,CDM,49592,CPT,975,RC,,outpatient,,,2204,1983.6,,0.95,,2093.8,Percent of total billed charges,,,0.98,,2159.92,Percent of total billed charges,,,0.95,,2093.8,Percent of total billed charges,,,0.95,,2093.8,Percent of total billed charges,,,0.97,,2137.88,Percent of total billed charges,,,0.96,,2115.84,Percent of total billed charges,,,0.95,,2093.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2093.8,Percent of total billed charges,,2093.8,2159.92,
HC PR 49615 Rpr Aa Hernia Recr 3-10 Cm Reducible Cdm,PX-97500171,CDM,49615,CPT,975,RC,,inpatient,,,2307,2076.3,,0.95,,2191.65,Percent of total billed charges,,,0.98,,2260.86,Percent of total billed charges,,,0.95,,2191.65,Percent of total billed charges,,,0.97,,2237.79,Percent of total billed charges,,,0.97,,2237.79,Percent of total billed charges,,,0.96,,2214.72,Percent of total billed charges,,,0.95,,2191.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2191.65,Percent of total billed charges,,2191.65,2260.86,
HC PR 49615 Rpr Aa Hernia Recr 3-10 Cm Reducible Cdm,PX-97500171,CDM,49615,CPT,975,RC,,outpatient,,,2307,2076.3,,0.95,,2191.65,Percent of total billed charges,,,0.98,,2260.86,Percent of total billed charges,,,0.95,,2191.65,Percent of total billed charges,,,0.95,,2191.65,Percent of total billed charges,,,0.97,,2237.79,Percent of total billed charges,,,0.96,,2214.72,Percent of total billed charges,,,0.95,,2191.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2191.65,Percent of total billed charges,,2191.65,2260.86,
HC PR 49595 Rpr Aa Hernia 1st > 10 Cm Reducible Cdm,PX-97500167,CDM,49595,CPT,975,RC,,inpatient,,,2314,2082.6,,0.95,,2198.3,Percent of total billed charges,,,0.98,,2267.72,Percent of total billed charges,,,0.95,,2198.3,Percent of total billed charges,,,0.97,,2244.58,Percent of total billed charges,,,0.97,,2244.58,Percent of total billed charges,,,0.96,,2221.44,Percent of total billed charges,,,0.95,,2198.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2198.3,Percent of total billed charges,,2198.3,2267.72,
HC PR 49595 Rpr Aa Hernia 1st > 10 Cm Reducible Cdm,PX-97500167,CDM,49595,CPT,975,RC,,outpatient,,,2314,2082.6,,0.95,,2198.3,Percent of total billed charges,,,0.98,,2267.72,Percent of total billed charges,,,0.95,,2198.3,Percent of total billed charges,,,0.95,,2198.3,Percent of total billed charges,,,0.97,,2244.58,Percent of total billed charges,,,0.96,,2221.44,Percent of total billed charges,,,0.95,,2198.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2198.3,Percent of total billed charges,,2198.3,2267.72,
HC PR 49613 Rpr Aa Hernia Recr < 3 Cm Reducible Cdm,PX-97500169,CDM,49613,CPT,975,RC,,inpatient,,,2014,1812.6,,0.95,,1913.3,Percent of total billed charges,,,0.98,,1973.72,Percent of total billed charges,,,0.95,,1913.3,Percent of total billed charges,,,0.97,,1953.58,Percent of total billed charges,,,0.97,,1953.58,Percent of total billed charges,,,0.96,,1933.44,Percent of total billed charges,,,0.95,,1913.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1913.3,Percent of total billed charges,,1913.3,1973.72,
HC PR 49613 Rpr Aa Hernia Recr < 3 Cm Reducible Cdm,PX-97500169,CDM,49613,CPT,975,RC,,outpatient,,,2014,1812.6,,0.95,,1913.3,Percent of total billed charges,,,0.98,,1973.72,Percent of total billed charges,,,0.95,,1913.3,Percent of total billed charges,,,0.95,,1913.3,Percent of total billed charges,,,0.97,,1953.58,Percent of total billed charges,,,0.96,,1933.44,Percent of total billed charges,,,0.95,,1913.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1913.3,Percent of total billed charges,,1913.3,1973.72,
HC PR 49594 Rpr Aa Hernia 1st 3-10 Cm Ncrc8/Strangulated Cdm,PX-97500166,CDM,49594,CPT,975,RC,,inpatient,,,2314,2082.6,,0.95,,2198.3,Percent of total billed charges,,,0.98,,2267.72,Percent of total billed charges,,,0.95,,2198.3,Percent of total billed charges,,,0.97,,2244.58,Percent of total billed charges,,,0.97,,2244.58,Percent of total billed charges,,,0.96,,2221.44,Percent of total billed charges,,,0.95,,2198.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2198.3,Percent of total billed charges,,2198.3,2267.72,
HC PR 49594 Rpr Aa Hernia 1st 3-10 Cm Ncrc8/Strangulated Cdm,PX-97500166,CDM,49594,CPT,975,RC,,outpatient,,,2314,2082.6,,0.95,,2198.3,Percent of total billed charges,,,0.98,,2267.72,Percent of total billed charges,,,0.95,,2198.3,Percent of total billed charges,,,0.95,,2198.3,Percent of total billed charges,,,0.97,,2244.58,Percent of total billed charges,,,0.96,,2221.44,Percent of total billed charges,,,0.95,,2198.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2198.3,Percent of total billed charges,,2198.3,2267.72,
HC PR 49596 Rpr Aa Hernia 1st > 10 Cm Ncrc8/Strangulated Cdm,PX-97500168,CDM,49596,CPT,975,RC,,inpatient,,,2505,2254.5,,0.95,,2379.75,Percent of total billed charges,,,0.98,,2454.9,Percent of total billed charges,,,0.95,,2379.75,Percent of total billed charges,,,0.97,,2429.85,Percent of total billed charges,,,0.97,,2429.85,Percent of total billed charges,,,0.96,,2404.8,Percent of total billed charges,,,0.95,,2379.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2379.75,Percent of total billed charges,,2379.75,2454.9,
HC PR 49596 Rpr Aa Hernia 1st > 10 Cm Ncrc8/Strangulated Cdm,PX-97500168,CDM,49596,CPT,975,RC,,outpatient,,,2505,2254.5,,0.95,,2379.75,Percent of total billed charges,,,0.98,,2454.9,Percent of total billed charges,,,0.95,,2379.75,Percent of total billed charges,,,0.95,,2379.75,Percent of total billed charges,,,0.97,,2429.85,Percent of total billed charges,,,0.96,,2404.8,Percent of total billed charges,,,0.95,,2379.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2379.75,Percent of total billed charges,,2379.75,2454.9,
HC PR 49593 Rpr Aa Hernia 1st 3-10 Cm Reducible Cdm,PX-97500165,CDM,49593,CPT,975,RC,,inpatient,,,2204,1983.6,,0.95,,2093.8,Percent of total billed charges,,,0.98,,2159.92,Percent of total billed charges,,,0.95,,2093.8,Percent of total billed charges,,,0.97,,2137.88,Percent of total billed charges,,,0.97,,2137.88,Percent of total billed charges,,,0.96,,2115.84,Percent of total billed charges,,,0.95,,2093.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2093.8,Percent of total billed charges,,2093.8,2159.92,
HC PR 49593 Rpr Aa Hernia 1st 3-10 Cm Reducible Cdm,PX-97500165,CDM,49593,CPT,975,RC,,outpatient,,,2204,1983.6,,0.95,,2093.8,Percent of total billed charges,,,0.98,,2159.92,Percent of total billed charges,,,0.95,,2093.8,Percent of total billed charges,,,0.95,,2093.8,Percent of total billed charges,,,0.97,,2137.88,Percent of total billed charges,,,0.96,,2115.84,Percent of total billed charges,,,0.95,,2093.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2093.8,Percent of total billed charges,,2093.8,2159.92,
HC PR 49618 Rpr Aa Hernia Recr > 10 Cm Ncrc8/Strangulated Cdm,PX-97500174,CDM,49618,CPT,975,RC,,inpatient,,,3036,2732.4,,0.95,,2884.2,Percent of total billed charges,,,0.98,,2975.28,Percent of total billed charges,,,0.95,,2884.2,Percent of total billed charges,,,0.97,,2944.92,Percent of total billed charges,,,0.97,,2944.92,Percent of total billed charges,,,0.96,,2914.56,Percent of total billed charges,,,0.95,,2884.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2884.2,Percent of total billed charges,,2884.2,2975.28,
HC PR 49618 Rpr Aa Hernia Recr > 10 Cm Ncrc8/Strangulated Cdm,PX-97500174,CDM,49618,CPT,975,RC,,outpatient,,,3036,2732.4,,0.95,,2884.2,Percent of total billed charges,,,0.98,,2975.28,Percent of total billed charges,,,0.95,,2884.2,Percent of total billed charges,,,0.95,,2884.2,Percent of total billed charges,,,0.97,,2944.92,Percent of total billed charges,,,0.96,,2914.56,Percent of total billed charges,,,0.95,,2884.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2884.2,Percent of total billed charges,,2884.2,2975.28,
HC PR 49591 Rpr Aa Hernia 1st < 3 Cm Reducible Cdm,PX-97500163,CDM,49591,CPT,975,RC,,inpatient,,,1744,1569.6,,0.95,,1656.8,Percent of total billed charges,,,0.98,,1709.12,Percent of total billed charges,,,0.95,,1656.8,Percent of total billed charges,,,0.97,,1691.68,Percent of total billed charges,,,0.97,,1691.68,Percent of total billed charges,,,0.96,,1674.24,Percent of total billed charges,,,0.95,,1656.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1656.8,Percent of total billed charges,,1656.8,1709.12,
HC PR 49591 Rpr Aa Hernia 1st < 3 Cm Reducible Cdm,PX-97500163,CDM,49591,CPT,975,RC,,outpatient,,,1744,1569.6,,0.95,,1656.8,Percent of total billed charges,,,0.98,,1709.12,Percent of total billed charges,,,0.95,,1656.8,Percent of total billed charges,,,0.95,,1656.8,Percent of total billed charges,,,0.97,,1691.68,Percent of total billed charges,,,0.96,,1674.24,Percent of total billed charges,,,0.95,,1656.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1656.8,Percent of total billed charges,,1656.8,1709.12,
HC PR 49617 Rpr Aa Hernia Recr > 10 Cm Reducible Cdm,PX-97500173,CDM,49617,CPT,975,RC,,inpatient,,,2676,2408.4,,0.95,,2542.2,Percent of total billed charges,,,0.98,,2622.48,Percent of total billed charges,,,0.95,,2542.2,Percent of total billed charges,,,0.97,,2595.72,Percent of total billed charges,,,0.97,,2595.72,Percent of total billed charges,,,0.96,,2568.96,Percent of total billed charges,,,0.95,,2542.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2542.2,Percent of total billed charges,,2542.2,2622.48,
HC PR 49617 Rpr Aa Hernia Recr > 10 Cm Reducible Cdm,PX-97500173,CDM,49617,CPT,975,RC,,outpatient,,,2676,2408.4,,0.95,,2542.2,Percent of total billed charges,,,0.98,,2622.48,Percent of total billed charges,,,0.95,,2542.2,Percent of total billed charges,,,0.95,,2542.2,Percent of total billed charges,,,0.97,,2595.72,Percent of total billed charges,,,0.96,,2568.96,Percent of total billed charges,,,0.95,,2542.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2542.2,Percent of total billed charges,,2542.2,2622.48,
HC PR 49616 Rpr Aa Hernia Recr 3-10 Cm Ncrc8/Strangulated Cdm,PX-97500172,CDM,49616,CPT,975,RC,,inpatient,,,2307,2076.3,,0.95,,2191.65,Percent of total billed charges,,,0.98,,2260.86,Percent of total billed charges,,,0.95,,2191.65,Percent of total billed charges,,,0.97,,2237.79,Percent of total billed charges,,,0.97,,2237.79,Percent of total billed charges,,,0.96,,2214.72,Percent of total billed charges,,,0.95,,2191.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2191.65,Percent of total billed charges,,2191.65,2260.86,
HC PR 49616 Rpr Aa Hernia Recr 3-10 Cm Ncrc8/Strangulated Cdm,PX-97500172,CDM,49616,CPT,975,RC,,outpatient,,,2307,2076.3,,0.95,,2191.65,Percent of total billed charges,,,0.98,,2260.86,Percent of total billed charges,,,0.95,,2191.65,Percent of total billed charges,,,0.95,,2191.65,Percent of total billed charges,,,0.97,,2237.79,Percent of total billed charges,,,0.96,,2214.72,Percent of total billed charges,,,0.95,,2191.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2191.65,Percent of total billed charges,,2191.65,2260.86,
HC PR 49614 Rpr Aa Hernia Recr < 3 Cm Ncrc8/Strangulated Cdm,PX-97500170,CDM,49614,CPT,975,RC,,inpatient,,,2307,2076.3,,0.95,,2191.65,Percent of total billed charges,,,0.98,,2260.86,Percent of total billed charges,,,0.95,,2191.65,Percent of total billed charges,,,0.97,,2237.79,Percent of total billed charges,,,0.97,,2237.79,Percent of total billed charges,,,0.96,,2214.72,Percent of total billed charges,,,0.95,,2191.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2191.65,Percent of total billed charges,,2191.65,2260.86,
HC PR 49614 Rpr Aa Hernia Recr < 3 Cm Ncrc8/Strangulated Cdm,PX-97500170,CDM,49614,CPT,975,RC,,outpatient,,,2307,2076.3,,0.95,,2191.65,Percent of total billed charges,,,0.98,,2260.86,Percent of total billed charges,,,0.95,,2191.65,Percent of total billed charges,,,0.95,,2191.65,Percent of total billed charges,,,0.97,,2237.79,Percent of total billed charges,,,0.96,,2214.72,Percent of total billed charges,,,0.95,,2191.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2191.65,Percent of total billed charges,,2191.65,2260.86,
HC PR 15853 Removal Sutures/Staples Not Requiring Anesthesia Rhc,PX-52100224,CDM,15853,CPT,521,RC,,inpatient,,,24,21.6,,0.95,,22.8,Percent of total billed charges,,,0.98,,23.52,Percent of total billed charges,,,0.95,,22.8,Percent of total billed charges,,,0.97,,23.28,Percent of total billed charges,,,0.97,,23.28,Percent of total billed charges,,,0.96,,23.04,Percent of total billed charges,,,0.95,,22.8,Percent of total billed charges,,,,,,,,,0.95,,22.8,Percent of total billed charges,,22.8,23.52,
HC PR 15853 Removal Sutures/Staples Not Requiring Anesthesia Rhc,PX-52100224,CDM,15853,CPT,521,RC,,outpatient,,,24,21.6,,0.95,,22.8,Percent of total billed charges,,,0.98,,23.52,Percent of total billed charges,,,0.95,,22.8,Percent of total billed charges,,,0.95,,22.8,Percent of total billed charges,,,0.97,,23.28,Percent of total billed charges,,,0.96,,23.04,Percent of total billed charges,,,0.95,,22.8,Percent of total billed charges,,,,,,,,,0.95,,22.8,Percent of total billed charges,,22.8,23.52,
"Blood test, lipids (cholesterol and triglycerides)",PX-30100541,CDM,80061,CPT,301,RC,,inpatient,,,165,148.5,,0.95,,156.75,Percent of total billed charges,,,0.98,,161.7,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.96,,158.4,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,,,,,,,0.95,,156.75,Percent of total billed charges,,156.75,161.7,
"Blood test, lipids (cholesterol and triglycerides)",PX-30100541,CDM,80061,CPT,301,RC,,outpatient,,,165,148.5,,0.95,,156.75,Percent of total billed charges,,,0.98,,161.7,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.96,,158.4,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,,,,,,,0.95,,156.75,Percent of total billed charges,,156.75,161.7,
"Blood test, lipids (cholesterol and triglycerides)",PX-30100542,CDM,80061,CPT,301,RC,,inpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,,,0.95,,133,Percent of total billed charges,,133,137.2,
"Blood test, lipids (cholesterol and triglycerides)",PX-30100542,CDM,80061,CPT,301,RC,,outpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,,,0.95,,133,Percent of total billed charges,,133,137.2,
Tacrolimus level,PX-30100543,CDM,80197,CPT,301,RC,,inpatient,,,119,107.1,,0.95,,113.05,Percent of total billed charges,,,0.98,,116.62,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.96,,114.24,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,113.05,Percent of total billed charges,,113.05,116.62,
Tacrolimus level,PX-30100543,CDM,80197,CPT,301,RC,,outpatient,,,119,107.1,,0.95,,113.05,Percent of total billed charges,,,0.98,,116.62,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,0.97,,115.43,Percent of total billed charges,,,0.96,,114.24,Percent of total billed charges,,,0.95,,113.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,113.05,Percent of total billed charges,,113.05,116.62,
Vancomycin (antibiotic) level,PX-30100544,CDM,80202,CPT,301,RC,,inpatient,,,192,172.8,,0.95,,182.4,Percent of total billed charges,,,0.98,,188.16,Percent of total billed charges,,,0.95,,182.4,Percent of total billed charges,,,0.97,,186.24,Percent of total billed charges,,,0.97,,186.24,Percent of total billed charges,,,0.96,,184.32,Percent of total billed charges,,,0.95,,182.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,182.4,Percent of total billed charges,,182.4,188.16,
Vancomycin (antibiotic) level,PX-30100544,CDM,80202,CPT,301,RC,,outpatient,,,192,172.8,,0.95,,182.4,Percent of total billed charges,,,0.98,,188.16,Percent of total billed charges,,,0.95,,182.4,Percent of total billed charges,,,0.95,,182.4,Percent of total billed charges,,,0.97,,186.24,Percent of total billed charges,,,0.96,,184.32,Percent of total billed charges,,,0.95,,182.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,182.4,Percent of total billed charges,,182.4,188.16,
"Testing for drug presence, by chemistry analyzers",PX-30100547,CDM,80307,CPT,301,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Testing for drug presence, by chemistry analyzers",PX-30100547,CDM,80307,CPT,301,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Testing for drug presence, by chemistry analyzers",PX-30100548,CDM,80307,CPT,301,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Testing for drug presence, by chemistry analyzers",PX-30100548,CDM,80307,CPT,301,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Testing for drug presence, by chemistry analyzers",PX-30100549,CDM,80307,CPT,301,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Testing for drug presence, by chemistry analyzers",PX-30100549,CDM,80307,CPT,301,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Testing for drug presence, by chemistry analyzers",PX-30100550,CDM,80307,CPT,301,RC,,inpatient,,,290,261,,0.95,,275.5,Percent of total billed charges,,,0.98,,284.2,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.96,,278.4,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,275.5,Percent of total billed charges,,275.5,284.2,
"Testing for drug presence, by chemistry analyzers",PX-30100550,CDM,80307,CPT,301,RC,,outpatient,,,290,261,,0.95,,275.5,Percent of total billed charges,,,0.98,,284.2,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.96,,278.4,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,275.5,Percent of total billed charges,,275.5,284.2,
"Testing for drug presence, by chemistry analyzers",PX-30100551,CDM,80307,CPT,301,RC,,inpatient,,,290,261,,0.95,,275.5,Percent of total billed charges,,,0.98,,284.2,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.96,,278.4,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,275.5,Percent of total billed charges,,275.5,284.2,
"Testing for drug presence, by chemistry analyzers",PX-30100551,CDM,80307,CPT,301,RC,,outpatient,,,290,261,,0.95,,275.5,Percent of total billed charges,,,0.98,,284.2,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.96,,278.4,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,275.5,Percent of total billed charges,,275.5,284.2,
"Testing for drug presence, by chemistry analyzers",PX-30100552,CDM,80307,CPT,301,RC,,inpatient,,,290,261,,0.95,,275.5,Percent of total billed charges,,,0.98,,284.2,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.96,,278.4,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,275.5,Percent of total billed charges,,275.5,284.2,
"Testing for drug presence, by chemistry analyzers",PX-30100552,CDM,80307,CPT,301,RC,,outpatient,,,290,261,,0.95,,275.5,Percent of total billed charges,,,0.98,,284.2,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.96,,278.4,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,275.5,Percent of total billed charges,,275.5,284.2,
"Testing for drug presence, by chemistry analyzers",PX-30100553,CDM,80307,CPT,301,RC,,inpatient,,,290,261,,0.95,,275.5,Percent of total billed charges,,,0.98,,284.2,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.96,,278.4,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,275.5,Percent of total billed charges,,275.5,284.2,
"Testing for drug presence, by chemistry analyzers",PX-30100553,CDM,80307,CPT,301,RC,,outpatient,,,290,261,,0.95,,275.5,Percent of total billed charges,,,0.98,,284.2,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.96,,278.4,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,275.5,Percent of total billed charges,,275.5,284.2,
"Testing for drug presence, by chemistry analyzers",PX-30100554,CDM,80307,CPT,301,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Testing for drug presence, by chemistry analyzers",PX-30100554,CDM,80307,CPT,301,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
Albumin (protein) level,PX-30100562,CDM,82040,CPT,301,RC,,inpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
Albumin (protein) level,PX-30100562,CDM,82040,CPT,301,RC,,outpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
"Cerebrospinal fluid, or amniotic fluid albumin level",PX-30100563,CDM,82042,CPT,301,RC,,inpatient,,,22,19.8,,0.95,,20.9,Percent of total billed charges,,,0.98,,21.56,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.96,,21.12,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,20.9,Percent of total billed charges,,20.9,21.56,
"Cerebrospinal fluid, or amniotic fluid albumin level",PX-30100563,CDM,82042,CPT,301,RC,,outpatient,,,22,19.8,,0.95,,20.9,Percent of total billed charges,,,0.98,,21.56,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.96,,21.12,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,20.9,Percent of total billed charges,,20.9,21.56,
Urine microalbumin (protein) level,PX-30100564,CDM,82043,CPT,301,RC,,inpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
Urine microalbumin (protein) level,PX-30100564,CDM,82043,CPT,301,RC,,outpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
"Alpha-fetoprotein (AFP) level, serum",PX-30100565,CDM,82105,CPT,301,RC,,inpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
"Alpha-fetoprotein (AFP) level, serum",PX-30100565,CDM,82105,CPT,301,RC,,outpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Amylase (enzyme) level,PX-30100567,CDM,82150,CPT,301,RC,,inpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
Amylase (enzyme) level,PX-30100567,CDM,82150,CPT,301,RC,,outpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
Amylase (enzyme) level,PX-30100568,CDM,82150,CPT,301,RC,,inpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
Amylase (enzyme) level,PX-30100568,CDM,82150,CPT,301,RC,,outpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
Amylase (enzyme) level,PX-30100569,CDM,82150,CPT,301,RC,,inpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
Amylase (enzyme) level,PX-30100569,CDM,82150,CPT,301,RC,,outpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
"Bilirubin level, total",PX-30100570,CDM,82247,CPT,301,RC,,inpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
"Bilirubin level, total",PX-30100570,CDM,82247,CPT,301,RC,,outpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
"Bilirubin level, total",PX-30100571,CDM,82247,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
"Bilirubin level, total",PX-30100571,CDM,82247,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
"Bilirubin level, direct",PX-30100572,CDM,82248,CPT,301,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
"Bilirubin level, direct",PX-30100572,CDM,82248,CPT,301,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
"Calcium level, total",PX-30100574,CDM,82310,CPT,301,RC,,inpatient,,,70,63,,0.95,,66.5,Percent of total billed charges,,,0.98,,68.6,Percent of total billed charges,,,0.95,,66.5,Percent of total billed charges,,,0.97,,67.9,Percent of total billed charges,,,0.97,,67.9,Percent of total billed charges,,,0.96,,67.2,Percent of total billed charges,,,0.95,,66.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,66.5,Percent of total billed charges,,66.5,68.6,
"Calcium level, total",PX-30100574,CDM,82310,CPT,301,RC,,outpatient,,,70,63,,0.95,,66.5,Percent of total billed charges,,,0.98,,68.6,Percent of total billed charges,,,0.95,,66.5,Percent of total billed charges,,,0.95,,66.5,Percent of total billed charges,,,0.97,,67.9,Percent of total billed charges,,,0.96,,67.2,Percent of total billed charges,,,0.95,,66.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,66.5,Percent of total billed charges,,66.5,68.6,
"Collagen cross links test, urine test for bone health",PX-30100578,CDM,82523,CPT,301,RC,,inpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
"Collagen cross links test, urine test for bone health",PX-30100578,CDM,82523,CPT,301,RC,,outpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
"Cortisol (hormone) measurement, total",PX-30100579,CDM,82533,CPT,301,RC,,inpatient,,,194,174.6,,0.95,,184.3,Percent of total billed charges,,,0.98,,190.12,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,0.97,,188.18,Percent of total billed charges,,,0.97,,188.18,Percent of total billed charges,,,0.96,,186.24,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,,,,,,,0.95,,184.3,Percent of total billed charges,,184.3,190.12,
"Cortisol (hormone) measurement, total",PX-30100579,CDM,82533,CPT,301,RC,,outpatient,,,194,174.6,,0.95,,184.3,Percent of total billed charges,,,0.98,,190.12,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,0.97,,188.18,Percent of total billed charges,,,0.96,,186.24,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,,,,,,,0.95,,184.3,Percent of total billed charges,,184.3,190.12,
"Cortisol (hormone) measurement, total",PX-30100580,CDM,82533,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
"Cortisol (hormone) measurement, total",PX-30100580,CDM,82533,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
"Cortisol (hormone) measurement, total",PX-30100581,CDM,82533,CPT,301,RC,,inpatient,,,194,174.6,,0.95,,184.3,Percent of total billed charges,,,0.98,,190.12,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,0.97,,188.18,Percent of total billed charges,,,0.97,,188.18,Percent of total billed charges,,,0.96,,186.24,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,,,,,,,0.95,,184.3,Percent of total billed charges,,184.3,190.12,
"Cortisol (hormone) measurement, total",PX-30100581,CDM,82533,CPT,301,RC,,outpatient,,,194,174.6,,0.95,,184.3,Percent of total billed charges,,,0.98,,190.12,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,0.97,,188.18,Percent of total billed charges,,,0.96,,186.24,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,,,,,,,0.95,,184.3,Percent of total billed charges,,184.3,190.12,
"Cortisol (hormone) measurement, total",PX-30100582,CDM,82533,CPT,301,RC,,inpatient,,,194,174.6,,0.95,,184.3,Percent of total billed charges,,,0.98,,190.12,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,0.97,,188.18,Percent of total billed charges,,,0.97,,188.18,Percent of total billed charges,,,0.96,,186.24,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,,,,,,,0.95,,184.3,Percent of total billed charges,,184.3,190.12,
"Cortisol (hormone) measurement, total",PX-30100582,CDM,82533,CPT,301,RC,,outpatient,,,194,174.6,,0.95,,184.3,Percent of total billed charges,,,0.98,,190.12,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,0.97,,188.18,Percent of total billed charges,,,0.96,,186.24,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,,,,,,,0.95,,184.3,Percent of total billed charges,,184.3,190.12,
"Creatine kinase (cardiac enzyme) level, total",PX-30100585,CDM,82550,CPT,301,RC,,inpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
"Creatine kinase (cardiac enzyme) level, total",PX-30100585,CDM,82550,CPT,301,RC,,outpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
"Creatine kinase (cardiac enzyme) level, MB fraction only",PX-30100587,CDM,82553,CPT,301,RC,,inpatient,,,171,153.9,,0.95,,162.45,Percent of total billed charges,,,0.98,,167.58,Percent of total billed charges,,,0.95,,162.45,Percent of total billed charges,,,0.97,,165.87,Percent of total billed charges,,,0.97,,165.87,Percent of total billed charges,,,0.96,,164.16,Percent of total billed charges,,,0.95,,162.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,162.45,Percent of total billed charges,,162.45,167.58,
"Creatine kinase (cardiac enzyme) level, MB fraction only",PX-30100587,CDM,82553,CPT,301,RC,,outpatient,,,171,153.9,,0.95,,162.45,Percent of total billed charges,,,0.98,,167.58,Percent of total billed charges,,,0.95,,162.45,Percent of total billed charges,,,0.95,,162.45,Percent of total billed charges,,,0.97,,165.87,Percent of total billed charges,,,0.96,,164.16,Percent of total billed charges,,,0.95,,162.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,162.45,Percent of total billed charges,,162.45,167.58,
Creatinine level to test for kidney function/muscle injury,PX-30100592,CDM,82570,CPT,301,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Creatinine level to test for kidney function/muscle injury,PX-30100592,CDM,82570,CPT,301,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Creatinine level to test for kidney function/muscle injury,PX-30100593,CDM,82570,CPT,301,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Creatinine level to test for kidney function/muscle injury,PX-30100593,CDM,82570,CPT,301,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Creatinine level to test for kidney function/muscle injury,PX-30100594,CDM,82570,CPT,301,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Creatinine level to test for kidney function/muscle injury,PX-30100594,CDM,82570,CPT,301,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Creatinine level to test for kidney function/muscle injury,PX-30100595,CDM,82570,CPT,301,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Creatinine level to test for kidney function/muscle injury,PX-30100595,CDM,82570,CPT,301,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Measurement of total estradiol (hormone),PX-30100596,CDM,82670,CPT,301,RC,,inpatient,,,206,185.4,,0.95,,195.7,Percent of total billed charges,,,0.98,,201.88,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.96,,197.76,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,195.7,Percent of total billed charges,,195.7,201.88,
Measurement of total estradiol (hormone),PX-30100596,CDM,82670,CPT,301,RC,,outpatient,,,206,185.4,,0.95,,195.7,Percent of total billed charges,,,0.98,,201.88,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.96,,197.76,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,195.7,Percent of total billed charges,,195.7,201.88,
Estriol (hormone) level,PX-30100597,CDM,82677,CPT,301,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Estriol (hormone) level,PX-30100597,CDM,82677,CPT,301,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Estriol (hormone) level,PX-30100598,CDM,82677,CPT,301,RC,,inpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
Estriol (hormone) level,PX-30100598,CDM,82677,CPT,301,RC,,outpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
Gammaglobulin test,PX-30100603,CDM,82784,CPT,301,RC,,inpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,,,0.95,,76,Percent of total billed charges,,76,78.4,
Gammaglobulin test,PX-30100603,CDM,82784,CPT,301,RC,,outpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,,,0.95,,76,Percent of total billed charges,,76,78.4,
Gammaglobulin test,PX-30100604,CDM,82784,CPT,301,RC,,inpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,,,0.95,,76,Percent of total billed charges,,76,78.4,
Gammaglobulin test,PX-30100604,CDM,82784,CPT,301,RC,,outpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,,,0.95,,76,Percent of total billed charges,,76,78.4,
Gammaglobulin test,PX-30100605,CDM,82784,CPT,301,RC,,inpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,,,0.95,,76,Percent of total billed charges,,76,78.4,
Gammaglobulin test,PX-30100605,CDM,82784,CPT,301,RC,,outpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,,,0.95,,76,Percent of total billed charges,,76,78.4,
Gammaglobulin test,PX-30100606,CDM,82784,CPT,301,RC,,inpatient,,,48,43.2,,0.95,,45.6,Percent of total billed charges,,,0.98,,47.04,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.96,,46.08,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,45.6,Percent of total billed charges,,45.6,47.04,
Gammaglobulin test,PX-30100606,CDM,82784,CPT,301,RC,,outpatient,,,48,43.2,,0.95,,45.6,Percent of total billed charges,,,0.98,,47.04,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.96,,46.08,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,45.6,Percent of total billed charges,,45.6,47.04,
Gammaglobulin test,PX-30100607,CDM,82784,CPT,301,RC,,inpatient,,,48,43.2,,0.95,,45.6,Percent of total billed charges,,,0.98,,47.04,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.96,,46.08,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,45.6,Percent of total billed charges,,45.6,47.04,
Gammaglobulin test,PX-30100607,CDM,82784,CPT,301,RC,,outpatient,,,48,43.2,,0.95,,45.6,Percent of total billed charges,,,0.98,,47.04,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.96,,46.08,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,45.6,Percent of total billed charges,,45.6,47.04,
IgE (immune system protein) level,PX-30100609,CDM,82785,CPT,301,RC,,inpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
IgE (immune system protein) level,PX-30100609,CDM,82785,CPT,301,RC,,outpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
IgE (immune system protein) level,PX-30100610,CDM,82785,CPT,301,RC,,inpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
IgE (immune system protein) level,PX-30100610,CDM,82785,CPT,301,RC,,outpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
Blood glucose level after receiving glucose,PX-30100616,CDM,82950,CPT,301,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Blood glucose level after receiving glucose,PX-30100616,CDM,82950,CPT,301,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Breath test analysis for helicobacter pylori,PX-30100617,CDM,83013,CPT,301,RC,,inpatient,,,312,280.8,,0.95,,296.4,Percent of total billed charges,,,0.98,,305.76,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,0.97,,302.64,Percent of total billed charges,,,0.97,,302.64,Percent of total billed charges,,,0.96,,299.52,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,296.4,Percent of total billed charges,,296.4,305.76,
Breath test analysis for helicobacter pylori,PX-30100617,CDM,83013,CPT,301,RC,,outpatient,,,312,280.8,,0.95,,296.4,Percent of total billed charges,,,0.98,,305.76,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,0.97,,302.64,Percent of total billed charges,,,0.96,,299.52,Percent of total billed charges,,,0.95,,296.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,296.4,Percent of total billed charges,,296.4,305.76,
Lead level,PX-30100624,CDM,83655,CPT,301,RC,,inpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
Lead level,PX-30100624,CDM,83655,CPT,301,RC,,outpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
Lead level,PX-30100625,CDM,83655,CPT,301,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
Lead level,PX-30100625,CDM,83655,CPT,301,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
Lipase (fat enzyme) level,PX-30100626,CDM,83690,CPT,301,RC,,inpatient,,,121,108.9,,0.95,,114.95,Percent of total billed charges,,,0.98,,118.58,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.96,,116.16,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114.95,Percent of total billed charges,,114.95,118.58,
Lipase (fat enzyme) level,PX-30100626,CDM,83690,CPT,301,RC,,outpatient,,,121,108.9,,0.95,,114.95,Percent of total billed charges,,,0.98,,118.58,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.96,,116.16,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114.95,Percent of total billed charges,,114.95,118.58,
"Lipoprotein level, quantitation of lipoprotein particle",PX-30100627,CDM,83704,CPT,301,RC,,inpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
"Lipoprotein level, quantitation of lipoprotein particle",PX-30100627,CDM,83704,CPT,301,RC,,outpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
Natriuretic peptide (heart and blood vessel protein) level,PX-30100630,CDM,83880,CPT,301,RC,,inpatient,,,262,235.8,,0.95,,248.9,Percent of total billed charges,,,0.98,,256.76,Percent of total billed charges,,,0.95,,248.9,Percent of total billed charges,,,0.97,,254.14,Percent of total billed charges,,,0.97,,254.14,Percent of total billed charges,,,0.96,,251.52,Percent of total billed charges,,,0.95,,248.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,248.9,Percent of total billed charges,,248.9,256.76,
Natriuretic peptide (heart and blood vessel protein) level,PX-30100630,CDM,83880,CPT,301,RC,,outpatient,,,262,235.8,,0.95,,248.9,Percent of total billed charges,,,0.98,,256.76,Percent of total billed charges,,,0.95,,248.9,Percent of total billed charges,,,0.95,,248.9,Percent of total billed charges,,,0.97,,254.14,Percent of total billed charges,,,0.96,,251.52,Percent of total billed charges,,,0.95,,248.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,248.9,Percent of total billed charges,,248.9,256.76,
Natriuretic peptide (heart and blood vessel protein) level,PX-30100631,CDM,83880,CPT,301,RC,,inpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
Natriuretic peptide (heart and blood vessel protein) level,PX-30100631,CDM,83880,CPT,301,RC,,outpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
"Phosphatase (enzyme) level, alkaline",PX-30100632,CDM,84075,CPT,301,RC,,inpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
"Phosphatase (enzyme) level, alkaline",PX-30100632,CDM,84075,CPT,301,RC,,outpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
"Phosphatase (enzyme) measurement, alkaline, isoenzymes",PX-30100633,CDM,84080,CPT,301,RC,,inpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
"Phosphatase (enzyme) measurement, alkaline, isoenzymes",PX-30100633,CDM,84080,CPT,301,RC,,outpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
Urine potassium level,PX-30100635,CDM,84133,CPT,301,RC,,inpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
Urine potassium level,PX-30100635,CDM,84133,CPT,301,RC,,outpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
"Total protein level, blood",PX-30100636,CDM,84155,CPT,301,RC,,inpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
"Total protein level, blood",PX-30100636,CDM,84155,CPT,301,RC,,outpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
"Total protein level, blood",PX-30100637,CDM,84155,CPT,301,RC,,inpatient,,,153,137.7,,0.95,,145.35,Percent of total billed charges,,,0.98,,149.94,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.96,,146.88,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,,,,,,,0.95,,145.35,Percent of total billed charges,,145.35,149.94,
"Total protein level, blood",PX-30100637,CDM,84155,CPT,301,RC,,outpatient,,,153,137.7,,0.95,,145.35,Percent of total billed charges,,,0.98,,149.94,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.96,,146.88,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,,,,,,,0.95,,145.35,Percent of total billed charges,,145.35,149.94,
"Total protein level, blood",PX-30100638,CDM,84155,CPT,301,RC,,inpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
"Total protein level, blood",PX-30100638,CDM,84155,CPT,301,RC,,outpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
"Total protein level, urine",PX-30100639,CDM,84156,CPT,301,RC,,inpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
"Total protein level, urine",PX-30100639,CDM,84156,CPT,301,RC,,outpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
Pregnancy-associated plasma protein-A level,PX-30100642,CDM,84163,CPT,301,RC,,inpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
Pregnancy-associated plasma protein-A level,PX-30100642,CDM,84163,CPT,301,RC,,outpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
Pregnancy-associated plasma protein-A level,PX-30100643,CDM,84163,CPT,301,RC,,inpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
Pregnancy-associated plasma protein-A level,PX-30100643,CDM,84163,CPT,301,RC,,outpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
"Protein measurement, serum",PX-30100644,CDM,84165,CPT,301,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
"Protein measurement, serum",PX-30100644,CDM,84165,CPT,301,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
"Protein measurement, serum",PX-30100645,CDM,84165,CPT,301,RC,,inpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
"Protein measurement, serum",PX-30100645,CDM,84165,CPT,301,RC,,outpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
Sex hormone binding globulin (protein) level,PX-30100651,CDM,84270,CPT,301,RC,,inpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
Sex hormone binding globulin (protein) level,PX-30100651,CDM,84270,CPT,301,RC,,outpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
Urine sodium level,PX-30100652,CDM,84300,CPT,301,RC,,inpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
Urine sodium level,PX-30100652,CDM,84300,CPT,301,RC,,outpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
"Testosterone (hormone) level, free",PX-30100653,CDM,84402,CPT,301,RC,,inpatient,,,41,36.9,,0.95,,38.95,Percent of total billed charges,,,0.98,,40.18,Percent of total billed charges,,,0.95,,38.95,Percent of total billed charges,,,0.97,,39.77,Percent of total billed charges,,,0.97,,39.77,Percent of total billed charges,,,0.96,,39.36,Percent of total billed charges,,,0.95,,38.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38.95,Percent of total billed charges,,38.95,40.18,
"Testosterone (hormone) level, free",PX-30100653,CDM,84402,CPT,301,RC,,outpatient,,,41,36.9,,0.95,,38.95,Percent of total billed charges,,,0.98,,40.18,Percent of total billed charges,,,0.95,,38.95,Percent of total billed charges,,,0.95,,38.95,Percent of total billed charges,,,0.97,,39.77,Percent of total billed charges,,,0.96,,39.36,Percent of total billed charges,,,0.95,,38.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,38.95,Percent of total billed charges,,38.95,40.18,
"Testosterone (hormone) level, total",PX-30100655,CDM,84403,CPT,301,RC,,inpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
"Testosterone (hormone) level, total",PX-30100655,CDM,84403,CPT,301,RC,,outpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
"Testosterone (hormone) level, total",PX-30100656,CDM,84403,CPT,301,RC,,inpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
"Testosterone (hormone) level, total",PX-30100656,CDM,84403,CPT,301,RC,,outpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
"Testosterone (hormone) level, total",PX-30100657,CDM,84403,CPT,301,RC,,inpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
"Testosterone (hormone) level, total",PX-30100657,CDM,84403,CPT,301,RC,,outpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
"Thyroxine (thyroid chemical), total",PX-30100658,CDM,84436,CPT,301,RC,,inpatient,,,94,84.6,,0.95,,89.3,Percent of total billed charges,,,0.98,,92.12,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.96,,90.24,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,89.3,Percent of total billed charges,,89.3,92.12,
"Thyroxine (thyroid chemical), total",PX-30100658,CDM,84436,CPT,301,RC,,outpatient,,,94,84.6,,0.95,,89.3,Percent of total billed charges,,,0.98,,92.12,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,0.97,,91.18,Percent of total billed charges,,,0.96,,90.24,Percent of total billed charges,,,0.95,,89.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,89.3,Percent of total billed charges,,89.3,92.12,
"Thyroxine (thyroid chemical), free",PX-30100659,CDM,84439,CPT,301,RC,,inpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
"Thyroxine (thyroid chemical), free",PX-30100659,CDM,84439,CPT,301,RC,,outpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
"Blood test, thyroid stimulating hormone (TSH)",PX-30100660,CDM,84443,CPT,301,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"Blood test, thyroid stimulating hormone (TSH)",PX-30100660,CDM,84443,CPT,301,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"Blood test, thyroid stimulating hormone (TSH)",PX-30100661,CDM,84443,CPT,301,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"Blood test, thyroid stimulating hormone (TSH)",PX-30100661,CDM,84443,CPT,301,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"Blood test, thyroid stimulating hormone (TSH)",PX-30100662,CDM,84443,CPT,301,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"Blood test, thyroid stimulating hormone (TSH)",PX-30100662,CDM,84443,CPT,301,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
Thyroid hormone evaluation,PX-30100663,CDM,84479,CPT,301,RC,,inpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
Thyroid hormone evaluation,PX-30100663,CDM,84479,CPT,301,RC,,outpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
Thyroid hormone evaluation,PX-30100664,CDM,84479,CPT,301,RC,,inpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
Thyroid hormone evaluation,PX-30100664,CDM,84479,CPT,301,RC,,outpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
"Thyroid hormone, T3 measurement, total",PX-30100665,CDM,84480,CPT,301,RC,,inpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
"Thyroid hormone, T3 measurement, total",PX-30100665,CDM,84480,CPT,301,RC,,outpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
"Troponin (protein) analysis, quantitative",PX-30100666,CDM,84484,CPT,301,RC,,inpatient,,,156,140.4,,0.95,,148.2,Percent of total billed charges,,,0.98,,152.88,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,0.97,,151.32,Percent of total billed charges,,,0.97,,151.32,Percent of total billed charges,,,0.96,,149.76,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,148.2,Percent of total billed charges,,148.2,152.88,
"Troponin (protein) analysis, quantitative",PX-30100666,CDM,84484,CPT,301,RC,,outpatient,,,156,140.4,,0.95,,148.2,Percent of total billed charges,,,0.98,,152.88,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,0.97,,151.32,Percent of total billed charges,,,0.96,,149.76,Percent of total billed charges,,,0.95,,148.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,148.2,Percent of total billed charges,,148.2,152.88,
"Urea nitrogen level to assess kidney function, quantitative",PX-30100667,CDM,84520,CPT,301,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
"Urea nitrogen level to assess kidney function, quantitative",PX-30100667,CDM,84520,CPT,301,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
"Uric acid level, blood",PX-30100668,CDM,84550,CPT,301,RC,,inpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
"Uric acid level, blood",PX-30100668,CDM,84550,CPT,301,RC,,outpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
"Gonadotropin, chorionic (reproductive hormone) level",PX-30100670,CDM,84702,CPT,301,RC,,inpatient,,,185,166.5,,0.95,,175.75,Percent of total billed charges,,,0.98,,181.3,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,0.97,,179.45,Percent of total billed charges,,,0.97,,179.45,Percent of total billed charges,,,0.96,,177.6,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,175.75,Percent of total billed charges,,175.75,181.3,
"Gonadotropin, chorionic (reproductive hormone) level",PX-30100670,CDM,84702,CPT,301,RC,,outpatient,,,185,166.5,,0.95,,175.75,Percent of total billed charges,,,0.98,,181.3,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,0.97,,179.45,Percent of total billed charges,,,0.96,,177.6,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,175.75,Percent of total billed charges,,175.75,181.3,
"Measure antibody to allergic, crude allergen extract, each",PX-30200493,CDM,86003,CPT,302,RC,,inpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
"Measure antibody to allergic, crude allergen extract, each",PX-30200493,CDM,86003,CPT,302,RC,,outpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
"Measure antibody to allergic, crude allergen extract, each",PX-30200496,CDM,86003,CPT,302,RC,,inpatient,,,23,20.7,,0.95,,21.85,Percent of total billed charges,,,0.98,,22.54,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.96,,22.08,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,21.85,Percent of total billed charges,,21.85,22.54,
"Measure antibody to allergic, crude allergen extract, each",PX-30200496,CDM,86003,CPT,302,RC,,outpatient,,,23,20.7,,0.95,,21.85,Percent of total billed charges,,,0.98,,22.54,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.96,,22.08,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,21.85,Percent of total billed charges,,21.85,22.54,
Screening test for autoimmune disorder,PX-30200498,CDM,86038,CPT,302,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
Screening test for autoimmune disorder,PX-30200498,CDM,86038,CPT,302,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
Screening test for autoimmune disorder,PX-30200499,CDM,86038,CPT,302,RC,,inpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
Screening test for autoimmune disorder,PX-30200499,CDM,86038,CPT,302,RC,,outpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
Screening test for autoimmune disorder,PX-30200500,CDM,86038,CPT,302,RC,,inpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
Screening test for autoimmune disorder,PX-30200500,CDM,86038,CPT,302,RC,,outpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
Screening test for autoimmune disorder,PX-30200502,CDM,86038,CPT,302,RC,,inpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
Screening test for autoimmune disorder,PX-30200502,CDM,86038,CPT,302,RC,,outpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
Measure C-reactive protein to detect infection/inflammation,PX-30200504,CDM,86140,CPT,302,RC,,inpatient,,,28,25.2,,0.95,,26.6,Percent of total billed charges,,,0.98,,27.44,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.96,,26.88,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,26.6,Percent of total billed charges,,26.6,27.44,
Measure C-reactive protein to detect infection/inflammation,PX-30200504,CDM,86140,CPT,302,RC,,outpatient,,,28,25.2,,0.95,,26.6,Percent of total billed charges,,,0.98,,27.44,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.96,,26.88,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,26.6,Percent of total billed charges,,26.6,27.44,
Measure C-reactive protein to detect infection/inflammation,PX-30200505,CDM,86140,CPT,302,RC,,inpatient,,,28,25.2,,0.95,,26.6,Percent of total billed charges,,,0.98,,27.44,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.96,,26.88,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,,,,,,,0.95,,26.6,Percent of total billed charges,,26.6,27.44,
Measure C-reactive protein to detect infection/inflammation,PX-30200505,CDM,86140,CPT,302,RC,,outpatient,,,28,25.2,,0.95,,26.6,Percent of total billed charges,,,0.98,,27.44,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.96,,26.88,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,,,,,,,0.95,,26.6,Percent of total billed charges,,26.6,27.44,
Beta 2 glycoprotein 1 antibody measurement,PX-30200506,CDM,86146,CPT,302,RC,,inpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
Beta 2 glycoprotein 1 antibody measurement,PX-30200506,CDM,86146,CPT,302,RC,,outpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
"Measure of complement (immune system proteins), antigen,",PX-30200514,CDM,86160,CPT,302,RC,,inpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
"Measure of complement (immune system proteins), antigen,",PX-30200514,CDM,86160,CPT,302,RC,,outpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
"Measure of complement (immune system proteins), antigen,",PX-30200515,CDM,86160,CPT,302,RC,,inpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
"Measure of complement (immune system proteins), antigen,",PX-30200515,CDM,86160,CPT,302,RC,,outpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
"Measure of complement (immune system proteins), antigen,",PX-30200516,CDM,86160,CPT,302,RC,,inpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
"Measure of complement (immune system proteins), antigen,",PX-30200516,CDM,86160,CPT,302,RC,,outpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
"Measurement of DNA antibody, native or double stranded",PX-30200517,CDM,86225,CPT,302,RC,,inpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
"Measurement of DNA antibody, native or double stranded",PX-30200517,CDM,86225,CPT,302,RC,,outpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
"Measure antibody to assess autoimmune disorder, any method",PX-30200519,CDM,86235,CPT,302,RC,,inpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
"Measure antibody to assess autoimmune disorder, any method",PX-30200519,CDM,86235,CPT,302,RC,,outpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
"Measure antibody to assess autoimmune disorder, any method",PX-30200520,CDM,86235,CPT,302,RC,,inpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
"Measure antibody to assess autoimmune disorder, any method",PX-30200520,CDM,86235,CPT,302,RC,,outpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
"Measure antibody to assess autoimmune disorder, any method",PX-30200521,CDM,86235,CPT,302,RC,,inpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
"Measure antibody to assess autoimmune disorder, any method",PX-30200521,CDM,86235,CPT,302,RC,,outpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
"Measure antibody to assess autoimmune disorder, any method",PX-30200522,CDM,86235,CPT,302,RC,,inpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
"Measure antibody to assess autoimmune disorder, any method",PX-30200522,CDM,86235,CPT,302,RC,,outpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
Immunologic analysis technique on serum (immunofixation),PX-30200526,CDM,86334,CPT,302,RC,,inpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
Immunologic analysis technique on serum (immunofixation),PX-30200526,CDM,86334,CPT,302,RC,,outpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
Immunologic analysis on body/other fluids w/ concentration,PX-30200530,CDM,86335,CPT,302,RC,,inpatient,,,132,118.8,,0.95,,125.4,Percent of total billed charges,,,0.98,,129.36,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.96,,126.72,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,125.4,Percent of total billed charges,,125.4,129.36,
Immunologic analysis on body/other fluids w/ concentration,PX-30200530,CDM,86335,CPT,302,RC,,outpatient,,,132,118.8,,0.95,,125.4,Percent of total billed charges,,,0.98,,129.36,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.96,,126.72,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,125.4,Percent of total billed charges,,125.4,129.36,
Inhibin A (reproductive organ hormone) measurement,PX-30200532,CDM,86336,CPT,302,RC,,inpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Inhibin A (reproductive organ hormone) measurement,PX-30200532,CDM,86336,CPT,302,RC,,outpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Islet cell (pancreas) antibody measurement,PX-30200534,CDM,86341,CPT,302,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Islet cell (pancreas) antibody measurement,PX-30200534,CDM,86341,CPT,302,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
"T cell count and ratio, including ratio",PX-30200535,CDM,86360,CPT,302,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
"T cell count and ratio, including ratio",PX-30200535,CDM,86360,CPT,302,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Microsomal antibodies (autoantibody) measurement,PX-30200536,CDM,86376,CPT,302,RC,,inpatient,,,72,64.8,,0.95,,68.4,Percent of total billed charges,,,0.98,,70.56,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.96,,69.12,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,68.4,Percent of total billed charges,,68.4,70.56,
Microsomal antibodies (autoantibody) measurement,PX-30200536,CDM,86376,CPT,302,RC,,outpatient,,,72,64.8,,0.95,,68.4,Percent of total billed charges,,,0.98,,70.56,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.96,,69.12,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,68.4,Percent of total billed charges,,68.4,70.56,
Rheumatoid factor level,PX-30200537,CDM,86431,CPT,302,RC,,inpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
Rheumatoid factor level,PX-30200537,CDM,86431,CPT,302,RC,,outpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
Rheumatoid factor level,PX-30200538,CDM,86431,CPT,302,RC,,inpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
Rheumatoid factor level,PX-30200538,CDM,86431,CPT,302,RC,,outpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
Rheumatoid factor level,PX-30200539,CDM,86431,CPT,302,RC,,inpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
Rheumatoid factor level,PX-30200539,CDM,86431,CPT,302,RC,,outpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
"Tuberculosis test, gamma interferon",PX-30200540,CDM,86480,CPT,302,RC,,inpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
"Tuberculosis test, gamma interferon",PX-30200540,CDM,86480,CPT,302,RC,,outpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
"Tuberculosis test, gamma interferon",PX-30200541,CDM,86480,CPT,302,RC,,inpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
"Tuberculosis test, gamma interferon",PX-30200541,CDM,86480,CPT,302,RC,,outpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
"Tuberculosis test, gamma interferon",PX-30200542,CDM,86480,CPT,302,RC,,inpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
"Tuberculosis test, gamma interferon",PX-30200542,CDM,86480,CPT,302,RC,,outpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
Syphilis detection test,PX-30200543,CDM,86592,CPT,302,RC,,inpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
Syphilis detection test,PX-30200543,CDM,86592,CPT,302,RC,,outpatient,,,65,58.5,,0.95,,61.75,Percent of total billed charges,,,0.98,,63.7,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,0.97,,63.05,Percent of total billed charges,,,0.96,,62.4,Percent of total billed charges,,,0.95,,61.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,61.75,Percent of total billed charges,,61.75,63.7,
Analysis for antibody to aspergillus (fungus),PX-30200545,CDM,86606,CPT,302,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
Analysis for antibody to aspergillus (fungus),PX-30200545,CDM,86606,CPT,302,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
Analysis for antibody to fungus,PX-30200547,CDM,86671,CPT,302,RC,,inpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
Analysis for antibody to fungus,PX-30200547,CDM,86671,CPT,302,RC,,outpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
Analysis for antibody to Hepatitis D virus,PX-30200550,CDM,86692,CPT,302,RC,,inpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
Analysis for antibody to Hepatitis D virus,PX-30200550,CDM,86692,CPT,302,RC,,outpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
"Analysis for antibody to Herpes simplex virus, type 1",PX-30200551,CDM,86695,CPT,302,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
"Analysis for antibody to Herpes simplex virus, type 1",PX-30200551,CDM,86695,CPT,302,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Hepatitis B core antibody measurement,PX-30200553,CDM,86704,CPT,302,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Hepatitis B core antibody measurement,PX-30200553,CDM,86704,CPT,302,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
Hepatitis B core antibody measurement,PX-30200554,CDM,86704,CPT,302,RC,,inpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
Hepatitis B core antibody measurement,PX-30200554,CDM,86704,CPT,302,RC,,outpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
Analysis for antibody to protozoa (parasite),PX-30200556,CDM,86753,CPT,302,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Analysis for antibody to protozoa (parasite),PX-30200556,CDM,86753,CPT,302,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Analysis for antibody to Rickettsia (bacteria),PX-30200557,CDM,86757,CPT,302,RC,,inpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
Analysis for antibody to Rickettsia (bacteria),PX-30200557,CDM,86757,CPT,302,RC,,outpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
"Analysis for antibody, Treponema pallidum",PX-30200558,CDM,86780,CPT,302,RC,,inpatient,,,51,45.9,,0.95,,48.45,Percent of total billed charges,,,0.98,,49.98,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.96,,48.96,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,48.45,Percent of total billed charges,,48.45,49.98,
"Analysis for antibody, Treponema pallidum",PX-30200558,CDM,86780,CPT,302,RC,,outpatient,,,51,45.9,,0.95,,48.45,Percent of total billed charges,,,0.98,,49.98,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.96,,48.96,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,48.45,Percent of total billed charges,,48.45,49.98,
"Analysis for antibody, Treponema pallidum",PX-30200559,CDM,86780,CPT,302,RC,,inpatient,,,51,45.9,,0.95,,48.45,Percent of total billed charges,,,0.98,,49.98,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.96,,48.96,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,48.45,Percent of total billed charges,,48.45,49.98,
"Analysis for antibody, Treponema pallidum",PX-30200559,CDM,86780,CPT,302,RC,,outpatient,,,51,45.9,,0.95,,48.45,Percent of total billed charges,,,0.98,,49.98,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.96,,48.96,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,48.45,Percent of total billed charges,,48.45,49.98,
"Analysis for antibody, Treponema pallidum",PX-30200560,CDM,86780,CPT,302,RC,,inpatient,,,51,45.9,,0.95,,48.45,Percent of total billed charges,,,0.98,,49.98,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.96,,48.96,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,48.45,Percent of total billed charges,,48.45,49.98,
"Analysis for antibody, Treponema pallidum",PX-30200560,CDM,86780,CPT,302,RC,,outpatient,,,51,45.9,,0.95,,48.45,Percent of total billed charges,,,0.98,,49.98,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,0.97,,49.47,Percent of total billed charges,,,0.96,,48.96,Percent of total billed charges,,,0.95,,48.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,48.45,Percent of total billed charges,,48.45,49.98,
Thyroglobulin (thyroid protein) antibody measurement,PX-30200562,CDM,86800,CPT,302,RC,,inpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Thyroglobulin (thyroid protein) antibody measurement,PX-30200562,CDM,86800,CPT,302,RC,,outpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Thyroglobulin (thyroid protein) antibody measurement,PX-30200563,CDM,86800,CPT,302,RC,,inpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
Thyroglobulin (thyroid protein) antibody measurement,PX-30200563,CDM,86800,CPT,302,RC,,outpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
Thyroglobulin (thyroid protein) antibody measurement,PX-30200564,CDM,86800,CPT,302,RC,,inpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Thyroglobulin (thyroid protein) antibody measurement,PX-30200564,CDM,86800,CPT,302,RC,,outpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Blood typing for Rh (D) antigen,PX-30200566,CDM,86901,CPT,302,RC,,inpatient,,,109,98.1,,0.95,,103.55,Percent of total billed charges,,,0.98,,106.82,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,0.97,,105.73,Percent of total billed charges,,,0.97,,105.73,Percent of total billed charges,,,0.96,,104.64,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,103.55,Percent of total billed charges,,103.55,106.82,
Blood typing for Rh (D) antigen,PX-30200566,CDM,86901,CPT,302,RC,,outpatient,,,109,98.1,,0.95,,103.55,Percent of total billed charges,,,0.98,,106.82,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,0.97,,105.73,Percent of total billed charges,,,0.96,,104.64,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,103.55,Percent of total billed charges,,103.55,106.82,
Blood typing for Rh (D) antigen,PX-30200567,CDM,86901,CPT,302,RC,,inpatient,,,109,98.1,,0.95,,103.55,Percent of total billed charges,,,0.98,,106.82,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,0.97,,105.73,Percent of total billed charges,,,0.97,,105.73,Percent of total billed charges,,,0.96,,104.64,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,,,,,,,0.95,,103.55,Percent of total billed charges,,103.55,106.82,
Blood typing for Rh (D) antigen,PX-30200567,CDM,86901,CPT,302,RC,,outpatient,,,109,98.1,,0.95,,103.55,Percent of total billed charges,,,0.98,,106.82,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,0.97,,105.73,Percent of total billed charges,,,0.96,,104.64,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,,,,,,,0.95,,103.55,Percent of total billed charges,,103.55,106.82,
Red blood cell concentration measurement,PX-30500136,CDM,85014,CPT,305,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
Red blood cell concentration measurement,PX-30500136,CDM,85014,CPT,305,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
Red blood cell concentration measurement,PX-30500137,CDM,85014,CPT,305,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
Red blood cell concentration measurement,PX-30500137,CDM,85014,CPT,305,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"Blood count, hemoglobin",PX-30500138,CDM,85018,CPT,305,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"Blood count, hemoglobin",PX-30500138,CDM,85018,CPT,305,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"CBC, automated test and differential WBC count",PX-30500141,CDM,85025,CPT,305,RC,,inpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
"CBC, automated test and differential WBC count",PX-30500141,CDM,85025,CPT,305,RC,,outpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
"CBC, automated test and differential WBC count",PX-30500142,CDM,85025,CPT,305,RC,,inpatient,,,97,87.3,,0.95,,92.15,Percent of total billed charges,,,0.98,,95.06,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,0.97,,94.09,Percent of total billed charges,,,0.97,,94.09,Percent of total billed charges,,,0.96,,93.12,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,92.15,Percent of total billed charges,,92.15,95.06,
"CBC, automated test and differential WBC count",PX-30500142,CDM,85025,CPT,305,RC,,outpatient,,,97,87.3,,0.95,,92.15,Percent of total billed charges,,,0.98,,95.06,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,0.97,,94.09,Percent of total billed charges,,,0.96,,93.12,Percent of total billed charges,,,0.95,,92.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,92.15,Percent of total billed charges,,92.15,95.06,
"Complete blood cell count, automated test",PX-30500144,CDM,85027,CPT,305,RC,,inpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
"Complete blood cell count, automated test",PX-30500144,CDM,85027,CPT,305,RC,,outpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
"Complete blood cell count, automated test",PX-30500145,CDM,85027,CPT,305,RC,,inpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
"Complete blood cell count, automated test",PX-30500145,CDM,85027,CPT,305,RC,,outpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
"Complete blood cell count, automated test",PX-30500146,CDM,85027,CPT,305,RC,,inpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
"Complete blood cell count, automated test",PX-30500146,CDM,85027,CPT,305,RC,,outpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
"Complete blood cell count, automated test",PX-30500147,CDM,85027,CPT,305,RC,,inpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
"Complete blood cell count, automated test",PX-30500147,CDM,85027,CPT,305,RC,,outpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
"Platelet count, automated test",PX-30500148,CDM,85049,CPT,305,RC,,inpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
"Platelet count, automated test",PX-30500148,CDM,85049,CPT,305,RC,,outpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
HC Thromboplastin Time Partial Plasma/Whole Blood #,PX-30500168,CDM,85730,CPT,305,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
HC Thromboplastin Time Partial Plasma/Whole Blood #,PX-30500168,CDM,85730,CPT,305,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
"Coagulation assessment blood test, plasma or whole blood",PX-30500169,CDM,85730,CPT,305,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
"Coagulation assessment blood test, plasma or whole blood",PX-30500169,CDM,85730,CPT,305,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
"Bacterial culture, any other source except urine, blood",PX-30600362,CDM,87070,CPT,306,RC,,inpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
"Bacterial culture, any other source except urine, blood",PX-30600362,CDM,87070,CPT,306,RC,,outpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
"Bacterial culture, any other source except urine, blood",PX-30600363,CDM,87070,CPT,306,RC,,inpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
"Bacterial culture, any other source except urine, blood",PX-30600363,CDM,87070,CPT,306,RC,,outpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
"Bacterial culture, any other source except urine, blood",PX-30600364,CDM,87070,CPT,306,RC,,inpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
"Bacterial culture, any other source except urine, blood",PX-30600364,CDM,87070,CPT,306,RC,,outpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
"Bacterial culture, any other source except urine, blood",PX-30600365,CDM,87070,CPT,306,RC,,inpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
"Bacterial culture, any other source except urine, blood",PX-30600365,CDM,87070,CPT,306,RC,,outpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
"Bacterial culture, any other source except urine, blood",PX-30600366,CDM,87070,CPT,306,RC,,inpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
"Bacterial culture, any other source except urine, blood",PX-30600366,CDM,87070,CPT,306,RC,,outpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
Screening test for pathogenic organisms,PX-30600369,CDM,87081,CPT,306,RC,,inpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
Screening test for pathogenic organisms,PX-30600369,CDM,87081,CPT,306,RC,,outpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
Screening test for pathogenic organisms,PX-30600370,CDM,87081,CPT,306,RC,,inpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
Screening test for pathogenic organisms,PX-30600370,CDM,87081,CPT,306,RC,,outpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
Screening test for pathogenic organisms,PX-30600371,CDM,87081,CPT,306,RC,,inpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
Screening test for pathogenic organisms,PX-30600371,CDM,87081,CPT,306,RC,,outpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
"Bacterial colony count, urine",PX-30600372,CDM,87086,CPT,306,RC,,inpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
"Bacterial colony count, urine",PX-30600372,CDM,87086,CPT,306,RC,,outpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
Culture for acid-fast bacilli,PX-30600373,CDM,87116,CPT,306,RC,,inpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
Culture for acid-fast bacilli,PX-30600373,CDM,87116,CPT,306,RC,,outpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
Special fluorescent/acid fast stain for microorganism,PX-30600377,CDM,87206,CPT,306,RC,,inpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
Special fluorescent/acid fast stain for microorganism,PX-30600377,CDM,87206,CPT,306,RC,,outpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
Special fluorescent/acid fast stain for microorganism,PX-30600378,CDM,87206,CPT,306,RC,,inpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
Special fluorescent/acid fast stain for microorganism,PX-30600378,CDM,87206,CPT,306,RC,,outpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
Test byimmunoassay for hepatitis B surface antigen,PX-30600380,CDM,87340,CPT,306,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
Test byimmunoassay for hepatitis B surface antigen,PX-30600380,CDM,87340,CPT,306,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"Test for candida species (yeast), direct probe",PX-30600384,CDM,87480,CPT,306,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
"Test for candida species (yeast), direct probe",PX-30600384,CDM,87480,CPT,306,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
"Test for gardnerella vaginalis (bacteria), direct probe",PX-30600386,CDM,87510,CPT,306,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
"Test for gardnerella vaginalis (bacteria), direct probe",PX-30600386,CDM,87510,CPT,306,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
"Test by nucleic acid for Hepatitis C virus, quantification",PX-30600388,CDM,87522,CPT,306,RC,,inpatient,,,325,292.5,,0.95,,308.75,Percent of total billed charges,,,0.98,,318.5,Percent of total billed charges,,,0.95,,308.75,Percent of total billed charges,,,0.97,,315.25,Percent of total billed charges,,,0.97,,315.25,Percent of total billed charges,,,0.96,,312,Percent of total billed charges,,,0.95,,308.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,308.75,Percent of total billed charges,,308.75,318.5,
"Test by nucleic acid for Hepatitis C virus, quantification",PX-30600388,CDM,87522,CPT,306,RC,,outpatient,,,325,292.5,,0.95,,308.75,Percent of total billed charges,,,0.98,,318.5,Percent of total billed charges,,,0.95,,308.75,Percent of total billed charges,,,0.95,,308.75,Percent of total billed charges,,,0.97,,315.25,Percent of total billed charges,,,0.96,,312,Percent of total billed charges,,,0.95,,308.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,308.75,Percent of total billed charges,,308.75,318.5,
"Test bynucleic acid for herpes simplex virus, amplified",PX-30600390,CDM,87529,CPT,306,RC,,inpatient,,,211,189.9,,0.95,,200.45,Percent of total billed charges,,,0.98,,206.78,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,0.97,,204.67,Percent of total billed charges,,,0.97,,204.67,Percent of total billed charges,,,0.96,,202.56,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,200.45,Percent of total billed charges,,200.45,206.78,
"Test bynucleic acid for herpes simplex virus, amplified",PX-30600390,CDM,87529,CPT,306,RC,,outpatient,,,211,189.9,,0.95,,200.45,Percent of total billed charges,,,0.98,,206.78,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,0.97,,204.67,Percent of total billed charges,,,0.96,,202.56,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,200.45,Percent of total billed charges,,200.45,206.78,
"Test by nucleic acid for HIV-1 virus, quantification",PX-30600391,CDM,87536,CPT,306,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Test by nucleic acid for HIV-1 virus, quantification",PX-30600391,CDM,87536,CPT,306,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Test by nucleic acid for HIV-1 virus, quantification",PX-30600392,CDM,87536,CPT,306,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Test by nucleic acid for HIV-1 virus, quantification",PX-30600392,CDM,87536,CPT,306,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"Test by nucleic acid for Trichomonas vaginalis , direct",PX-30600398,CDM,87660,CPT,306,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
"Test by nucleic acid for Trichomonas vaginalis , direct",PX-30600398,CDM,87660,CPT,306,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
"Test by nucleic acid for Trichomonas vaginalis , amplified",PX-30600400,CDM,87661,CPT,306,RC,,inpatient,,,165,148.5,,0.95,,156.75,Percent of total billed charges,,,0.98,,161.7,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.96,,158.4,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,156.75,Percent of total billed charges,,156.75,161.7,
"Test by nucleic acid for Trichomonas vaginalis , amplified",PX-30600400,CDM,87661,CPT,306,RC,,outpatient,,,165,148.5,,0.95,,156.75,Percent of total billed charges,,,0.98,,161.7,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.96,,158.4,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,156.75,Percent of total billed charges,,156.75,161.7,
Infectious agent drug susceptibility analysis,PX-30600407,CDM,87900,CPT,306,RC,,inpatient,,,424,381.6,,0.95,,402.8,Percent of total billed charges,,,0.98,,415.52,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,0.97,,411.28,Percent of total billed charges,,,0.97,,411.28,Percent of total billed charges,,,0.96,,407.04,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,402.8,Percent of total billed charges,,402.8,415.52,
Infectious agent drug susceptibility analysis,PX-30600407,CDM,87900,CPT,306,RC,,outpatient,,,424,381.6,,0.95,,402.8,Percent of total billed charges,,,0.98,,415.52,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,0.97,,411.28,Percent of total billed charges,,,0.96,,407.04,Percent of total billed charges,,,0.95,,402.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,402.8,Percent of total billed charges,,402.8,415.52,
Analysis test by nucleic acid for HIV-1 virus,PX-30600408,CDM,87901,CPT,306,RC,,inpatient,,,1007,906.3,,0.95,,956.65,Percent of total billed charges,,,0.98,,986.86,Percent of total billed charges,,,0.95,,956.65,Percent of total billed charges,,,0.97,,976.79,Percent of total billed charges,,,0.97,,976.79,Percent of total billed charges,,,0.96,,966.72,Percent of total billed charges,,,0.95,,956.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,956.65,Percent of total billed charges,,956.65,986.86,
Analysis test by nucleic acid for HIV-1 virus,PX-30600408,CDM,87901,CPT,306,RC,,outpatient,,,1007,906.3,,0.95,,956.65,Percent of total billed charges,,,0.98,,986.86,Percent of total billed charges,,,0.95,,956.65,Percent of total billed charges,,,0.95,,956.65,Percent of total billed charges,,,0.97,,976.79,Percent of total billed charges,,,0.96,,966.72,Percent of total billed charges,,,0.95,,956.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,956.65,Percent of total billed charges,,956.65,986.86,
Analysis test by nucleic acid for Hepatitis C virus,PX-30600409,CDM,87902,CPT,306,RC,,inpatient,,,674,606.6,,0.95,,640.3,Percent of total billed charges,,,0.98,,660.52,Percent of total billed charges,,,0.95,,640.3,Percent of total billed charges,,,0.97,,653.78,Percent of total billed charges,,,0.97,,653.78,Percent of total billed charges,,,0.96,,647.04,Percent of total billed charges,,,0.95,,640.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,640.3,Percent of total billed charges,,640.3,660.52,
Analysis test by nucleic acid for Hepatitis C virus,PX-30600409,CDM,87902,CPT,306,RC,,outpatient,,,674,606.6,,0.95,,640.3,Percent of total billed charges,,,0.98,,660.52,Percent of total billed charges,,,0.95,,640.3,Percent of total billed charges,,,0.95,,640.3,Percent of total billed charges,,,0.97,,653.78,Percent of total billed charges,,,0.96,,647.04,Percent of total billed charges,,,0.95,,640.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,640.3,Percent of total billed charges,,640.3,660.52,
Analysis test by nucleic acid for Hepatitis C virus,PX-30600410,CDM,87902,CPT,306,RC,,inpatient,,,674,606.6,,0.95,,640.3,Percent of total billed charges,,,0.98,,660.52,Percent of total billed charges,,,0.95,,640.3,Percent of total billed charges,,,0.97,,653.78,Percent of total billed charges,,,0.97,,653.78,Percent of total billed charges,,,0.96,,647.04,Percent of total billed charges,,,0.95,,640.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,640.3,Percent of total billed charges,,640.3,660.52,
Analysis test by nucleic acid for Hepatitis C virus,PX-30600410,CDM,87902,CPT,306,RC,,outpatient,,,674,606.6,,0.95,,640.3,Percent of total billed charges,,,0.98,,660.52,Percent of total billed charges,,,0.95,,640.3,Percent of total billed charges,,,0.95,,640.3,Percent of total billed charges,,,0.97,,653.78,Percent of total billed charges,,,0.96,,647.04,Percent of total billed charges,,,0.95,,640.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,640.3,Percent of total billed charges,,640.3,660.52,
Analysis test by nucleic acid for Hepatitis C virus,PX-30600411,CDM,87902,CPT,306,RC,,inpatient,,,674,606.6,,0.95,,640.3,Percent of total billed charges,,,0.98,,660.52,Percent of total billed charges,,,0.95,,640.3,Percent of total billed charges,,,0.97,,653.78,Percent of total billed charges,,,0.97,,653.78,Percent of total billed charges,,,0.96,,647.04,Percent of total billed charges,,,0.95,,640.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,640.3,Percent of total billed charges,,640.3,660.52,
Analysis test by nucleic acid for Hepatitis C virus,PX-30600411,CDM,87902,CPT,306,RC,,outpatient,,,674,606.6,,0.95,,640.3,Percent of total billed charges,,,0.98,,660.52,Percent of total billed charges,,,0.95,,640.3,Percent of total billed charges,,,0.95,,640.3,Percent of total billed charges,,,0.97,,653.78,Percent of total billed charges,,,0.96,,647.04,Percent of total billed charges,,,0.95,,640.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,640.3,Percent of total billed charges,,640.3,660.52,
HC F2 Gene Analysis 20210g >a Variant #,PX-31000203,CDM,81240,CPT,310,RC,,inpatient,,,352,316.8,,0.95,,334.4,Percent of total billed charges,,,0.98,,344.96,Percent of total billed charges,,,0.95,,334.4,Percent of total billed charges,,,0.97,,341.44,Percent of total billed charges,,,0.97,,341.44,Percent of total billed charges,,,0.96,,337.92,Percent of total billed charges,,,0.95,,334.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,334.4,Percent of total billed charges,,334.4,344.96,
HC F2 Gene Analysis 20210g >a Variant #,PX-31000203,CDM,81240,CPT,310,RC,,outpatient,,,352,316.8,,0.95,,334.4,Percent of total billed charges,,,0.98,,344.96,Percent of total billed charges,,,0.95,,334.4,Percent of total billed charges,,,0.95,,334.4,Percent of total billed charges,,,0.97,,341.44,Percent of total billed charges,,,0.96,,337.92,Percent of total billed charges,,,0.95,,334.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,334.4,Percent of total billed charges,,334.4,344.96,
Methylation analysis,PX-31000205,CDM,81331,CPT,310,RC,,inpatient,,,194,174.6,,0.95,,184.3,Percent of total billed charges,,,0.98,,190.12,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,0.97,,188.18,Percent of total billed charges,,,0.97,,188.18,Percent of total billed charges,,,0.96,,186.24,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,184.3,Percent of total billed charges,,184.3,190.12,
Methylation analysis,PX-31000205,CDM,81331,CPT,310,RC,,outpatient,,,194,174.6,,0.95,,184.3,Percent of total billed charges,,,0.98,,190.12,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,0.97,,188.18,Percent of total billed charges,,,0.96,,186.24,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,184.3,Percent of total billed charges,,184.3,190.12,
"Pap test, automated thin layer preparation",PX-31100048,CDM,88175,CPT,311,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"Pap test, automated thin layer preparation",PX-31100048,CDM,88175,CPT,311,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"Pap test, automated thin layer preparation",PX-31100049,CDM,88175,CPT,311,RC,,inpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
"Pap test, automated thin layer preparation",PX-31100049,CDM,88175,CPT,311,RC,,outpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
"Pap test, automated thin layer preparation",PX-31100050,CDM,88175,CPT,311,RC,,inpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
"Pap test, automated thin layer preparation",PX-31100050,CDM,88175,CPT,311,RC,,outpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
"Test by nucleic acid for HIV-1 virus, quantification",PX-30600417,CDM,87536,CPT,306,RC,,inpatient,,,309,278.1,,0.95,,293.55,Percent of total billed charges,,,0.98,,302.82,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,0.97,,299.73,Percent of total billed charges,,,0.97,,299.73,Percent of total billed charges,,,0.96,,296.64,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,293.55,Percent of total billed charges,,293.55,302.82,
"Test by nucleic acid for HIV-1 virus, quantification",PX-30600417,CDM,87536,CPT,306,RC,,outpatient,,,309,278.1,,0.95,,293.55,Percent of total billed charges,,,0.98,,302.82,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,0.97,,299.73,Percent of total billed charges,,,0.96,,296.64,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,293.55,Percent of total billed charges,,293.55,302.82,
Analysis test by nucleic acid for Hepatitis C virus,PX-30600418,CDM,87902,CPT,306,RC,,inpatient,,,670,603,,0.95,,636.5,Percent of total billed charges,,,0.98,,656.6,Percent of total billed charges,,,0.95,,636.5,Percent of total billed charges,,,0.97,,649.9,Percent of total billed charges,,,0.97,,649.9,Percent of total billed charges,,,0.96,,643.2,Percent of total billed charges,,,0.95,,636.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,636.5,Percent of total billed charges,,636.5,656.6,
Analysis test by nucleic acid for Hepatitis C virus,PX-30600418,CDM,87902,CPT,306,RC,,outpatient,,,670,603,,0.95,,636.5,Percent of total billed charges,,,0.98,,656.6,Percent of total billed charges,,,0.95,,636.5,Percent of total billed charges,,,0.95,,636.5,Percent of total billed charges,,,0.97,,649.9,Percent of total billed charges,,,0.96,,643.2,Percent of total billed charges,,,0.95,,636.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,636.5,Percent of total billed charges,,636.5,656.6,
"Measure antibody to allergic, crude allergen extract, each",PX-30200645,CDM,86003,CPT,302,RC,,inpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
"Measure antibody to allergic, crude allergen extract, each",PX-30200645,CDM,86003,CPT,302,RC,,outpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
Immunologic analysis on body/other fluids w/ concentration,PX-30200655,CDM,86335,CPT,302,RC,,inpatient,,,45,40.5,,0.95,,42.75,Percent of total billed charges,,,0.98,,44.1,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.96,,43.2,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,42.75,Percent of total billed charges,,42.75,44.1,
Immunologic analysis on body/other fluids w/ concentration,PX-30200655,CDM,86335,CPT,302,RC,,outpatient,,,45,40.5,,0.95,,42.75,Percent of total billed charges,,,0.98,,44.1,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.96,,43.2,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,42.75,Percent of total billed charges,,42.75,44.1,
HC PR 10030 Image-Guided Catheter Fluid Collection Drainage Cdm,PX-97500253,CDM,10030,CPT,975,RC,,inpatient,,,1552,1396.8,,0.95,,1474.4,Percent of total billed charges,,,0.98,,1520.96,Percent of total billed charges,,,0.95,,1474.4,Percent of total billed charges,,,0.97,,1505.44,Percent of total billed charges,,,0.97,,1505.44,Percent of total billed charges,,,0.96,,1489.92,Percent of total billed charges,,,0.95,,1474.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1474.4,Percent of total billed charges,,1474.4,1520.96,
HC PR 10030 Image-Guided Catheter Fluid Collection Drainage Cdm,PX-97500253,CDM,10030,CPT,975,RC,,outpatient,,,1552,1396.8,,0.95,,1474.4,Percent of total billed charges,,,0.98,,1520.96,Percent of total billed charges,,,0.95,,1474.4,Percent of total billed charges,,,0.95,,1474.4,Percent of total billed charges,,,0.97,,1505.44,Percent of total billed charges,,,0.96,,1489.92,Percent of total billed charges,,,0.95,,1474.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1474.4,Percent of total billed charges,,1474.4,1520.96,
HC Drsg Therahoney 4x5 Mnk0087,PX-3254557WWM,CDM,3254557WWM,LOCAL,270,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
HC Drsg Therahoney 4x5 Mnk0087,PX-3254557WWM,CDM,3254557WWM,LOCAL,270,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
Analysis w/ chemiluminescent (light and chemical )reaction,PX-30100759,CDM,82397,CPT,301,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Analysis w/ chemiluminescent (light and chemical )reaction,PX-30100759,CDM,82397,CPT,301,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Urine chloride level,PX-30100761,CDM,82436,CPT,301,RC,,inpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
Urine chloride level,PX-30100761,CDM,82436,CPT,301,RC,,outpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
"Creatine kinase (cardiac enzyme) level, MB fraction only",PX-30100762,CDM,82553,CPT,301,RC,,inpatient,,,171,153.9,,0.95,,162.45,Percent of total billed charges,,,0.98,,167.58,Percent of total billed charges,,,0.95,,162.45,Percent of total billed charges,,,0.97,,165.87,Percent of total billed charges,,,0.97,,165.87,Percent of total billed charges,,,0.96,,164.16,Percent of total billed charges,,,0.95,,162.45,Percent of total billed charges,,,,,,,,,0.95,,162.45,Percent of total billed charges,,162.45,167.58,
"Creatine kinase (cardiac enzyme) level, MB fraction only",PX-30100762,CDM,82553,CPT,301,RC,,outpatient,,,171,153.9,,0.95,,162.45,Percent of total billed charges,,,0.98,,167.58,Percent of total billed charges,,,0.95,,162.45,Percent of total billed charges,,,0.95,,162.45,Percent of total billed charges,,,0.97,,165.87,Percent of total billed charges,,,0.96,,164.16,Percent of total billed charges,,,0.95,,162.45,Percent of total billed charges,,,,,,,,,0.95,,162.45,Percent of total billed charges,,162.45,167.58,
"Cortisol (hormone) measurement, total",PX-30100764,CDM,82533,CPT,301,RC,,inpatient,,,194,174.6,,0.95,,184.3,Percent of total billed charges,,,0.98,,190.12,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,0.97,,188.18,Percent of total billed charges,,,0.97,,188.18,Percent of total billed charges,,,0.96,,186.24,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,,,,,,,0.95,,184.3,Percent of total billed charges,,184.3,190.12,
"Cortisol (hormone) measurement, total",PX-30100764,CDM,82533,CPT,301,RC,,outpatient,,,194,174.6,,0.95,,184.3,Percent of total billed charges,,,0.98,,190.12,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,0.97,,188.18,Percent of total billed charges,,,0.96,,186.24,Percent of total billed charges,,,0.95,,184.3,Percent of total billed charges,,,,,,,,,0.95,,184.3,Percent of total billed charges,,184.3,190.12,
Glucose (sugar) level on body fluid,PX-30100765,CDM,82945,CPT,301,RC,,inpatient,,,81,72.9,,0.95,,76.95,Percent of total billed charges,,,0.98,,79.38,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.96,,77.76,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76.95,Percent of total billed charges,,76.95,79.38,
Glucose (sugar) level on body fluid,PX-30100765,CDM,82945,CPT,301,RC,,outpatient,,,81,72.9,,0.95,,76.95,Percent of total billed charges,,,0.98,,79.38,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.96,,77.76,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76.95,Percent of total billed charges,,76.95,79.38,
Lead level,PX-30100766,CDM,83655,CPT,301,RC,,inpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
Lead level,PX-30100766,CDM,83655,CPT,301,RC,,outpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
"PSA (prostate specific antigen) measurement, free",PX-30100770,CDM,84154,CPT,301,RC,,inpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
"PSA (prostate specific antigen) measurement, free",PX-30100770,CDM,84154,CPT,301,RC,,outpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
Triglycerides level,PX-30100771,CDM,84478,CPT,301,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Triglycerides level,PX-30100771,CDM,84478,CPT,301,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
Zinc level,PX-30100772,CDM,84630,CPT,301,RC,,inpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
Zinc level,PX-30100772,CDM,84630,CPT,301,RC,,outpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
"Bilirubin level, total",PX-30100775,CDM,82247,CPT,301,RC,,inpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
"Bilirubin level, total",PX-30100775,CDM,82247,CPT,301,RC,,outpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
"Phenytoin level, free",PX-30100776,CDM,80186,CPT,301,RC,,inpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
"Phenytoin level, free",PX-30100776,CDM,80186,CPT,301,RC,,outpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
"Cerebrospinal fluid, or amniotic fluid albumin level",PX-30100777,CDM,82042,CPT,301,RC,,inpatient,,,22,19.8,,0.95,,20.9,Percent of total billed charges,,,0.98,,21.56,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.96,,21.12,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,20.9,Percent of total billed charges,,20.9,21.56,
"Cerebrospinal fluid, or amniotic fluid albumin level",PX-30100777,CDM,82042,CPT,301,RC,,outpatient,,,22,19.8,,0.95,,20.9,Percent of total billed charges,,,0.98,,21.56,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.96,,21.12,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,20.9,Percent of total billed charges,,20.9,21.56,
Total cell count for B cells (white blood cells),PX-30200668,CDM,86355,CPT,302,RC,,inpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
Total cell count for B cells (white blood cells),PX-30200668,CDM,86355,CPT,302,RC,,outpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
"T cell count and ratio, including ratio",PX-30200669,CDM,86360,CPT,302,RC,,inpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
"T cell count and ratio, including ratio",PX-30200669,CDM,86360,CPT,302,RC,,outpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
"T cells count, total",PX-30200670,CDM,86359,CPT,302,RC,,inpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
"T cells count, total",PX-30200670,CDM,86359,CPT,302,RC,,outpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
Total cell count for natural killer cells (WBC),PX-30200671,CDM,86357,CPT,302,RC,,inpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
Total cell count for natural killer cells (WBC),PX-30200671,CDM,86357,CPT,302,RC,,outpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
Thyroglobulin (thyroid protein) antibody measurement,PX-30200676,CDM,86800,CPT,302,RC,,inpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Thyroglobulin (thyroid protein) antibody measurement,PX-30200676,CDM,86800,CPT,302,RC,,outpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
"Measurement of DNA antibody, native or double stranded",PX-30200677,CDM,86225,CPT,302,RC,,inpatient,,,66,59.4,,0.95,,62.7,Percent of total billed charges,,,0.98,,64.68,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,0.97,,64.02,Percent of total billed charges,,,0.97,,64.02,Percent of total billed charges,,,0.96,,63.36,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,62.7,Percent of total billed charges,,62.7,64.68,
"Measurement of DNA antibody, native or double stranded",PX-30200677,CDM,86225,CPT,302,RC,,outpatient,,,66,59.4,,0.95,,62.7,Percent of total billed charges,,,0.98,,64.68,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,0.97,,64.02,Percent of total billed charges,,,0.96,,63.36,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,62.7,Percent of total billed charges,,62.7,64.68,
Immunologic analysis on body/other fluids w/ concentration,PX-30200680,CDM,86335,CPT,302,RC,,inpatient,,,139,125.1,,0.95,,132.05,Percent of total billed charges,,,0.98,,136.22,Percent of total billed charges,,,0.95,,132.05,Percent of total billed charges,,,0.97,,134.83,Percent of total billed charges,,,0.97,,134.83,Percent of total billed charges,,,0.96,,133.44,Percent of total billed charges,,,0.95,,132.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,132.05,Percent of total billed charges,,132.05,136.22,
Immunologic analysis on body/other fluids w/ concentration,PX-30200680,CDM,86335,CPT,302,RC,,outpatient,,,139,125.1,,0.95,,132.05,Percent of total billed charges,,,0.98,,136.22,Percent of total billed charges,,,0.95,,132.05,Percent of total billed charges,,,0.95,,132.05,Percent of total billed charges,,,0.97,,134.83,Percent of total billed charges,,,0.96,,133.44,Percent of total billed charges,,,0.95,,132.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,132.05,Percent of total billed charges,,132.05,136.22,
Hepatitis B core antibody (IgM) measurement,PX-30200681,CDM,86705,CPT,302,RC,,inpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Hepatitis B core antibody (IgM) measurement,PX-30200681,CDM,86705,CPT,302,RC,,outpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
Hepatitis B surface antibody measurement,PX-30200682,CDM,86706,CPT,302,RC,,inpatient,,,117,105.3,,0.95,,111.15,Percent of total billed charges,,,0.98,,114.66,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.96,,112.32,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,111.15,Percent of total billed charges,,111.15,114.66,
Hepatitis B surface antibody measurement,PX-30200682,CDM,86706,CPT,302,RC,,outpatient,,,117,105.3,,0.95,,111.15,Percent of total billed charges,,,0.98,,114.66,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.96,,112.32,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,111.15,Percent of total billed charges,,111.15,114.66,
Hepatitis C antibody measurement,PX-30200683,CDM,86803,CPT,302,RC,,inpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
Hepatitis C antibody measurement,PX-30200683,CDM,86803,CPT,302,RC,,outpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
Hepatitis B core antibody measurement,PX-30200684,CDM,86704,CPT,302,RC,,inpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
Hepatitis B core antibody measurement,PX-30200684,CDM,86704,CPT,302,RC,,outpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
Hepatitis B core antibody measurement,PX-30200685,CDM,86704,CPT,302,RC,,inpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
Hepatitis B core antibody measurement,PX-30200685,CDM,86704,CPT,302,RC,,outpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
Hepatitis B surface antibody measurement,PX-30200686,CDM,86706,CPT,302,RC,,inpatient,,,117,105.3,,0.95,,111.15,Percent of total billed charges,,,0.98,,114.66,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.96,,112.32,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,,,,,,,0.95,,111.15,Percent of total billed charges,,111.15,114.66,
Hepatitis B surface antibody measurement,PX-30200686,CDM,86706,CPT,302,RC,,outpatient,,,117,105.3,,0.95,,111.15,Percent of total billed charges,,,0.98,,114.66,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.96,,112.32,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,,,,,,,0.95,,111.15,Percent of total billed charges,,111.15,114.66,
Measurement of Hepatitis A antibody,PX-30200687,CDM,86708,CPT,302,RC,,inpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
Measurement of Hepatitis A antibody,PX-30200687,CDM,86708,CPT,302,RC,,outpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
Hepatitis C antibody measurement,PX-30200688,CDM,86803,CPT,302,RC,,inpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
Hepatitis C antibody measurement,PX-30200688,CDM,86803,CPT,302,RC,,outpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
Hepatitis C antibody measurement,PX-30200689,CDM,86803,CPT,302,RC,,inpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
Hepatitis C antibody measurement,PX-30200689,CDM,86803,CPT,302,RC,,outpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
"Test bynucleic acid for chlamydia trachomatis, amplified",PX-30600427,CDM,87491,CPT,306,RC,,inpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
"Test bynucleic acid for chlamydia trachomatis, amplified",PX-30600427,CDM,87491,CPT,306,RC,,outpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
"Test by nucleic acid for Neisseria gonorrhoeae , amplified",PX-30600428,CDM,87591,CPT,306,RC,,inpatient,,,84,75.6,,0.95,,79.8,Percent of total billed charges,,,0.98,,82.32,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,0.97,,81.48,Percent of total billed charges,,,0.97,,81.48,Percent of total billed charges,,,0.96,,80.64,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,79.8,Percent of total billed charges,,79.8,82.32,
"Test by nucleic acid for Neisseria gonorrhoeae , amplified",PX-30600428,CDM,87591,CPT,306,RC,,outpatient,,,84,75.6,,0.95,,79.8,Percent of total billed charges,,,0.98,,82.32,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,0.97,,81.48,Percent of total billed charges,,,0.96,,80.64,Percent of total billed charges,,,0.95,,79.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,79.8,Percent of total billed charges,,79.8,82.32,
"Test by nucleic acid for HPV, high-risk types",PX-30600429,CDM,87624,CPT,306,RC,,inpatient,,,127,114.3,,0.95,,120.65,Percent of total billed charges,,,0.98,,124.46,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,0.97,,123.19,Percent of total billed charges,,,0.97,,123.19,Percent of total billed charges,,,0.96,,121.92,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,120.65,Percent of total billed charges,,120.65,124.46,
"Test by nucleic acid for HPV, high-risk types",PX-30600429,CDM,87624,CPT,306,RC,,outpatient,,,127,114.3,,0.95,,120.65,Percent of total billed charges,,,0.98,,124.46,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,0.97,,123.19,Percent of total billed charges,,,0.96,,121.92,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,120.65,Percent of total billed charges,,120.65,124.46,
Test by immunoassay for hepatitis B surface antigen,PX-30600431,CDM,87340,CPT,306,RC,,inpatient,,,45,40.5,,0.95,,42.75,Percent of total billed charges,,,0.98,,44.1,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.96,,43.2,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,42.75,Percent of total billed charges,,42.75,44.1,
Test by immunoassay for hepatitis B surface antigen,PX-30600431,CDM,87340,CPT,306,RC,,outpatient,,,45,40.5,,0.95,,42.75,Percent of total billed charges,,,0.98,,44.1,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.96,,43.2,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,42.75,Percent of total billed charges,,42.75,44.1,
Test byimmunoassay for hepatitis B surface antigen,PX-30600432,CDM,87340,CPT,306,RC,,inpatient,,,45,40.5,,0.95,,42.75,Percent of total billed charges,,,0.98,,44.1,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.96,,43.2,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,,,,,,,0.95,,42.75,Percent of total billed charges,,42.75,44.1,
Test byimmunoassay for hepatitis B surface antigen,PX-30600432,CDM,87340,CPT,306,RC,,outpatient,,,45,40.5,,0.95,,42.75,Percent of total billed charges,,,0.98,,44.1,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.96,,43.2,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,,,,,,,0.95,,42.75,Percent of total billed charges,,42.75,44.1,
"Test bynucleic acid for herpes simplex virus, amplified",PX-30600435,CDM,87529,CPT,306,RC,,inpatient,,,211,189.9,,0.95,,200.45,Percent of total billed charges,,,0.98,,206.78,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,0.97,,204.67,Percent of total billed charges,,,0.97,,204.67,Percent of total billed charges,,,0.96,,202.56,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,200.45,Percent of total billed charges,,200.45,206.78,
"Test bynucleic acid for herpes simplex virus, amplified",PX-30600435,CDM,87529,CPT,306,RC,,outpatient,,,211,189.9,,0.95,,200.45,Percent of total billed charges,,,0.98,,206.78,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,0.97,,204.67,Percent of total billed charges,,,0.96,,202.56,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,200.45,Percent of total billed charges,,200.45,206.78,
"Bacterial culture, any other source except urine, blood",PX-30600447,CDM,87070,CPT,306,RC,,inpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
"Bacterial culture, any other source except urine, blood",PX-30600447,CDM,87070,CPT,306,RC,,outpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
"Pap test, automated thin layer preparation",PX-31100056,CDM,88175,CPT,311,RC,,inpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
"Pap test, automated thin layer preparation",PX-31100056,CDM,88175,CPT,311,RC,,outpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
Analysis of cell function and analysis for genetic marker,PX-30200697,CDM,86352,CPT,302,RC,,inpatient,,,415,373.5,,0.95,,394.25,Percent of total billed charges,,,0.98,,406.7,Percent of total billed charges,,,0.95,,394.25,Percent of total billed charges,,,0.97,,402.55,Percent of total billed charges,,,0.97,,402.55,Percent of total billed charges,,,0.96,,398.4,Percent of total billed charges,,,0.95,,394.25,Percent of total billed charges,,,,,,,,,0.95,,394.25,Percent of total billed charges,,394.25,406.7,
Analysis of cell function and analysis for genetic marker,PX-30200697,CDM,86352,CPT,302,RC,,outpatient,,,415,373.5,,0.95,,394.25,Percent of total billed charges,,,0.98,,406.7,Percent of total billed charges,,,0.95,,394.25,Percent of total billed charges,,,0.95,,394.25,Percent of total billed charges,,,0.97,,402.55,Percent of total billed charges,,,0.96,,398.4,Percent of total billed charges,,,0.95,,394.25,Percent of total billed charges,,,,,,,,,0.95,,394.25,Percent of total billed charges,,394.25,406.7,
HC Molecular Pathology Procedure Level 9 #,PX-31000235,CDM,81408,CPT,310,RC,,inpatient,,,958,862.2,,0.95,,910.1,Percent of total billed charges,,,0.98,,938.84,Percent of total billed charges,,,0.95,,910.1,Percent of total billed charges,,,0.97,,929.26,Percent of total billed charges,,,0.97,,929.26,Percent of total billed charges,,,0.96,,919.68,Percent of total billed charges,,,0.95,,910.1,Percent of total billed charges,,,,,,,,,0.95,,910.1,Percent of total billed charges,,910.1,938.84,
HC Molecular Pathology Procedure Level 9 #,PX-31000235,CDM,81408,CPT,310,RC,,outpatient,,,958,862.2,,0.95,,910.1,Percent of total billed charges,,,0.98,,938.84,Percent of total billed charges,,,0.95,,910.1,Percent of total billed charges,,,0.95,,910.1,Percent of total billed charges,,,0.97,,929.26,Percent of total billed charges,,,0.96,,919.68,Percent of total billed charges,,,0.95,,910.1,Percent of total billed charges,,,,,,,,,0.95,,910.1,Percent of total billed charges,,910.1,938.84,
Special fluorescent/acid fast stain for microorganism,PX-30600470,CDM,87206,CPT,306,RC,,inpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
Special fluorescent/acid fast stain for microorganism,PX-30600470,CDM,87206,CPT,306,RC,,outpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
HC Rt Bronch Level 4,PX-36000024,CDM,36000024,LOCAL,360,RC,,inpatient,,,2153,1937.7,,0.95,,2045.35,Percent of total billed charges,,,0.98,,2109.94,Percent of total billed charges,,,0.95,,2045.35,Percent of total billed charges,,,0.97,,2088.41,Percent of total billed charges,,,0.97,,2088.41,Percent of total billed charges,,,0.96,,2066.88,Percent of total billed charges,,,0.95,,2045.35,Percent of total billed charges,,,,,,,,,0.95,,2045.35,Percent of total billed charges,,2045.35,2109.94,
HC Rt Bronch Level 4,PX-36000024,CDM,36000024,LOCAL,360,RC,,outpatient,,,2153,1937.7,,0.95,,2045.35,Percent of total billed charges,,,0.98,,2109.94,Percent of total billed charges,,,0.95,,2045.35,Percent of total billed charges,,,0.95,,2045.35,Percent of total billed charges,,,0.97,,2088.41,Percent of total billed charges,,,0.96,,2066.88,Percent of total billed charges,,,0.95,,2045.35,Percent of total billed charges,,,,,,,,,0.95,,2045.35,Percent of total billed charges,,2045.35,2109.94,
HC PR 32557 Perq Drainage Pleura Insert Cath W/Imaging Cdm,PX-97500281,CDM,32557,CPT,975,RC,,inpatient,,,1605,1444.5,,0.95,,1524.75,Percent of total billed charges,,,0.98,,1572.9,Percent of total billed charges,,,0.95,,1524.75,Percent of total billed charges,,,0.97,,1556.85,Percent of total billed charges,,,0.97,,1556.85,Percent of total billed charges,,,0.96,,1540.8,Percent of total billed charges,,,0.95,,1524.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1524.75,Percent of total billed charges,,1524.75,1572.9,
HC PR 32557 Perq Drainage Pleura Insert Cath W/Imaging Cdm,PX-97500281,CDM,32557,CPT,975,RC,,outpatient,,,1605,1444.5,,0.95,,1524.75,Percent of total billed charges,,,0.98,,1572.9,Percent of total billed charges,,,0.95,,1524.75,Percent of total billed charges,,,0.95,,1524.75,Percent of total billed charges,,,0.97,,1556.85,Percent of total billed charges,,,0.96,,1540.8,Percent of total billed charges,,,0.95,,1524.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1524.75,Percent of total billed charges,,1524.75,1572.9,
HC Rt Bronch Level 3,PX-36000023,CDM,36000023,LOCAL,360,RC,,inpatient,,,2091,1881.9,,0.95,,1986.45,Percent of total billed charges,,,0.98,,2049.18,Percent of total billed charges,,,0.95,,1986.45,Percent of total billed charges,,,0.97,,2028.27,Percent of total billed charges,,,0.97,,2028.27,Percent of total billed charges,,,0.96,,2007.36,Percent of total billed charges,,,0.95,,1986.45,Percent of total billed charges,,,,,,,,,0.95,,1986.45,Percent of total billed charges,,1986.45,2049.18,
HC Rt Bronch Level 3,PX-36000023,CDM,36000023,LOCAL,360,RC,,outpatient,,,2091,1881.9,,0.95,,1986.45,Percent of total billed charges,,,0.98,,2049.18,Percent of total billed charges,,,0.95,,1986.45,Percent of total billed charges,,,0.95,,1986.45,Percent of total billed charges,,,0.97,,2028.27,Percent of total billed charges,,,0.96,,2007.36,Percent of total billed charges,,,0.95,,1986.45,Percent of total billed charges,,,,,,,,,0.95,,1986.45,Percent of total billed charges,,1986.45,2049.18,
HC PR 24665 Open Tx Radial Head/Neck Fracture Cdm,PX-97500283,CDM,24665,CPT,975,RC,,inpatient,,,1644,1479.6,,0.95,,1561.8,Percent of total billed charges,,,0.98,,1611.12,Percent of total billed charges,,,0.95,,1561.8,Percent of total billed charges,,,0.97,,1594.68,Percent of total billed charges,,,0.97,,1594.68,Percent of total billed charges,,,0.96,,1578.24,Percent of total billed charges,,,0.95,,1561.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1561.8,Percent of total billed charges,,1561.8,1611.12,
HC PR 24665 Open Tx Radial Head/Neck Fracture Cdm,PX-97500283,CDM,24665,CPT,975,RC,,outpatient,,,1644,1479.6,,0.95,,1561.8,Percent of total billed charges,,,0.98,,1611.12,Percent of total billed charges,,,0.95,,1561.8,Percent of total billed charges,,,0.95,,1561.8,Percent of total billed charges,,,0.97,,1594.68,Percent of total billed charges,,,0.96,,1578.24,Percent of total billed charges,,,0.95,,1561.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1561.8,Percent of total billed charges,,1561.8,1611.12,
HC PR 27347 Excision Lesion Meniscus/Capsule Knee Cdm,PX-97500282,CDM,27347,CPT,975,RC,,inpatient,,,1322,1189.8,,0.95,,1255.9,Percent of total billed charges,,,0.98,,1295.56,Percent of total billed charges,,,0.95,,1255.9,Percent of total billed charges,,,0.97,,1282.34,Percent of total billed charges,,,0.97,,1282.34,Percent of total billed charges,,,0.96,,1269.12,Percent of total billed charges,,,0.95,,1255.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1255.9,Percent of total billed charges,,1255.9,1295.56,
HC PR 27347 Excision Lesion Meniscus/Capsule Knee Cdm,PX-97500282,CDM,27347,CPT,975,RC,,outpatient,,,1322,1189.8,,0.95,,1255.9,Percent of total billed charges,,,0.98,,1295.56,Percent of total billed charges,,,0.95,,1255.9,Percent of total billed charges,,,0.95,,1255.9,Percent of total billed charges,,,0.97,,1282.34,Percent of total billed charges,,,0.96,,1269.12,Percent of total billed charges,,,0.95,,1255.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1255.9,Percent of total billed charges,,1255.9,1295.56,
HC Rt Bronch Level 1,PX-36000021,CDM,36000021,LOCAL,360,RC,,inpatient,,,1876,1688.4,,0.95,,1782.2,Percent of total billed charges,,,0.98,,1838.48,Percent of total billed charges,,,0.95,,1782.2,Percent of total billed charges,,,0.97,,1819.72,Percent of total billed charges,,,0.97,,1819.72,Percent of total billed charges,,,0.96,,1800.96,Percent of total billed charges,,,0.95,,1782.2,Percent of total billed charges,,,,,,,,,0.95,,1782.2,Percent of total billed charges,,1782.2,1838.48,
HC Rt Bronch Level 1,PX-36000021,CDM,36000021,LOCAL,360,RC,,outpatient,,,1876,1688.4,,0.95,,1782.2,Percent of total billed charges,,,0.98,,1838.48,Percent of total billed charges,,,0.95,,1782.2,Percent of total billed charges,,,0.95,,1782.2,Percent of total billed charges,,,0.97,,1819.72,Percent of total billed charges,,,0.96,,1800.96,Percent of total billed charges,,,0.95,,1782.2,Percent of total billed charges,,,,,,,,,0.95,,1782.2,Percent of total billed charges,,1782.2,1838.48,
HC Rt Bronch Level 2,PX-36000022,CDM,36000022,LOCAL,360,RC,,inpatient,,,2031,1827.9,,0.95,,1929.45,Percent of total billed charges,,,0.98,,1990.38,Percent of total billed charges,,,0.95,,1929.45,Percent of total billed charges,,,0.97,,1970.07,Percent of total billed charges,,,0.97,,1970.07,Percent of total billed charges,,,0.96,,1949.76,Percent of total billed charges,,,0.95,,1929.45,Percent of total billed charges,,,,,,,,,0.95,,1929.45,Percent of total billed charges,,1929.45,1990.38,
HC Rt Bronch Level 2,PX-36000022,CDM,36000022,LOCAL,360,RC,,outpatient,,,2031,1827.9,,0.95,,1929.45,Percent of total billed charges,,,0.98,,1990.38,Percent of total billed charges,,,0.95,,1929.45,Percent of total billed charges,,,0.95,,1929.45,Percent of total billed charges,,,0.97,,1970.07,Percent of total billed charges,,,0.96,,1949.76,Percent of total billed charges,,,0.95,,1929.45,Percent of total billed charges,,,,,,,,,0.95,,1929.45,Percent of total billed charges,,1929.45,1990.38,
"Blood test, lipids (cholesterol and triglycerides)",PX-30100855,CDM,80061,CPT,301,RC,,inpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
"Blood test, lipids (cholesterol and triglycerides)",PX-30100855,CDM,80061,CPT,301,RC,,outpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
"Blood test, lipids (cholesterol and triglycerides)",PX-30100856,CDM,80061,CPT,301,RC,,inpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
"Blood test, lipids (cholesterol and triglycerides)",PX-30100856,CDM,80061,CPT,301,RC,,outpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
"Testing for drug presence, by chemistry analyzers",PX-30100857,CDM,80307,CPT,301,RC,,inpatient,,,290,261,,0.95,,275.5,Percent of total billed charges,,,0.98,,284.2,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.96,,278.4,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,275.5,Percent of total billed charges,,275.5,284.2,
"Testing for drug presence, by chemistry analyzers",PX-30100857,CDM,80307,CPT,301,RC,,outpatient,,,290,261,,0.95,,275.5,Percent of total billed charges,,,0.98,,284.2,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.96,,278.4,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,275.5,Percent of total billed charges,,275.5,284.2,
"Testing for drug presence, by chemistry analyzers",PX-30100858,CDM,80307,CPT,301,RC,,inpatient,,,290,261,,0.95,,275.5,Percent of total billed charges,,,0.98,,284.2,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.96,,278.4,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,275.5,Percent of total billed charges,,275.5,284.2,
"Testing for drug presence, by chemistry analyzers",PX-30100858,CDM,80307,CPT,301,RC,,outpatient,,,290,261,,0.95,,275.5,Percent of total billed charges,,,0.98,,284.2,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.96,,278.4,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,275.5,Percent of total billed charges,,275.5,284.2,
"Testing for drug presence, by chemistry analyzers",PX-30100859,CDM,80307,CPT,301,RC,,inpatient,,,290,261,,0.95,,275.5,Percent of total billed charges,,,0.98,,284.2,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.96,,278.4,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,275.5,Percent of total billed charges,,275.5,284.2,
"Testing for drug presence, by chemistry analyzers",PX-30100859,CDM,80307,CPT,301,RC,,outpatient,,,290,261,,0.95,,275.5,Percent of total billed charges,,,0.98,,284.2,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.96,,278.4,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,275.5,Percent of total billed charges,,275.5,284.2,
"Testing for drug presence, by chemistry analyzers",PX-30100860,CDM,80307,CPT,301,RC,,inpatient,,,290,261,,0.95,,275.5,Percent of total billed charges,,,0.98,,284.2,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.96,,278.4,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,275.5,Percent of total billed charges,,275.5,284.2,
"Testing for drug presence, by chemistry analyzers",PX-30100860,CDM,80307,CPT,301,RC,,outpatient,,,290,261,,0.95,,275.5,Percent of total billed charges,,,0.98,,284.2,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,0.97,,281.3,Percent of total billed charges,,,0.96,,278.4,Percent of total billed charges,,,0.95,,275.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,275.5,Percent of total billed charges,,275.5,284.2,
"Total protein level, urine",PX-30100862,CDM,84156,CPT,301,RC,,inpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
"Total protein level, urine",PX-30100862,CDM,84156,CPT,301,RC,,outpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
Analysis for antibody to Coccidioides (bacteria),PX-30200773,CDM,86635,CPT,302,RC,,inpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
Analysis for antibody to Coccidioides (bacteria),PX-30200773,CDM,86635,CPT,302,RC,,outpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
HC PR 25447 Repair Wrist Joint(S) Cdm,PX-97500272,CDM,25447,CPT,975,RC,,inpatient,,,2073,1865.7,,0.95,,1969.35,Percent of total billed charges,,,0.98,,2031.54,Percent of total billed charges,,,0.95,,1969.35,Percent of total billed charges,,,0.97,,2010.81,Percent of total billed charges,,,0.97,,2010.81,Percent of total billed charges,,,0.96,,1990.08,Percent of total billed charges,,,0.95,,1969.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1969.35,Percent of total billed charges,,1969.35,2031.54,
HC PR 25447 Repair Wrist Joint(S) Cdm,PX-97500272,CDM,25447,CPT,975,RC,,outpatient,,,2073,1865.7,,0.95,,1969.35,Percent of total billed charges,,,0.98,,2031.54,Percent of total billed charges,,,0.95,,1969.35,Percent of total billed charges,,,0.95,,1969.35,Percent of total billed charges,,,0.97,,2010.81,Percent of total billed charges,,,0.96,,1990.08,Percent of total billed charges,,,0.95,,1969.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1969.35,Percent of total billed charges,,1969.35,2031.54,
HC PR 26121 Fasct Palm W/WO Z-Plasty Tissue Reargmt/Skn Grft Cdm,PX-97500285,CDM,26121,CPT,975,RC,,inpatient,,,1501,1350.9,,0.95,,1425.95,Percent of total billed charges,,,0.98,,1470.98,Percent of total billed charges,,,0.95,,1425.95,Percent of total billed charges,,,0.97,,1455.97,Percent of total billed charges,,,0.97,,1455.97,Percent of total billed charges,,,0.96,,1440.96,Percent of total billed charges,,,0.95,,1425.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1425.95,Percent of total billed charges,,1425.95,1470.98,
HC PR 26121 Fasct Palm W/WO Z-Plasty Tissue Reargmt/Skn Grft Cdm,PX-97500285,CDM,26121,CPT,975,RC,,outpatient,,,1501,1350.9,,0.95,,1425.95,Percent of total billed charges,,,0.98,,1470.98,Percent of total billed charges,,,0.95,,1425.95,Percent of total billed charges,,,0.95,,1425.95,Percent of total billed charges,,,0.97,,1455.97,Percent of total billed charges,,,0.96,,1440.96,Percent of total billed charges,,,0.95,,1425.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1425.95,Percent of total billed charges,,1425.95,1470.98,
HC Prothrombin Time #,PX-30500214,CDM,85610,CPT,305,RC,,inpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC Prothrombin Time #,PX-30500214,CDM,85610,CPT,305,RC,,outpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC PR Rx Covid-19 Vac Single Dose (Moderna) Pf 6m to 11y Im 25 Mcg/0.25 Ml,PX-63600170,CDM,91321,CPT,636,RC,,inpatient,,,242,217.8,,0.95,,229.9,Percent of total billed charges,,,0.98,,237.16,Percent of total billed charges,,,0.95,,229.9,Percent of total billed charges,,,0.97,,234.74,Percent of total billed charges,,,0.97,,234.74,Percent of total billed charges,,,0.96,,232.32,Percent of total billed charges,,,0.95,,229.9,Percent of total billed charges,,,,,,,,,0.95,,229.9,Percent of total billed charges,,229.9,237.16,
HC PR Rx Covid-19 Vac Single Dose (Moderna) Pf 6m to 11y Im 25 Mcg/0.25 Ml,PX-63600170,CDM,91321,CPT,636,RC,,outpatient,,,242,217.8,,0.95,,229.9,Percent of total billed charges,,,0.98,,237.16,Percent of total billed charges,,,0.95,,229.9,Percent of total billed charges,,,0.95,,229.9,Percent of total billed charges,,,0.97,,234.74,Percent of total billed charges,,,0.96,,232.32,Percent of total billed charges,,,0.95,,229.9,Percent of total billed charges,,,,,,,,,0.95,,229.9,Percent of total billed charges,,229.9,237.16,
HC PR Rx Covid-19 Vaccine Single Dose (Moderna) Pf Im 50 Mcg/0.5 Ml,PX-63600171,CDM,91322,CPT,636,RC,,inpatient,,,242,217.8,,0.95,,229.9,Percent of total billed charges,,,0.98,,237.16,Percent of total billed charges,,,0.95,,229.9,Percent of total billed charges,,,0.97,,234.74,Percent of total billed charges,,,0.97,,234.74,Percent of total billed charges,,,0.96,,232.32,Percent of total billed charges,,,0.95,,229.9,Percent of total billed charges,,,,,,,,,0.95,,229.9,Percent of total billed charges,,229.9,237.16,
HC PR Rx Covid-19 Vaccine Single Dose (Moderna) Pf Im 50 Mcg/0.5 Ml,PX-63600171,CDM,91322,CPT,636,RC,,outpatient,,,242,217.8,,0.95,,229.9,Percent of total billed charges,,,0.98,,237.16,Percent of total billed charges,,,0.95,,229.9,Percent of total billed charges,,,0.95,,229.9,Percent of total billed charges,,,0.97,,234.74,Percent of total billed charges,,,0.96,,232.32,Percent of total billed charges,,,0.95,,229.9,Percent of total billed charges,,,,,,,,,0.95,,229.9,Percent of total billed charges,,229.9,237.16,
HC Covid 19 Immunization Single Dose Admin,PX-77100046,CDM,90480,CPT,771,RC,,inpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
HC Covid 19 Immunization Single Dose Admin,PX-77100046,CDM,90480,CPT,771,RC,,outpatient,,,68,61.2,,0.95,,64.6,Percent of total billed charges,,,0.98,,66.64,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,0.97,,65.96,Percent of total billed charges,,,0.96,,65.28,Percent of total billed charges,,,0.95,,64.6,Percent of total billed charges,,,,,,,,,0.95,,64.6,Percent of total billed charges,,64.6,66.64,
HC PR Rx Rsv Monoclonal Antibody Im 0.5 Ml,PX-63600172,CDM,90380,CPT,636,RC,,inpatient,,,23,20.7,,0.95,,21.85,Percent of total billed charges,,,0.98,,22.54,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.96,,22.08,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,,,,,,,0.95,,21.85,Percent of total billed charges,,21.85,22.54,
HC PR Rx Rsv Monoclonal Antibody Im 0.5 Ml,PX-63600172,CDM,90380,CPT,636,RC,,outpatient,,,23,20.7,,0.95,,21.85,Percent of total billed charges,,,0.98,,22.54,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.96,,22.08,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,,,,,,,0.95,,21.85,Percent of total billed charges,,21.85,22.54,
HC Procalcitonin (Pct) #,PX-30100967,CDM,84145,CPT,301,RC,,inpatient,,,299,269.1,,0.95,,284.05,Percent of total billed charges,,,0.98,,293.02,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,0.97,,290.03,Percent of total billed charges,,,0.97,,290.03,Percent of total billed charges,,,0.96,,287.04,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,,,,,,,0.95,,284.05,Percent of total billed charges,,284.05,293.02,
HC Procalcitonin (Pct) #,PX-30100967,CDM,84145,CPT,301,RC,,outpatient,,,299,269.1,,0.95,,284.05,Percent of total billed charges,,,0.98,,293.02,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,0.97,,290.03,Percent of total billed charges,,,0.96,,287.04,Percent of total billed charges,,,0.95,,284.05,Percent of total billed charges,,,,,,,,,0.95,,284.05,Percent of total billed charges,,284.05,293.02,
Acetylcholine receptor (AChR) binding antibody,PX-30200821,CDM,86041,CPT,302,RC,,inpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,,,0.95,,133,Percent of total billed charges,,133,137.2,
Acetylcholine receptor (AChR) binding antibody,PX-30200821,CDM,86041,CPT,302,RC,,outpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,,,0.95,,133,Percent of total billed charges,,133,137.2,
Anti-mullerian hormone (AMH),PX-30100971,CDM,82166,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Anti-mullerian hormone (AMH),PX-30100971,CDM,82166,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
"Training and education, 45 minutes or more",PX-90000086,CDM,G0177,HCPCS,900,RC,,inpatient,,,200,180,,0.95,,190,Percent of total billed charges,,,0.98,,196,Percent of total billed charges,,,0.95,,190,Percent of total billed charges,,,0.97,,194,Percent of total billed charges,,,0.97,,194,Percent of total billed charges,,,0.96,,192,Percent of total billed charges,,,0.95,,190,Percent of total billed charges,,,,,,,,,0.95,,190,Percent of total billed charges,,190,196,
"Training and education, 45 minutes or more",PX-90000086,CDM,G0177,HCPCS,900,RC,,outpatient,,,200,180,,0.95,,190,Percent of total billed charges,,,0.98,,196,Percent of total billed charges,,,0.95,,190,Percent of total billed charges,,,0.95,,190,Percent of total billed charges,,,0.97,,194,Percent of total billed charges,,,0.96,,192,Percent of total billed charges,,,0.95,,190,Percent of total billed charges,,,,,,,,,0.95,,190,Percent of total billed charges,,190,196,
OB Umbil Vessel Cath 5fr (#8888160432),PX-3254641WWM,CDM,A4649,HCPCS,270,RC,,inpatient,,,178,160.2,,0.95,,169.1,Percent of total billed charges,,,0.98,,174.44,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,0.97,,172.66,Percent of total billed charges,,,0.97,,172.66,Percent of total billed charges,,,0.96,,170.88,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,,,,,,,0.95,,169.1,Percent of total billed charges,,169.1,174.44,
OB Umbil Vessel Cath 5fr (#8888160432),PX-3254641WWM,CDM,A4649,HCPCS,270,RC,,outpatient,,,178,160.2,,0.95,,169.1,Percent of total billed charges,,,0.98,,174.44,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,0.97,,172.66,Percent of total billed charges,,,0.96,,170.88,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,,,,,,,0.95,,169.1,Percent of total billed charges,,169.1,174.44,
OB Umbil Vessel Cath Tray (#8888160408),PX-3254642WWM,CDM,A4649,HCPCS,270,RC,,inpatient,,,150,135,,0.95,,142.5,Percent of total billed charges,,,0.98,,147,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,0.97,,145.5,Percent of total billed charges,,,0.97,,145.5,Percent of total billed charges,,,0.96,,144,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,,,,,,,0.95,,142.5,Percent of total billed charges,,142.5,147,
OB Umbil Vessel Cath Tray (#8888160408),PX-3254642WWM,CDM,A4649,HCPCS,270,RC,,outpatient,,,150,135,,0.95,,142.5,Percent of total billed charges,,,0.98,,147,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,0.97,,145.5,Percent of total billed charges,,,0.96,,144,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,,,,,,,0.95,,142.5,Percent of total billed charges,,142.5,147,
Central Line 3 Lumen 7fr (#Arw24703x1ah),PX-3254637WWM,CDM,A4649,HCPCS,270,RC,,inpatient,,,665,598.5,,0.95,,631.75,Percent of total billed charges,,,0.98,,651.7,Percent of total billed charges,,,0.95,,631.75,Percent of total billed charges,,,0.97,,645.05,Percent of total billed charges,,,0.97,,645.05,Percent of total billed charges,,,0.96,,638.4,Percent of total billed charges,,,0.95,,631.75,Percent of total billed charges,,,,,,,,,0.95,,631.75,Percent of total billed charges,,631.75,651.7,
Central Line 3 Lumen 7fr (#Arw24703x1ah),PX-3254637WWM,CDM,A4649,HCPCS,270,RC,,outpatient,,,665,598.5,,0.95,,631.75,Percent of total billed charges,,,0.98,,651.7,Percent of total billed charges,,,0.95,,631.75,Percent of total billed charges,,,0.95,,631.75,Percent of total billed charges,,,0.97,,645.05,Percent of total billed charges,,,0.96,,638.4,Percent of total billed charges,,,0.95,,631.75,Percent of total billed charges,,,,,,,,,0.95,,631.75,Percent of total billed charges,,631.75,651.7,
Central Line Psi9fr (#Arw299031ah),PX-3254638WWM,CDM,A4649,HCPCS,270,RC,,inpatient,,,615,553.5,,0.95,,584.25,Percent of total billed charges,,,0.98,,602.7,Percent of total billed charges,,,0.95,,584.25,Percent of total billed charges,,,0.97,,596.55,Percent of total billed charges,,,0.97,,596.55,Percent of total billed charges,,,0.96,,590.4,Percent of total billed charges,,,0.95,,584.25,Percent of total billed charges,,,,,,,,,0.95,,584.25,Percent of total billed charges,,584.25,602.7,
Central Line Psi9fr (#Arw299031ah),PX-3254638WWM,CDM,A4649,HCPCS,270,RC,,outpatient,,,615,553.5,,0.95,,584.25,Percent of total billed charges,,,0.98,,602.7,Percent of total billed charges,,,0.95,,584.25,Percent of total billed charges,,,0.95,,584.25,Percent of total billed charges,,,0.97,,596.55,Percent of total billed charges,,,0.96,,590.4,Percent of total billed charges,,,0.95,,584.25,Percent of total billed charges,,,,,,,,,0.95,,584.25,Percent of total billed charges,,584.25,602.7,
Ted Sox Knee 2xl/Long (#Mds160698h),PX-3254633WWM,CDM,A6530,HCPCS,270,RC,,inpatient,,,31,27.9,,0.95,,29.45,Percent of total billed charges,,,0.98,,30.38,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.96,,29.76,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,,,,,,,0.95,,29.45,Percent of total billed charges,,29.45,30.38,
Ted Sox Knee 2xl/Long (#Mds160698h),PX-3254633WWM,CDM,A6530,HCPCS,270,RC,,outpatient,,,31,27.9,,0.95,,29.45,Percent of total billed charges,,,0.98,,30.38,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.96,,29.76,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,,,,,,,0.95,,29.45,Percent of total billed charges,,29.45,30.38,
Drsg Hydrocolloid 2x2 (#Msc5522),PX-3254634WWM,CDM,A6234,HCPCS,270,RC,,inpatient,,,6,5.4,,0.95,,5.7,Percent of total billed charges,,,0.98,,5.88,Percent of total billed charges,,,0.95,,5.7,Percent of total billed charges,,,0.97,,5.82,Percent of total billed charges,,,0.97,,5.82,Percent of total billed charges,,,0.96,,5.76,Percent of total billed charges,,,0.95,,5.7,Percent of total billed charges,,,,,,,,,0.95,,5.7,Percent of total billed charges,,5.7,5.88,
Drsg Hydrocolloid 2x2 (#Msc5522),PX-3254634WWM,CDM,A6234,HCPCS,270,RC,,outpatient,,,6,5.4,,0.95,,5.7,Percent of total billed charges,,,0.98,,5.88,Percent of total billed charges,,,0.95,,5.7,Percent of total billed charges,,,0.95,,5.7,Percent of total billed charges,,,0.97,,5.82,Percent of total billed charges,,,0.96,,5.76,Percent of total billed charges,,,0.95,,5.7,Percent of total billed charges,,,,,,,,,0.95,,5.7,Percent of total billed charges,,5.7,5.88,
Drsg Hydrocolloid 4x4 (#Msc5444),PX-3254635WWM,CDM,A6234,HCPCS,270,RC,,inpatient,,,14,12.6,,0.95,,13.3,Percent of total billed charges,,,0.98,,13.72,Percent of total billed charges,,,0.95,,13.3,Percent of total billed charges,,,0.97,,13.58,Percent of total billed charges,,,0.97,,13.58,Percent of total billed charges,,,0.96,,13.44,Percent of total billed charges,,,0.95,,13.3,Percent of total billed charges,,,,,,,,,0.95,,13.3,Percent of total billed charges,,13.3,13.72,
Drsg Hydrocolloid 4x4 (#Msc5444),PX-3254635WWM,CDM,A6234,HCPCS,270,RC,,outpatient,,,14,12.6,,0.95,,13.3,Percent of total billed charges,,,0.98,,13.72,Percent of total billed charges,,,0.95,,13.3,Percent of total billed charges,,,0.95,,13.3,Percent of total billed charges,,,0.97,,13.58,Percent of total billed charges,,,0.96,,13.44,Percent of total billed charges,,,0.95,,13.3,Percent of total billed charges,,,,,,,,,0.95,,13.3,Percent of total billed charges,,13.3,13.72,
Chest Drain Unit (#8888571370),PX-3254640WWM,CDM,A4649,HCPCS,270,RC,,inpatient,,,142,127.8,,0.95,,134.9,Percent of total billed charges,,,0.98,,139.16,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,0.97,,137.74,Percent of total billed charges,,,0.97,,137.74,Percent of total billed charges,,,0.96,,136.32,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,,,,,,,0.95,,134.9,Percent of total billed charges,,134.9,139.16,
Chest Drain Unit (#8888571370),PX-3254640WWM,CDM,A4649,HCPCS,270,RC,,outpatient,,,142,127.8,,0.95,,134.9,Percent of total billed charges,,,0.98,,139.16,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,0.97,,137.74,Percent of total billed charges,,,0.96,,136.32,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,,,,,,,0.95,,134.9,Percent of total billed charges,,134.9,139.16,
Ted Sox Knee 2xl/Reg (#Mds160694h),PX-3254632WWM,CDM,A6530,HCPCS,270,RC,,inpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
Ted Sox Knee 2xl/Reg (#Mds160694h),PX-3254632WWM,CDM,A6530,HCPCS,270,RC,,outpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
Alcohols levels,PX-30101066,CDM,80320,CPT,301,RC,,inpatient,,,165,148.5,,0.95,,156.75,Percent of total billed charges,,,0.98,,161.7,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.96,,158.4,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,,,,,,,0.95,,156.75,Percent of total billed charges,,156.75,161.7,
Alcohols levels,PX-30101066,CDM,80320,CPT,301,RC,,outpatient,,,165,148.5,,0.95,,156.75,Percent of total billed charges,,,0.98,,161.7,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.96,,158.4,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,,,,,,,0.95,,156.75,Percent of total billed charges,,156.75,161.7,
Analysis for antibody to Candida (yeast),PX-30200881,CDM,86628,CPT,302,RC,,inpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
Analysis for antibody to Candida (yeast),PX-30200881,CDM,86628,CPT,302,RC,,outpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
Manual urinalysis test w/exam using microscope automated,PX-30700016,CDM,81001,CPT,307,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Manual urinalysis test w/exam using microscope automated,PX-30700016,CDM,81001,CPT,307,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Natriuretic peptide (heart and blood vessel protein) level,PX-31000325,CDM,83880,CPT,310,RC,,inpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
Natriuretic peptide (heart and blood vessel protein) level,PX-31000325,CDM,83880,CPT,310,RC,,outpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
Cortisol hormone measurement total,PX-30101056,CDM,82533,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Cortisol hormone measurement total,PX-30101056,CDM,82533,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Cortisol hormone measurement total,PX-30101060,CDM,82533,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Cortisol hormone measurement total,PX-30101060,CDM,82533,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Blood count hemoglobin,PX-30500244,CDM,85018,CPT,305,RC,,inpatient,,,45,40.5,,0.95,,42.75,Percent of total billed charges,,,0.98,,44.1,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.96,,43.2,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,,,,,,,0.95,,42.75,Percent of total billed charges,,42.75,44.1,
Blood count hemoglobin,PX-30500244,CDM,85018,CPT,305,RC,,outpatient,,,45,40.5,,0.95,,42.75,Percent of total billed charges,,,0.98,,44.1,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.96,,43.2,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,,,,,,,0.95,,42.75,Percent of total billed charges,,42.75,44.1,
Manual urinalysis test w/exam using microscope automated,PX-30700015,CDM,81001,CPT,307,RC,,inpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Manual urinalysis test w/exam using microscope automated,PX-30700015,CDM,81001,CPT,307,RC,,outpatient,,,73,65.7,,0.95,,69.35,Percent of total billed charges,,,0.98,,71.54,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,0.97,,70.81,Percent of total billed charges,,,0.96,,70.08,Percent of total billed charges,,,0.95,,69.35,Percent of total billed charges,,,,,,,,,0.95,,69.35,Percent of total billed charges,,69.35,71.54,
Cortisol hormone measurement total,PX-30101063,CDM,82533,CPT,301,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
Cortisol hormone measurement total,PX-30101063,CDM,82533,CPT,301,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
PSA (prostate specific antigen) measurement total,PX-30101046,CDM,84153,CPT,301,RC,,inpatient,,,150,135,,0.95,,142.5,Percent of total billed charges,,,0.98,,147,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,0.97,,145.5,Percent of total billed charges,,,0.97,,145.5,Percent of total billed charges,,,0.96,,144,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,,,,,,,0.95,,142.5,Percent of total billed charges,,142.5,147,
PSA (prostate specific antigen) measurement total,PX-30101046,CDM,84153,CPT,301,RC,,outpatient,,,150,135,,0.95,,142.5,Percent of total billed charges,,,0.98,,147,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,0.97,,145.5,Percent of total billed charges,,,0.96,,144,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,,,,,,,0.95,,142.5,Percent of total billed charges,,142.5,147,
Urine sodium level,PX-30101044,CDM,84300,CPT,301,RC,,inpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
Urine sodium level,PX-30101044,CDM,84300,CPT,301,RC,,outpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
Automated urinalysis test,PX-30700014,CDM,81003,CPT,307,RC,,inpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,,,0.95,,47.5,Percent of total billed charges,,47.5,49,
Automated urinalysis test,PX-30700014,CDM,81003,CPT,307,RC,,outpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,,,0.95,,47.5,Percent of total billed charges,,47.5,49,
Red blood cell concentration measurement,PX-30500243,CDM,85014,CPT,305,RC,,inpatient,,,46,41.4,,0.95,,43.7,Percent of total billed charges,,,0.98,,45.08,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,0.97,,44.62,Percent of total billed charges,,,0.97,,44.62,Percent of total billed charges,,,0.96,,44.16,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,,,,,,,0.95,,43.7,Percent of total billed charges,,43.7,45.08,
Red blood cell concentration measurement,PX-30500243,CDM,85014,CPT,305,RC,,outpatient,,,46,41.4,,0.95,,43.7,Percent of total billed charges,,,0.98,,45.08,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,0.97,,44.62,Percent of total billed charges,,,0.96,,44.16,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,,,,,,,0.95,,43.7,Percent of total billed charges,,43.7,45.08,
Natriuretic peptide (heart and blood vessel protein) level,PX-30101073,CDM,83880,CPT,301,RC,,inpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
Natriuretic peptide (heart and blood vessel protein) level,PX-30101073,CDM,83880,CPT,301,RC,,outpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
Automated urinalysis test,PX-30700017,CDM,81003,CPT,307,RC,,inpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,,,0.95,,47.5,Percent of total billed charges,,47.5,49,
Automated urinalysis test,PX-30700017,CDM,81003,CPT,307,RC,,outpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,,,0.95,,47.5,Percent of total billed charges,,47.5,49,
Lactic acid level,PX-30101086,CDM,83605,CPT,301,RC,,inpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
Lactic acid level,PX-30101086,CDM,83605,CPT,301,RC,,outpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
Lactic acid level,PX-30101085,CDM,83605,CPT,301,RC,,inpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
Lactic acid level,PX-30101085,CDM,83605,CPT,301,RC,,outpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
HC Wound Cleanser Sub Crr108008,PX-3254643WWM,CDM,3254643WWM,LOCAL,270,RC,,inpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
HC Wound Cleanser Sub Crr108008,PX-3254643WWM,CDM,3254643WWM,LOCAL,270,RC,,outpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
Correction of Bunion- Phalanx Osteotomy Rhc,PX-52100306,CDM,28298,CPT,521,RC,,inpatient,,,2040,1836,,0.95,,1938,Percent of total billed charges,,,0.98,,1999.2,Percent of total billed charges,,,0.95,,1938,Percent of total billed charges,,,0.97,,1978.8,Percent of total billed charges,,,0.97,,1978.8,Percent of total billed charges,,,0.96,,1958.4,Percent of total billed charges,,,0.95,,1938,Percent of total billed charges,,,,,,,,,0.95,,1938,Percent of total billed charges,,1938,1999.2,
Correction of Bunion- Phalanx Osteotomy Rhc,PX-52100306,CDM,28298,CPT,521,RC,,outpatient,,,2040,1836,,0.95,,1938,Percent of total billed charges,,,0.98,,1999.2,Percent of total billed charges,,,0.95,,1938,Percent of total billed charges,,,0.95,,1938,Percent of total billed charges,,,0.97,,1978.8,Percent of total billed charges,,,0.96,,1958.4,Percent of total billed charges,,,0.95,,1938,Percent of total billed charges,,,,,,,,,0.95,,1938,Percent of total billed charges,,1938,1999.2,
HC Cath Midline 3fr Sp4153108d,PX-3254627WWM,CDM,3254627WWM,LOCAL,270,RC,,inpatient,,,415,373.5,,0.95,,394.25,Percent of total billed charges,,,0.98,,406.7,Percent of total billed charges,,,0.95,,394.25,Percent of total billed charges,,,0.97,,402.55,Percent of total billed charges,,,0.97,,402.55,Percent of total billed charges,,,0.96,,398.4,Percent of total billed charges,,,0.95,,394.25,Percent of total billed charges,,,,,,,,,0.95,,394.25,Percent of total billed charges,,394.25,406.7,
HC Cath Midline 3fr Sp4153108d,PX-3254627WWM,CDM,3254627WWM,LOCAL,270,RC,,outpatient,,,415,373.5,,0.95,,394.25,Percent of total billed charges,,,0.98,,406.7,Percent of total billed charges,,,0.95,,394.25,Percent of total billed charges,,,0.95,,394.25,Percent of total billed charges,,,0.97,,402.55,Percent of total billed charges,,,0.96,,398.4,Percent of total billed charges,,,0.95,,394.25,Percent of total billed charges,,,,,,,,,0.95,,394.25,Percent of total billed charges,,394.25,406.7,
HC Abd Binder Sm/MD Ss1100,PX-3254655WWM,CDM,3254655WWM,LOCAL,270,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
HC Abd Binder Sm/MD Ss1100,PX-3254655WWM,CDM,3254655WWM,LOCAL,270,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
HC Drsg Sacrum 7x7 Mscov77epz,PX-3254629WWM,CDM,3254629WWM,LOCAL,270,RC,,inpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC Drsg Sacrum 7x7 Mscov77epz,PX-3254629WWM,CDM,3254629WWM,LOCAL,270,RC,,outpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC Drsg Hydrocolloid 4x4 Msc5544,PX-3254628WWM,CDM,3254628WWM,LOCAL,270,RC,,inpatient,,,15,13.5,,0.95,,14.25,Percent of total billed charges,,,0.98,,14.7,Percent of total billed charges,,,0.95,,14.25,Percent of total billed charges,,,0.97,,14.55,Percent of total billed charges,,,0.97,,14.55,Percent of total billed charges,,,0.96,,14.4,Percent of total billed charges,,,0.95,,14.25,Percent of total billed charges,,,,,,,,,0.95,,14.25,Percent of total billed charges,,14.25,14.7,
HC Drsg Hydrocolloid 4x4 Msc5544,PX-3254628WWM,CDM,3254628WWM,LOCAL,270,RC,,outpatient,,,15,13.5,,0.95,,14.25,Percent of total billed charges,,,0.98,,14.7,Percent of total billed charges,,,0.95,,14.25,Percent of total billed charges,,,0.95,,14.25,Percent of total billed charges,,,0.97,,14.55,Percent of total billed charges,,,0.96,,14.4,Percent of total billed charges,,,0.95,,14.25,Percent of total billed charges,,,,,,,,,0.95,,14.25,Percent of total billed charges,,14.25,14.7,
HC Sling Arm Ped 204020,PX-3254654WWM,CDM,3254654WWM,LOCAL,270,RC,,inpatient,,,15,13.5,,0.95,,14.25,Percent of total billed charges,,,0.98,,14.7,Percent of total billed charges,,,0.95,,14.25,Percent of total billed charges,,,0.97,,14.55,Percent of total billed charges,,,0.97,,14.55,Percent of total billed charges,,,0.96,,14.4,Percent of total billed charges,,,0.95,,14.25,Percent of total billed charges,,,,,,,,,0.95,,14.25,Percent of total billed charges,,14.25,14.7,
HC Sling Arm Ped 204020,PX-3254654WWM,CDM,3254654WWM,LOCAL,270,RC,,outpatient,,,15,13.5,,0.95,,14.25,Percent of total billed charges,,,0.98,,14.7,Percent of total billed charges,,,0.95,,14.25,Percent of total billed charges,,,0.95,,14.25,Percent of total billed charges,,,0.97,,14.55,Percent of total billed charges,,,0.96,,14.4,Percent of total billed charges,,,0.95,,14.25,Percent of total billed charges,,,,,,,,,0.95,,14.25,Percent of total billed charges,,14.25,14.7,
HC Abd Binder Lg/Xl 5437694,PX-3254656WWM,CDM,3254656WWM,LOCAL,270,RC,,inpatient,,,60,54,,0.95,,57,Percent of total billed charges,,,0.98,,58.8,Percent of total billed charges,,,0.95,,57,Percent of total billed charges,,,0.97,,58.2,Percent of total billed charges,,,0.97,,58.2,Percent of total billed charges,,,0.96,,57.6,Percent of total billed charges,,,0.95,,57,Percent of total billed charges,,,,,,,,,0.95,,57,Percent of total billed charges,,57,58.8,
HC Abd Binder Lg/Xl 5437694,PX-3254656WWM,CDM,3254656WWM,LOCAL,270,RC,,outpatient,,,60,54,,0.95,,57,Percent of total billed charges,,,0.98,,58.8,Percent of total billed charges,,,0.95,,57,Percent of total billed charges,,,0.95,,57,Percent of total billed charges,,,0.97,,58.2,Percent of total billed charges,,,0.96,,57.6,Percent of total billed charges,,,0.95,,57,Percent of total billed charges,,,,,,,,,0.95,,57,Percent of total billed charges,,57,58.8,
HC PR Rx Pneumococcal Vaccine 13 Valent Im 0.5 Ml,PX-63610093,CDM,90670,HCPCS,636,RC,,inpatient,,,504,453.6,,0.95,,478.8,Percent of total billed charges,,,0.98,,493.92,Percent of total billed charges,,,0.95,,478.8,Percent of total billed charges,,,0.97,,488.88,Percent of total billed charges,,,0.97,,488.88,Percent of total billed charges,,,0.96,,483.84,Percent of total billed charges,,,0.95,,478.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,478.8,Percent of total billed charges,,478.8,493.92,
HC PR Rx Pneumococcal Vaccine 13 Valent Im 0.5 Ml,PX-63610093,CDM,90670,HCPCS,636,RC,,outpatient,,,504,453.6,,0.95,,478.8,Percent of total billed charges,,,0.98,,493.92,Percent of total billed charges,,,0.95,,478.8,Percent of total billed charges,,,0.95,,478.8,Percent of total billed charges,,,0.97,,488.88,Percent of total billed charges,,,0.96,,483.84,Percent of total billed charges,,,0.95,,478.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,478.8,Percent of total billed charges,,478.8,493.92,
Closed treatment of broken bone separating nose airways,PX-36011039,CDM,21337,CPT,360,RC,,inpatient,,,1273,1145.7,,0.95,,1209.35,Percent of total billed charges,,,0.98,,1247.54,Percent of total billed charges,,,0.95,,1209.35,Percent of total billed charges,,,0.97,,1234.81,Percent of total billed charges,,,0.97,,1234.81,Percent of total billed charges,,,0.96,,1222.08,Percent of total billed charges,,,0.95,,1209.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1209.35,Percent of total billed charges,,1209.35,1247.54,
Closed treatment of broken bone separating nose airways,PX-36011039,CDM,21337,CPT,360,RC,,outpatient,,,1273,1145.7,,0.95,,1209.35,Percent of total billed charges,,,0.98,,1247.54,Percent of total billed charges,,,0.95,,1209.35,Percent of total billed charges,,,0.95,,1209.35,Percent of total billed charges,,,0.97,,1234.81,Percent of total billed charges,,,0.96,,1222.08,Percent of total billed charges,,,0.95,,1209.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1209.35,Percent of total billed charges,,1209.35,1247.54,
Removal of appendix using an endoscope,PX-36011109,CDM,44970,CPT,360,RC,,inpatient,,,1736,1562.4,,0.95,,1649.2,Percent of total billed charges,,,0.98,,1701.28,Percent of total billed charges,,,0.95,,1649.2,Percent of total billed charges,,,0.97,,1683.92,Percent of total billed charges,,,0.97,,1683.92,Percent of total billed charges,,,0.96,,1666.56,Percent of total billed charges,,,0.95,,1649.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1649.2,Percent of total billed charges,,1649.2,1701.28,
Removal of appendix using an endoscope,PX-36011109,CDM,44970,CPT,360,RC,,outpatient,,,1736,1562.4,,0.95,,1649.2,Percent of total billed charges,,,0.98,,1701.28,Percent of total billed charges,,,0.95,,1649.2,Percent of total billed charges,,,0.95,,1649.2,Percent of total billed charges,,,0.97,,1683.92,Percent of total billed charges,,,0.96,,1666.56,Percent of total billed charges,,,0.95,,1649.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1649.2,Percent of total billed charges,,1649.2,1701.28,
Partial removal of hymen,PX-36011144,CDM,56700,CPT,360,RC,,inpatient,,,1215,1093.5,,0.95,,1154.25,Percent of total billed charges,,,0.98,,1190.7,Percent of total billed charges,,,0.95,,1154.25,Percent of total billed charges,,,0.97,,1178.55,Percent of total billed charges,,,0.97,,1178.55,Percent of total billed charges,,,0.96,,1166.4,Percent of total billed charges,,,0.95,,1154.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1154.25,Percent of total billed charges,,1154.25,1190.7,
Partial removal of hymen,PX-36011144,CDM,56700,CPT,360,RC,,outpatient,,,1215,1093.5,,0.95,,1154.25,Percent of total billed charges,,,0.98,,1190.7,Percent of total billed charges,,,0.95,,1154.25,Percent of total billed charges,,,0.95,,1154.25,Percent of total billed charges,,,0.97,,1178.55,Percent of total billed charges,,,0.96,,1166.4,Percent of total billed charges,,,0.95,,1154.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1154.25,Percent of total billed charges,,1154.25,1190.7,
Repair of joint between finger and palm,PX-36011154,CDM,26548,CPT,360,RC,,inpatient,,,2980,2682,,0.95,,2831,Percent of total billed charges,,,0.98,,2920.4,Percent of total billed charges,,,0.95,,2831,Percent of total billed charges,,,0.97,,2890.6,Percent of total billed charges,,,0.97,,2890.6,Percent of total billed charges,,,0.96,,2860.8,Percent of total billed charges,,,0.95,,2831,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2831,Percent of total billed charges,,2831,2920.4,
Repair of joint between finger and palm,PX-36011154,CDM,26548,CPT,360,RC,,outpatient,,,2980,2682,,0.95,,2831,Percent of total billed charges,,,0.98,,2920.4,Percent of total billed charges,,,0.95,,2831,Percent of total billed charges,,,0.95,,2831,Percent of total billed charges,,,0.97,,2890.6,Percent of total billed charges,,,0.96,,2860.8,Percent of total billed charges,,,0.95,,2831,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2831,Percent of total billed charges,,2831,2920.4,
Removal of multiple external noncancer growths of anus,PX-36011159,CDM,46230,CPT,360,RC,,inpatient,,,830,747,,0.95,,788.5,Percent of total billed charges,,,0.98,,813.4,Percent of total billed charges,,,0.95,,788.5,Percent of total billed charges,,,0.97,,805.1,Percent of total billed charges,,,0.97,,805.1,Percent of total billed charges,,,0.96,,796.8,Percent of total billed charges,,,0.95,,788.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,788.5,Percent of total billed charges,,788.5,813.4,
Removal of multiple external noncancer growths of anus,PX-36011159,CDM,46230,CPT,360,RC,,outpatient,,,830,747,,0.95,,788.5,Percent of total billed charges,,,0.98,,813.4,Percent of total billed charges,,,0.95,,788.5,Percent of total billed charges,,,0.95,,788.5,Percent of total billed charges,,,0.97,,805.1,Percent of total billed charges,,,0.96,,796.8,Percent of total billed charges,,,0.95,,788.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,788.5,Percent of total billed charges,,788.5,813.4,
HC PR G0444 Depression Screen Annual Cdm,PX-98310969,CDM,G0444,HCPCS,983,RC,,inpatient,,,48,43.2,,0.95,,45.6,Percent of total billed charges,,,0.98,,47.04,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.96,,46.08,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,45.6,Percent of total billed charges,,45.6,47.04,
HC PR G0444 Depression Screen Annual Cdm,PX-98310969,CDM,G0444,HCPCS,983,RC,,outpatient,,,48,43.2,,0.95,,45.6,Percent of total billed charges,,,0.98,,47.04,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.96,,46.08,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,45.6,Percent of total billed charges,,45.6,47.04,
HC PR 24147 Partial Removal of Elbow,PX-97513657,CDM,24147,CPT,975,RC,,inpatient,,,1571,1413.9,,0.95,,1492.45,Percent of total billed charges,,,0.98,,1539.58,Percent of total billed charges,,,0.95,,1492.45,Percent of total billed charges,,,0.97,,1523.87,Percent of total billed charges,,,0.97,,1523.87,Percent of total billed charges,,,0.96,,1508.16,Percent of total billed charges,,,0.95,,1492.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1492.45,Percent of total billed charges,,1492.45,1539.58,
HC PR 24147 Partial Removal of Elbow,PX-97513657,CDM,24147,CPT,975,RC,,outpatient,,,1571,1413.9,,0.95,,1492.45,Percent of total billed charges,,,0.98,,1539.58,Percent of total billed charges,,,0.95,,1492.45,Percent of total billed charges,,,0.95,,1492.45,Percent of total billed charges,,,0.97,,1523.87,Percent of total billed charges,,,0.96,,1508.16,Percent of total billed charges,,,0.95,,1492.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1492.45,Percent of total billed charges,,1492.45,1539.58,
HC PR Rx Hyaluronan or Derivative (Gel-One) Inj 1 Ea,PX-63610188,CDM,J7326,HCPCS,636,RC,,inpatient,,,3135,2821.5,,0.95,,2978.25,Percent of total billed charges,,,0.98,,3072.3,Percent of total billed charges,,,0.95,,2978.25,Percent of total billed charges,,,0.97,,3040.95,Percent of total billed charges,,,0.97,,3040.95,Percent of total billed charges,,,0.96,,3009.6,Percent of total billed charges,,,0.95,,2978.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2978.25,Percent of total billed charges,,2978.25,3072.3,
HC PR Rx Hyaluronan or Derivative (Gel-One) Inj 1 Ea,PX-63610188,CDM,J7326,HCPCS,636,RC,,outpatient,,,3135,2821.5,,0.95,,2978.25,Percent of total billed charges,,,0.98,,3072.3,Percent of total billed charges,,,0.95,,2978.25,Percent of total billed charges,,,0.95,,2978.25,Percent of total billed charges,,,0.97,,3040.95,Percent of total billed charges,,,0.96,,3009.6,Percent of total billed charges,,,0.95,,2978.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2978.25,Percent of total billed charges,,2978.25,3072.3,
HC Endoscopy/Gastrointestinal Procedure Level 1,PX-75010315,CDM,75010315,LOCAL,750,RC,,inpatient,,,1876,1688.4,,0.95,,1782.2,Percent of total billed charges,,,0.98,,1838.48,Percent of total billed charges,,,0.95,,1782.2,Percent of total billed charges,,,0.97,,1819.72,Percent of total billed charges,,,0.97,,1819.72,Percent of total billed charges,,,0.96,,1800.96,Percent of total billed charges,,,0.95,,1782.2,Percent of total billed charges,,,,,,,,,0.95,,1782.2,Percent of total billed charges,,1782.2,1838.48,
HC Endoscopy/Gastrointestinal Procedure Level 1,PX-75010315,CDM,75010315,LOCAL,750,RC,,outpatient,,,1876,1688.4,,0.95,,1782.2,Percent of total billed charges,,,0.98,,1838.48,Percent of total billed charges,,,0.95,,1782.2,Percent of total billed charges,,,0.95,,1782.2,Percent of total billed charges,,,0.97,,1819.72,Percent of total billed charges,,,0.96,,1800.96,Percent of total billed charges,,,0.95,,1782.2,Percent of total billed charges,,,,,,,,,0.95,,1782.2,Percent of total billed charges,,1782.2,1838.48,
HC Endoscopy/Gastrointestinal Procedure Level 2,PX-75010316,CDM,75010316,LOCAL,750,RC,,inpatient,,,2031,1827.9,,0.95,,1929.45,Percent of total billed charges,,,0.98,,1990.38,Percent of total billed charges,,,0.95,,1929.45,Percent of total billed charges,,,0.97,,1970.07,Percent of total billed charges,,,0.97,,1970.07,Percent of total billed charges,,,0.96,,1949.76,Percent of total billed charges,,,0.95,,1929.45,Percent of total billed charges,,,,,,,,,0.95,,1929.45,Percent of total billed charges,,1929.45,1990.38,
HC Endoscopy/Gastrointestinal Procedure Level 2,PX-75010316,CDM,75010316,LOCAL,750,RC,,outpatient,,,2031,1827.9,,0.95,,1929.45,Percent of total billed charges,,,0.98,,1990.38,Percent of total billed charges,,,0.95,,1929.45,Percent of total billed charges,,,0.95,,1929.45,Percent of total billed charges,,,0.97,,1970.07,Percent of total billed charges,,,0.96,,1949.76,Percent of total billed charges,,,0.95,,1929.45,Percent of total billed charges,,,,,,,,,0.95,,1929.45,Percent of total billed charges,,1929.45,1990.38,
HC Endoscopy/Gastrointestinal Procedure Level 3,PX-75010317,CDM,75010317,LOCAL,750,RC,,inpatient,,,2091,1881.9,,0.95,,1986.45,Percent of total billed charges,,,0.98,,2049.18,Percent of total billed charges,,,0.95,,1986.45,Percent of total billed charges,,,0.97,,2028.27,Percent of total billed charges,,,0.97,,2028.27,Percent of total billed charges,,,0.96,,2007.36,Percent of total billed charges,,,0.95,,1986.45,Percent of total billed charges,,,,,,,,,0.95,,1986.45,Percent of total billed charges,,1986.45,2049.18,
HC Endoscopy/Gastrointestinal Procedure Level 3,PX-75010317,CDM,75010317,LOCAL,750,RC,,outpatient,,,2091,1881.9,,0.95,,1986.45,Percent of total billed charges,,,0.98,,2049.18,Percent of total billed charges,,,0.95,,1986.45,Percent of total billed charges,,,0.95,,1986.45,Percent of total billed charges,,,0.97,,2028.27,Percent of total billed charges,,,0.96,,2007.36,Percent of total billed charges,,,0.95,,1986.45,Percent of total billed charges,,,,,,,,,0.95,,1986.45,Percent of total billed charges,,1986.45,2049.18,
HC Endoscopy/Gastrointestinal Procedure Level 4,PX-75010318,CDM,75010318,LOCAL,750,RC,,inpatient,,,2153,1937.7,,0.95,,2045.35,Percent of total billed charges,,,0.98,,2109.94,Percent of total billed charges,,,0.95,,2045.35,Percent of total billed charges,,,0.97,,2088.41,Percent of total billed charges,,,0.97,,2088.41,Percent of total billed charges,,,0.96,,2066.88,Percent of total billed charges,,,0.95,,2045.35,Percent of total billed charges,,,,,,,,,0.95,,2045.35,Percent of total billed charges,,2045.35,2109.94,
HC Endoscopy/Gastrointestinal Procedure Level 4,PX-75010318,CDM,75010318,LOCAL,750,RC,,outpatient,,,2153,1937.7,,0.95,,2045.35,Percent of total billed charges,,,0.98,,2109.94,Percent of total billed charges,,,0.95,,2045.35,Percent of total billed charges,,,0.95,,2045.35,Percent of total billed charges,,,0.97,,2088.41,Percent of total billed charges,,,0.96,,2066.88,Percent of total billed charges,,,0.95,,2045.35,Percent of total billed charges,,,,,,,,,0.95,,2045.35,Percent of total billed charges,,2045.35,2109.94,
Test by immunoassay HIV-1 antigen HIV-1/HIV-2 antibodies,PX-30210183,CDM,87389,CPT,300,RC,,inpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
Test by immunoassay HIV-1 antigen HIV-1/HIV-2 antibodies,PX-30210183,CDM,87389,CPT,300,RC,,outpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
Molecular pathology procedure level 5,PX-31010679,CDM,81404,CPT,310,RC,,inpatient,,,849,764.1,,0.95,,806.55,Percent of total billed charges,,,0.98,,832.02,Percent of total billed charges,,,0.95,,806.55,Percent of total billed charges,,,0.97,,823.53,Percent of total billed charges,,,0.97,,823.53,Percent of total billed charges,,,0.96,,815.04,Percent of total billed charges,,,0.95,,806.55,Percent of total billed charges,,,,,,,,,0.95,,806.55,Percent of total billed charges,,806.55,832.02,
Molecular pathology procedure level 5,PX-31010679,CDM,81404,CPT,310,RC,,outpatient,,,849,764.1,,0.95,,806.55,Percent of total billed charges,,,0.98,,832.02,Percent of total billed charges,,,0.95,,806.55,Percent of total billed charges,,,0.95,,806.55,Percent of total billed charges,,,0.97,,823.53,Percent of total billed charges,,,0.96,,815.04,Percent of total billed charges,,,0.95,,806.55,Percent of total billed charges,,,,,,,,,0.95,,806.55,Percent of total billed charges,,806.55,832.02,
HC PR 10035 Perq Dev Soft Tiss 1st Imag,PX-96911231,CDM,10035,CPT,983,RC,,inpatient,,,885,796.5,,0.95,,840.75,Percent of total billed charges,,,0.98,,867.3,Percent of total billed charges,,,0.95,,840.75,Percent of total billed charges,,,0.97,,858.45,Percent of total billed charges,,,0.97,,858.45,Percent of total billed charges,,,0.96,,849.6,Percent of total billed charges,,,0.95,,840.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,840.75,Percent of total billed charges,,840.75,867.3,
HC PR 10035 Perq Dev Soft Tiss 1st Imag,PX-96911231,CDM,10035,CPT,983,RC,,outpatient,,,885,796.5,,0.95,,840.75,Percent of total billed charges,,,0.98,,867.3,Percent of total billed charges,,,0.95,,840.75,Percent of total billed charges,,,0.95,,840.75,Percent of total billed charges,,,0.97,,858.45,Percent of total billed charges,,,0.96,,849.6,Percent of total billed charges,,,0.95,,840.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,840.75,Percent of total billed charges,,840.75,867.3,
"X-ray of entire middle and lower spine, 1 view",PX-32010604,CDM,72081,CPT,320,RC,,inpatient,,,309,278.1,,0.95,,293.55,Percent of total billed charges,,,0.98,,302.82,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,0.97,,299.73,Percent of total billed charges,,,0.97,,299.73,Percent of total billed charges,,,0.96,,296.64,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,293.55,Percent of total billed charges,,293.55,302.82,
"X-ray of entire middle and lower spine, 1 view",PX-32010604,CDM,72081,CPT,320,RC,,outpatient,,,309,278.1,,0.95,,293.55,Percent of total billed charges,,,0.98,,302.82,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,0.97,,299.73,Percent of total billed charges,,,0.96,,296.64,Percent of total billed charges,,,0.95,,293.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,293.55,Percent of total billed charges,,293.55,302.82,
"X-ray of entire middle and lower spine, 2-3 views",PX-32010605,CDM,72082,CPT,320,RC,,inpatient,,,702,631.8,,0.95,,666.9,Percent of total billed charges,,,0.98,,687.96,Percent of total billed charges,,,0.95,,666.9,Percent of total billed charges,,,0.97,,680.94,Percent of total billed charges,,,0.97,,680.94,Percent of total billed charges,,,0.96,,673.92,Percent of total billed charges,,,0.95,,666.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,666.9,Percent of total billed charges,,666.9,687.96,
"X-ray of entire middle and lower spine, 2-3 views",PX-32010605,CDM,72082,CPT,320,RC,,outpatient,,,702,631.8,,0.95,,666.9,Percent of total billed charges,,,0.98,,687.96,Percent of total billed charges,,,0.95,,666.9,Percent of total billed charges,,,0.95,,666.9,Percent of total billed charges,,,0.97,,680.94,Percent of total billed charges,,,0.96,,673.92,Percent of total billed charges,,,0.95,,666.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,666.9,Percent of total billed charges,,666.9,687.96,
"X-ray of entire middle and lower spine, 4-5 views",PX-32010606,CDM,72083,CPT,320,RC,,inpatient,,,605,544.5,,0.95,,574.75,Percent of total billed charges,,,0.98,,592.9,Percent of total billed charges,,,0.95,,574.75,Percent of total billed charges,,,0.97,,586.85,Percent of total billed charges,,,0.97,,586.85,Percent of total billed charges,,,0.96,,580.8,Percent of total billed charges,,,0.95,,574.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,574.75,Percent of total billed charges,,574.75,592.9,
"X-ray of entire middle and lower spine, 4-5 views",PX-32010606,CDM,72083,CPT,320,RC,,outpatient,,,605,544.5,,0.95,,574.75,Percent of total billed charges,,,0.98,,592.9,Percent of total billed charges,,,0.95,,574.75,Percent of total billed charges,,,0.95,,574.75,Percent of total billed charges,,,0.97,,586.85,Percent of total billed charges,,,0.96,,580.8,Percent of total billed charges,,,0.95,,574.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,574.75,Percent of total billed charges,,574.75,592.9,
"X-ray of entire middle and lower spine, minimum of 6 views",PX-32010607,CDM,72084,CPT,320,RC,,inpatient,,,758,682.2,,0.95,,720.1,Percent of total billed charges,,,0.98,,742.84,Percent of total billed charges,,,0.95,,720.1,Percent of total billed charges,,,0.97,,735.26,Percent of total billed charges,,,0.97,,735.26,Percent of total billed charges,,,0.96,,727.68,Percent of total billed charges,,,0.95,,720.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,720.1,Percent of total billed charges,,720.1,742.84,
"X-ray of entire middle and lower spine, minimum of 6 views",PX-32010607,CDM,72084,CPT,320,RC,,outpatient,,,758,682.2,,0.95,,720.1,Percent of total billed charges,,,0.98,,742.84,Percent of total billed charges,,,0.95,,720.1,Percent of total billed charges,,,0.95,,720.1,Percent of total billed charges,,,0.97,,735.26,Percent of total billed charges,,,0.96,,727.68,Percent of total billed charges,,,0.95,,720.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,720.1,Percent of total billed charges,,720.1,742.84,
"X-ray of hip, 1 view",PX-32010608,CDM,73501,CPT,320,RC,,inpatient,,,280,252,,0.95,,266,Percent of total billed charges,,,0.98,,274.4,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,0.97,,271.6,Percent of total billed charges,,,0.97,,271.6,Percent of total billed charges,,,0.96,,268.8,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,,,,,,,0.95,,266,Percent of total billed charges,,266,274.4,
"X-ray of hip, 1 view",PX-32010608,CDM,73501,CPT,320,RC,,outpatient,,,280,252,,0.95,,266,Percent of total billed charges,,,0.98,,274.4,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,0.97,,271.6,Percent of total billed charges,,,0.96,,268.8,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,,,,,,,0.95,,266,Percent of total billed charges,,266,274.4,
"X-ray of hip, 2-3 views",PX-32010609,CDM,73502,CPT,320,RC,,inpatient,,,412,370.8,,0.95,,391.4,Percent of total billed charges,,,0.98,,403.76,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.96,,395.52,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,391.4,Percent of total billed charges,,391.4,403.76,
"X-ray of hip, 2-3 views",PX-32010609,CDM,73502,CPT,320,RC,,outpatient,,,412,370.8,,0.95,,391.4,Percent of total billed charges,,,0.98,,403.76,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,0.97,,399.64,Percent of total billed charges,,,0.96,,395.52,Percent of total billed charges,,,0.95,,391.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,391.4,Percent of total billed charges,,391.4,403.76,
"X-ray of hip, minimum of 4 views",PX-32010610,CDM,73503,CPT,320,RC,,inpatient,,,615,553.5,,0.95,,584.25,Percent of total billed charges,,,0.98,,602.7,Percent of total billed charges,,,0.95,,584.25,Percent of total billed charges,,,0.97,,596.55,Percent of total billed charges,,,0.97,,596.55,Percent of total billed charges,,,0.96,,590.4,Percent of total billed charges,,,0.95,,584.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,584.25,Percent of total billed charges,,584.25,602.7,
"X-ray of hip, minimum of 4 views",PX-32010610,CDM,73503,CPT,320,RC,,outpatient,,,615,553.5,,0.95,,584.25,Percent of total billed charges,,,0.98,,602.7,Percent of total billed charges,,,0.95,,584.25,Percent of total billed charges,,,0.95,,584.25,Percent of total billed charges,,,0.97,,596.55,Percent of total billed charges,,,0.96,,590.4,Percent of total billed charges,,,0.95,,584.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,584.25,Percent of total billed charges,,584.25,602.7,
"X-ray of both hips, 2 views",PX-32010611,CDM,73521,CPT,320,RC,,inpatient,,,490,441,,0.95,,465.5,Percent of total billed charges,,,0.98,,480.2,Percent of total billed charges,,,0.95,,465.5,Percent of total billed charges,,,0.97,,475.3,Percent of total billed charges,,,0.97,,475.3,Percent of total billed charges,,,0.96,,470.4,Percent of total billed charges,,,0.95,,465.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,465.5,Percent of total billed charges,,465.5,480.2,
"X-ray of both hips, 2 views",PX-32010611,CDM,73521,CPT,320,RC,,outpatient,,,490,441,,0.95,,465.5,Percent of total billed charges,,,0.98,,480.2,Percent of total billed charges,,,0.95,,465.5,Percent of total billed charges,,,0.95,,465.5,Percent of total billed charges,,,0.97,,475.3,Percent of total billed charges,,,0.96,,470.4,Percent of total billed charges,,,0.95,,465.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,465.5,Percent of total billed charges,,465.5,480.2,
"X-ray of both hips, 3-4 views",PX-32010612,CDM,73522,CPT,320,RC,,inpatient,,,598,538.2,,0.95,,568.1,Percent of total billed charges,,,0.98,,586.04,Percent of total billed charges,,,0.95,,568.1,Percent of total billed charges,,,0.97,,580.06,Percent of total billed charges,,,0.97,,580.06,Percent of total billed charges,,,0.96,,574.08,Percent of total billed charges,,,0.95,,568.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,568.1,Percent of total billed charges,,568.1,586.04,
"X-ray of both hips, 3-4 views",PX-32010612,CDM,73522,CPT,320,RC,,outpatient,,,598,538.2,,0.95,,568.1,Percent of total billed charges,,,0.98,,586.04,Percent of total billed charges,,,0.95,,568.1,Percent of total billed charges,,,0.95,,568.1,Percent of total billed charges,,,0.97,,580.06,Percent of total billed charges,,,0.96,,574.08,Percent of total billed charges,,,0.95,,568.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,568.1,Percent of total billed charges,,568.1,586.04,
"X-ray of both hips, minimum of 5 views",PX-32010613,CDM,73523,CPT,320,RC,,inpatient,,,618,556.2,,0.95,,587.1,Percent of total billed charges,,,0.98,,605.64,Percent of total billed charges,,,0.95,,587.1,Percent of total billed charges,,,0.97,,599.46,Percent of total billed charges,,,0.97,,599.46,Percent of total billed charges,,,0.96,,593.28,Percent of total billed charges,,,0.95,,587.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,587.1,Percent of total billed charges,,587.1,605.64,
"X-ray of both hips, minimum of 5 views",PX-32010613,CDM,73523,CPT,320,RC,,outpatient,,,618,556.2,,0.95,,587.1,Percent of total billed charges,,,0.98,,605.64,Percent of total billed charges,,,0.95,,587.1,Percent of total billed charges,,,0.95,,587.1,Percent of total billed charges,,,0.97,,599.46,Percent of total billed charges,,,0.96,,593.28,Percent of total billed charges,,,0.95,,587.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,587.1,Percent of total billed charges,,587.1,605.64,
"X-ray of thigh bone, 1 view",PX-32010614,CDM,73551,CPT,320,RC,,inpatient,,,279,251.1,,0.95,,265.05,Percent of total billed charges,,,0.98,,273.42,Percent of total billed charges,,,0.95,,265.05,Percent of total billed charges,,,0.97,,270.63,Percent of total billed charges,,,0.97,,270.63,Percent of total billed charges,,,0.96,,267.84,Percent of total billed charges,,,0.95,,265.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,265.05,Percent of total billed charges,,265.05,273.42,
"X-ray of thigh bone, 1 view",PX-32010614,CDM,73551,CPT,320,RC,,outpatient,,,279,251.1,,0.95,,265.05,Percent of total billed charges,,,0.98,,273.42,Percent of total billed charges,,,0.95,,265.05,Percent of total billed charges,,,0.95,,265.05,Percent of total billed charges,,,0.97,,270.63,Percent of total billed charges,,,0.96,,267.84,Percent of total billed charges,,,0.95,,265.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,265.05,Percent of total billed charges,,265.05,273.42,
"X-ray of thigh bone, minimum 2 views",PX-32010615,CDM,73552,CPT,320,RC,,inpatient,,,356,320.4,,0.95,,338.2,Percent of total billed charges,,,0.98,,348.88,Percent of total billed charges,,,0.95,,338.2,Percent of total billed charges,,,0.97,,345.32,Percent of total billed charges,,,0.97,,345.32,Percent of total billed charges,,,0.96,,341.76,Percent of total billed charges,,,0.95,,338.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,338.2,Percent of total billed charges,,338.2,348.88,
"X-ray of thigh bone, minimum 2 views",PX-32010615,CDM,73552,CPT,320,RC,,outpatient,,,356,320.4,,0.95,,338.2,Percent of total billed charges,,,0.98,,348.88,Percent of total billed charges,,,0.95,,338.2,Percent of total billed charges,,,0.95,,338.2,Percent of total billed charges,,,0.97,,345.32,Percent of total billed charges,,,0.96,,341.76,Percent of total billed charges,,,0.95,,338.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,338.2,Percent of total billed charges,,338.2,348.88,
HC PR 99490 CHRONIC CARE MGMT SERVICES 1ST 20 MIN p/ CALENDAR MONTH,PX-98311141,CDM,99490,CPT,983,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
HC PR 99490 CHRONIC CARE MGMT SERVICES 1ST 20 MIN p/ CALENDAR MONTH,PX-98311141,CDM,99490,CPT,983,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
HC PR Rx Rho D Immune Globulin Inj 300 Mcg (1500 Iu),PX-63610194,CDM,J2790,HCPCS,636,RC,,inpatient,,,402,361.8,,0.95,,381.9,Percent of total billed charges,,,0.98,,393.96,Percent of total billed charges,,,0.95,,381.9,Percent of total billed charges,,,0.97,,389.94,Percent of total billed charges,,,0.97,,389.94,Percent of total billed charges,,,0.96,,385.92,Percent of total billed charges,,,0.95,,381.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,381.9,Percent of total billed charges,,381.9,393.96,
HC PR Rx Rho D Immune Globulin Inj 300 Mcg (1500 Iu),PX-63610194,CDM,J2790,HCPCS,636,RC,,outpatient,,,402,361.8,,0.95,,381.9,Percent of total billed charges,,,0.98,,393.96,Percent of total billed charges,,,0.95,,381.9,Percent of total billed charges,,,0.95,,381.9,Percent of total billed charges,,,0.97,,389.94,Percent of total billed charges,,,0.96,,385.92,Percent of total billed charges,,,0.95,,381.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,381.9,Percent of total billed charges,,381.9,393.96,
HC PR Rx Levonorgestrel Iud (Mirena) Iud 5 Yr 52 Mg,PX-63610217,CDM,J7298,HCPCS,636,RC,,inpatient,,,1951,1755.9,,0.95,,1853.45,Percent of total billed charges,,,0.98,,1911.98,Percent of total billed charges,,,0.95,,1853.45,Percent of total billed charges,,,0.97,,1892.47,Percent of total billed charges,,,0.97,,1892.47,Percent of total billed charges,,,0.96,,1872.96,Percent of total billed charges,,,0.95,,1853.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1853.45,Percent of total billed charges,,1853.45,1911.98,
HC PR Rx Levonorgestrel Iud (Mirena) Iud 5 Yr 52 Mg,PX-63610217,CDM,J7298,HCPCS,636,RC,,outpatient,,,1951,1755.9,,0.95,,1853.45,Percent of total billed charges,,,0.98,,1911.98,Percent of total billed charges,,,0.95,,1853.45,Percent of total billed charges,,,0.95,,1853.45,Percent of total billed charges,,,0.97,,1892.47,Percent of total billed charges,,,0.96,,1872.96,Percent of total billed charges,,,0.95,,1853.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1853.45,Percent of total billed charges,,1853.45,1911.98,
HC Definitive Drugs Exclude Ia and Enzyme Methods per Day 1-7 Drugs,PX-30110148,CDM,G0480,CPT,301,RC,,inpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
HC Definitive Drugs Exclude Ia and Enzyme Methods per Day 1-7 Drugs,PX-30110148,CDM,G0480,CPT,301,RC,,outpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
HC PR ED 69209 Removal Impacted Cerumen Irrigation/Lvg Unilat Cdm,PX-98110645,CDM,69209,CPT,981,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
HC PR ED 69209 Removal Impacted Cerumen Irrigation/Lvg Unilat Cdm,PX-98110645,CDM,69209,CPT,981,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
HC or Introducer 8.5#0603180,PX-3250095WWM,CDM,3250095WWM,LOCAL,270,RC,,inpatient,,,266,239.4,,0.95,,252.7,Percent of total billed charges,,,0.98,,260.68,Percent of total billed charges,,,0.95,,252.7,Percent of total billed charges,,,0.97,,258.02,Percent of total billed charges,,,0.97,,258.02,Percent of total billed charges,,,0.96,,255.36,Percent of total billed charges,,,0.95,,252.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,252.7,Percent of total billed charges,,252.7,260.68,
HC or Introducer 8.5#0603180,PX-3250095WWM,CDM,3250095WWM,LOCAL,270,RC,,outpatient,,,266,239.4,,0.95,,252.7,Percent of total billed charges,,,0.98,,260.68,Percent of total billed charges,,,0.95,,252.7,Percent of total billed charges,,,0.95,,252.7,Percent of total billed charges,,,0.97,,258.02,Percent of total billed charges,,,0.96,,255.36,Percent of total billed charges,,,0.95,,252.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,252.7,Percent of total billed charges,,252.7,260.68,
HC or Pain Pump 270 Ml,PX-3250281WWM,CDM,3250281WWM,LOCAL,270,RC,,inpatient,,,421,378.9,,0.95,,399.95,Percent of total billed charges,,,0.98,,412.58,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,0.97,,408.37,Percent of total billed charges,,,0.97,,408.37,Percent of total billed charges,,,0.96,,404.16,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,399.95,Percent of total billed charges,,399.95,412.58,
HC or Pain Pump 270 Ml,PX-3250281WWM,CDM,3250281WWM,LOCAL,270,RC,,outpatient,,,421,378.9,,0.95,,399.95,Percent of total billed charges,,,0.98,,412.58,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,0.97,,408.37,Percent of total billed charges,,,0.96,,404.16,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,399.95,Percent of total billed charges,,399.95,412.58,
HC or Pain Pump 100 Ml,PX-3250288WWM,CDM,3250288WWM,LOCAL,270,RC,,inpatient,,,316,284.4,,0.95,,300.2,Percent of total billed charges,,,0.98,,309.68,Percent of total billed charges,,,0.95,,300.2,Percent of total billed charges,,,0.97,,306.52,Percent of total billed charges,,,0.97,,306.52,Percent of total billed charges,,,0.96,,303.36,Percent of total billed charges,,,0.95,,300.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,300.2,Percent of total billed charges,,300.2,309.68,
HC or Pain Pump 100 Ml,PX-3250288WWM,CDM,3250288WWM,LOCAL,270,RC,,outpatient,,,316,284.4,,0.95,,300.2,Percent of total billed charges,,,0.98,,309.68,Percent of total billed charges,,,0.95,,300.2,Percent of total billed charges,,,0.95,,300.2,Percent of total billed charges,,,0.97,,306.52,Percent of total billed charges,,,0.96,,303.36,Percent of total billed charges,,,0.95,,300.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,300.2,Percent of total billed charges,,300.2,309.68,
HC or Colon Clip#Hx2004135,PX-3250387WWM,CDM,3250387WWM,LOCAL,278,RC,,inpatient,,,186,167.4,,0.95,,176.7,Percent of total billed charges,,,0.98,,182.28,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.96,,178.56,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,176.7,Percent of total billed charges,,176.7,182.28,
HC or Colon Clip#Hx2004135,PX-3250387WWM,CDM,3250387WWM,LOCAL,278,RC,,outpatient,,,186,167.4,,0.95,,176.7,Percent of total billed charges,,,0.98,,182.28,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.96,,178.56,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,176.7,Percent of total billed charges,,176.7,182.28,
HC or Bone Wax 2 31g,PX-3250425WWM,CDM,3250425WWM,LOCAL,270,RC,,inpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
HC or Bone Wax 2 31g,PX-3250425WWM,CDM,3250425WWM,LOCAL,270,RC,,outpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
HC or Liga Clip Sm #Lc20,PX-3250426WWM,CDM,3250426WWM,LOCAL,278,RC,,inpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
HC or Liga Clip Sm #Lc20,PX-3250426WWM,CDM,3250426WWM,LOCAL,278,RC,,outpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
HC or Liga Clip Med Lc3,PX-3250427WWM,CDM,3250427WWM,LOCAL,278,RC,,inpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
HC or Liga Clip Med Lc3,PX-3250427WWM,CDM,3250427WWM,LOCAL,278,RC,,outpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
HC or Snare Rotate#M00561821,PX-3250583WWM,CDM,3250583WWM,LOCAL,270,RC,,inpatient,,,192,172.8,,0.95,,182.4,Percent of total billed charges,,,0.98,,188.16,Percent of total billed charges,,,0.95,,182.4,Percent of total billed charges,,,0.97,,186.24,Percent of total billed charges,,,0.97,,186.24,Percent of total billed charges,,,0.96,,184.32,Percent of total billed charges,,,0.95,,182.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,182.4,Percent of total billed charges,,182.4,188.16,
HC or Snare Rotate#M00561821,PX-3250583WWM,CDM,3250583WWM,LOCAL,270,RC,,outpatient,,,192,172.8,,0.95,,182.4,Percent of total billed charges,,,0.98,,188.16,Percent of total billed charges,,,0.95,,182.4,Percent of total billed charges,,,0.95,,182.4,Percent of total billed charges,,,0.97,,186.24,Percent of total billed charges,,,0.96,,184.32,Percent of total billed charges,,,0.95,,182.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,182.4,Percent of total billed charges,,182.4,188.16,
HC or Mesh Bard Xlg #0112780,PX-3250618WWM,CDM,3250618WWM,LOCAL,278,RC,,inpatient,,,435,391.5,,0.95,,413.25,Percent of total billed charges,,,0.98,,426.3,Percent of total billed charges,,,0.95,,413.25,Percent of total billed charges,,,0.97,,421.95,Percent of total billed charges,,,0.97,,421.95,Percent of total billed charges,,,0.96,,417.6,Percent of total billed charges,,,0.95,,413.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,413.25,Percent of total billed charges,,413.25,426.3,
HC or Mesh Bard Xlg #0112780,PX-3250618WWM,CDM,3250618WWM,LOCAL,278,RC,,outpatient,,,435,391.5,,0.95,,413.25,Percent of total billed charges,,,0.98,,426.3,Percent of total billed charges,,,0.95,,413.25,Percent of total billed charges,,,0.95,,413.25,Percent of total billed charges,,,0.97,,421.95,Percent of total billed charges,,,0.96,,417.6,Percent of total billed charges,,,0.95,,413.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,413.25,Percent of total billed charges,,413.25,426.3,
HC or Drain Jp 15fr,PX-3250671WWM,CDM,3250671WWM,LOCAL,270,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
HC or Drain Jp 15fr,PX-3250671WWM,CDM,3250671WWM,LOCAL,270,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
HC or Drain Jp 19fr,PX-3250672WWM,CDM,3250672WWM,LOCAL,270,RC,,inpatient,,,117,105.3,,0.95,,111.15,Percent of total billed charges,,,0.98,,114.66,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.96,,112.32,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,111.15,Percent of total billed charges,,111.15,114.66,
HC or Drain Jp 19fr,PX-3250672WWM,CDM,3250672WWM,LOCAL,270,RC,,outpatient,,,117,105.3,,0.95,,111.15,Percent of total billed charges,,,0.98,,114.66,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.96,,112.32,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,111.15,Percent of total billed charges,,111.15,114.66,
HC or Suct Set/Vigrd#Smp001s,PX-3252517WWM,CDM,3252517WWM,LOCAL,270,RC,,inpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95,Percent of total billed charges,,95,98,
HC or Suct Set/Vigrd#Smp001s,PX-3252517WWM,CDM,3252517WWM,LOCAL,270,RC,,outpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95,Percent of total billed charges,,95,98,
HC or Purse String #20242,PX-3252522WWM,CDM,3252522WWM,LOCAL,270,RC,,inpatient,,,444,399.6,,0.95,,421.8,Percent of total billed charges,,,0.98,,435.12,Percent of total billed charges,,,0.95,,421.8,Percent of total billed charges,,,0.97,,430.68,Percent of total billed charges,,,0.97,,430.68,Percent of total billed charges,,,0.96,,426.24,Percent of total billed charges,,,0.95,,421.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,421.8,Percent of total billed charges,,421.8,435.12,
HC or Purse String #20242,PX-3252522WWM,CDM,3252522WWM,LOCAL,270,RC,,outpatient,,,444,399.6,,0.95,,421.8,Percent of total billed charges,,,0.98,,435.12,Percent of total billed charges,,,0.95,,421.8,Percent of total billed charges,,,0.95,,421.8,Percent of total billed charges,,,0.97,,430.68,Percent of total billed charges,,,0.96,,426.24,Percent of total billed charges,,,0.95,,421.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,421.8,Percent of total billed charges,,421.8,435.12,
HC or Cath Junostomy 7fr,PX-3252525WWM,CDM,3252525WWM,LOCAL,270,RC,,inpatient,,,458,412.2,,0.95,,435.1,Percent of total billed charges,,,0.98,,448.84,Percent of total billed charges,,,0.95,,435.1,Percent of total billed charges,,,0.97,,444.26,Percent of total billed charges,,,0.97,,444.26,Percent of total billed charges,,,0.96,,439.68,Percent of total billed charges,,,0.95,,435.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,435.1,Percent of total billed charges,,435.1,448.84,
HC or Cath Junostomy 7fr,PX-3252525WWM,CDM,3252525WWM,LOCAL,270,RC,,outpatient,,,458,412.2,,0.95,,435.1,Percent of total billed charges,,,0.98,,448.84,Percent of total billed charges,,,0.95,,435.1,Percent of total billed charges,,,0.95,,435.1,Percent of total billed charges,,,0.97,,444.26,Percent of total billed charges,,,0.96,,439.68,Percent of total billed charges,,,0.95,,435.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,435.1,Percent of total billed charges,,435.1,448.84,
HC or Cath Junostomy 16fr,PX-3252526WWM,CDM,3252526WWM,LOCAL,270,RC,,inpatient,,,583,524.7,,0.95,,553.85,Percent of total billed charges,,,0.98,,571.34,Percent of total billed charges,,,0.95,,553.85,Percent of total billed charges,,,0.97,,565.51,Percent of total billed charges,,,0.97,,565.51,Percent of total billed charges,,,0.96,,559.68,Percent of total billed charges,,,0.95,,553.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,553.85,Percent of total billed charges,,553.85,571.34,
HC or Cath Junostomy 16fr,PX-3252526WWM,CDM,3252526WWM,LOCAL,270,RC,,outpatient,,,583,524.7,,0.95,,553.85,Percent of total billed charges,,,0.98,,571.34,Percent of total billed charges,,,0.95,,553.85,Percent of total billed charges,,,0.95,,553.85,Percent of total billed charges,,,0.97,,565.51,Percent of total billed charges,,,0.96,,559.68,Percent of total billed charges,,,0.95,,553.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,553.85,Percent of total billed charges,,553.85,571.34,
HC or Ils Strght #Sdh29,PX-3252530WWM,CDM,3252530WWM,LOCAL,270,RC,,inpatient,,,846,761.4,,0.95,,803.7,Percent of total billed charges,,,0.98,,829.08,Percent of total billed charges,,,0.95,,803.7,Percent of total billed charges,,,0.97,,820.62,Percent of total billed charges,,,0.97,,820.62,Percent of total billed charges,,,0.96,,812.16,Percent of total billed charges,,,0.95,,803.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,803.7,Percent of total billed charges,,803.7,829.08,
HC or Ils Strght #Sdh29,PX-3252530WWM,CDM,3252530WWM,LOCAL,270,RC,,outpatient,,,846,761.4,,0.95,,803.7,Percent of total billed charges,,,0.98,,829.08,Percent of total billed charges,,,0.95,,803.7,Percent of total billed charges,,,0.95,,803.7,Percent of total billed charges,,,0.97,,820.62,Percent of total billed charges,,,0.96,,812.16,Percent of total billed charges,,,0.95,,803.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,803.7,Percent of total billed charges,,803.7,829.08,
HC or Ils Strght #Sdh25,PX-3252531WWM,CDM,3252531WWM,LOCAL,270,RC,,inpatient,,,718,646.2,,0.95,,682.1,Percent of total billed charges,,,0.98,,703.64,Percent of total billed charges,,,0.95,,682.1,Percent of total billed charges,,,0.97,,696.46,Percent of total billed charges,,,0.97,,696.46,Percent of total billed charges,,,0.96,,689.28,Percent of total billed charges,,,0.95,,682.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,682.1,Percent of total billed charges,,682.1,703.64,
HC or Ils Strght #Sdh25,PX-3252531WWM,CDM,3252531WWM,LOCAL,270,RC,,outpatient,,,718,646.2,,0.95,,682.1,Percent of total billed charges,,,0.98,,703.64,Percent of total billed charges,,,0.95,,682.1,Percent of total billed charges,,,0.95,,682.1,Percent of total billed charges,,,0.97,,696.46,Percent of total billed charges,,,0.96,,689.28,Percent of total billed charges,,,0.95,,682.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,682.1,Percent of total billed charges,,682.1,703.64,
HC or Stapler Lnr Re60#Tx60b,PX-3252532WWM,CDM,3252532WWM,LOCAL,270,RC,,inpatient,,,284,255.6,,0.95,,269.8,Percent of total billed charges,,,0.98,,278.32,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,0.97,,275.48,Percent of total billed charges,,,0.97,,275.48,Percent of total billed charges,,,0.96,,272.64,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,269.8,Percent of total billed charges,,269.8,278.32,
HC or Stapler Lnr Re60#Tx60b,PX-3252532WWM,CDM,3252532WWM,LOCAL,270,RC,,outpatient,,,284,255.6,,0.95,,269.8,Percent of total billed charges,,,0.98,,278.32,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,0.97,,275.48,Percent of total billed charges,,,0.96,,272.64,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,269.8,Percent of total billed charges,,269.8,278.32,
HC or Stapler Lnr Re60 Xr60b,PX-3252534WWM,CDM,3252534WWM,LOCAL,270,RC,,inpatient,,,259,233.1,,0.95,,246.05,Percent of total billed charges,,,0.98,,253.82,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,0.97,,251.23,Percent of total billed charges,,,0.97,,251.23,Percent of total billed charges,,,0.96,,248.64,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,246.05,Percent of total billed charges,,246.05,253.82,
HC or Stapler Lnr Re60 Xr60b,PX-3252534WWM,CDM,3252534WWM,LOCAL,270,RC,,outpatient,,,259,233.1,,0.95,,246.05,Percent of total billed charges,,,0.98,,253.82,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,0.97,,251.23,Percent of total billed charges,,,0.96,,248.64,Percent of total billed charges,,,0.95,,246.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,246.05,Percent of total billed charges,,246.05,253.82,
HC or Ils Strght #Sdh33,PX-3252535WWM,CDM,3252535WWM,LOCAL,270,RC,,inpatient,,,770,693,,0.95,,731.5,Percent of total billed charges,,,0.98,,754.6,Percent of total billed charges,,,0.95,,731.5,Percent of total billed charges,,,0.97,,746.9,Percent of total billed charges,,,0.97,,746.9,Percent of total billed charges,,,0.96,,739.2,Percent of total billed charges,,,0.95,,731.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,731.5,Percent of total billed charges,,731.5,754.6,
HC or Ils Strght #Sdh33,PX-3252535WWM,CDM,3252535WWM,LOCAL,270,RC,,outpatient,,,770,693,,0.95,,731.5,Percent of total billed charges,,,0.98,,754.6,Percent of total billed charges,,,0.95,,731.5,Percent of total billed charges,,,0.95,,731.5,Percent of total billed charges,,,0.97,,746.9,Percent of total billed charges,,,0.96,,739.2,Percent of total billed charges,,,0.95,,731.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,731.5,Percent of total billed charges,,731.5,754.6,
HC or Surgicell Abs/Hem#1963,PX-3252536WWM,CDM,3252536WWM,LOCAL,270,RC,,inpatient,,,426,383.4,,0.95,,404.7,Percent of total billed charges,,,0.98,,417.48,Percent of total billed charges,,,0.95,,404.7,Percent of total billed charges,,,0.97,,413.22,Percent of total billed charges,,,0.97,,413.22,Percent of total billed charges,,,0.96,,408.96,Percent of total billed charges,,,0.95,,404.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,404.7,Percent of total billed charges,,404.7,417.48,
HC or Surgicell Abs/Hem#1963,PX-3252536WWM,CDM,3252536WWM,LOCAL,270,RC,,outpatient,,,426,383.4,,0.95,,404.7,Percent of total billed charges,,,0.98,,417.48,Percent of total billed charges,,,0.95,,404.7,Percent of total billed charges,,,0.95,,404.7,Percent of total billed charges,,,0.97,,413.22,Percent of total billed charges,,,0.96,,408.96,Percent of total billed charges,,,0.95,,404.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,404.7,Percent of total billed charges,,404.7,417.48,
HC or Forcep Dishotbi#Fd230u,PX-3252547WWM,CDM,3252547WWM,LOCAL,270,RC,,inpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
HC or Forcep Dishotbi#Fd230u,PX-3252547WWM,CDM,3252547WWM,LOCAL,270,RC,,outpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
HC or Rectal Tube 30fr 056130,PX-3252549WWM,CDM,3252549WWM,LOCAL,270,RC,,inpatient,,,31,27.9,,0.95,,29.45,Percent of total billed charges,,,0.98,,30.38,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.96,,29.76,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,29.45,Percent of total billed charges,,29.45,30.38,
HC or Rectal Tube 30fr 056130,PX-3252549WWM,CDM,3252549WWM,LOCAL,270,RC,,outpatient,,,31,27.9,,0.95,,29.45,Percent of total billed charges,,,0.98,,30.38,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.96,,29.76,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,29.45,Percent of total billed charges,,29.45,30.38,
HC or Suct Irrig #250070520,PX-3252559WWM,CDM,3252559WWM,LOCAL,270,RC,,inpatient,,,214,192.6,,0.95,,203.3,Percent of total billed charges,,,0.98,,209.72,Percent of total billed charges,,,0.95,,203.3,Percent of total billed charges,,,0.97,,207.58,Percent of total billed charges,,,0.97,,207.58,Percent of total billed charges,,,0.96,,205.44,Percent of total billed charges,,,0.95,,203.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,203.3,Percent of total billed charges,,203.3,209.72,
HC or Suct Irrig #250070520,PX-3252559WWM,CDM,3252559WWM,LOCAL,270,RC,,outpatient,,,214,192.6,,0.95,,203.3,Percent of total billed charges,,,0.98,,209.72,Percent of total billed charges,,,0.95,,203.3,Percent of total billed charges,,,0.95,,203.3,Percent of total billed charges,,,0.97,,207.58,Percent of total billed charges,,,0.96,,205.44,Percent of total billed charges,,,0.95,,203.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,203.3,Percent of total billed charges,,203.3,209.72,
HC or Liga Clip App M#Er320,PX-3252594WWM,CDM,3252594WWM,LOCAL,278,RC,,inpatient,,,214,192.6,,0.95,,203.3,Percent of total billed charges,,,0.98,,209.72,Percent of total billed charges,,,0.95,,203.3,Percent of total billed charges,,,0.97,,207.58,Percent of total billed charges,,,0.97,,207.58,Percent of total billed charges,,,0.96,,205.44,Percent of total billed charges,,,0.95,,203.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,203.3,Percent of total billed charges,,203.3,209.72,
HC or Liga Clip App M#Er320,PX-3252594WWM,CDM,3252594WWM,LOCAL,278,RC,,outpatient,,,214,192.6,,0.95,,203.3,Percent of total billed charges,,,0.98,,209.72,Percent of total billed charges,,,0.95,,203.3,Percent of total billed charges,,,0.95,,203.3,Percent of total billed charges,,,0.97,,207.58,Percent of total billed charges,,,0.96,,205.44,Percent of total billed charges,,,0.95,,203.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,203.3,Percent of total billed charges,,203.3,209.72,
HC or Liga Clip App L #Er420,PX-3252595WWM,CDM,3252595WWM,LOCAL,278,RC,,inpatient,,,284,255.6,,0.95,,269.8,Percent of total billed charges,,,0.98,,278.32,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,0.97,,275.48,Percent of total billed charges,,,0.97,,275.48,Percent of total billed charges,,,0.96,,272.64,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,269.8,Percent of total billed charges,,269.8,278.32,
HC or Liga Clip App L #Er420,PX-3252595WWM,CDM,3252595WWM,LOCAL,278,RC,,outpatient,,,284,255.6,,0.95,,269.8,Percent of total billed charges,,,0.98,,278.32,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,0.97,,275.48,Percent of total billed charges,,,0.96,,272.64,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,269.8,Percent of total billed charges,,269.8,278.32,
HC or Mesh Bard Sm #0112750,PX-3252598WWM,CDM,3252598WWM,LOCAL,278,RC,,inpatient,,,627,564.3,,0.95,,595.65,Percent of total billed charges,,,0.98,,614.46,Percent of total billed charges,,,0.95,,595.65,Percent of total billed charges,,,0.97,,608.19,Percent of total billed charges,,,0.97,,608.19,Percent of total billed charges,,,0.96,,601.92,Percent of total billed charges,,,0.95,,595.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,595.65,Percent of total billed charges,,595.65,614.46,
HC or Mesh Bard Sm #0112750,PX-3252598WWM,CDM,3252598WWM,LOCAL,278,RC,,outpatient,,,627,564.3,,0.95,,595.65,Percent of total billed charges,,,0.98,,614.46,Percent of total billed charges,,,0.95,,595.65,Percent of total billed charges,,,0.95,,595.65,Percent of total billed charges,,,0.97,,608.19,Percent of total billed charges,,,0.96,,601.92,Percent of total billed charges,,,0.95,,595.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,595.65,Percent of total billed charges,,595.65,614.46,
HC or Orthosorb 2.0mm 842052,PX-3252600WWM,CDM,3252600WWM,LOCAL,270,RC,,inpatient,,,373,335.7,,0.95,,354.35,Percent of total billed charges,,,0.98,,365.54,Percent of total billed charges,,,0.95,,354.35,Percent of total billed charges,,,0.97,,361.81,Percent of total billed charges,,,0.97,,361.81,Percent of total billed charges,,,0.96,,358.08,Percent of total billed charges,,,0.95,,354.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,354.35,Percent of total billed charges,,354.35,365.54,
HC or Orthosorb 2.0mm 842052,PX-3252600WWM,CDM,3252600WWM,LOCAL,270,RC,,outpatient,,,373,335.7,,0.95,,354.35,Percent of total billed charges,,,0.98,,365.54,Percent of total billed charges,,,0.95,,354.35,Percent of total billed charges,,,0.95,,354.35,Percent of total billed charges,,,0.97,,361.81,Percent of total billed charges,,,0.96,,358.08,Percent of total billed charges,,,0.95,,354.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,354.35,Percent of total billed charges,,354.35,365.54,
HC or Blade Agee Ctr#810106,PX-3252601WWM,CDM,3252601WWM,LOCAL,270,RC,,inpatient,,,527,474.3,,0.95,,500.65,Percent of total billed charges,,,0.98,,516.46,Percent of total billed charges,,,0.95,,500.65,Percent of total billed charges,,,0.97,,511.19,Percent of total billed charges,,,0.97,,511.19,Percent of total billed charges,,,0.96,,505.92,Percent of total billed charges,,,0.95,,500.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,500.65,Percent of total billed charges,,500.65,516.46,
HC or Blade Agee Ctr#810106,PX-3252601WWM,CDM,3252601WWM,LOCAL,270,RC,,outpatient,,,527,474.3,,0.95,,500.65,Percent of total billed charges,,,0.98,,516.46,Percent of total billed charges,,,0.95,,500.65,Percent of total billed charges,,,0.95,,500.65,Percent of total billed charges,,,0.97,,511.19,Percent of total billed charges,,,0.96,,505.92,Percent of total billed charges,,,0.95,,500.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,500.65,Percent of total billed charges,,500.65,516.46,
HC or Orthosorb 1.3mm 841052,PX-3252605WWM,CDM,3252605WWM,LOCAL,270,RC,,inpatient,,,611,549.9,,0.95,,580.45,Percent of total billed charges,,,0.98,,598.78,Percent of total billed charges,,,0.95,,580.45,Percent of total billed charges,,,0.97,,592.67,Percent of total billed charges,,,0.97,,592.67,Percent of total billed charges,,,0.96,,586.56,Percent of total billed charges,,,0.95,,580.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,580.45,Percent of total billed charges,,580.45,598.78,
HC or Orthosorb 1.3mm 841052,PX-3252605WWM,CDM,3252605WWM,LOCAL,270,RC,,outpatient,,,611,549.9,,0.95,,580.45,Percent of total billed charges,,,0.98,,598.78,Percent of total billed charges,,,0.95,,580.45,Percent of total billed charges,,,0.95,,580.45,Percent of total billed charges,,,0.97,,592.67,Percent of total billed charges,,,0.96,,586.56,Percent of total billed charges,,,0.95,,580.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,580.45,Percent of total billed charges,,580.45,598.78,
HC or Wire K 035x6 #186058,PX-3252613WWM,CDM,3252613WWM,LOCAL,278,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC or Wire K 035x6 #186058,PX-3252613WWM,CDM,3252613WWM,LOCAL,278,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC or Wire K 062x6 #186090,PX-3252614WWM,CDM,3252614WWM,LOCAL,278,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC or Wire K 062x6 #186090,PX-3252614WWM,CDM,3252614WWM,LOCAL,278,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC or Wire K 035x9 #186-0169,PX-3252615WWM,CDM,3252615WWM,LOCAL,278,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC or Wire K 035x9 #186-0169,PX-3252615WWM,CDM,3252615WWM,LOCAL,278,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC or Wire K 045x9 #1860269,PX-3252616WWM,CDM,3252616WWM,LOCAL,278,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC or Wire K 045x9 #1860269,PX-3252616WWM,CDM,3252616WWM,LOCAL,278,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC or Wire K 062x9 #1860369,PX-3252617WWM,CDM,3252617WWM,LOCAL,278,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC or Wire K 062x9 #1860369,PX-3252617WWM,CDM,3252617WWM,LOCAL,278,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC or Wire C 062x5 #5050-249,PX-3252618WWM,CDM,3252618WWM,LOCAL,278,RC,,inpatient,,,55,49.5,,0.95,,52.25,Percent of total billed charges,,,0.98,,53.9,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.96,,52.8,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,52.25,Percent of total billed charges,,52.25,53.9,
HC or Wire C 062x5 #5050-249,PX-3252618WWM,CDM,3252618WWM,LOCAL,278,RC,,outpatient,,,55,49.5,,0.95,,52.25,Percent of total billed charges,,,0.98,,53.9,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.96,,52.8,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,52.25,Percent of total billed charges,,52.25,53.9,
HC or Wire C 045x5#5050-248,PX-3252619WWM,CDM,3252619WWM,LOCAL,278,RC,,inpatient,,,55,49.5,,0.95,,52.25,Percent of total billed charges,,,0.98,,53.9,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.96,,52.8,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,52.25,Percent of total billed charges,,52.25,53.9,
HC or Wire C 045x5#5050-248,PX-3252619WWM,CDM,3252619WWM,LOCAL,278,RC,,outpatient,,,55,49.5,,0.95,,52.25,Percent of total billed charges,,,0.98,,53.9,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.96,,52.8,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,52.25,Percent of total billed charges,,52.25,53.9,
HC or Wire Guide #Aw14735,PX-3252641WWM,CDM,3252641WWM,LOCAL,278,RC,,inpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
HC or Wire Guide #Aw14735,PX-3252641WWM,CDM,3252641WWM,LOCAL,278,RC,,outpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
HC or Drain Jp 7fr #U1301330,PX-3252645WWM,CDM,3252645WWM,LOCAL,270,RC,,inpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
HC or Drain Jp 7fr #U1301330,PX-3252645WWM,CDM,3252645WWM,LOCAL,270,RC,,outpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
HC or Suct Coag 10fr#E2505,PX-3252706WWM,CDM,3252706WWM,LOCAL,270,RC,,inpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
HC or Suct Coag 10fr#E2505,PX-3252706WWM,CDM,3252706WWM,LOCAL,270,RC,,outpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
HC or Mesh Monofilament 3x6,PX-3252707WWM,CDM,3252707WWM,LOCAL,278,RC,,inpatient,,,298,268.2,,0.95,,283.1,Percent of total billed charges,,,0.98,,292.04,Percent of total billed charges,,,0.95,,283.1,Percent of total billed charges,,,0.97,,289.06,Percent of total billed charges,,,0.97,,289.06,Percent of total billed charges,,,0.96,,286.08,Percent of total billed charges,,,0.95,,283.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,283.1,Percent of total billed charges,,283.1,292.04,
HC or Mesh Monofilament 3x6,PX-3252707WWM,CDM,3252707WWM,LOCAL,278,RC,,outpatient,,,298,268.2,,0.95,,283.1,Percent of total billed charges,,,0.98,,292.04,Percent of total billed charges,,,0.95,,283.1,Percent of total billed charges,,,0.95,,283.1,Percent of total billed charges,,,0.97,,289.06,Percent of total billed charges,,,0.96,,286.08,Percent of total billed charges,,,0.95,,283.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,283.1,Percent of total billed charges,,283.1,292.04,
HC or Mesh Monofilament 1x4,PX-3252708WWM,CDM,3252708WWM,LOCAL,278,RC,,inpatient,,,228,205.2,,0.95,,216.6,Percent of total billed charges,,,0.98,,223.44,Percent of total billed charges,,,0.95,,216.6,Percent of total billed charges,,,0.97,,221.16,Percent of total billed charges,,,0.97,,221.16,Percent of total billed charges,,,0.96,,218.88,Percent of total billed charges,,,0.95,,216.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,216.6,Percent of total billed charges,,216.6,223.44,
HC or Mesh Monofilament 1x4,PX-3252708WWM,CDM,3252708WWM,LOCAL,278,RC,,outpatient,,,228,205.2,,0.95,,216.6,Percent of total billed charges,,,0.98,,223.44,Percent of total billed charges,,,0.95,,216.6,Percent of total billed charges,,,0.95,,216.6,Percent of total billed charges,,,0.97,,221.16,Percent of total billed charges,,,0.96,,218.88,Percent of total billed charges,,,0.95,,216.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,216.6,Percent of total billed charges,,216.6,223.44,
HC or Cutter Lin 55mm #Tlc55,PX-3252709WWM,CDM,3252709WWM,LOCAL,270,RC,,inpatient,,,295,265.5,,0.95,,280.25,Percent of total billed charges,,,0.98,,289.1,Percent of total billed charges,,,0.95,,280.25,Percent of total billed charges,,,0.97,,286.15,Percent of total billed charges,,,0.97,,286.15,Percent of total billed charges,,,0.96,,283.2,Percent of total billed charges,,,0.95,,280.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,280.25,Percent of total billed charges,,280.25,289.1,
HC or Cutter Lin 55mm #Tlc55,PX-3252709WWM,CDM,3252709WWM,LOCAL,270,RC,,outpatient,,,295,265.5,,0.95,,280.25,Percent of total billed charges,,,0.98,,289.1,Percent of total billed charges,,,0.95,,280.25,Percent of total billed charges,,,0.95,,280.25,Percent of total billed charges,,,0.97,,286.15,Percent of total billed charges,,,0.96,,283.2,Percent of total billed charges,,,0.95,,280.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,280.25,Percent of total billed charges,,280.25,289.1,
HC or Cutter Lin Reloadtcr55,PX-3252710WWM,CDM,3252710WWM,LOCAL,270,RC,,inpatient,,,189,170.1,,0.95,,179.55,Percent of total billed charges,,,0.98,,185.22,Percent of total billed charges,,,0.95,,179.55,Percent of total billed charges,,,0.97,,183.33,Percent of total billed charges,,,0.97,,183.33,Percent of total billed charges,,,0.96,,181.44,Percent of total billed charges,,,0.95,,179.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,179.55,Percent of total billed charges,,179.55,185.22,
HC or Cutter Lin Reloadtcr55,PX-3252710WWM,CDM,3252710WWM,LOCAL,270,RC,,outpatient,,,189,170.1,,0.95,,179.55,Percent of total billed charges,,,0.98,,185.22,Percent of total billed charges,,,0.95,,179.55,Percent of total billed charges,,,0.95,,179.55,Percent of total billed charges,,,0.97,,183.33,Percent of total billed charges,,,0.96,,181.44,Percent of total billed charges,,,0.95,,179.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,179.55,Percent of total billed charges,,179.55,185.22,
HC or Stapler Pwr Lds#092001,PX-3252712WWM,CDM,3252712WWM,LOCAL,270,RC,,inpatient,,,741,666.9,,0.95,,703.95,Percent of total billed charges,,,0.98,,726.18,Percent of total billed charges,,,0.95,,703.95,Percent of total billed charges,,,0.97,,718.77,Percent of total billed charges,,,0.97,,718.77,Percent of total billed charges,,,0.96,,711.36,Percent of total billed charges,,,0.95,,703.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,703.95,Percent of total billed charges,,703.95,726.18,
HC or Stapler Pwr Lds#092001,PX-3252712WWM,CDM,3252712WWM,LOCAL,270,RC,,outpatient,,,741,666.9,,0.95,,703.95,Percent of total billed charges,,,0.98,,726.18,Percent of total billed charges,,,0.95,,703.95,Percent of total billed charges,,,0.95,,703.95,Percent of total billed charges,,,0.97,,718.77,Percent of total billed charges,,,0.96,,711.36,Percent of total billed charges,,,0.95,,703.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,703.95,Percent of total billed charges,,703.95,726.18,
HC or Cath Cholan16.5g#18305,PX-3252715WWM,CDM,3252715WWM,LOCAL,270,RC,,inpatient,,,211,189.9,,0.95,,200.45,Percent of total billed charges,,,0.98,,206.78,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,0.97,,204.67,Percent of total billed charges,,,0.97,,204.67,Percent of total billed charges,,,0.96,,202.56,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,200.45,Percent of total billed charges,,200.45,206.78,
HC or Cath Cholan16.5g#18305,PX-3252715WWM,CDM,3252715WWM,LOCAL,270,RC,,outpatient,,,211,189.9,,0.95,,200.45,Percent of total billed charges,,,0.98,,206.78,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,0.97,,204.67,Percent of total billed charges,,,0.96,,202.56,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,200.45,Percent of total billed charges,,200.45,206.78,
HC or Liga Clip Ex #Lt400,PX-3252716WWM,CDM,3252716WWM,LOCAL,278,RC,,inpatient,,,46,41.4,,0.95,,43.7,Percent of total billed charges,,,0.98,,45.08,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,0.97,,44.62,Percent of total billed charges,,,0.97,,44.62,Percent of total billed charges,,,0.96,,44.16,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,43.7,Percent of total billed charges,,43.7,45.08,
HC or Liga Clip Ex #Lt400,PX-3252716WWM,CDM,3252716WWM,LOCAL,278,RC,,outpatient,,,46,41.4,,0.95,,43.7,Percent of total billed charges,,,0.98,,45.08,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,0.97,,44.62,Percent of total billed charges,,,0.96,,44.16,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,43.7,Percent of total billed charges,,43.7,45.08,
HC or Patch Hern/80x12#10101,PX-3252717WWM,CDM,3252717WWM,LOCAL,278,RC,,inpatient,,,760,684,,0.95,,722,Percent of total billed charges,,,0.98,,744.8,Percent of total billed charges,,,0.95,,722,Percent of total billed charges,,,0.97,,737.2,Percent of total billed charges,,,0.97,,737.2,Percent of total billed charges,,,0.96,,729.6,Percent of total billed charges,,,0.95,,722,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,722,Percent of total billed charges,,722,744.8,
HC or Patch Hern/80x12#10101,PX-3252717WWM,CDM,3252717WWM,LOCAL,278,RC,,outpatient,,,760,684,,0.95,,722,Percent of total billed charges,,,0.98,,744.8,Percent of total billed charges,,,0.95,,722,Percent of total billed charges,,,0.95,,722,Percent of total billed charges,,,0.97,,737.2,Percent of total billed charges,,,0.96,,729.6,Percent of total billed charges,,,0.95,,722,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,722,Percent of total billed charges,,722,744.8,
HC or Patch Hern/8/8#010103,PX-3252718WWM,CDM,3252718WWM,LOCAL,278,RC,,inpatient,,,889,800.1,,0.95,,844.55,Percent of total billed charges,,,0.98,,871.22,Percent of total billed charges,,,0.95,,844.55,Percent of total billed charges,,,0.97,,862.33,Percent of total billed charges,,,0.97,,862.33,Percent of total billed charges,,,0.96,,853.44,Percent of total billed charges,,,0.95,,844.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,844.55,Percent of total billed charges,,844.55,871.22,
HC or Patch Hern/8/8#010103,PX-3252718WWM,CDM,3252718WWM,LOCAL,278,RC,,outpatient,,,889,800.1,,0.95,,844.55,Percent of total billed charges,,,0.98,,871.22,Percent of total billed charges,,,0.95,,844.55,Percent of total billed charges,,,0.95,,844.55,Percent of total billed charges,,,0.97,,862.33,Percent of total billed charges,,,0.96,,853.44,Percent of total billed charges,,,0.95,,844.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,844.55,Percent of total billed charges,,844.55,871.22,
HC or Patch Hern/11x14#10105,PX-3252719WWM,CDM,3252719WWM,LOCAL,278,RC,,inpatient,,,926,833.4,,0.95,,879.7,Percent of total billed charges,,,0.98,,907.48,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,0.97,,898.22,Percent of total billed charges,,,0.97,,898.22,Percent of total billed charges,,,0.96,,888.96,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,879.7,Percent of total billed charges,,879.7,907.48,
HC or Patch Hern/11x14#10105,PX-3252719WWM,CDM,3252719WWM,LOCAL,278,RC,,outpatient,,,926,833.4,,0.95,,879.7,Percent of total billed charges,,,0.98,,907.48,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,0.97,,898.22,Percent of total billed charges,,,0.96,,888.96,Percent of total billed charges,,,0.95,,879.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,879.7,Percent of total billed charges,,879.7,907.48,
HC or Drain Jp Fh 10mm #1309,PX-3252750WWM,CDM,3252750WWM,LOCAL,270,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC or Drain Jp Fh 10mm #1309,PX-3252750WWM,CDM,3252750WWM,LOCAL,270,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC or Drain Tls 7fr #6640,PX-3252785WWM,CDM,3252785WWM,LOCAL,270,RC,,inpatient,,,158,142.2,,0.95,,150.1,Percent of total billed charges,,,0.98,,154.84,Percent of total billed charges,,,0.95,,150.1,Percent of total billed charges,,,0.97,,153.26,Percent of total billed charges,,,0.97,,153.26,Percent of total billed charges,,,0.96,,151.68,Percent of total billed charges,,,0.95,,150.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,150.1,Percent of total billed charges,,150.1,154.84,
HC or Drain Tls 7fr #6640,PX-3252785WWM,CDM,3252785WWM,LOCAL,270,RC,,outpatient,,,158,142.2,,0.95,,150.1,Percent of total billed charges,,,0.98,,154.84,Percent of total billed charges,,,0.95,,150.1,Percent of total billed charges,,,0.95,,150.1,Percent of total billed charges,,,0.97,,153.26,Percent of total billed charges,,,0.96,,151.68,Percent of total billed charges,,,0.95,,150.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,150.1,Percent of total billed charges,,150.1,154.84,
HC or Suct Poole Tip#0035040,PX-3252787WWM,CDM,3252787WWM,LOCAL,270,RC,,inpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
HC or Suct Poole Tip#0035040,PX-3252787WWM,CDM,3252787WWM,LOCAL,270,RC,,outpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
HC or Jp Resvr #Su1301305,PX-3252789WWM,CDM,3252789WWM,LOCAL,270,RC,,inpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
HC or Jp Resvr #Su1301305,PX-3252789WWM,CDM,3252789WWM,LOCAL,270,RC,,outpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
HC or Colon Hot Snare#Sd21ou,PX-3252815WWM,CDM,3252815WWM,LOCAL,270,RC,,inpatient,,,479,431.1,,0.95,,455.05,Percent of total billed charges,,,0.98,,469.42,Percent of total billed charges,,,0.95,,455.05,Percent of total billed charges,,,0.97,,464.63,Percent of total billed charges,,,0.97,,464.63,Percent of total billed charges,,,0.96,,459.84,Percent of total billed charges,,,0.95,,455.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,455.05,Percent of total billed charges,,455.05,469.42,
HC or Colon Hot Snare#Sd21ou,PX-3252815WWM,CDM,3252815WWM,LOCAL,270,RC,,outpatient,,,479,431.1,,0.95,,455.05,Percent of total billed charges,,,0.98,,469.42,Percent of total billed charges,,,0.95,,455.05,Percent of total billed charges,,,0.95,,455.05,Percent of total billed charges,,,0.97,,464.63,Percent of total billed charges,,,0.96,,459.84,Percent of total billed charges,,,0.95,,455.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,455.05,Percent of total billed charges,,455.05,469.42,
HC or Endopouch Retrv#Pouch,PX-3252840WWM,CDM,3252840WWM,LOCAL,270,RC,,inpatient,,,235,211.5,,0.95,,223.25,Percent of total billed charges,,,0.98,,230.3,Percent of total billed charges,,,0.95,,223.25,Percent of total billed charges,,,0.97,,227.95,Percent of total billed charges,,,0.97,,227.95,Percent of total billed charges,,,0.96,,225.6,Percent of total billed charges,,,0.95,,223.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,223.25,Percent of total billed charges,,223.25,230.3,
HC or Endopouch Retrv#Pouch,PX-3252840WWM,CDM,3252840WWM,LOCAL,270,RC,,outpatient,,,235,211.5,,0.95,,223.25,Percent of total billed charges,,,0.98,,230.3,Percent of total billed charges,,,0.95,,223.25,Percent of total billed charges,,,0.95,,223.25,Percent of total billed charges,,,0.97,,227.95,Percent of total billed charges,,,0.96,,225.6,Percent of total billed charges,,,0.95,,223.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,223.25,Percent of total billed charges,,223.25,230.3,
HC or Mesh Composix 4x8,PX-3252850WWM,CDM,3252850WWM,LOCAL,278,RC,,inpatient,,,966,869.4,,0.95,,917.7,Percent of total billed charges,,,0.98,,946.68,Percent of total billed charges,,,0.95,,917.7,Percent of total billed charges,,,0.97,,937.02,Percent of total billed charges,,,0.97,,937.02,Percent of total billed charges,,,0.96,,927.36,Percent of total billed charges,,,0.95,,917.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,917.7,Percent of total billed charges,,917.7,946.68,
HC or Mesh Composix 4x8,PX-3252850WWM,CDM,3252850WWM,LOCAL,278,RC,,outpatient,,,966,869.4,,0.95,,917.7,Percent of total billed charges,,,0.98,,946.68,Percent of total billed charges,,,0.95,,917.7,Percent of total billed charges,,,0.95,,917.7,Percent of total billed charges,,,0.97,,937.02,Percent of total billed charges,,,0.96,,927.36,Percent of total billed charges,,,0.95,,917.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,917.7,Percent of total billed charges,,917.7,946.68,
HC or Sigmoid Suct #0033050,PX-3252892WWM,CDM,3252892WWM,LOCAL,270,RC,,inpatient,,,23,20.7,,0.95,,21.85,Percent of total billed charges,,,0.98,,22.54,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.96,,22.08,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,21.85,Percent of total billed charges,,21.85,22.54,
HC or Sigmoid Suct #0033050,PX-3252892WWM,CDM,3252892WWM,LOCAL,270,RC,,outpatient,,,23,20.7,,0.95,,21.85,Percent of total billed charges,,,0.98,,22.54,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,0.97,,22.31,Percent of total billed charges,,,0.96,,22.08,Percent of total billed charges,,,0.95,,21.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,21.85,Percent of total billed charges,,21.85,22.54,
HC or Stapler Prox #Prw35,PX-3252909WWM,CDM,3252909WWM,LOCAL,270,RC,,inpatient,,,132,118.8,,0.95,,125.4,Percent of total billed charges,,,0.98,,129.36,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.96,,126.72,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,125.4,Percent of total billed charges,,125.4,129.36,
HC or Stapler Prox #Prw35,PX-3252909WWM,CDM,3252909WWM,LOCAL,270,RC,,outpatient,,,132,118.8,,0.95,,125.4,Percent of total billed charges,,,0.98,,129.36,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.96,,126.72,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,125.4,Percent of total billed charges,,125.4,129.36,
HC or Stapler Prox Prr35,PX-3252910WWM,CDM,3252910WWM,LOCAL,270,RC,,inpatient,,,132,118.8,,0.95,,125.4,Percent of total billed charges,,,0.98,,129.36,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.96,,126.72,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,125.4,Percent of total billed charges,,125.4,129.36,
HC or Stapler Prox Prr35,PX-3252910WWM,CDM,3252910WWM,LOCAL,270,RC,,outpatient,,,132,118.8,,0.95,,125.4,Percent of total billed charges,,,0.98,,129.36,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.96,,126.72,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,125.4,Percent of total billed charges,,125.4,129.36,
HC or Portacath#0603590,PX-3252911WWM,CDM,3252911WWM,LOCAL,278,RC,,inpatient,,,2561,2304.9,,0.95,,2432.95,Percent of total billed charges,,,0.98,,2509.78,Percent of total billed charges,,,0.95,,2432.95,Percent of total billed charges,,,0.97,,2484.17,Percent of total billed charges,,,0.97,,2484.17,Percent of total billed charges,,,0.96,,2458.56,Percent of total billed charges,,,0.95,,2432.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2432.95,Percent of total billed charges,,2432.95,2509.78,
HC or Portacath#0603590,PX-3252911WWM,CDM,3252911WWM,LOCAL,278,RC,,outpatient,,,2561,2304.9,,0.95,,2432.95,Percent of total billed charges,,,0.98,,2509.78,Percent of total billed charges,,,0.95,,2432.95,Percent of total billed charges,,,0.95,,2432.95,Percent of total billed charges,,,0.97,,2484.17,Percent of total billed charges,,,0.96,,2458.56,Percent of total billed charges,,,0.95,,2432.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2432.95,Percent of total billed charges,,2432.95,2509.78,
HC or Stapler Prox+MD #Pmr35,PX-3252912WWM,CDM,3252912WWM,LOCAL,270,RC,,inpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
HC or Stapler Prox+MD #Pmr35,PX-3252912WWM,CDM,3252912WWM,LOCAL,270,RC,,outpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
HC or Groshong 9.5fr#7726952,PX-3252924WWM,CDM,3252924WWM,LOCAL,270,RC,,inpatient,,,1017,915.3,,0.95,,966.15,Percent of total billed charges,,,0.98,,996.66,Percent of total billed charges,,,0.95,,966.15,Percent of total billed charges,,,0.97,,986.49,Percent of total billed charges,,,0.97,,986.49,Percent of total billed charges,,,0.96,,976.32,Percent of total billed charges,,,0.95,,966.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,966.15,Percent of total billed charges,,966.15,996.66,
HC or Groshong 9.5fr#7726952,PX-3252924WWM,CDM,3252924WWM,LOCAL,270,RC,,outpatient,,,1017,915.3,,0.95,,966.15,Percent of total billed charges,,,0.98,,996.66,Percent of total billed charges,,,0.95,,966.15,Percent of total billed charges,,,0.95,,966.15,Percent of total billed charges,,,0.97,,986.49,Percent of total billed charges,,,0.96,,976.32,Percent of total billed charges,,,0.95,,966.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,966.15,Percent of total billed charges,,966.15,996.66,
HC or Uterine Asp Tube #151,PX-3252972WWM,CDM,3252972WWM,LOCAL,270,RC,,inpatient,,,63,56.7,,0.95,,59.85,Percent of total billed charges,,,0.98,,61.74,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.96,,60.48,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,59.85,Percent of total billed charges,,59.85,61.74,
HC or Uterine Asp Tube #151,PX-3252972WWM,CDM,3252972WWM,LOCAL,270,RC,,outpatient,,,63,56.7,,0.95,,59.85,Percent of total billed charges,,,0.98,,61.74,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.96,,60.48,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,59.85,Percent of total billed charges,,59.85,61.74,
HC or Curette Cvd 8mm #280,PX-3252973WWM,CDM,3252973WWM,LOCAL,270,RC,,inpatient,,,22,19.8,,0.95,,20.9,Percent of total billed charges,,,0.98,,21.56,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.96,,21.12,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,20.9,Percent of total billed charges,,20.9,21.56,
HC or Curette Cvd 8mm #280,PX-3252973WWM,CDM,3252973WWM,LOCAL,270,RC,,outpatient,,,22,19.8,,0.95,,20.9,Percent of total billed charges,,,0.98,,21.56,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.96,,21.12,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,20.9,Percent of total billed charges,,20.9,21.56,
HC or Curette Cvd 9mm #281,PX-3252974WWM,CDM,3252974WWM,LOCAL,270,RC,,inpatient,,,22,19.8,,0.95,,20.9,Percent of total billed charges,,,0.98,,21.56,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.96,,21.12,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,20.9,Percent of total billed charges,,20.9,21.56,
HC or Curette Cvd 9mm #281,PX-3252974WWM,CDM,3252974WWM,LOCAL,270,RC,,outpatient,,,22,19.8,,0.95,,20.9,Percent of total billed charges,,,0.98,,21.56,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.96,,21.12,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,20.9,Percent of total billed charges,,20.9,21.56,
HC or Curette 7mm #279,PX-3252975WWM,CDM,3252975WWM,LOCAL,270,RC,,inpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
HC or Curette 7mm #279,PX-3252975WWM,CDM,3252975WWM,LOCAL,270,RC,,outpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
HC or 3mm Ldb Cath #Ldc315,PX-3252989WWM,CDM,3252989WWM,LOCAL,270,RC,,inpatient,,,493,443.7,,0.95,,468.35,Percent of total billed charges,,,0.98,,483.14,Percent of total billed charges,,,0.95,,468.35,Percent of total billed charges,,,0.97,,478.21,Percent of total billed charges,,,0.97,,478.21,Percent of total billed charges,,,0.96,,473.28,Percent of total billed charges,,,0.95,,468.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,468.35,Percent of total billed charges,,468.35,483.14,
HC or 3mm Ldb Cath #Ldc315,PX-3252989WWM,CDM,3252989WWM,LOCAL,270,RC,,outpatient,,,493,443.7,,0.95,,468.35,Percent of total billed charges,,,0.98,,483.14,Percent of total billed charges,,,0.95,,468.35,Percent of total billed charges,,,0.95,,468.35,Percent of total billed charges,,,0.97,,478.21,Percent of total billed charges,,,0.96,,473.28,Percent of total billed charges,,,0.95,,468.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,468.35,Percent of total billed charges,,468.35,483.14,
HC or Drain Jp 7 Fr,PX-3253055WWM,CDM,3253055WWM,LOCAL,270,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC or Drain Jp 7 Fr,PX-3253055WWM,CDM,3253055WWM,LOCAL,270,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC or Bio Post@Washer,PX-3253056WWM,CDM,3253056WWM,LOCAL,270,RC,,inpatient,,,593,533.7,,0.95,,563.35,Percent of total billed charges,,,0.98,,581.14,Percent of total billed charges,,,0.95,,563.35,Percent of total billed charges,,,0.97,,575.21,Percent of total billed charges,,,0.97,,575.21,Percent of total billed charges,,,0.96,,569.28,Percent of total billed charges,,,0.95,,563.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,563.35,Percent of total billed charges,,563.35,581.14,
HC or Bio Post@Washer,PX-3253056WWM,CDM,3253056WWM,LOCAL,270,RC,,outpatient,,,593,533.7,,0.95,,563.35,Percent of total billed charges,,,0.98,,581.14,Percent of total billed charges,,,0.95,,563.35,Percent of total billed charges,,,0.95,,563.35,Percent of total billed charges,,,0.97,,575.21,Percent of total billed charges,,,0.96,,569.28,Percent of total billed charges,,,0.95,,563.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,563.35,Percent of total billed charges,,563.35,581.14,
HC or Biocorkscrew 5.0,PX-3253062WWM,CDM,3253062WWM,LOCAL,270,RC,,inpatient,,,631,567.9,,0.95,,599.45,Percent of total billed charges,,,0.98,,618.38,Percent of total billed charges,,,0.95,,599.45,Percent of total billed charges,,,0.97,,612.07,Percent of total billed charges,,,0.97,,612.07,Percent of total billed charges,,,0.96,,605.76,Percent of total billed charges,,,0.95,,599.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,599.45,Percent of total billed charges,,599.45,618.38,
HC or Biocorkscrew 5.0,PX-3253062WWM,CDM,3253062WWM,LOCAL,270,RC,,outpatient,,,631,567.9,,0.95,,599.45,Percent of total billed charges,,,0.98,,618.38,Percent of total billed charges,,,0.95,,599.45,Percent of total billed charges,,,0.95,,599.45,Percent of total billed charges,,,0.97,,612.07,Percent of total billed charges,,,0.96,,605.76,Percent of total billed charges,,,0.95,,599.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,599.45,Percent of total billed charges,,599.45,618.38,
HC or Guide Wire,PX-3253071WWM,CDM,3253071WWM,LOCAL,270,RC,,inpatient,,,737,663.3,,0.95,,700.15,Percent of total billed charges,,,0.98,,722.26,Percent of total billed charges,,,0.95,,700.15,Percent of total billed charges,,,0.97,,714.89,Percent of total billed charges,,,0.97,,714.89,Percent of total billed charges,,,0.96,,707.52,Percent of total billed charges,,,0.95,,700.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,700.15,Percent of total billed charges,,700.15,722.26,
HC or Guide Wire,PX-3253071WWM,CDM,3253071WWM,LOCAL,270,RC,,outpatient,,,737,663.3,,0.95,,700.15,Percent of total billed charges,,,0.98,,722.26,Percent of total billed charges,,,0.95,,700.15,Percent of total billed charges,,,0.95,,700.15,Percent of total billed charges,,,0.97,,714.89,Percent of total billed charges,,,0.96,,707.52,Percent of total billed charges,,,0.95,,700.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,700.15,Percent of total billed charges,,700.15,722.26,
Or Clip Applier,PX-3253089WWM,CDM,3253089WWM,LOCAL,278,RC,,inpatient,,,273,245.7,,0.95,,259.35,Percent of total billed charges,,,0.98,,267.54,Percent of total billed charges,,,0.95,,259.35,Percent of total billed charges,,,0.97,,264.81,Percent of total billed charges,,,0.97,,264.81,Percent of total billed charges,,,0.96,,262.08,Percent of total billed charges,,,0.95,,259.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,259.35,Percent of total billed charges,,259.35,267.54,
Or Clip Applier,PX-3253089WWM,CDM,3253089WWM,LOCAL,278,RC,,outpatient,,,273,245.7,,0.95,,259.35,Percent of total billed charges,,,0.98,,267.54,Percent of total billed charges,,,0.95,,259.35,Percent of total billed charges,,,0.95,,259.35,Percent of total billed charges,,,0.97,,264.81,Percent of total billed charges,,,0.96,,262.08,Percent of total billed charges,,,0.95,,259.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,259.35,Percent of total billed charges,,259.35,267.54,
HC or Bx Instr 14gx10cm,PX-3253112WWM,CDM,3253112WWM,LOCAL,270,RC,,inpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
HC or Bx Instr 14gx10cm,PX-3253112WWM,CDM,3253112WWM,LOCAL,270,RC,,outpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
HC or Bx Instr 14gx16cm,PX-3253113WWM,CDM,3253113WWM,LOCAL,270,RC,,inpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
HC or Bx Instr 14gx16cm,PX-3253113WWM,CDM,3253113WWM,LOCAL,270,RC,,outpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
HC or Stapler Curv #Cs40b,PX-3253143WWM,CDM,3253143WWM,LOCAL,270,RC,,inpatient,,,982,883.8,,0.95,,932.9,Percent of total billed charges,,,0.98,,962.36,Percent of total billed charges,,,0.95,,932.9,Percent of total billed charges,,,0.97,,952.54,Percent of total billed charges,,,0.97,,952.54,Percent of total billed charges,,,0.96,,942.72,Percent of total billed charges,,,0.95,,932.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,932.9,Percent of total billed charges,,932.9,962.36,
HC or Stapler Curv #Cs40b,PX-3253143WWM,CDM,3253143WWM,LOCAL,270,RC,,outpatient,,,982,883.8,,0.95,,932.9,Percent of total billed charges,,,0.98,,962.36,Percent of total billed charges,,,0.95,,932.9,Percent of total billed charges,,,0.95,,932.9,Percent of total billed charges,,,0.97,,952.54,Percent of total billed charges,,,0.96,,942.72,Percent of total billed charges,,,0.95,,932.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,932.9,Percent of total billed charges,,932.9,962.36,
HC or Stapler Curv Rel#Cr40b,PX-3253144WWM,CDM,3253144WWM,LOCAL,270,RC,,inpatient,,,509,458.1,,0.95,,483.55,Percent of total billed charges,,,0.98,,498.82,Percent of total billed charges,,,0.95,,483.55,Percent of total billed charges,,,0.97,,493.73,Percent of total billed charges,,,0.97,,493.73,Percent of total billed charges,,,0.96,,488.64,Percent of total billed charges,,,0.95,,483.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,483.55,Percent of total billed charges,,483.55,498.82,
HC or Stapler Curv Rel#Cr40b,PX-3253144WWM,CDM,3253144WWM,LOCAL,270,RC,,outpatient,,,509,458.1,,0.95,,483.55,Percent of total billed charges,,,0.98,,498.82,Percent of total billed charges,,,0.95,,483.55,Percent of total billed charges,,,0.95,,483.55,Percent of total billed charges,,,0.97,,493.73,Percent of total billed charges,,,0.96,,488.64,Percent of total billed charges,,,0.95,,483.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,483.55,Percent of total billed charges,,483.55,498.82,
HC or Forcep Egd #FB-230k.B,PX-3253145WWM,CDM,3253145WWM,LOCAL,270,RC,,inpatient,,,72,64.8,,0.95,,68.4,Percent of total billed charges,,,0.98,,70.56,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.96,,69.12,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,68.4,Percent of total billed charges,,68.4,70.56,
HC or Forcep Egd #FB-230k.B,PX-3253145WWM,CDM,3253145WWM,LOCAL,270,RC,,outpatient,,,72,64.8,,0.95,,68.4,Percent of total billed charges,,,0.98,,70.56,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.96,,69.12,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,68.4,Percent of total billed charges,,68.4,70.56,
HC or Forcep Colon#FB-230u.B,PX-3253146WWM,CDM,3253146WWM,LOCAL,270,RC,,inpatient,,,72,64.8,,0.95,,68.4,Percent of total billed charges,,,0.98,,70.56,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.96,,69.12,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,68.4,Percent of total billed charges,,68.4,70.56,
HC or Forcep Colon#FB-230u.B,PX-3253146WWM,CDM,3253146WWM,LOCAL,270,RC,,outpatient,,,72,64.8,,0.95,,68.4,Percent of total billed charges,,,0.98,,70.56,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.96,,69.12,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,68.4,Percent of total billed charges,,68.4,70.56,
HC or Mesh Proceed #Pcdr1,PX-3253167WWM,CDM,3253167WWM,LOCAL,278,RC,,inpatient,,,929,836.1,,0.95,,882.55,Percent of total billed charges,,,0.98,,910.42,Percent of total billed charges,,,0.95,,882.55,Percent of total billed charges,,,0.97,,901.13,Percent of total billed charges,,,0.97,,901.13,Percent of total billed charges,,,0.96,,891.84,Percent of total billed charges,,,0.95,,882.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,882.55,Percent of total billed charges,,882.55,910.42,
HC or Mesh Proceed #Pcdr1,PX-3253167WWM,CDM,3253167WWM,LOCAL,278,RC,,outpatient,,,929,836.1,,0.95,,882.55,Percent of total billed charges,,,0.98,,910.42,Percent of total billed charges,,,0.95,,882.55,Percent of total billed charges,,,0.95,,882.55,Percent of total billed charges,,,0.97,,901.13,Percent of total billed charges,,,0.96,,891.84,Percent of total billed charges,,,0.95,,882.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,882.55,Percent of total billed charges,,882.55,910.42,
HC or Mesh Composix 3x6,PX-3253177WWM,CDM,3253177WWM,LOCAL,278,RC,,inpatient,,,925,832.5,,0.95,,878.75,Percent of total billed charges,,,0.98,,906.5,Percent of total billed charges,,,0.95,,878.75,Percent of total billed charges,,,0.97,,897.25,Percent of total billed charges,,,0.97,,897.25,Percent of total billed charges,,,0.96,,888,Percent of total billed charges,,,0.95,,878.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,878.75,Percent of total billed charges,,878.75,906.5,
HC or Mesh Composix 3x6,PX-3253177WWM,CDM,3253177WWM,LOCAL,278,RC,,outpatient,,,925,832.5,,0.95,,878.75,Percent of total billed charges,,,0.98,,906.5,Percent of total billed charges,,,0.95,,878.75,Percent of total billed charges,,,0.95,,878.75,Percent of total billed charges,,,0.97,,897.25,Percent of total billed charges,,,0.96,,888,Percent of total billed charges,,,0.95,,878.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,878.75,Percent of total billed charges,,878.75,906.5,
HC or Introducer 10fr 060111,PX-3253183WWM,CDM,3253183WWM,LOCAL,270,RC,,inpatient,,,221,198.9,,0.95,,209.95,Percent of total billed charges,,,0.98,,216.58,Percent of total billed charges,,,0.95,,209.95,Percent of total billed charges,,,0.97,,214.37,Percent of total billed charges,,,0.97,,214.37,Percent of total billed charges,,,0.96,,212.16,Percent of total billed charges,,,0.95,,209.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,209.95,Percent of total billed charges,,209.95,216.58,
HC or Introducer 10fr 060111,PX-3253183WWM,CDM,3253183WWM,LOCAL,270,RC,,outpatient,,,221,198.9,,0.95,,209.95,Percent of total billed charges,,,0.98,,216.58,Percent of total billed charges,,,0.95,,209.95,Percent of total billed charges,,,0.95,,209.95,Percent of total billed charges,,,0.97,,214.37,Percent of total billed charges,,,0.96,,212.16,Percent of total billed charges,,,0.95,,209.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,209.95,Percent of total billed charges,,209.95,216.58,
HC or Mesh Bard Med #0112760,PX-3253189WWM,CDM,3253189WWM,LOCAL,278,RC,,inpatient,,,631,567.9,,0.95,,599.45,Percent of total billed charges,,,0.98,,618.38,Percent of total billed charges,,,0.95,,599.45,Percent of total billed charges,,,0.97,,612.07,Percent of total billed charges,,,0.97,,612.07,Percent of total billed charges,,,0.96,,605.76,Percent of total billed charges,,,0.95,,599.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,599.45,Percent of total billed charges,,599.45,618.38,
HC or Mesh Bard Med #0112760,PX-3253189WWM,CDM,3253189WWM,LOCAL,278,RC,,outpatient,,,631,567.9,,0.95,,599.45,Percent of total billed charges,,,0.98,,618.38,Percent of total billed charges,,,0.95,,599.45,Percent of total billed charges,,,0.95,,599.45,Percent of total billed charges,,,0.97,,612.07,Percent of total billed charges,,,0.96,,605.76,Percent of total billed charges,,,0.95,,599.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,599.45,Percent of total billed charges,,599.45,618.38,
HC or Mesh Bard Lg #0112770,PX-3253190WWM,CDM,3253190WWM,LOCAL,278,RC,,inpatient,,,364,327.6,,0.95,,345.8,Percent of total billed charges,,,0.98,,356.72,Percent of total billed charges,,,0.95,,345.8,Percent of total billed charges,,,0.97,,353.08,Percent of total billed charges,,,0.97,,353.08,Percent of total billed charges,,,0.96,,349.44,Percent of total billed charges,,,0.95,,345.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,345.8,Percent of total billed charges,,345.8,356.72,
HC or Mesh Bard Lg #0112770,PX-3253190WWM,CDM,3253190WWM,LOCAL,278,RC,,outpatient,,,364,327.6,,0.95,,345.8,Percent of total billed charges,,,0.98,,356.72,Percent of total billed charges,,,0.95,,345.8,Percent of total billed charges,,,0.95,,345.8,Percent of total billed charges,,,0.97,,353.08,Percent of total billed charges,,,0.96,,349.44,Percent of total billed charges,,,0.95,,345.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,345.8,Percent of total billed charges,,345.8,356.72,
HC or Screw 1.5x6 #200.006,PX-3253200WWM,CDM,3253200WWM,LOCAL,278,RC,,inpatient,,,112,100.8,,0.95,,106.4,Percent of total billed charges,,,0.98,,109.76,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.96,,107.52,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,106.4,Percent of total billed charges,,106.4,109.76,
HC or Screw 1.5x6 #200.006,PX-3253200WWM,CDM,3253200WWM,LOCAL,278,RC,,outpatient,,,112,100.8,,0.95,,106.4,Percent of total billed charges,,,0.98,,109.76,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.96,,107.52,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,106.4,Percent of total billed charges,,106.4,109.76,
HC or Screw 1.5x8 #200.008,PX-3253201WWM,CDM,3253201WWM,LOCAL,278,RC,,inpatient,,,112,100.8,,0.95,,106.4,Percent of total billed charges,,,0.98,,109.76,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.96,,107.52,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,106.4,Percent of total billed charges,,106.4,109.76,
HC or Screw 1.5x8 #200.008,PX-3253201WWM,CDM,3253201WWM,LOCAL,278,RC,,outpatient,,,112,100.8,,0.95,,106.4,Percent of total billed charges,,,0.98,,109.76,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.96,,107.52,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,106.4,Percent of total billed charges,,106.4,109.76,
HC or Screw 1.5x10 #200.010,PX-3253202WWM,CDM,3253202WWM,LOCAL,278,RC,,inpatient,,,112,100.8,,0.95,,106.4,Percent of total billed charges,,,0.98,,109.76,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.96,,107.52,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,106.4,Percent of total billed charges,,106.4,109.76,
HC or Screw 1.5x10 #200.010,PX-3253202WWM,CDM,3253202WWM,LOCAL,278,RC,,outpatient,,,112,100.8,,0.95,,106.4,Percent of total billed charges,,,0.98,,109.76,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.96,,107.52,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,106.4,Percent of total billed charges,,106.4,109.76,
HC or Screw 1.5x12 #200.012,PX-3253203WWM,CDM,3253203WWM,LOCAL,278,RC,,inpatient,,,112,100.8,,0.95,,106.4,Percent of total billed charges,,,0.98,,109.76,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.96,,107.52,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,106.4,Percent of total billed charges,,106.4,109.76,
HC or Screw 1.5x12 #200.012,PX-3253203WWM,CDM,3253203WWM,LOCAL,278,RC,,outpatient,,,112,100.8,,0.95,,106.4,Percent of total billed charges,,,0.98,,109.76,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.96,,107.52,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,106.4,Percent of total billed charges,,106.4,109.76,
HC or Screw 1.5x14 #200.014,PX-3253204WWM,CDM,3253204WWM,LOCAL,278,RC,,inpatient,,,112,100.8,,0.95,,106.4,Percent of total billed charges,,,0.98,,109.76,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.96,,107.52,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,106.4,Percent of total billed charges,,106.4,109.76,
HC or Screw 1.5x14 #200.014,PX-3253204WWM,CDM,3253204WWM,LOCAL,278,RC,,outpatient,,,112,100.8,,0.95,,106.4,Percent of total billed charges,,,0.98,,109.76,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.96,,107.52,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,106.4,Percent of total billed charges,,106.4,109.76,
HC or Screw 1.5x16 #200.016,PX-3253205WWM,CDM,3253205WWM,LOCAL,278,RC,,inpatient,,,112,100.8,,0.95,,106.4,Percent of total billed charges,,,0.98,,109.76,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.96,,107.52,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,106.4,Percent of total billed charges,,106.4,109.76,
HC or Screw 1.5x16 #200.016,PX-3253205WWM,CDM,3253205WWM,LOCAL,278,RC,,outpatient,,,112,100.8,,0.95,,106.4,Percent of total billed charges,,,0.98,,109.76,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.96,,107.52,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,106.4,Percent of total billed charges,,106.4,109.76,
HC or Screw 2.0x6 #201.006,PX-3253206WWM,CDM,3253206WWM,LOCAL,278,RC,,inpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
HC or Screw 2.0x6 #201.006,PX-3253206WWM,CDM,3253206WWM,LOCAL,278,RC,,outpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
HC or Screw 2.0x8 #201.008,PX-3253207WWM,CDM,3253207WWM,LOCAL,278,RC,,inpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw 2.0x8 #201.008,PX-3253207WWM,CDM,3253207WWM,LOCAL,278,RC,,outpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw 2.0x10 #201.010,PX-3253208WWM,CDM,3253208WWM,LOCAL,278,RC,,inpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw 2.0x10 #201.010,PX-3253208WWM,CDM,3253208WWM,LOCAL,278,RC,,outpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw 2.0x12 #201.012,PX-3253209WWM,CDM,3253209WWM,LOCAL,278,RC,,inpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw 2.0x12 #201.012,PX-3253209WWM,CDM,3253209WWM,LOCAL,278,RC,,outpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw 2.0x14 #201.014,PX-3253210WWM,CDM,3253210WWM,LOCAL,278,RC,,inpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw 2.0x14 #201.014,PX-3253210WWM,CDM,3253210WWM,LOCAL,278,RC,,outpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw 2.0x16 #201.016,PX-3253211WWM,CDM,3253211WWM,LOCAL,278,RC,,inpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw 2.0x16 #201.016,PX-3253211WWM,CDM,3253211WWM,LOCAL,278,RC,,outpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw 2.0x18 #201.018,PX-3253212WWM,CDM,3253212WWM,LOCAL,278,RC,,inpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw 2.0x18 #201.018,PX-3253212WWM,CDM,3253212WWM,LOCAL,278,RC,,outpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw 2.0x20 #201.020,PX-3253213WWM,CDM,3253213WWM,LOCAL,278,RC,,inpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw 2.0x20 #201.020,PX-3253213WWM,CDM,3253213WWM,LOCAL,278,RC,,outpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw 2.7x6 #202.006,PX-3253214WWM,CDM,3253214WWM,LOCAL,278,RC,,inpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw 2.7x6 #202.006,PX-3253214WWM,CDM,3253214WWM,LOCAL,278,RC,,outpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw 2.7x8 #202.008,PX-3253215WWM,CDM,3253215WWM,LOCAL,278,RC,,inpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw 2.7x8 #202.008,PX-3253215WWM,CDM,3253215WWM,LOCAL,278,RC,,outpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw 2.7x10 #202.010,PX-3253216WWM,CDM,3253216WWM,LOCAL,278,RC,,inpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
HC or Screw 2.7x10 #202.010,PX-3253216WWM,CDM,3253216WWM,LOCAL,278,RC,,outpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
HC or Screw 2.7x12 #202.012,PX-3253217WWM,CDM,3253217WWM,LOCAL,278,RC,,inpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
HC or Screw 2.7x12 #202.012,PX-3253217WWM,CDM,3253217WWM,LOCAL,278,RC,,outpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
HC or Screw 2.7x14 #202.014,PX-3253218WWM,CDM,3253218WWM,LOCAL,278,RC,,inpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
HC or Screw 2.7x14 #202.014,PX-3253218WWM,CDM,3253218WWM,LOCAL,278,RC,,outpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
HC or Screw 2.7x16 #202.016,PX-3253219WWM,CDM,3253219WWM,LOCAL,278,RC,,inpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
HC or Screw 2.7x16 #202.016,PX-3253219WWM,CDM,3253219WWM,LOCAL,278,RC,,outpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
HC or Screw 2.7x18 #202.018,PX-3253220WWM,CDM,3253220WWM,LOCAL,278,RC,,inpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
HC or Screw 2.7x18 #202.018,PX-3253220WWM,CDM,3253220WWM,LOCAL,278,RC,,outpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
HC or Screw 2.7x20 #202.020,PX-3253221WWM,CDM,3253221WWM,LOCAL,278,RC,,inpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
HC or Screw 2.7x20 #202.020,PX-3253221WWM,CDM,3253221WWM,LOCAL,278,RC,,outpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
HC or Screw 2.7x22 #202.022,PX-3253222WWM,CDM,3253222WWM,LOCAL,278,RC,,inpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
HC or Screw 2.7x22 #202.022,PX-3253222WWM,CDM,3253222WWM,LOCAL,278,RC,,outpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
HC or Screw 2.7x24 #202.024,PX-3253223WWM,CDM,3253223WWM,LOCAL,278,RC,,inpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
HC or Screw 2.7x24 #202.024,PX-3253223WWM,CDM,3253223WWM,LOCAL,278,RC,,outpatient,,,113,101.7,,0.95,,107.35,Percent of total billed charges,,,0.98,,110.74,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,0.97,,109.61,Percent of total billed charges,,,0.96,,108.48,Percent of total billed charges,,,0.95,,107.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,107.35,Percent of total billed charges,,107.35,110.74,
HC or Plate 3 Hole #242.03,PX-3253224WWM,CDM,3253224WWM,LOCAL,278,RC,,inpatient,,,186,167.4,,0.95,,176.7,Percent of total billed charges,,,0.98,,182.28,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.96,,178.56,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,176.7,Percent of total billed charges,,176.7,182.28,
HC or Plate 3 Hole #242.03,PX-3253224WWM,CDM,3253224WWM,LOCAL,278,RC,,outpatient,,,186,167.4,,0.95,,176.7,Percent of total billed charges,,,0.98,,182.28,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.96,,178.56,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,176.7,Percent of total billed charges,,176.7,182.28,
HC or Plate 4 Hole #242.04,PX-3253225WWM,CDM,3253225WWM,LOCAL,278,RC,,inpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
HC or Plate 4 Hole #242.04,PX-3253225WWM,CDM,3253225WWM,LOCAL,278,RC,,outpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
HC or Plate 5 Hole #242.05,PX-3253226WWM,CDM,3253226WWM,LOCAL,278,RC,,inpatient,,,211,189.9,,0.95,,200.45,Percent of total billed charges,,,0.98,,206.78,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,0.97,,204.67,Percent of total billed charges,,,0.97,,204.67,Percent of total billed charges,,,0.96,,202.56,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,200.45,Percent of total billed charges,,200.45,206.78,
HC or Plate 5 Hole #242.05,PX-3253226WWM,CDM,3253226WWM,LOCAL,278,RC,,outpatient,,,211,189.9,,0.95,,200.45,Percent of total billed charges,,,0.98,,206.78,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,0.97,,204.67,Percent of total billed charges,,,0.96,,202.56,Percent of total billed charges,,,0.95,,200.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,200.45,Percent of total billed charges,,200.45,206.78,
HC or Plate 6 Hole #242.06,PX-3253227WWM,CDM,3253227WWM,LOCAL,278,RC,,inpatient,,,234,210.6,,0.95,,222.3,Percent of total billed charges,,,0.98,,229.32,Percent of total billed charges,,,0.95,,222.3,Percent of total billed charges,,,0.97,,226.98,Percent of total billed charges,,,0.97,,226.98,Percent of total billed charges,,,0.96,,224.64,Percent of total billed charges,,,0.95,,222.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,222.3,Percent of total billed charges,,222.3,229.32,
HC or Plate 6 Hole #242.06,PX-3253227WWM,CDM,3253227WWM,LOCAL,278,RC,,outpatient,,,234,210.6,,0.95,,222.3,Percent of total billed charges,,,0.98,,229.32,Percent of total billed charges,,,0.95,,222.3,Percent of total billed charges,,,0.95,,222.3,Percent of total billed charges,,,0.97,,226.98,Percent of total billed charges,,,0.96,,224.64,Percent of total billed charges,,,0.95,,222.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,222.3,Percent of total billed charges,,222.3,229.32,
HC or Plate 7 Hole #242.07,PX-3253228WWM,CDM,3253228WWM,LOCAL,278,RC,,inpatient,,,244,219.6,,0.95,,231.8,Percent of total billed charges,,,0.98,,239.12,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,0.97,,236.68,Percent of total billed charges,,,0.97,,236.68,Percent of total billed charges,,,0.96,,234.24,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,231.8,Percent of total billed charges,,231.8,239.12,
HC or Plate 7 Hole #242.07,PX-3253228WWM,CDM,3253228WWM,LOCAL,278,RC,,outpatient,,,244,219.6,,0.95,,231.8,Percent of total billed charges,,,0.98,,239.12,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,0.97,,236.68,Percent of total billed charges,,,0.96,,234.24,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,231.8,Percent of total billed charges,,231.8,239.12,
HC or Plate 8 Hole #242.08,PX-3253229WWM,CDM,3253229WWM,LOCAL,278,RC,,inpatient,,,261,234.9,,0.95,,247.95,Percent of total billed charges,,,0.98,,255.78,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,0.97,,253.17,Percent of total billed charges,,,0.97,,253.17,Percent of total billed charges,,,0.96,,250.56,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,247.95,Percent of total billed charges,,247.95,255.78,
HC or Plate 8 Hole #242.08,PX-3253229WWM,CDM,3253229WWM,LOCAL,278,RC,,outpatient,,,261,234.9,,0.95,,247.95,Percent of total billed charges,,,0.98,,255.78,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,0.97,,253.17,Percent of total billed charges,,,0.96,,250.56,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,247.95,Percent of total billed charges,,247.95,255.78,
HC or Plate 3 Hole #243.13,PX-3253230WWM,CDM,3253230WWM,LOCAL,278,RC,,inpatient,,,209,188.1,,0.95,,198.55,Percent of total billed charges,,,0.98,,204.82,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.96,,200.64,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,198.55,Percent of total billed charges,,198.55,204.82,
HC or Plate 3 Hole #243.13,PX-3253230WWM,CDM,3253230WWM,LOCAL,278,RC,,outpatient,,,209,188.1,,0.95,,198.55,Percent of total billed charges,,,0.98,,204.82,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.96,,200.64,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,198.55,Percent of total billed charges,,198.55,204.82,
HC or Plate 4 Hole #243.14,PX-3253231WWM,CDM,3253231WWM,LOCAL,278,RC,,inpatient,,,174,156.6,,0.95,,165.3,Percent of total billed charges,,,0.98,,170.52,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,0.97,,168.78,Percent of total billed charges,,,0.97,,168.78,Percent of total billed charges,,,0.96,,167.04,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,165.3,Percent of total billed charges,,165.3,170.52,
HC or Plate 4 Hole #243.14,PX-3253231WWM,CDM,3253231WWM,LOCAL,278,RC,,outpatient,,,174,156.6,,0.95,,165.3,Percent of total billed charges,,,0.98,,170.52,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,0.97,,168.78,Percent of total billed charges,,,0.96,,167.04,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,165.3,Percent of total billed charges,,165.3,170.52,
HC or Plate 5 Hole #243.15,PX-3253232WWM,CDM,3253232WWM,LOCAL,278,RC,,inpatient,,,186,167.4,,0.95,,176.7,Percent of total billed charges,,,0.98,,182.28,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.96,,178.56,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,176.7,Percent of total billed charges,,176.7,182.28,
HC or Plate 5 Hole #243.15,PX-3253232WWM,CDM,3253232WWM,LOCAL,278,RC,,outpatient,,,186,167.4,,0.95,,176.7,Percent of total billed charges,,,0.98,,182.28,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.96,,178.56,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,176.7,Percent of total billed charges,,176.7,182.28,
HC or Plate T-3 Hole #242.41,PX-3253233WWM,CDM,3253233WWM,LOCAL,278,RC,,inpatient,,,209,188.1,,0.95,,198.55,Percent of total billed charges,,,0.98,,204.82,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.96,,200.64,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,198.55,Percent of total billed charges,,198.55,204.82,
HC or Plate T-3 Hole #242.41,PX-3253233WWM,CDM,3253233WWM,LOCAL,278,RC,,outpatient,,,209,188.1,,0.95,,198.55,Percent of total billed charges,,,0.98,,204.82,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.96,,200.64,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,198.55,Percent of total billed charges,,198.55,204.82,
HC or Plate T-2 Hole #243.41,PX-3253234WWM,CDM,3253234WWM,LOCAL,278,RC,,inpatient,,,209,188.1,,0.95,,198.55,Percent of total billed charges,,,0.98,,204.82,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.96,,200.64,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,198.55,Percent of total billed charges,,198.55,204.82,
HC or Plate T-2 Hole #243.41,PX-3253234WWM,CDM,3253234WWM,LOCAL,278,RC,,outpatient,,,209,188.1,,0.95,,198.55,Percent of total billed charges,,,0.98,,204.82,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.96,,200.64,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,198.55,Percent of total billed charges,,198.55,204.82,
HC or Plate L-Rt 3 Hole #242,PX-3253235WWM,CDM,3253235WWM,LOCAL,278,RC,,inpatient,,,209,188.1,,0.95,,198.55,Percent of total billed charges,,,0.98,,204.82,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.96,,200.64,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,198.55,Percent of total billed charges,,198.55,204.82,
HC or Plate L-Rt 3 Hole #242,PX-3253235WWM,CDM,3253235WWM,LOCAL,278,RC,,outpatient,,,209,188.1,,0.95,,198.55,Percent of total billed charges,,,0.98,,204.82,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.96,,200.64,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,198.55,Percent of total billed charges,,198.55,204.82,
HC or Plate L-Lt 3 Hole #242,PX-3253236WWM,CDM,3253236WWM,LOCAL,278,RC,,inpatient,,,209,188.1,,0.95,,198.55,Percent of total billed charges,,,0.98,,204.82,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.96,,200.64,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,198.55,Percent of total billed charges,,198.55,204.82,
HC or Plate L-Lt 3 Hole #242,PX-3253236WWM,CDM,3253236WWM,LOCAL,278,RC,,outpatient,,,209,188.1,,0.95,,198.55,Percent of total billed charges,,,0.98,,204.82,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.96,,200.64,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,198.55,Percent of total billed charges,,198.55,204.82,
HC or Plate L-Rt 2 Hole #243,PX-3253237WWM,CDM,3253237WWM,LOCAL,278,RC,,inpatient,,,176,158.4,,0.95,,167.2,Percent of total billed charges,,,0.98,,172.48,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,0.97,,170.72,Percent of total billed charges,,,0.97,,170.72,Percent of total billed charges,,,0.96,,168.96,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,167.2,Percent of total billed charges,,167.2,172.48,
HC or Plate L-Rt 2 Hole #243,PX-3253237WWM,CDM,3253237WWM,LOCAL,278,RC,,outpatient,,,176,158.4,,0.95,,167.2,Percent of total billed charges,,,0.98,,172.48,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,0.97,,170.72,Percent of total billed charges,,,0.96,,168.96,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,167.2,Percent of total billed charges,,167.2,172.48,
HC or Plate L-Lt 2 Hole #243,PX-3253238WWM,CDM,3253238WWM,LOCAL,278,RC,,inpatient,,,209,188.1,,0.95,,198.55,Percent of total billed charges,,,0.98,,204.82,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.96,,200.64,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,198.55,Percent of total billed charges,,198.55,204.82,
HC or Plate L-Lt 2 Hole #243,PX-3253238WWM,CDM,3253238WWM,LOCAL,278,RC,,outpatient,,,209,188.1,,0.95,,198.55,Percent of total billed charges,,,0.98,,204.82,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.96,,200.64,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,198.55,Percent of total billed charges,,198.55,204.82,
HC or Screw-Washer 7.0 #219,PX-3253239WWM,CDM,3253239WWM,LOCAL,278,RC,,inpatient,,,107,96.3,,0.95,,101.65,Percent of total billed charges,,,0.98,,104.86,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.96,,102.72,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,101.65,Percent of total billed charges,,101.65,104.86,
HC or Screw-Washer 7.0 #219,PX-3253239WWM,CDM,3253239WWM,LOCAL,278,RC,,outpatient,,,107,96.3,,0.95,,101.65,Percent of total billed charges,,,0.98,,104.86,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.96,,102.72,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,101.65,Percent of total billed charges,,101.65,104.86,
HC or K-Wire 0.6 #292.06,PX-3253240WWM,CDM,3253240WWM,LOCAL,270,RC,,inpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
HC or K-Wire 0.6 #292.06,PX-3253240WWM,CDM,3253240WWM,LOCAL,270,RC,,outpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
HC or K-Wire 0.8 #292.08,PX-3253241WWM,CDM,3253241WWM,LOCAL,270,RC,,inpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
HC or K-Wire 0.8 #292.08,PX-3253241WWM,CDM,3253241WWM,LOCAL,270,RC,,outpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
HC or K-Wire 1.0 #292.10,PX-3253242WWM,CDM,3253242WWM,LOCAL,270,RC,,inpatient,,,46,41.4,,0.95,,43.7,Percent of total billed charges,,,0.98,,45.08,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,0.97,,44.62,Percent of total billed charges,,,0.97,,44.62,Percent of total billed charges,,,0.96,,44.16,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,43.7,Percent of total billed charges,,43.7,45.08,
HC or K-Wire 1.0 #292.10,PX-3253242WWM,CDM,3253242WWM,LOCAL,270,RC,,outpatient,,,46,41.4,,0.95,,43.7,Percent of total billed charges,,,0.98,,45.08,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,0.97,,44.62,Percent of total billed charges,,,0.96,,44.16,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,43.7,Percent of total billed charges,,43.7,45.08,
HC or K-Wire 1.25 #292.12,PX-3253243WWM,CDM,3253243WWM,LOCAL,270,RC,,inpatient,,,46,41.4,,0.95,,43.7,Percent of total billed charges,,,0.98,,45.08,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,0.97,,44.62,Percent of total billed charges,,,0.97,,44.62,Percent of total billed charges,,,0.96,,44.16,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,43.7,Percent of total billed charges,,43.7,45.08,
HC or K-Wire 1.25 #292.12,PX-3253243WWM,CDM,3253243WWM,LOCAL,270,RC,,outpatient,,,46,41.4,,0.95,,43.7,Percent of total billed charges,,,0.98,,45.08,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,0.97,,44.62,Percent of total billed charges,,,0.96,,44.16,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,43.7,Percent of total billed charges,,43.7,45.08,
HC or K-Wire 1.6 #292.16,PX-3253244WWM,CDM,3253244WWM,LOCAL,270,RC,,inpatient,,,46,41.4,,0.95,,43.7,Percent of total billed charges,,,0.98,,45.08,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,0.97,,44.62,Percent of total billed charges,,,0.97,,44.62,Percent of total billed charges,,,0.96,,44.16,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,43.7,Percent of total billed charges,,43.7,45.08,
HC or K-Wire 1.6 #292.16,PX-3253244WWM,CDM,3253244WWM,LOCAL,270,RC,,outpatient,,,46,41.4,,0.95,,43.7,Percent of total billed charges,,,0.98,,45.08,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,0.97,,44.62,Percent of total billed charges,,,0.96,,44.16,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,43.7,Percent of total billed charges,,43.7,45.08,
HC or Trocar 5mm #B5lt,PX-3253248WWM,CDM,3253248WWM,LOCAL,270,RC,,inpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
HC or Trocar 5mm #B5lt,PX-3253248WWM,CDM,3253248WWM,LOCAL,270,RC,,outpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
HC or Trocar 5mm#Cb5lt,PX-3253249WWM,CDM,3253249WWM,LOCAL,270,RC,,inpatient,,,142,127.8,,0.95,,134.9,Percent of total billed charges,,,0.98,,139.16,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,0.97,,137.74,Percent of total billed charges,,,0.97,,137.74,Percent of total billed charges,,,0.96,,136.32,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,134.9,Percent of total billed charges,,134.9,139.16,
HC or Trocar 5mm#Cb5lt,PX-3253249WWM,CDM,3253249WWM,LOCAL,270,RC,,outpatient,,,142,127.8,,0.95,,134.9,Percent of total billed charges,,,0.98,,139.16,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,0.97,,137.74,Percent of total billed charges,,,0.96,,136.32,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,134.9,Percent of total billed charges,,134.9,139.16,
HC or Trocar 12mm #B12lt,PX-3253250WWM,CDM,3253250WWM,LOCAL,270,RC,,inpatient,,,239,215.1,,0.95,,227.05,Percent of total billed charges,,,0.98,,234.22,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,0.97,,231.83,Percent of total billed charges,,,0.97,,231.83,Percent of total billed charges,,,0.96,,229.44,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,227.05,Percent of total billed charges,,227.05,234.22,
HC or Trocar 12mm #B12lt,PX-3253250WWM,CDM,3253250WWM,LOCAL,270,RC,,outpatient,,,239,215.1,,0.95,,227.05,Percent of total billed charges,,,0.98,,234.22,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,0.97,,231.83,Percent of total billed charges,,,0.96,,229.44,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,227.05,Percent of total billed charges,,227.05,234.22,
HC or Trocar 12mm#Cb12lt,PX-3253251WWM,CDM,3253251WWM,LOCAL,270,RC,,inpatient,,,185,166.5,,0.95,,175.75,Percent of total billed charges,,,0.98,,181.3,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,0.97,,179.45,Percent of total billed charges,,,0.97,,179.45,Percent of total billed charges,,,0.96,,177.6,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,175.75,Percent of total billed charges,,175.75,181.3,
HC or Trocar 12mm#Cb12lt,PX-3253251WWM,CDM,3253251WWM,LOCAL,270,RC,,outpatient,,,185,166.5,,0.95,,175.75,Percent of total billed charges,,,0.98,,181.3,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,0.97,,179.45,Percent of total billed charges,,,0.96,,177.6,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,175.75,Percent of total billed charges,,175.75,181.3,
HC or Wire K.Thrd 0.045,PX-3253270WWM,CDM,3253270WWM,LOCAL,278,RC,,inpatient,,,36,32.4,,0.95,,34.2,Percent of total billed charges,,,0.98,,35.28,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.96,,34.56,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,34.2,Percent of total billed charges,,34.2,35.28,
HC or Wire K.Thrd 0.045,PX-3253270WWM,CDM,3253270WWM,LOCAL,278,RC,,outpatient,,,36,32.4,,0.95,,34.2,Percent of total billed charges,,,0.98,,35.28,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.96,,34.56,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,34.2,Percent of total billed charges,,34.2,35.28,
HC or Wire K.Thrd 0.062,PX-3253271WWM,CDM,3253271WWM,LOCAL,278,RC,,inpatient,,,36,32.4,,0.95,,34.2,Percent of total billed charges,,,0.98,,35.28,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.96,,34.56,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,34.2,Percent of total billed charges,,34.2,35.28,
HC or Wire K.Thrd 0.062,PX-3253271WWM,CDM,3253271WWM,LOCAL,278,RC,,outpatient,,,36,32.4,,0.95,,34.2,Percent of total billed charges,,,0.98,,35.28,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.96,,34.56,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,34.2,Percent of total billed charges,,34.2,35.28,
HC or Mesh Ventralex #001030,PX-3253277WWM,CDM,3253277WWM,LOCAL,278,RC,,inpatient,,,2599,2339.1,,0.95,,2469.05,Percent of total billed charges,,,0.98,,2547.02,Percent of total billed charges,,,0.95,,2469.05,Percent of total billed charges,,,0.97,,2521.03,Percent of total billed charges,,,0.97,,2521.03,Percent of total billed charges,,,0.96,,2495.04,Percent of total billed charges,,,0.95,,2469.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2469.05,Percent of total billed charges,,2469.05,2547.02,
HC or Mesh Ventralex #001030,PX-3253277WWM,CDM,3253277WWM,LOCAL,278,RC,,outpatient,,,2599,2339.1,,0.95,,2469.05,Percent of total billed charges,,,0.98,,2547.02,Percent of total billed charges,,,0.95,,2469.05,Percent of total billed charges,,,0.95,,2469.05,Percent of total billed charges,,,0.97,,2521.03,Percent of total billed charges,,,0.96,,2495.04,Percent of total billed charges,,,0.95,,2469.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2469.05,Percent of total billed charges,,2469.05,2547.02,
HC or Liga Clip Med #Mcm20,PX-3253281WWM,CDM,3253281WWM,LOCAL,278,RC,,inpatient,,,235,211.5,,0.95,,223.25,Percent of total billed charges,,,0.98,,230.3,Percent of total billed charges,,,0.95,,223.25,Percent of total billed charges,,,0.97,,227.95,Percent of total billed charges,,,0.97,,227.95,Percent of total billed charges,,,0.96,,225.6,Percent of total billed charges,,,0.95,,223.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,223.25,Percent of total billed charges,,223.25,230.3,
HC or Liga Clip Med #Mcm20,PX-3253281WWM,CDM,3253281WWM,LOCAL,278,RC,,outpatient,,,235,211.5,,0.95,,223.25,Percent of total billed charges,,,0.98,,230.3,Percent of total billed charges,,,0.95,,223.25,Percent of total billed charges,,,0.95,,223.25,Percent of total billed charges,,,0.97,,227.95,Percent of total billed charges,,,0.96,,225.6,Percent of total billed charges,,,0.95,,223.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,223.25,Percent of total billed charges,,223.25,230.3,
HC or Liga Clip Lg #Mcl20,PX-3253282WWM,CDM,3253282WWM,LOCAL,278,RC,,inpatient,,,272,244.8,,0.95,,258.4,Percent of total billed charges,,,0.98,,266.56,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,0.97,,263.84,Percent of total billed charges,,,0.97,,263.84,Percent of total billed charges,,,0.96,,261.12,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,258.4,Percent of total billed charges,,258.4,266.56,
HC or Liga Clip Lg #Mcl20,PX-3253282WWM,CDM,3253282WWM,LOCAL,278,RC,,outpatient,,,272,244.8,,0.95,,258.4,Percent of total billed charges,,,0.98,,266.56,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,0.97,,263.84,Percent of total billed charges,,,0.96,,261.12,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,258.4,Percent of total billed charges,,258.4,266.56,
HC or Screw 2.7x20 #202.820,PX-3253300WWM,CDM,3253300WWM,LOCAL,278,RC,,inpatient,,,123,110.7,,0.95,,116.85,Percent of total billed charges,,,0.98,,120.54,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.96,,118.08,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,116.85,Percent of total billed charges,,116.85,120.54,
HC or Screw 2.7x20 #202.820,PX-3253300WWM,CDM,3253300WWM,LOCAL,278,RC,,outpatient,,,123,110.7,,0.95,,116.85,Percent of total billed charges,,,0.98,,120.54,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.96,,118.08,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,116.85,Percent of total billed charges,,116.85,120.54,
HC or Screw 2.7x16 #202.816,PX-3253301WWM,CDM,3253301WWM,LOCAL,278,RC,,inpatient,,,123,110.7,,0.95,,116.85,Percent of total billed charges,,,0.98,,120.54,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.96,,118.08,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,116.85,Percent of total billed charges,,116.85,120.54,
HC or Screw 2.7x16 #202.816,PX-3253301WWM,CDM,3253301WWM,LOCAL,278,RC,,outpatient,,,123,110.7,,0.95,,116.85,Percent of total billed charges,,,0.98,,120.54,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.96,,118.08,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,116.85,Percent of total billed charges,,116.85,120.54,
HC or Screw 2.7x18 #202.818,PX-3253302WWM,CDM,3253302WWM,LOCAL,278,RC,,inpatient,,,109,98.1,,0.95,,103.55,Percent of total billed charges,,,0.98,,106.82,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,0.97,,105.73,Percent of total billed charges,,,0.97,,105.73,Percent of total billed charges,,,0.96,,104.64,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,103.55,Percent of total billed charges,,103.55,106.82,
HC or Screw 2.7x18 #202.818,PX-3253302WWM,CDM,3253302WWM,LOCAL,278,RC,,outpatient,,,109,98.1,,0.95,,103.55,Percent of total billed charges,,,0.98,,106.82,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,0.97,,105.73,Percent of total billed charges,,,0.96,,104.64,Percent of total billed charges,,,0.95,,103.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,103.55,Percent of total billed charges,,103.55,106.82,
HC or Gia 55 Gia8038s,PX-3253305WWM,CDM,3253305WWM,LOCAL,270,RC,,inpatient,,,877,789.3,,0.95,,833.15,Percent of total billed charges,,,0.98,,859.46,Percent of total billed charges,,,0.95,,833.15,Percent of total billed charges,,,0.97,,850.69,Percent of total billed charges,,,0.97,,850.69,Percent of total billed charges,,,0.96,,841.92,Percent of total billed charges,,,0.95,,833.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,833.15,Percent of total billed charges,,833.15,859.46,
HC or Gia 55 Gia8038s,PX-3253305WWM,CDM,3253305WWM,LOCAL,270,RC,,outpatient,,,877,789.3,,0.95,,833.15,Percent of total billed charges,,,0.98,,859.46,Percent of total billed charges,,,0.95,,833.15,Percent of total billed charges,,,0.95,,833.15,Percent of total billed charges,,,0.97,,850.69,Percent of total billed charges,,,0.96,,841.92,Percent of total billed charges,,,0.95,,833.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,833.15,Percent of total billed charges,,833.15,859.46,
HC or Gia 55 Reload Gia8038l,PX-3253306WWM,CDM,3253306WWM,LOCAL,270,RC,,inpatient,,,667,600.3,,0.95,,633.65,Percent of total billed charges,,,0.98,,653.66,Percent of total billed charges,,,0.95,,633.65,Percent of total billed charges,,,0.97,,646.99,Percent of total billed charges,,,0.97,,646.99,Percent of total billed charges,,,0.96,,640.32,Percent of total billed charges,,,0.95,,633.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,633.65,Percent of total billed charges,,633.65,653.66,
HC or Gia 55 Reload Gia8038l,PX-3253306WWM,CDM,3253306WWM,LOCAL,270,RC,,outpatient,,,667,600.3,,0.95,,633.65,Percent of total billed charges,,,0.98,,653.66,Percent of total billed charges,,,0.95,,633.65,Percent of total billed charges,,,0.95,,633.65,Percent of total billed charges,,,0.97,,646.99,Percent of total billed charges,,,0.96,,640.32,Percent of total billed charges,,,0.95,,633.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,633.65,Percent of total billed charges,,633.65,653.66,
HC or Ils Crvd #Cdh25,PX-3253329WWM,CDM,3253329WWM,LOCAL,270,RC,,inpatient,,,794,714.6,,0.95,,754.3,Percent of total billed charges,,,0.98,,778.12,Percent of total billed charges,,,0.95,,754.3,Percent of total billed charges,,,0.97,,770.18,Percent of total billed charges,,,0.97,,770.18,Percent of total billed charges,,,0.96,,762.24,Percent of total billed charges,,,0.95,,754.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,754.3,Percent of total billed charges,,754.3,778.12,
HC or Ils Crvd #Cdh25,PX-3253329WWM,CDM,3253329WWM,LOCAL,270,RC,,outpatient,,,794,714.6,,0.95,,754.3,Percent of total billed charges,,,0.98,,778.12,Percent of total billed charges,,,0.95,,754.3,Percent of total billed charges,,,0.95,,754.3,Percent of total billed charges,,,0.97,,770.18,Percent of total billed charges,,,0.96,,762.24,Percent of total billed charges,,,0.95,,754.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,754.3,Percent of total billed charges,,754.3,778.12,
HC or Ils Crvd #Cdh29,PX-3253330WWM,CDM,3253330WWM,LOCAL,270,RC,,inpatient,,,827,744.3,,0.95,,785.65,Percent of total billed charges,,,0.98,,810.46,Percent of total billed charges,,,0.95,,785.65,Percent of total billed charges,,,0.97,,802.19,Percent of total billed charges,,,0.97,,802.19,Percent of total billed charges,,,0.96,,793.92,Percent of total billed charges,,,0.95,,785.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,785.65,Percent of total billed charges,,785.65,810.46,
HC or Ils Crvd #Cdh29,PX-3253330WWM,CDM,3253330WWM,LOCAL,270,RC,,outpatient,,,827,744.3,,0.95,,785.65,Percent of total billed charges,,,0.98,,810.46,Percent of total billed charges,,,0.95,,785.65,Percent of total billed charges,,,0.95,,785.65,Percent of total billed charges,,,0.97,,802.19,Percent of total billed charges,,,0.96,,793.92,Percent of total billed charges,,,0.95,,785.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,785.65,Percent of total billed charges,,785.65,810.46,
HC or Ils Crvd #Cdh33,PX-3253331WWM,CDM,3253331WWM,LOCAL,270,RC,,inpatient,,,794,714.6,,0.95,,754.3,Percent of total billed charges,,,0.98,,778.12,Percent of total billed charges,,,0.95,,754.3,Percent of total billed charges,,,0.97,,770.18,Percent of total billed charges,,,0.97,,770.18,Percent of total billed charges,,,0.96,,762.24,Percent of total billed charges,,,0.95,,754.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,754.3,Percent of total billed charges,,754.3,778.12,
HC or Ils Crvd #Cdh33,PX-3253331WWM,CDM,3253331WWM,LOCAL,270,RC,,outpatient,,,794,714.6,,0.95,,754.3,Percent of total billed charges,,,0.98,,778.12,Percent of total billed charges,,,0.95,,754.3,Percent of total billed charges,,,0.95,,754.3,Percent of total billed charges,,,0.97,,770.18,Percent of total billed charges,,,0.96,,762.24,Percent of total billed charges,,,0.95,,754.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,754.3,Percent of total billed charges,,754.3,778.12,
HC or Arthro Tube#0350-202-0,PX-3253337WWM,CDM,3253337WWM,LOCAL,270,RC,,inpatient,,,359,323.1,,0.95,,341.05,Percent of total billed charges,,,0.98,,351.82,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,0.97,,348.23,Percent of total billed charges,,,0.97,,348.23,Percent of total billed charges,,,0.96,,344.64,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,341.05,Percent of total billed charges,,341.05,351.82,
HC or Arthro Tube#0350-202-0,PX-3253337WWM,CDM,3253337WWM,LOCAL,270,RC,,outpatient,,,359,323.1,,0.95,,341.05,Percent of total billed charges,,,0.98,,351.82,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,0.97,,348.23,Percent of total billed charges,,,0.96,,344.64,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,341.05,Percent of total billed charges,,341.05,351.82,
HC or Baker Tube 16 Fr,PX-3253338WWM,CDM,3253338WWM,LOCAL,270,RC,,inpatient,,,354,318.6,,0.95,,336.3,Percent of total billed charges,,,0.98,,346.92,Percent of total billed charges,,,0.95,,336.3,Percent of total billed charges,,,0.97,,343.38,Percent of total billed charges,,,0.97,,343.38,Percent of total billed charges,,,0.96,,339.84,Percent of total billed charges,,,0.95,,336.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,336.3,Percent of total billed charges,,336.3,346.92,
HC or Baker Tube 16 Fr,PX-3253338WWM,CDM,3253338WWM,LOCAL,270,RC,,outpatient,,,354,318.6,,0.95,,336.3,Percent of total billed charges,,,0.98,,346.92,Percent of total billed charges,,,0.95,,336.3,Percent of total billed charges,,,0.95,,336.3,Percent of total billed charges,,,0.97,,343.38,Percent of total billed charges,,,0.96,,339.84,Percent of total billed charges,,,0.95,,336.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,336.3,Percent of total billed charges,,336.3,346.92,
HC or Cath Cholan #2405-50,PX-3253351WWM,CDM,3253351WWM,LOCAL,270,RC,,inpatient,,,304,273.6,,0.95,,288.8,Percent of total billed charges,,,0.98,,297.92,Percent of total billed charges,,,0.95,,288.8,Percent of total billed charges,,,0.97,,294.88,Percent of total billed charges,,,0.97,,294.88,Percent of total billed charges,,,0.96,,291.84,Percent of total billed charges,,,0.95,,288.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,288.8,Percent of total billed charges,,288.8,297.92,
HC or Cath Cholan #2405-50,PX-3253351WWM,CDM,3253351WWM,LOCAL,270,RC,,outpatient,,,304,273.6,,0.95,,288.8,Percent of total billed charges,,,0.98,,297.92,Percent of total billed charges,,,0.95,,288.8,Percent of total billed charges,,,0.95,,288.8,Percent of total billed charges,,,0.97,,294.88,Percent of total billed charges,,,0.96,,291.84,Percent of total billed charges,,,0.95,,288.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,288.8,Percent of total billed charges,,288.8,297.92,
HC or Mesh Med Circle Strap,PX-3253363WWM,CDM,3253363WWM,LOCAL,278,RC,,inpatient,,,1133,1019.7,,0.95,,1076.35,Percent of total billed charges,,,0.98,,1110.34,Percent of total billed charges,,,0.95,,1076.35,Percent of total billed charges,,,0.97,,1099.01,Percent of total billed charges,,,0.97,,1099.01,Percent of total billed charges,,,0.96,,1087.68,Percent of total billed charges,,,0.95,,1076.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1076.35,Percent of total billed charges,,1076.35,1110.34,
HC or Mesh Med Circle Strap,PX-3253363WWM,CDM,3253363WWM,LOCAL,278,RC,,outpatient,,,1133,1019.7,,0.95,,1076.35,Percent of total billed charges,,,0.98,,1110.34,Percent of total billed charges,,,0.95,,1076.35,Percent of total billed charges,,,0.95,,1076.35,Percent of total billed charges,,,0.97,,1099.01,Percent of total billed charges,,,0.96,,1087.68,Percent of total billed charges,,,0.95,,1076.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1076.35,Percent of total billed charges,,1076.35,1110.34,
HC or Jp 7mm W/Trocar #Su130,PX-3253365WWM,CDM,3253365WWM,LOCAL,270,RC,,inpatient,,,49,44.1,,0.95,,46.55,Percent of total billed charges,,,0.98,,48.02,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.96,,47.04,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,46.55,Percent of total billed charges,,46.55,48.02,
HC or Jp 7mm W/Trocar #Su130,PX-3253365WWM,CDM,3253365WWM,LOCAL,270,RC,,outpatient,,,49,44.1,,0.95,,46.55,Percent of total billed charges,,,0.98,,48.02,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.96,,47.04,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,46.55,Percent of total billed charges,,46.55,48.02,
HC or Jp 10mm W/Trocar #Su13,PX-3253366WWM,CDM,3253366WWM,LOCAL,270,RC,,inpatient,,,49,44.1,,0.95,,46.55,Percent of total billed charges,,,0.98,,48.02,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.96,,47.04,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,46.55,Percent of total billed charges,,46.55,48.02,
HC or Jp 10mm W/Trocar #Su13,PX-3253366WWM,CDM,3253366WWM,LOCAL,270,RC,,outpatient,,,49,44.1,,0.95,,46.55,Percent of total billed charges,,,0.98,,48.02,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.96,,47.04,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,46.55,Percent of total billed charges,,46.55,48.02,
HC or Jp 7mm #Su130-1310,PX-3253367WWM,CDM,3253367WWM,LOCAL,270,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC or Jp 7mm #Su130-1310,PX-3253367WWM,CDM,3253367WWM,LOCAL,270,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC or Arthro Surfas Hook,PX-3253384WWM,CDM,3253384WWM,LOCAL,270,RC,,inpatient,,,437,393.3,,0.95,,415.15,Percent of total billed charges,,,0.98,,428.26,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,0.97,,423.89,Percent of total billed charges,,,0.97,,423.89,Percent of total billed charges,,,0.96,,419.52,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,415.15,Percent of total billed charges,,415.15,428.26,
HC or Arthro Surfas Hook,PX-3253384WWM,CDM,3253384WWM,LOCAL,270,RC,,outpatient,,,437,393.3,,0.95,,415.15,Percent of total billed charges,,,0.98,,428.26,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,0.97,,423.89,Percent of total billed charges,,,0.96,,419.52,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,415.15,Percent of total billed charges,,415.15,428.26,
HC or Aggres Plus 5.5#375564,PX-3253385WWM,CDM,3253385WWM,LOCAL,270,RC,,inpatient,,,212,190.8,,0.95,,201.4,Percent of total billed charges,,,0.98,,207.76,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,0.97,,205.64,Percent of total billed charges,,,0.97,,205.64,Percent of total billed charges,,,0.96,,203.52,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,201.4,Percent of total billed charges,,201.4,207.76,
HC or Aggres Plus 5.5#375564,PX-3253385WWM,CDM,3253385WWM,LOCAL,270,RC,,outpatient,,,212,190.8,,0.95,,201.4,Percent of total billed charges,,,0.98,,207.76,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,0.97,,205.64,Percent of total billed charges,,,0.96,,203.52,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,201.4,Percent of total billed charges,,201.4,207.76,
HC or Anchor Xcel 3.0,PX-3253390WWM,CDM,3253390WWM,LOCAL,270,RC,,inpatient,,,579,521.1,,0.95,,550.05,Percent of total billed charges,,,0.98,,567.42,Percent of total billed charges,,,0.95,,550.05,Percent of total billed charges,,,0.97,,561.63,Percent of total billed charges,,,0.97,,561.63,Percent of total billed charges,,,0.96,,555.84,Percent of total billed charges,,,0.95,,550.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,550.05,Percent of total billed charges,,550.05,567.42,
HC or Anchor Xcel 3.0,PX-3253390WWM,CDM,3253390WWM,LOCAL,270,RC,,outpatient,,,579,521.1,,0.95,,550.05,Percent of total billed charges,,,0.98,,567.42,Percent of total billed charges,,,0.95,,550.05,Percent of total billed charges,,,0.95,,550.05,Percent of total billed charges,,,0.97,,561.63,Percent of total billed charges,,,0.96,,555.84,Percent of total billed charges,,,0.95,,550.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,550.05,Percent of total billed charges,,550.05,567.42,
HC or Aggres Plus 4.0#375544,PX-3253393WWM,CDM,3253393WWM,LOCAL,270,RC,,inpatient,,,232,208.8,,0.95,,220.4,Percent of total billed charges,,,0.98,,227.36,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,0.97,,225.04,Percent of total billed charges,,,0.97,,225.04,Percent of total billed charges,,,0.96,,222.72,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,220.4,Percent of total billed charges,,220.4,227.36,
HC or Aggres Plus 4.0#375544,PX-3253393WWM,CDM,3253393WWM,LOCAL,270,RC,,outpatient,,,232,208.8,,0.95,,220.4,Percent of total billed charges,,,0.98,,227.36,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,0.97,,225.04,Percent of total billed charges,,,0.96,,222.72,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,220.4,Percent of total billed charges,,220.4,227.36,
HC or Trocar Xl 5mm#B5xt,PX-3253399WWM,CDM,3253399WWM,LOCAL,270,RC,,inpatient,,,244,219.6,,0.95,,231.8,Percent of total billed charges,,,0.98,,239.12,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,0.97,,236.68,Percent of total billed charges,,,0.97,,236.68,Percent of total billed charges,,,0.96,,234.24,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,231.8,Percent of total billed charges,,231.8,239.12,
HC or Trocar Xl 5mm#B5xt,PX-3253399WWM,CDM,3253399WWM,LOCAL,270,RC,,outpatient,,,244,219.6,,0.95,,231.8,Percent of total billed charges,,,0.98,,239.12,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,0.97,,236.68,Percent of total billed charges,,,0.96,,234.24,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,231.8,Percent of total billed charges,,231.8,239.12,
HC or Trocar Xl 12mm#B12xt,PX-3253400WWM,CDM,3253400WWM,LOCAL,270,RC,,inpatient,,,216,194.4,,0.95,,205.2,Percent of total billed charges,,,0.98,,211.68,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,0.97,,209.52,Percent of total billed charges,,,0.97,,209.52,Percent of total billed charges,,,0.96,,207.36,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,205.2,Percent of total billed charges,,205.2,211.68,
HC or Trocar Xl 12mm#B12xt,PX-3253400WWM,CDM,3253400WWM,LOCAL,270,RC,,outpatient,,,216,194.4,,0.95,,205.2,Percent of total billed charges,,,0.98,,211.68,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,0.97,,209.52,Percent of total billed charges,,,0.96,,207.36,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,205.2,Percent of total billed charges,,205.2,211.68,
HC or Mesh Surg 4x8 #1952,PX-3253434WWM,CDM,3253434WWM,LOCAL,278,RC,,inpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
HC or Mesh Surg 4x8 #1952,PX-3253434WWM,CDM,3253434WWM,LOCAL,278,RC,,outpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
HC or Mesh Surg 2x3 #1953,PX-3253435WWM,CDM,3253435WWM,LOCAL,278,RC,,inpatient,,,165,148.5,,0.95,,156.75,Percent of total billed charges,,,0.98,,161.7,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.96,,158.4,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,156.75,Percent of total billed charges,,156.75,161.7,
HC or Mesh Surg 2x3 #1953,PX-3253435WWM,CDM,3253435WWM,LOCAL,278,RC,,outpatient,,,165,148.5,,0.95,,156.75,Percent of total billed charges,,,0.98,,161.7,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.96,,158.4,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,156.75,Percent of total billed charges,,156.75,161.7,
HC or Endo Clip Applier Med,PX-3253437WWM,CDM,3253437WWM,LOCAL,278,RC,,inpatient,,,693,623.7,,0.95,,658.35,Percent of total billed charges,,,0.98,,679.14,Percent of total billed charges,,,0.95,,658.35,Percent of total billed charges,,,0.97,,672.21,Percent of total billed charges,,,0.97,,672.21,Percent of total billed charges,,,0.96,,665.28,Percent of total billed charges,,,0.95,,658.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,658.35,Percent of total billed charges,,658.35,679.14,
HC or Endo Clip Applier Med,PX-3253437WWM,CDM,3253437WWM,LOCAL,278,RC,,outpatient,,,693,623.7,,0.95,,658.35,Percent of total billed charges,,,0.98,,679.14,Percent of total billed charges,,,0.95,,658.35,Percent of total billed charges,,,0.95,,658.35,Percent of total billed charges,,,0.97,,672.21,Percent of total billed charges,,,0.96,,665.28,Percent of total billed charges,,,0.95,,658.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,658.35,Percent of total billed charges,,658.35,679.14,
HC or Endo Clip Applier Lg,PX-3253438WWM,CDM,3253438WWM,LOCAL,270,RC,,inpatient,,,666,599.4,,0.95,,632.7,Percent of total billed charges,,,0.98,,652.68,Percent of total billed charges,,,0.95,,632.7,Percent of total billed charges,,,0.97,,646.02,Percent of total billed charges,,,0.97,,646.02,Percent of total billed charges,,,0.96,,639.36,Percent of total billed charges,,,0.95,,632.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,632.7,Percent of total billed charges,,632.7,652.68,
HC or Endo Clip Applier Lg,PX-3253438WWM,CDM,3253438WWM,LOCAL,270,RC,,outpatient,,,666,599.4,,0.95,,632.7,Percent of total billed charges,,,0.98,,652.68,Percent of total billed charges,,,0.95,,632.7,Percent of total billed charges,,,0.95,,632.7,Percent of total billed charges,,,0.97,,646.02,Percent of total billed charges,,,0.96,,639.36,Percent of total billed charges,,,0.95,,632.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,632.7,Percent of total billed charges,,632.7,652.68,
HC or Power Port #1808000,PX-3253509WWM,CDM,3253509WWM,LOCAL,278,RC,,inpatient,,,1656,1490.4,,0.95,,1573.2,Percent of total billed charges,,,0.98,,1622.88,Percent of total billed charges,,,0.95,,1573.2,Percent of total billed charges,,,0.97,,1606.32,Percent of total billed charges,,,0.97,,1606.32,Percent of total billed charges,,,0.96,,1589.76,Percent of total billed charges,,,0.95,,1573.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1573.2,Percent of total billed charges,,1573.2,1622.88,
HC or Power Port #1808000,PX-3253509WWM,CDM,3253509WWM,LOCAL,278,RC,,outpatient,,,1656,1490.4,,0.95,,1573.2,Percent of total billed charges,,,0.98,,1622.88,Percent of total billed charges,,,0.95,,1573.2,Percent of total billed charges,,,0.95,,1573.2,Percent of total billed charges,,,0.97,,1606.32,Percent of total billed charges,,,0.96,,1589.76,Percent of total billed charges,,,0.95,,1573.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1573.2,Percent of total billed charges,,1573.2,1622.88,
HC or Shoulder Stab Kit,PX-3253524WWM,CDM,3253524WWM,LOCAL,270,RC,,inpatient,,,244,219.6,,0.95,,231.8,Percent of total billed charges,,,0.98,,239.12,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,0.97,,236.68,Percent of total billed charges,,,0.97,,236.68,Percent of total billed charges,,,0.96,,234.24,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,231.8,Percent of total billed charges,,231.8,239.12,
HC or Shoulder Stab Kit,PX-3253524WWM,CDM,3253524WWM,LOCAL,270,RC,,outpatient,,,244,219.6,,0.95,,231.8,Percent of total billed charges,,,0.98,,239.12,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,0.97,,236.68,Percent of total billed charges,,,0.96,,234.24,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,231.8,Percent of total billed charges,,231.8,239.12,
HC or Arthro Resector,PX-3253531WWM,CDM,3253531WWM,LOCAL,270,RC,,inpatient,,,212,190.8,,0.95,,201.4,Percent of total billed charges,,,0.98,,207.76,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,0.97,,205.64,Percent of total billed charges,,,0.97,,205.64,Percent of total billed charges,,,0.96,,203.52,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,201.4,Percent of total billed charges,,201.4,207.76,
HC or Arthro Resector,PX-3253531WWM,CDM,3253531WWM,LOCAL,270,RC,,outpatient,,,212,190.8,,0.95,,201.4,Percent of total billed charges,,,0.98,,207.76,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,0.97,,205.64,Percent of total billed charges,,,0.96,,203.52,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,201.4,Percent of total billed charges,,201.4,207.76,
HC or Strk Aggres Wid Blade,PX-3253534WWM,CDM,3253534WWM,LOCAL,270,RC,,inpatient,,,159,143.1,,0.95,,151.05,Percent of total billed charges,,,0.98,,155.82,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,0.97,,154.23,Percent of total billed charges,,,0.97,,154.23,Percent of total billed charges,,,0.96,,152.64,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,151.05,Percent of total billed charges,,151.05,155.82,
HC or Strk Aggres Wid Blade,PX-3253534WWM,CDM,3253534WWM,LOCAL,270,RC,,outpatient,,,159,143.1,,0.95,,151.05,Percent of total billed charges,,,0.98,,155.82,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,0.97,,154.23,Percent of total billed charges,,,0.96,,152.64,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,151.05,Percent of total billed charges,,151.05,155.82,
HC or Strk Minor Mod Prod,PX-3253535WWM,CDM,3253535WWM,LOCAL,270,RC,,inpatient,,,282,253.8,,0.95,,267.9,Percent of total billed charges,,,0.98,,276.36,Percent of total billed charges,,,0.95,,267.9,Percent of total billed charges,,,0.97,,273.54,Percent of total billed charges,,,0.97,,273.54,Percent of total billed charges,,,0.96,,270.72,Percent of total billed charges,,,0.95,,267.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,267.9,Percent of total billed charges,,267.9,276.36,
HC or Strk Minor Mod Prod,PX-3253535WWM,CDM,3253535WWM,LOCAL,270,RC,,outpatient,,,282,253.8,,0.95,,267.9,Percent of total billed charges,,,0.98,,276.36,Percent of total billed charges,,,0.95,,267.9,Percent of total billed charges,,,0.95,,267.9,Percent of total billed charges,,,0.97,,273.54,Percent of total billed charges,,,0.96,,270.72,Percent of total billed charges,,,0.95,,267.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,267.9,Percent of total billed charges,,267.9,276.36,
HC or Strk Narrow Blade,PX-3253536WWM,CDM,3253536WWM,LOCAL,270,RC,,inpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
HC or Strk Narrow Blade,PX-3253536WWM,CDM,3253536WWM,LOCAL,270,RC,,outpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
HC or Corkscrew Sut Anch,PX-3253537WWM,CDM,3253537WWM,LOCAL,270,RC,,inpatient,,,605,544.5,,0.95,,574.75,Percent of total billed charges,,,0.98,,592.9,Percent of total billed charges,,,0.95,,574.75,Percent of total billed charges,,,0.97,,586.85,Percent of total billed charges,,,0.97,,586.85,Percent of total billed charges,,,0.96,,580.8,Percent of total billed charges,,,0.95,,574.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,574.75,Percent of total billed charges,,574.75,592.9,
HC or Corkscrew Sut Anch,PX-3253537WWM,CDM,3253537WWM,LOCAL,270,RC,,outpatient,,,605,544.5,,0.95,,574.75,Percent of total billed charges,,,0.98,,592.9,Percent of total billed charges,,,0.95,,574.75,Percent of total billed charges,,,0.95,,574.75,Percent of total billed charges,,,0.97,,586.85,Percent of total billed charges,,,0.96,,580.8,Percent of total billed charges,,,0.95,,574.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,574.75,Percent of total billed charges,,574.75,592.9,
HC or Cannula Twistin 8x7#AR,PX-3253538WWM,CDM,3253538WWM,LOCAL,270,RC,,inpatient,,,132,118.8,,0.95,,125.4,Percent of total billed charges,,,0.98,,129.36,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.96,,126.72,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,125.4,Percent of total billed charges,,125.4,129.36,
HC or Cannula Twistin 8x7#AR,PX-3253538WWM,CDM,3253538WWM,LOCAL,270,RC,,outpatient,,,132,118.8,,0.95,,125.4,Percent of total billed charges,,,0.98,,129.36,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.96,,126.72,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,125.4,Percent of total billed charges,,125.4,129.36,
HC or Suture Lasso 90 Str,PX-3253539WWM,CDM,3253539WWM,LOCAL,270,RC,,inpatient,,,368,331.2,,0.95,,349.6,Percent of total billed charges,,,0.98,,360.64,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,0.97,,356.96,Percent of total billed charges,,,0.97,,356.96,Percent of total billed charges,,,0.96,,353.28,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,349.6,Percent of total billed charges,,349.6,360.64,
HC or Suture Lasso 90 Str,PX-3253539WWM,CDM,3253539WWM,LOCAL,270,RC,,outpatient,,,368,331.2,,0.95,,349.6,Percent of total billed charges,,,0.98,,360.64,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,0.97,,356.96,Percent of total billed charges,,,0.96,,353.28,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,349.6,Percent of total billed charges,,349.6,360.64,
HC or Imperv Stockinette,PX-3253541WWM,CDM,3253541WWM,LOCAL,270,RC,,inpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
HC or Imperv Stockinette,PX-3253541WWM,CDM,3253541WWM,LOCAL,270,RC,,outpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
HC or Esmark 6x9,PX-3253542WWM,CDM,3253542WWM,LOCAL,270,RC,,inpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
HC or Esmark 6x9,PX-3253542WWM,CDM,3253542WWM,LOCAL,270,RC,,outpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
HC or 1.0mm Cable With Crimp,PX-3253543WWM,CDM,3253543WWM,LOCAL,278,RC,,inpatient,,,1424,1281.6,,0.95,,1352.8,Percent of total billed charges,,,0.98,,1395.52,Percent of total billed charges,,,0.95,,1352.8,Percent of total billed charges,,,0.97,,1381.28,Percent of total billed charges,,,0.97,,1381.28,Percent of total billed charges,,,0.96,,1367.04,Percent of total billed charges,,,0.95,,1352.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1352.8,Percent of total billed charges,,1352.8,1395.52,
HC or 1.0mm Cable With Crimp,PX-3253543WWM,CDM,3253543WWM,LOCAL,278,RC,,outpatient,,,1424,1281.6,,0.95,,1352.8,Percent of total billed charges,,,0.98,,1395.52,Percent of total billed charges,,,0.95,,1352.8,Percent of total billed charges,,,0.95,,1352.8,Percent of total billed charges,,,0.97,,1381.28,Percent of total billed charges,,,0.96,,1367.04,Percent of total billed charges,,,0.95,,1352.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1352.8,Percent of total billed charges,,1352.8,1395.52,
HC or Frazier Suct 10fr#1660,PX-3253546WWM,CDM,3253546WWM,LOCAL,270,RC,,inpatient,,,21,18.9,,0.95,,19.95,Percent of total billed charges,,,0.98,,20.58,Percent of total billed charges,,,0.95,,19.95,Percent of total billed charges,,,0.97,,20.37,Percent of total billed charges,,,0.97,,20.37,Percent of total billed charges,,,0.96,,20.16,Percent of total billed charges,,,0.95,,19.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19.95,Percent of total billed charges,,19.95,20.58,
HC or Frazier Suct 10fr#1660,PX-3253546WWM,CDM,3253546WWM,LOCAL,270,RC,,outpatient,,,21,18.9,,0.95,,19.95,Percent of total billed charges,,,0.98,,20.58,Percent of total billed charges,,,0.95,,19.95,Percent of total billed charges,,,0.95,,19.95,Percent of total billed charges,,,0.97,,20.37,Percent of total billed charges,,,0.96,,20.16,Percent of total billed charges,,,0.95,,19.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19.95,Percent of total billed charges,,19.95,20.58,
HC or Corkscrew Anch 3.5,PX-3253551WWM,CDM,3253551WWM,LOCAL,270,RC,,inpatient,,,723,650.7,,0.95,,686.85,Percent of total billed charges,,,0.98,,708.54,Percent of total billed charges,,,0.95,,686.85,Percent of total billed charges,,,0.97,,701.31,Percent of total billed charges,,,0.97,,701.31,Percent of total billed charges,,,0.96,,694.08,Percent of total billed charges,,,0.95,,686.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,686.85,Percent of total billed charges,,686.85,708.54,
HC or Corkscrew Anch 3.5,PX-3253551WWM,CDM,3253551WWM,LOCAL,270,RC,,outpatient,,,723,650.7,,0.95,,686.85,Percent of total billed charges,,,0.98,,708.54,Percent of total billed charges,,,0.95,,686.85,Percent of total billed charges,,,0.95,,686.85,Percent of total billed charges,,,0.97,,701.31,Percent of total billed charges,,,0.96,,694.08,Percent of total billed charges,,,0.95,,686.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,686.85,Percent of total billed charges,,686.85,708.54,
HC or Screw 4.5 Cann,PX-3253552WWM,CDM,3253552WWM,LOCAL,278,RC,,inpatient,,,368,331.2,,0.95,,349.6,Percent of total billed charges,,,0.98,,360.64,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,0.97,,356.96,Percent of total billed charges,,,0.97,,356.96,Percent of total billed charges,,,0.96,,353.28,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,349.6,Percent of total billed charges,,349.6,360.64,
HC or Screw 4.5 Cann,PX-3253552WWM,CDM,3253552WWM,LOCAL,278,RC,,outpatient,,,368,331.2,,0.95,,349.6,Percent of total billed charges,,,0.98,,360.64,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,0.97,,356.96,Percent of total billed charges,,,0.96,,353.28,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,349.6,Percent of total billed charges,,349.6,360.64,
HC or Guidepin 2.4#1147-91,PX-3253553WWM,CDM,3253553WWM,LOCAL,270,RC,,inpatient,,,217,195.3,,0.95,,206.15,Percent of total billed charges,,,0.98,,212.66,Percent of total billed charges,,,0.95,,206.15,Percent of total billed charges,,,0.97,,210.49,Percent of total billed charges,,,0.97,,210.49,Percent of total billed charges,,,0.96,,208.32,Percent of total billed charges,,,0.95,,206.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,206.15,Percent of total billed charges,,206.15,212.66,
HC or Guidepin 2.4#1147-91,PX-3253553WWM,CDM,3253553WWM,LOCAL,270,RC,,outpatient,,,217,195.3,,0.95,,206.15,Percent of total billed charges,,,0.98,,212.66,Percent of total billed charges,,,0.95,,206.15,Percent of total billed charges,,,0.95,,206.15,Percent of total billed charges,,,0.97,,210.49,Percent of total billed charges,,,0.96,,208.32,Percent of total billed charges,,,0.95,,206.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,206.15,Percent of total billed charges,,206.15,212.66,
HC or Screw 70mm#4845-70-08,PX-3253558WWM,CDM,3253558WWM,LOCAL,278,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
HC or Screw 70mm#4845-70-08,PX-3253558WWM,CDM,3253558WWM,LOCAL,278,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
HC or Cannula Twistin Notch,PX-3253559WWM,CDM,3253559WWM,LOCAL,270,RC,,inpatient,,,166,149.4,,0.95,,157.7,Percent of total billed charges,,,0.98,,162.68,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.96,,159.36,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,157.7,Percent of total billed charges,,157.7,162.68,
HC or Cannula Twistin Notch,PX-3253559WWM,CDM,3253559WWM,LOCAL,270,RC,,outpatient,,,166,149.4,,0.95,,157.7,Percent of total billed charges,,,0.98,,162.68,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.96,,159.36,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,157.7,Percent of total billed charges,,157.7,162.68,
HC or Biopushlock 4.5,PX-3253562WWM,CDM,3253562WWM,LOCAL,270,RC,,inpatient,,,908,817.2,,0.95,,862.6,Percent of total billed charges,,,0.98,,889.84,Percent of total billed charges,,,0.95,,862.6,Percent of total billed charges,,,0.97,,880.76,Percent of total billed charges,,,0.97,,880.76,Percent of total billed charges,,,0.96,,871.68,Percent of total billed charges,,,0.95,,862.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,862.6,Percent of total billed charges,,862.6,889.84,
HC or Biopushlock 4.5,PX-3253562WWM,CDM,3253562WWM,LOCAL,270,RC,,outpatient,,,908,817.2,,0.95,,862.6,Percent of total billed charges,,,0.98,,889.84,Percent of total billed charges,,,0.95,,862.6,Percent of total billed charges,,,0.95,,862.6,Percent of total billed charges,,,0.97,,880.76,Percent of total billed charges,,,0.96,,871.68,Percent of total billed charges,,,0.95,,862.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,862.6,Percent of total billed charges,,862.6,889.84,
HC or Scorpion Needle,PX-3253563WWM,CDM,3253563WWM,LOCAL,270,RC,,inpatient,,,512,460.8,,0.95,,486.4,Percent of total billed charges,,,0.98,,501.76,Percent of total billed charges,,,0.95,,486.4,Percent of total billed charges,,,0.97,,496.64,Percent of total billed charges,,,0.97,,496.64,Percent of total billed charges,,,0.96,,491.52,Percent of total billed charges,,,0.95,,486.4,Percent of total billed charges,,,,,,,,,0.95,,486.4,Percent of total billed charges,,486.4,501.76,
HC or Scorpion Needle,PX-3253563WWM,CDM,3253563WWM,LOCAL,270,RC,,outpatient,,,512,460.8,,0.95,,486.4,Percent of total billed charges,,,0.98,,501.76,Percent of total billed charges,,,0.95,,486.4,Percent of total billed charges,,,0.95,,486.4,Percent of total billed charges,,,0.97,,496.64,Percent of total billed charges,,,0.96,,491.52,Percent of total billed charges,,,0.95,,486.4,Percent of total billed charges,,,,,,,,,0.95,,486.4,Percent of total billed charges,,486.4,501.76,
HC or Cannula Twistin 7x7#AR,PX-3253564WWM,CDM,3253564WWM,LOCAL,270,RC,,inpatient,,,166,149.4,,0.95,,157.7,Percent of total billed charges,,,0.98,,162.68,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.96,,159.36,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,157.7,Percent of total billed charges,,157.7,162.68,
HC or Cannula Twistin 7x7#AR,PX-3253564WWM,CDM,3253564WWM,LOCAL,270,RC,,outpatient,,,166,149.4,,0.95,,157.7,Percent of total billed charges,,,0.98,,162.68,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.96,,159.36,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,157.7,Percent of total billed charges,,157.7,162.68,
HC or Transtibial Acl,PX-3253567WWM,CDM,3253567WWM,LOCAL,270,RC,,inpatient,,,547,492.3,,0.95,,519.65,Percent of total billed charges,,,0.98,,536.06,Percent of total billed charges,,,0.95,,519.65,Percent of total billed charges,,,0.97,,530.59,Percent of total billed charges,,,0.97,,530.59,Percent of total billed charges,,,0.96,,525.12,Percent of total billed charges,,,0.95,,519.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,519.65,Percent of total billed charges,,519.65,536.06,
HC or Transtibial Acl,PX-3253567WWM,CDM,3253567WWM,LOCAL,270,RC,,outpatient,,,547,492.3,,0.95,,519.65,Percent of total billed charges,,,0.98,,536.06,Percent of total billed charges,,,0.95,,519.65,Percent of total billed charges,,,0.95,,519.65,Percent of total billed charges,,,0.97,,530.59,Percent of total billed charges,,,0.96,,525.12,Percent of total billed charges,,,0.95,,519.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,519.65,Percent of total billed charges,,519.65,536.06,
HC or Biomet Abs Screw,PX-3253568WWM,CDM,3253568WWM,LOCAL,270,RC,,inpatient,,,596,536.4,,0.95,,566.2,Percent of total billed charges,,,0.98,,584.08,Percent of total billed charges,,,0.95,,566.2,Percent of total billed charges,,,0.97,,578.12,Percent of total billed charges,,,0.97,,578.12,Percent of total billed charges,,,0.96,,572.16,Percent of total billed charges,,,0.95,,566.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,566.2,Percent of total billed charges,,566.2,584.08,
HC or Biomet Abs Screw,PX-3253568WWM,CDM,3253568WWM,LOCAL,270,RC,,outpatient,,,596,536.4,,0.95,,566.2,Percent of total billed charges,,,0.98,,584.08,Percent of total billed charges,,,0.95,,566.2,Percent of total billed charges,,,0.95,,566.2,Percent of total billed charges,,,0.97,,578.12,Percent of total billed charges,,,0.96,,572.16,Percent of total billed charges,,,0.95,,566.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,566.2,Percent of total billed charges,,566.2,584.08,
HC or Biomet Drill Bit 2.2,PX-3253569WWM,CDM,3253569WWM,LOCAL,270,RC,,inpatient,,,425,382.5,,0.95,,403.75,Percent of total billed charges,,,0.98,,416.5,Percent of total billed charges,,,0.95,,403.75,Percent of total billed charges,,,0.97,,412.25,Percent of total billed charges,,,0.97,,412.25,Percent of total billed charges,,,0.96,,408,Percent of total billed charges,,,0.95,,403.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,403.75,Percent of total billed charges,,403.75,416.5,
HC or Biomet Drill Bit 2.2,PX-3253569WWM,CDM,3253569WWM,LOCAL,270,RC,,outpatient,,,425,382.5,,0.95,,403.75,Percent of total billed charges,,,0.98,,416.5,Percent of total billed charges,,,0.95,,403.75,Percent of total billed charges,,,0.95,,403.75,Percent of total billed charges,,,0.97,,412.25,Percent of total billed charges,,,0.96,,408,Percent of total billed charges,,,0.95,,403.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,403.75,Percent of total billed charges,,403.75,416.5,
HC or Arthro Surfas 90s,PX-3253574WWM,CDM,3253574WWM,LOCAL,270,RC,,inpatient,,,458,412.2,,0.95,,435.1,Percent of total billed charges,,,0.98,,448.84,Percent of total billed charges,,,0.95,,435.1,Percent of total billed charges,,,0.97,,444.26,Percent of total billed charges,,,0.97,,444.26,Percent of total billed charges,,,0.96,,439.68,Percent of total billed charges,,,0.95,,435.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,435.1,Percent of total billed charges,,435.1,448.84,
HC or Arthro Surfas 90s,PX-3253574WWM,CDM,3253574WWM,LOCAL,270,RC,,outpatient,,,458,412.2,,0.95,,435.1,Percent of total billed charges,,,0.98,,448.84,Percent of total billed charges,,,0.95,,435.1,Percent of total billed charges,,,0.95,,435.1,Percent of total billed charges,,,0.97,,444.26,Percent of total billed charges,,,0.96,,439.68,Percent of total billed charges,,,0.95,,435.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,435.1,Percent of total billed charges,,435.1,448.84,
HC or Arthro Surfas 90s Max,PX-3253575WWM,CDM,3253575WWM,LOCAL,270,RC,,inpatient,,,435,391.5,,0.95,,413.25,Percent of total billed charges,,,0.98,,426.3,Percent of total billed charges,,,0.95,,413.25,Percent of total billed charges,,,0.97,,421.95,Percent of total billed charges,,,0.97,,421.95,Percent of total billed charges,,,0.96,,417.6,Percent of total billed charges,,,0.95,,413.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,413.25,Percent of total billed charges,,413.25,426.3,
HC or Arthro Surfas 90s Max,PX-3253575WWM,CDM,3253575WWM,LOCAL,270,RC,,outpatient,,,435,391.5,,0.95,,413.25,Percent of total billed charges,,,0.98,,426.3,Percent of total billed charges,,,0.95,,413.25,Percent of total billed charges,,,0.95,,413.25,Percent of total billed charges,,,0.97,,421.95,Percent of total billed charges,,,0.96,,417.6,Percent of total billed charges,,,0.95,,413.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,413.25,Percent of total billed charges,,413.25,426.3,
HC or Fiberstick #2#AR-7209,PX-3253576WWM,CDM,3253576WWM,LOCAL,270,RC,,inpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
HC or Fiberstick #2#AR-7209,PX-3253576WWM,CDM,3253576WWM,LOCAL,270,RC,,outpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
HC or Biopushlock 3.5#Ar1926,PX-3253577WWM,CDM,3253577WWM,LOCAL,270,RC,,inpatient,,,894,804.6,,0.95,,849.3,Percent of total billed charges,,,0.98,,876.12,Percent of total billed charges,,,0.95,,849.3,Percent of total billed charges,,,0.97,,867.18,Percent of total billed charges,,,0.97,,867.18,Percent of total billed charges,,,0.96,,858.24,Percent of total billed charges,,,0.95,,849.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,849.3,Percent of total billed charges,,849.3,876.12,
HC or Biopushlock 3.5#Ar1926,PX-3253577WWM,CDM,3253577WWM,LOCAL,270,RC,,outpatient,,,894,804.6,,0.95,,849.3,Percent of total billed charges,,,0.98,,876.12,Percent of total billed charges,,,0.95,,849.3,Percent of total billed charges,,,0.95,,849.3,Percent of total billed charges,,,0.97,,867.18,Percent of total billed charges,,,0.96,,858.24,Percent of total billed charges,,,0.95,,849.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,849.3,Percent of total billed charges,,849.3,876.12,
HC or Arthro Unhooded Bur,PX-3253578WWM,CDM,3253578WWM,LOCAL,270,RC,,inpatient,,,244,219.6,,0.95,,231.8,Percent of total billed charges,,,0.98,,239.12,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,0.97,,236.68,Percent of total billed charges,,,0.97,,236.68,Percent of total billed charges,,,0.96,,234.24,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,231.8,Percent of total billed charges,,231.8,239.12,
HC or Arthro Unhooded Bur,PX-3253578WWM,CDM,3253578WWM,LOCAL,270,RC,,outpatient,,,244,219.6,,0.95,,231.8,Percent of total billed charges,,,0.98,,239.12,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,0.97,,236.68,Percent of total billed charges,,,0.96,,234.24,Percent of total billed charges,,,0.95,,231.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,231.8,Percent of total billed charges,,231.8,239.12,
"HC or Coban 4"" #M20845",PX-3253579WWM,CDM,3253579WWM,LOCAL,270,RC,,inpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19,Percent of total billed charges,,19,19.6,
"HC or Coban 4"" #M20845",PX-3253579WWM,CDM,3253579WWM,LOCAL,270,RC,,outpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19,Percent of total billed charges,,19,19.6,
HC or Su Lasso 25 Rt,PX-3253589WWM,CDM,3253589WWM,LOCAL,270,RC,,inpatient,,,368,331.2,,0.95,,349.6,Percent of total billed charges,,,0.98,,360.64,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,0.97,,356.96,Percent of total billed charges,,,0.97,,356.96,Percent of total billed charges,,,0.96,,353.28,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,349.6,Percent of total billed charges,,349.6,360.64,
HC or Su Lasso 25 Rt,PX-3253589WWM,CDM,3253589WWM,LOCAL,270,RC,,outpatient,,,368,331.2,,0.95,,349.6,Percent of total billed charges,,,0.98,,360.64,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,0.97,,356.96,Percent of total billed charges,,,0.96,,353.28,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,349.6,Percent of total billed charges,,349.6,360.64,
HC or Biotenodesis Kit,PX-3253602WWM,CDM,3253602WWM,LOCAL,270,RC,,inpatient,,,529,476.1,,0.95,,502.55,Percent of total billed charges,,,0.98,,518.42,Percent of total billed charges,,,0.95,,502.55,Percent of total billed charges,,,0.97,,513.13,Percent of total billed charges,,,0.97,,513.13,Percent of total billed charges,,,0.96,,507.84,Percent of total billed charges,,,0.95,,502.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,502.55,Percent of total billed charges,,502.55,518.42,
HC or Biotenodesis Kit,PX-3253602WWM,CDM,3253602WWM,LOCAL,270,RC,,outpatient,,,529,476.1,,0.95,,502.55,Percent of total billed charges,,,0.98,,518.42,Percent of total billed charges,,,0.95,,502.55,Percent of total billed charges,,,0.95,,502.55,Percent of total billed charges,,,0.97,,513.13,Percent of total billed charges,,,0.96,,507.84,Percent of total billed charges,,,0.95,,502.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,502.55,Percent of total billed charges,,502.55,518.42,
HC or Screw Tenodesis 7x23,PX-3253603WWM,CDM,3253603WWM,LOCAL,278,RC,,inpatient,,,973,875.7,,0.95,,924.35,Percent of total billed charges,,,0.98,,953.54,Percent of total billed charges,,,0.95,,924.35,Percent of total billed charges,,,0.97,,943.81,Percent of total billed charges,,,0.97,,943.81,Percent of total billed charges,,,0.96,,934.08,Percent of total billed charges,,,0.95,,924.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,924.35,Percent of total billed charges,,924.35,953.54,
HC or Screw Tenodesis 7x23,PX-3253603WWM,CDM,3253603WWM,LOCAL,278,RC,,outpatient,,,973,875.7,,0.95,,924.35,Percent of total billed charges,,,0.98,,953.54,Percent of total billed charges,,,0.95,,924.35,Percent of total billed charges,,,0.95,,924.35,Percent of total billed charges,,,0.97,,943.81,Percent of total billed charges,,,0.96,,934.08,Percent of total billed charges,,,0.95,,924.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,924.35,Percent of total billed charges,,924.35,953.54,
HC or Biosuturetak 3-0,PX-3253604WWM,CDM,3253604WWM,LOCAL,270,RC,,inpatient,,,855,769.5,,0.95,,812.25,Percent of total billed charges,,,0.98,,837.9,Percent of total billed charges,,,0.95,,812.25,Percent of total billed charges,,,0.97,,829.35,Percent of total billed charges,,,0.97,,829.35,Percent of total billed charges,,,0.96,,820.8,Percent of total billed charges,,,0.95,,812.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,812.25,Percent of total billed charges,,812.25,837.9,
HC or Biosuturetak 3-0,PX-3253604WWM,CDM,3253604WWM,LOCAL,270,RC,,outpatient,,,855,769.5,,0.95,,812.25,Percent of total billed charges,,,0.98,,837.9,Percent of total billed charges,,,0.95,,812.25,Percent of total billed charges,,,0.95,,812.25,Percent of total billed charges,,,0.97,,829.35,Percent of total billed charges,,,0.96,,820.8,Percent of total billed charges,,,0.95,,812.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,812.25,Percent of total billed charges,,812.25,837.9,
HC or Drain Jp 10fr#Su130132,PX-3253606WWM,CDM,3253606WWM,LOCAL,270,RC,,inpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
HC or Drain Jp 10fr#Su130132,PX-3253606WWM,CDM,3253606WWM,LOCAL,270,RC,,outpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
HC or Blade Strk MD/MD,PX-3253607WWM,CDM,3253607WWM,LOCAL,270,RC,,inpatient,,,159,143.1,,0.95,,151.05,Percent of total billed charges,,,0.98,,155.82,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,0.97,,154.23,Percent of total billed charges,,,0.97,,154.23,Percent of total billed charges,,,0.96,,152.64,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,151.05,Percent of total billed charges,,151.05,155.82,
HC or Blade Strk MD/MD,PX-3253607WWM,CDM,3253607WWM,LOCAL,270,RC,,outpatient,,,159,143.1,,0.95,,151.05,Percent of total billed charges,,,0.98,,155.82,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,0.97,,154.23,Percent of total billed charges,,,0.96,,152.64,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,151.05,Percent of total billed charges,,151.05,155.82,
HC or Blade Strk Av/ MD,PX-3253608WWM,CDM,3253608WWM,LOCAL,270,RC,,inpatient,,,164,147.6,,0.95,,155.8,Percent of total billed charges,,,0.98,,160.72,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.96,,157.44,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,155.8,Percent of total billed charges,,155.8,160.72,
HC or Blade Strk Av/ MD,PX-3253608WWM,CDM,3253608WWM,LOCAL,270,RC,,outpatient,,,164,147.6,,0.95,,155.8,Percent of total billed charges,,,0.98,,160.72,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.96,,157.44,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,155.8,Percent of total billed charges,,155.8,160.72,
HC or Blade Strk MD/Nar,PX-3253609WWM,CDM,3253609WWM,LOCAL,270,RC,,inpatient,,,164,147.6,,0.95,,155.8,Percent of total billed charges,,,0.98,,160.72,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.96,,157.44,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,155.8,Percent of total billed charges,,155.8,160.72,
HC or Blade Strk MD/Nar,PX-3253609WWM,CDM,3253609WWM,LOCAL,270,RC,,outpatient,,,164,147.6,,0.95,,155.8,Percent of total billed charges,,,0.98,,160.72,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.96,,157.44,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,155.8,Percent of total billed charges,,155.8,160.72,
HC or Blade Strk Lg/MD,PX-3253610WWM,CDM,3253610WWM,LOCAL,270,RC,,inpatient,,,164,147.6,,0.95,,155.8,Percent of total billed charges,,,0.98,,160.72,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.96,,157.44,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,155.8,Percent of total billed charges,,155.8,160.72,
HC or Blade Strk Lg/MD,PX-3253610WWM,CDM,3253610WWM,LOCAL,270,RC,,outpatient,,,164,147.6,,0.95,,155.8,Percent of total billed charges,,,0.98,,160.72,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.96,,157.44,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,155.8,Percent of total billed charges,,155.8,160.72,
HC or Drill Bit 4.5#4806-145,PX-3253612WWM,CDM,3253612WWM,LOCAL,270,RC,,inpatient,,,196,176.4,,0.95,,186.2,Percent of total billed charges,,,0.98,,192.08,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,0.97,,190.12,Percent of total billed charges,,,0.97,,190.12,Percent of total billed charges,,,0.96,,188.16,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,186.2,Percent of total billed charges,,186.2,192.08,
HC or Drill Bit 4.5#4806-145,PX-3253612WWM,CDM,3253612WWM,LOCAL,270,RC,,outpatient,,,196,176.4,,0.95,,186.2,Percent of total billed charges,,,0.98,,192.08,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,0.97,,190.12,Percent of total billed charges,,,0.96,,188.16,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,186.2,Percent of total billed charges,,186.2,192.08,
HC or Screw Malleo 60#4845-0,PX-3253613WWM,CDM,3253613WWM,LOCAL,278,RC,,inpatient,,,123,110.7,,0.95,,116.85,Percent of total billed charges,,,0.98,,120.54,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.96,,118.08,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,116.85,Percent of total billed charges,,116.85,120.54,
HC or Screw Malleo 60#4845-0,PX-3253613WWM,CDM,3253613WWM,LOCAL,278,RC,,outpatient,,,123,110.7,,0.95,,116.85,Percent of total billed charges,,,0.98,,120.54,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.96,,118.08,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,116.85,Percent of total billed charges,,116.85,120.54,
HC or Screw Malleo 70#4845-0,PX-3253614WWM,CDM,3253614WWM,LOCAL,278,RC,,inpatient,,,123,110.7,,0.95,,116.85,Percent of total billed charges,,,0.98,,120.54,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.96,,118.08,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,116.85,Percent of total billed charges,,116.85,120.54,
HC or Screw Malleo 70#4845-0,PX-3253614WWM,CDM,3253614WWM,LOCAL,278,RC,,outpatient,,,123,110.7,,0.95,,116.85,Percent of total billed charges,,,0.98,,120.54,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.96,,118.08,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,116.85,Percent of total billed charges,,116.85,120.54,
HC or Screw Interf 9x25#Ar13,PX-3253615WWM,CDM,3253615WWM,LOCAL,278,RC,,inpatient,,,383,344.7,,0.95,,363.85,Percent of total billed charges,,,0.98,,375.34,Percent of total billed charges,,,0.95,,363.85,Percent of total billed charges,,,0.97,,371.51,Percent of total billed charges,,,0.97,,371.51,Percent of total billed charges,,,0.96,,367.68,Percent of total billed charges,,,0.95,,363.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,363.85,Percent of total billed charges,,363.85,375.34,
HC or Screw Interf 9x25#Ar13,PX-3253615WWM,CDM,3253615WWM,LOCAL,278,RC,,outpatient,,,383,344.7,,0.95,,363.85,Percent of total billed charges,,,0.98,,375.34,Percent of total billed charges,,,0.95,,363.85,Percent of total billed charges,,,0.95,,363.85,Percent of total billed charges,,,0.97,,371.51,Percent of total billed charges,,,0.96,,367.68,Percent of total billed charges,,,0.95,,363.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,363.85,Percent of total billed charges,,363.85,375.34,
HC or Screw Soft 9x25#Ar1391,PX-3253616WWM,CDM,3253616WWM,LOCAL,278,RC,,inpatient,,,383,344.7,,0.95,,363.85,Percent of total billed charges,,,0.98,,375.34,Percent of total billed charges,,,0.95,,363.85,Percent of total billed charges,,,0.97,,371.51,Percent of total billed charges,,,0.97,,371.51,Percent of total billed charges,,,0.96,,367.68,Percent of total billed charges,,,0.95,,363.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,363.85,Percent of total billed charges,,363.85,375.34,
HC or Screw Soft 9x25#Ar1391,PX-3253616WWM,CDM,3253616WWM,LOCAL,278,RC,,outpatient,,,383,344.7,,0.95,,363.85,Percent of total billed charges,,,0.98,,375.34,Percent of total billed charges,,,0.95,,363.85,Percent of total billed charges,,,0.95,,363.85,Percent of total billed charges,,,0.97,,371.51,Percent of total billed charges,,,0.96,,367.68,Percent of total billed charges,,,0.95,,363.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,363.85,Percent of total billed charges,,363.85,375.34,
HC or Biosuturetak,PX-3253618WWM,CDM,3253618WWM,LOCAL,270,RC,,inpatient,,,973,875.7,,0.95,,924.35,Percent of total billed charges,,,0.98,,953.54,Percent of total billed charges,,,0.95,,924.35,Percent of total billed charges,,,0.97,,943.81,Percent of total billed charges,,,0.97,,943.81,Percent of total billed charges,,,0.96,,934.08,Percent of total billed charges,,,0.95,,924.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,924.35,Percent of total billed charges,,924.35,953.54,
HC or Biosuturetak,PX-3253618WWM,CDM,3253618WWM,LOCAL,270,RC,,outpatient,,,973,875.7,,0.95,,924.35,Percent of total billed charges,,,0.98,,953.54,Percent of total billed charges,,,0.95,,924.35,Percent of total billed charges,,,0.95,,924.35,Percent of total billed charges,,,0.97,,943.81,Percent of total billed charges,,,0.96,,934.08,Percent of total billed charges,,,0.95,,924.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,924.35,Percent of total billed charges,,924.35,953.54,
HC or Allograft P.L.#0741531,PX-3253621WWM,CDM,3253621WWM,LOCAL,278,RC,,inpatient,,,6092,5482.8,,0.95,,5787.4,Percent of total billed charges,,,0.98,,5970.16,Percent of total billed charges,,,0.95,,5787.4,Percent of total billed charges,,,0.97,,5909.24,Percent of total billed charges,,,0.97,,5909.24,Percent of total billed charges,,,0.96,,5848.32,Percent of total billed charges,,,0.95,,5787.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,5787.4,Percent of total billed charges,,5787.4,5970.16,
HC or Allograft P.L.#0741531,PX-3253621WWM,CDM,3253621WWM,LOCAL,278,RC,,outpatient,,,6092,5482.8,,0.95,,5787.4,Percent of total billed charges,,,0.98,,5970.16,Percent of total billed charges,,,0.95,,5787.4,Percent of total billed charges,,,0.95,,5787.4,Percent of total billed charges,,,0.97,,5909.24,Percent of total billed charges,,,0.96,,5848.32,Percent of total billed charges,,,0.95,,5787.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,5787.4,Percent of total billed charges,,5787.4,5970.16,
HC or Vilex Hemi Implant,PX-3253626WWM,CDM,3253626WWM,LOCAL,278,RC,,inpatient,,,1922,1729.8,,0.95,,1825.9,Percent of total billed charges,,,0.98,,1883.56,Percent of total billed charges,,,0.95,,1825.9,Percent of total billed charges,,,0.97,,1864.34,Percent of total billed charges,,,0.97,,1864.34,Percent of total billed charges,,,0.96,,1845.12,Percent of total billed charges,,,0.95,,1825.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1825.9,Percent of total billed charges,,1825.9,1883.56,
HC or Vilex Hemi Implant,PX-3253626WWM,CDM,3253626WWM,LOCAL,278,RC,,outpatient,,,1922,1729.8,,0.95,,1825.9,Percent of total billed charges,,,0.98,,1883.56,Percent of total billed charges,,,0.95,,1825.9,Percent of total billed charges,,,0.95,,1825.9,Percent of total billed charges,,,0.97,,1864.34,Percent of total billed charges,,,0.96,,1845.12,Percent of total billed charges,,,0.95,,1825.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1825.9,Percent of total billed charges,,1825.9,1883.56,
HC or Vilex Guidewire,PX-3253627WWM,CDM,3253627WWM,LOCAL,270,RC,,inpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
HC or Vilex Guidewire,PX-3253627WWM,CDM,3253627WWM,LOCAL,270,RC,,outpatient,,,67,60.3,,0.95,,63.65,Percent of total billed charges,,,0.98,,65.66,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,0.97,,64.99,Percent of total billed charges,,,0.96,,64.32,Percent of total billed charges,,,0.95,,63.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,63.65,Percent of total billed charges,,63.65,65.66,
HC or Screw Arthrex 8x25,PX-3253628WWM,CDM,3253628WWM,LOCAL,278,RC,,inpatient,,,359,323.1,,0.95,,341.05,Percent of total billed charges,,,0.98,,351.82,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,0.97,,348.23,Percent of total billed charges,,,0.97,,348.23,Percent of total billed charges,,,0.96,,344.64,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,341.05,Percent of total billed charges,,341.05,351.82,
HC or Screw Arthrex 8x25,PX-3253628WWM,CDM,3253628WWM,LOCAL,278,RC,,outpatient,,,359,323.1,,0.95,,341.05,Percent of total billed charges,,,0.98,,351.82,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,0.97,,348.23,Percent of total billed charges,,,0.96,,344.64,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,341.05,Percent of total billed charges,,341.05,351.82,
HC or Screw Interf 8x25,PX-3253629WWM,CDM,3253629WWM,LOCAL,278,RC,,inpatient,,,359,323.1,,0.95,,341.05,Percent of total billed charges,,,0.98,,351.82,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,0.97,,348.23,Percent of total billed charges,,,0.97,,348.23,Percent of total billed charges,,,0.96,,344.64,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,341.05,Percent of total billed charges,,341.05,351.82,
HC or Screw Interf 8x25,PX-3253629WWM,CDM,3253629WWM,LOCAL,278,RC,,outpatient,,,359,323.1,,0.95,,341.05,Percent of total billed charges,,,0.98,,351.82,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,0.97,,348.23,Percent of total billed charges,,,0.96,,344.64,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,341.05,Percent of total billed charges,,341.05,351.82,
HC or Allograft Pl,PX-3253630WWM,CDM,3253630WWM,LOCAL,278,RC,,inpatient,,,4534,4080.6,,0.95,,4307.3,Percent of total billed charges,,,0.98,,4443.32,Percent of total billed charges,,,0.95,,4307.3,Percent of total billed charges,,,0.97,,4397.98,Percent of total billed charges,,,0.97,,4397.98,Percent of total billed charges,,,0.96,,4352.64,Percent of total billed charges,,,0.95,,4307.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4307.3,Percent of total billed charges,,4307.3,4443.32,
HC or Allograft Pl,PX-3253630WWM,CDM,3253630WWM,LOCAL,278,RC,,outpatient,,,4534,4080.6,,0.95,,4307.3,Percent of total billed charges,,,0.98,,4443.32,Percent of total billed charges,,,0.95,,4307.3,Percent of total billed charges,,,0.95,,4307.3,Percent of total billed charges,,,0.97,,4397.98,Percent of total billed charges,,,0.96,,4352.64,Percent of total billed charges,,,0.95,,4307.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4307.3,Percent of total billed charges,,4307.3,4443.32,
HC or Drain Jp Rnd 15fr,PX-3253631WWM,CDM,3253631WWM,LOCAL,270,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
HC or Drain Jp Rnd 15fr,PX-3253631WWM,CDM,3253631WWM,LOCAL,270,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
HC or Allograft Btb 17817000,PX-3253637WWM,CDM,3253637WWM,LOCAL,278,RC,,inpatient,,,4534,4080.6,,0.95,,4307.3,Percent of total billed charges,,,0.98,,4443.32,Percent of total billed charges,,,0.95,,4307.3,Percent of total billed charges,,,0.97,,4397.98,Percent of total billed charges,,,0.97,,4397.98,Percent of total billed charges,,,0.96,,4352.64,Percent of total billed charges,,,0.95,,4307.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4307.3,Percent of total billed charges,,4307.3,4443.32,
HC or Allograft Btb 17817000,PX-3253637WWM,CDM,3253637WWM,LOCAL,278,RC,,outpatient,,,4534,4080.6,,0.95,,4307.3,Percent of total billed charges,,,0.98,,4443.32,Percent of total billed charges,,,0.95,,4307.3,Percent of total billed charges,,,0.95,,4307.3,Percent of total billed charges,,,0.97,,4397.98,Percent of total billed charges,,,0.96,,4352.64,Percent of total billed charges,,,0.95,,4307.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4307.3,Percent of total billed charges,,4307.3,4443.32,
HC or Dbl Armed Needle#8535,PX-3253641WWM,CDM,3253641WWM,LOCAL,270,RC,,inpatient,,,153,137.7,,0.95,,145.35,Percent of total billed charges,,,0.98,,149.94,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.96,,146.88,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,145.35,Percent of total billed charges,,145.35,149.94,
HC or Dbl Armed Needle#8535,PX-3253641WWM,CDM,3253641WWM,LOCAL,270,RC,,outpatient,,,153,137.7,,0.95,,145.35,Percent of total billed charges,,,0.98,,149.94,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,0.97,,148.41,Percent of total billed charges,,,0.96,,146.88,Percent of total billed charges,,,0.95,,145.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,145.35,Percent of total billed charges,,145.35,149.94,
HC or Fiber Tape #Ar7237-7,PX-3253644WWM,CDM,3253644WWM,LOCAL,270,RC,,inpatient,,,178,160.2,,0.95,,169.1,Percent of total billed charges,,,0.98,,174.44,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,0.97,,172.66,Percent of total billed charges,,,0.97,,172.66,Percent of total billed charges,,,0.96,,170.88,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,169.1,Percent of total billed charges,,169.1,174.44,
HC or Fiber Tape #Ar7237-7,PX-3253644WWM,CDM,3253644WWM,LOCAL,270,RC,,outpatient,,,178,160.2,,0.95,,169.1,Percent of total billed charges,,,0.98,,174.44,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,0.97,,172.66,Percent of total billed charges,,,0.96,,170.88,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,169.1,Percent of total billed charges,,169.1,174.44,
HC or Bioteno Screw 5.5#Ar15,PX-3253645WWM,CDM,3253645WWM,LOCAL,270,RC,,inpatient,,,973,875.7,,0.95,,924.35,Percent of total billed charges,,,0.98,,953.54,Percent of total billed charges,,,0.95,,924.35,Percent of total billed charges,,,0.97,,943.81,Percent of total billed charges,,,0.97,,943.81,Percent of total billed charges,,,0.96,,934.08,Percent of total billed charges,,,0.95,,924.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,924.35,Percent of total billed charges,,924.35,953.54,
HC or Bioteno Screw 5.5#Ar15,PX-3253645WWM,CDM,3253645WWM,LOCAL,270,RC,,outpatient,,,973,875.7,,0.95,,924.35,Percent of total billed charges,,,0.98,,953.54,Percent of total billed charges,,,0.95,,924.35,Percent of total billed charges,,,0.95,,924.35,Percent of total billed charges,,,0.97,,943.81,Percent of total billed charges,,,0.96,,934.08,Percent of total billed charges,,,0.95,,924.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,924.35,Percent of total billed charges,,924.35,953.54,
HC or Scorp Needle #Ar13991n,PX-3253646WWM,CDM,3253646WWM,LOCAL,270,RC,,inpatient,,,368,331.2,,0.95,,349.6,Percent of total billed charges,,,0.98,,360.64,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,0.97,,356.96,Percent of total billed charges,,,0.97,,356.96,Percent of total billed charges,,,0.96,,353.28,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,349.6,Percent of total billed charges,,349.6,360.64,
HC or Scorp Needle #Ar13991n,PX-3253646WWM,CDM,3253646WWM,LOCAL,270,RC,,outpatient,,,368,331.2,,0.95,,349.6,Percent of total billed charges,,,0.98,,360.64,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,0.97,,356.96,Percent of total billed charges,,,0.96,,353.28,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,349.6,Percent of total billed charges,,349.6,360.64,
HC or Cannula Twistin 8x9#AR,PX-3253652WWM,CDM,3253652WWM,LOCAL,270,RC,,inpatient,,,166,149.4,,0.95,,157.7,Percent of total billed charges,,,0.98,,162.68,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.96,,159.36,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,157.7,Percent of total billed charges,,157.7,162.68,
HC or Cannula Twistin 8x9#AR,PX-3253652WWM,CDM,3253652WWM,LOCAL,270,RC,,outpatient,,,166,149.4,,0.95,,157.7,Percent of total billed charges,,,0.98,,162.68,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.96,,159.36,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,157.7,Percent of total billed charges,,157.7,162.68,
HC or Bioswivel Lock 5.5,PX-3253654WWM,CDM,3253654WWM,LOCAL,270,RC,,inpatient,,,935,841.5,,0.95,,888.25,Percent of total billed charges,,,0.98,,916.3,Percent of total billed charges,,,0.95,,888.25,Percent of total billed charges,,,0.97,,906.95,Percent of total billed charges,,,0.97,,906.95,Percent of total billed charges,,,0.96,,897.6,Percent of total billed charges,,,0.95,,888.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,888.25,Percent of total billed charges,,888.25,916.3,
HC or Bioswivel Lock 5.5,PX-3253654WWM,CDM,3253654WWM,LOCAL,270,RC,,outpatient,,,935,841.5,,0.95,,888.25,Percent of total billed charges,,,0.98,,916.3,Percent of total billed charges,,,0.95,,888.25,Percent of total billed charges,,,0.95,,888.25,Percent of total billed charges,,,0.97,,906.95,Percent of total billed charges,,,0.96,,897.6,Percent of total billed charges,,,0.95,,888.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,888.25,Percent of total billed charges,,888.25,916.3,
HC or Screw 4.5mm/ 18mm,PX-3253657WWM,CDM,3253657WWM,LOCAL,278,RC,,inpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw 4.5mm/ 18mm,PX-3253657WWM,CDM,3253657WWM,LOCAL,278,RC,,outpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw 4.5mm/ 20mm,PX-3253658WWM,CDM,3253658WWM,LOCAL,278,RC,,inpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw 4.5mm/ 20mm,PX-3253658WWM,CDM,3253658WWM,LOCAL,278,RC,,outpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw 4.5mm/ 22mm,PX-3253659WWM,CDM,3253659WWM,LOCAL,278,RC,,inpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw 4.5mm/ 22mm,PX-3253659WWM,CDM,3253659WWM,LOCAL,278,RC,,outpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw 4.5mm/ 50mm,PX-3253660WWM,CDM,3253660WWM,LOCAL,278,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC or Screw 4.5mm/ 50mm,PX-3253660WWM,CDM,3253660WWM,LOCAL,278,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC or Plate Semi Tub 5 Hole,PX-3253661WWM,CDM,3253661WWM,LOCAL,278,RC,,inpatient,,,164,147.6,,0.95,,155.8,Percent of total billed charges,,,0.98,,160.72,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.96,,157.44,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,155.8,Percent of total billed charges,,155.8,160.72,
HC or Plate Semi Tub 5 Hole,PX-3253661WWM,CDM,3253661WWM,LOCAL,278,RC,,outpatient,,,164,147.6,,0.95,,155.8,Percent of total billed charges,,,0.98,,160.72,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.96,,157.44,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,155.8,Percent of total billed charges,,155.8,160.72,
HC or Plate Semi Tub 6 Hole,PX-3253662WWM,CDM,3253662WWM,LOCAL,278,RC,,inpatient,,,185,166.5,,0.95,,175.75,Percent of total billed charges,,,0.98,,181.3,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,0.97,,179.45,Percent of total billed charges,,,0.97,,179.45,Percent of total billed charges,,,0.96,,177.6,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,175.75,Percent of total billed charges,,175.75,181.3,
HC or Plate Semi Tub 6 Hole,PX-3253662WWM,CDM,3253662WWM,LOCAL,278,RC,,outpatient,,,185,166.5,,0.95,,175.75,Percent of total billed charges,,,0.98,,181.3,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,0.97,,179.45,Percent of total billed charges,,,0.96,,177.6,Percent of total billed charges,,,0.95,,175.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,175.75,Percent of total billed charges,,175.75,181.3,
HC or Mesh Bard 3x6 #Dc01126,PX-3253664WWM,CDM,3253664WWM,LOCAL,278,RC,,inpatient,,,291,261.9,,0.95,,276.45,Percent of total billed charges,,,0.98,,285.18,Percent of total billed charges,,,0.95,,276.45,Percent of total billed charges,,,0.97,,282.27,Percent of total billed charges,,,0.97,,282.27,Percent of total billed charges,,,0.96,,279.36,Percent of total billed charges,,,0.95,,276.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,276.45,Percent of total billed charges,,276.45,285.18,
HC or Mesh Bard 3x6 #Dc01126,PX-3253664WWM,CDM,3253664WWM,LOCAL,278,RC,,outpatient,,,291,261.9,,0.95,,276.45,Percent of total billed charges,,,0.98,,285.18,Percent of total billed charges,,,0.95,,276.45,Percent of total billed charges,,,0.95,,276.45,Percent of total billed charges,,,0.97,,282.27,Percent of total billed charges,,,0.96,,279.36,Percent of total billed charges,,,0.95,,276.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,276.45,Percent of total billed charges,,276.45,285.18,
HC or Fiberlink #Ar7235,PX-3253665WWM,CDM,3253665WWM,LOCAL,270,RC,,inpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
HC or Fiberlink #Ar7235,PX-3253665WWM,CDM,3253665WWM,LOCAL,270,RC,,outpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
HC or Corkscrew Sut Anch 5.5,PX-3253666WWM,CDM,3253666WWM,LOCAL,270,RC,,inpatient,,,881,792.9,,0.95,,836.95,Percent of total billed charges,,,0.98,,863.38,Percent of total billed charges,,,0.95,,836.95,Percent of total billed charges,,,0.97,,854.57,Percent of total billed charges,,,0.97,,854.57,Percent of total billed charges,,,0.96,,845.76,Percent of total billed charges,,,0.95,,836.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,836.95,Percent of total billed charges,,836.95,863.38,
HC or Corkscrew Sut Anch 5.5,PX-3253666WWM,CDM,3253666WWM,LOCAL,270,RC,,outpatient,,,881,792.9,,0.95,,836.95,Percent of total billed charges,,,0.98,,863.38,Percent of total billed charges,,,0.95,,836.95,Percent of total billed charges,,,0.95,,836.95,Percent of total billed charges,,,0.97,,854.57,Percent of total billed charges,,,0.96,,845.76,Percent of total billed charges,,,0.95,,836.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,836.95,Percent of total billed charges,,836.95,863.38,
HC or Liga Clip #Er320,PX-3253668WWM,CDM,3253668WWM,LOCAL,278,RC,,inpatient,,,286,257.4,,0.95,,271.7,Percent of total billed charges,,,0.98,,280.28,Percent of total billed charges,,,0.95,,271.7,Percent of total billed charges,,,0.97,,277.42,Percent of total billed charges,,,0.97,,277.42,Percent of total billed charges,,,0.96,,274.56,Percent of total billed charges,,,0.95,,271.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,271.7,Percent of total billed charges,,271.7,280.28,
HC or Liga Clip #Er320,PX-3253668WWM,CDM,3253668WWM,LOCAL,278,RC,,outpatient,,,286,257.4,,0.95,,271.7,Percent of total billed charges,,,0.98,,280.28,Percent of total billed charges,,,0.95,,271.7,Percent of total billed charges,,,0.95,,271.7,Percent of total billed charges,,,0.97,,277.42,Percent of total billed charges,,,0.96,,274.56,Percent of total billed charges,,,0.95,,271.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,271.7,Percent of total billed charges,,271.7,280.28,
HC or Arthro Surfas Direct,PX-3253670WWM,CDM,3253670WWM,LOCAL,270,RC,,inpatient,,,414,372.6,,0.95,,393.3,Percent of total billed charges,,,0.98,,405.72,Percent of total billed charges,,,0.95,,393.3,Percent of total billed charges,,,0.97,,401.58,Percent of total billed charges,,,0.97,,401.58,Percent of total billed charges,,,0.96,,397.44,Percent of total billed charges,,,0.95,,393.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,393.3,Percent of total billed charges,,393.3,405.72,
HC or Arthro Surfas Direct,PX-3253670WWM,CDM,3253670WWM,LOCAL,270,RC,,outpatient,,,414,372.6,,0.95,,393.3,Percent of total billed charges,,,0.98,,405.72,Percent of total billed charges,,,0.95,,393.3,Percent of total billed charges,,,0.95,,393.3,Percent of total billed charges,,,0.97,,401.58,Percent of total billed charges,,,0.96,,397.44,Percent of total billed charges,,,0.95,,393.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,393.3,Percent of total billed charges,,393.3,405.72,
HC or Allograft Tend No Bone,PX-3253674WWM,CDM,3253674WWM,LOCAL,278,RC,,inpatient,,,2071,1863.9,,0.95,,1967.45,Percent of total billed charges,,,0.98,,2029.58,Percent of total billed charges,,,0.95,,1967.45,Percent of total billed charges,,,0.97,,2008.87,Percent of total billed charges,,,0.97,,2008.87,Percent of total billed charges,,,0.96,,1988.16,Percent of total billed charges,,,0.95,,1967.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1967.45,Percent of total billed charges,,1967.45,2029.58,
HC or Allograft Tend No Bone,PX-3253674WWM,CDM,3253674WWM,LOCAL,278,RC,,outpatient,,,2071,1863.9,,0.95,,1967.45,Percent of total billed charges,,,0.98,,2029.58,Percent of total billed charges,,,0.95,,1967.45,Percent of total billed charges,,,0.95,,1967.45,Percent of total billed charges,,,0.97,,2008.87,Percent of total billed charges,,,0.96,,1988.16,Percent of total billed charges,,,0.95,,1967.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1967.45,Percent of total billed charges,,1967.45,2029.58,
HC or Step Drill 2.4#Ar1250l,PX-3253679WWM,CDM,3253679WWM,LOCAL,270,RC,,inpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
HC or Step Drill 2.4#Ar1250l,PX-3253679WWM,CDM,3253679WWM,LOCAL,270,RC,,outpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
HC or Biosuturetak Fw# Ar193,PX-3253680WWM,CDM,3253680WWM,LOCAL,270,RC,,inpatient,,,645,580.5,,0.95,,612.75,Percent of total billed charges,,,0.98,,632.1,Percent of total billed charges,,,0.95,,612.75,Percent of total billed charges,,,0.97,,625.65,Percent of total billed charges,,,0.97,,625.65,Percent of total billed charges,,,0.96,,619.2,Percent of total billed charges,,,0.95,,612.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,612.75,Percent of total billed charges,,612.75,632.1,
HC or Biosuturetak Fw# Ar193,PX-3253680WWM,CDM,3253680WWM,LOCAL,270,RC,,outpatient,,,645,580.5,,0.95,,612.75,Percent of total billed charges,,,0.98,,632.1,Percent of total billed charges,,,0.95,,612.75,Percent of total billed charges,,,0.95,,612.75,Percent of total billed charges,,,0.97,,625.65,Percent of total billed charges,,,0.96,,619.2,Percent of total billed charges,,,0.95,,612.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,612.75,Percent of total billed charges,,612.75,632.1,
HC or Su Lasso 25 Lt# Ar4068,PX-3253681WWM,CDM,3253681WWM,LOCAL,270,RC,,inpatient,,,368,331.2,,0.95,,349.6,Percent of total billed charges,,,0.98,,360.64,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,0.97,,356.96,Percent of total billed charges,,,0.97,,356.96,Percent of total billed charges,,,0.96,,353.28,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,349.6,Percent of total billed charges,,349.6,360.64,
HC or Su Lasso 25 Lt# Ar4068,PX-3253681WWM,CDM,3253681WWM,LOCAL,270,RC,,outpatient,,,368,331.2,,0.95,,349.6,Percent of total billed charges,,,0.98,,360.64,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,0.97,,356.96,Percent of total billed charges,,,0.96,,353.28,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,349.6,Percent of total billed charges,,349.6,360.64,
HC or Su Lasso Cres# Ar4068c,PX-3253682WWM,CDM,3253682WWM,LOCAL,270,RC,,inpatient,,,368,331.2,,0.95,,349.6,Percent of total billed charges,,,0.98,,360.64,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,0.97,,356.96,Percent of total billed charges,,,0.97,,356.96,Percent of total billed charges,,,0.96,,353.28,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,349.6,Percent of total billed charges,,349.6,360.64,
HC or Su Lasso Cres# Ar4068c,PX-3253682WWM,CDM,3253682WWM,LOCAL,270,RC,,outpatient,,,368,331.2,,0.95,,349.6,Percent of total billed charges,,,0.98,,360.64,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,0.97,,356.96,Percent of total billed charges,,,0.96,,353.28,Percent of total billed charges,,,0.95,,349.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,349.6,Percent of total billed charges,,349.6,360.64,
HC or Su Fiberlink #2 #Ar723,PX-3253683WWM,CDM,3253683WWM,LOCAL,270,RC,,inpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
HC or Su Fiberlink #2 #Ar723,PX-3253683WWM,CDM,3253683WWM,LOCAL,270,RC,,outpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
HC or Drill Pushlock 3.5,PX-3253684WWM,CDM,3253684WWM,LOCAL,270,RC,,inpatient,,,253,227.7,,0.95,,240.35,Percent of total billed charges,,,0.98,,247.94,Percent of total billed charges,,,0.95,,240.35,Percent of total billed charges,,,0.97,,245.41,Percent of total billed charges,,,0.97,,245.41,Percent of total billed charges,,,0.96,,242.88,Percent of total billed charges,,,0.95,,240.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,240.35,Percent of total billed charges,,240.35,247.94,
HC or Drill Pushlock 3.5,PX-3253684WWM,CDM,3253684WWM,LOCAL,270,RC,,outpatient,,,253,227.7,,0.95,,240.35,Percent of total billed charges,,,0.98,,247.94,Percent of total billed charges,,,0.95,,240.35,Percent of total billed charges,,,0.95,,240.35,Percent of total billed charges,,,0.97,,245.41,Percent of total billed charges,,,0.96,,242.88,Percent of total billed charges,,,0.95,,240.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,240.35,Percent of total billed charges,,240.35,247.94,
HC or Cannula Low #AR-6548,PX-3253685WWM,CDM,3253685WWM,LOCAL,270,RC,,inpatient,,,166,149.4,,0.95,,157.7,Percent of total billed charges,,,0.98,,162.68,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.96,,159.36,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,157.7,Percent of total billed charges,,157.7,162.68,
HC or Cannula Low #AR-6548,PX-3253685WWM,CDM,3253685WWM,LOCAL,270,RC,,outpatient,,,166,149.4,,0.95,,157.7,Percent of total billed charges,,,0.98,,162.68,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.96,,159.36,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,157.7,Percent of total billed charges,,157.7,162.68,
HC or Net Foreign Body# 00711152,PX-3253686WWM,CDM,3253686WWM,LOCAL,270,RC,,inpatient,,,253,227.7,,0.95,,240.35,Percent of total billed charges,,,0.98,,247.94,Percent of total billed charges,,,0.95,,240.35,Percent of total billed charges,,,0.97,,245.41,Percent of total billed charges,,,0.97,,245.41,Percent of total billed charges,,,0.96,,242.88,Percent of total billed charges,,,0.95,,240.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,240.35,Percent of total billed charges,,240.35,247.94,
HC or Net Foreign Body# 00711152,PX-3253686WWM,CDM,3253686WWM,LOCAL,270,RC,,outpatient,,,253,227.7,,0.95,,240.35,Percent of total billed charges,,,0.98,,247.94,Percent of total billed charges,,,0.95,,240.35,Percent of total billed charges,,,0.95,,240.35,Percent of total billed charges,,,0.97,,245.41,Percent of total billed charges,,,0.96,,242.88,Percent of total billed charges,,,0.95,,240.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,240.35,Percent of total billed charges,,240.35,247.94,
HC or Roth Net Food Bolus,PX-3253687WWM,CDM,3253687WWM,LOCAL,270,RC,,inpatient,,,253,227.7,,0.95,,240.35,Percent of total billed charges,,,0.98,,247.94,Percent of total billed charges,,,0.95,,240.35,Percent of total billed charges,,,0.97,,245.41,Percent of total billed charges,,,0.97,,245.41,Percent of total billed charges,,,0.96,,242.88,Percent of total billed charges,,,0.95,,240.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,240.35,Percent of total billed charges,,240.35,247.94,
HC or Roth Net Food Bolus,PX-3253687WWM,CDM,3253687WWM,LOCAL,270,RC,,outpatient,,,253,227.7,,0.95,,240.35,Percent of total billed charges,,,0.98,,247.94,Percent of total billed charges,,,0.95,,240.35,Percent of total billed charges,,,0.95,,240.35,Percent of total billed charges,,,0.97,,245.41,Percent of total billed charges,,,0.96,,242.88,Percent of total billed charges,,,0.95,,240.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,240.35,Percent of total billed charges,,240.35,247.94,
HC or Hip Pushlock 3.5,PX-3253688WWM,CDM,3253688WWM,LOCAL,270,RC,,inpatient,,,461,414.9,,0.95,,437.95,Percent of total billed charges,,,0.98,,451.78,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,0.97,,447.17,Percent of total billed charges,,,0.97,,447.17,Percent of total billed charges,,,0.96,,442.56,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,437.95,Percent of total billed charges,,437.95,451.78,
HC or Hip Pushlock 3.5,PX-3253688WWM,CDM,3253688WWM,LOCAL,270,RC,,outpatient,,,461,414.9,,0.95,,437.95,Percent of total billed charges,,,0.98,,451.78,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,0.97,,447.17,Percent of total billed charges,,,0.96,,442.56,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,437.95,Percent of total billed charges,,437.95,451.78,
HC or Graft 8 Layer 13x15,PX-3253689WWM,CDM,3253689WWM,LOCAL,270,RC,,inpatient,,,4611,4149.9,,0.95,,4380.45,Percent of total billed charges,,,0.98,,4518.78,Percent of total billed charges,,,0.95,,4380.45,Percent of total billed charges,,,0.97,,4472.67,Percent of total billed charges,,,0.97,,4472.67,Percent of total billed charges,,,0.96,,4426.56,Percent of total billed charges,,,0.95,,4380.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4380.45,Percent of total billed charges,,4380.45,4518.78,
HC or Graft 8 Layer 13x15,PX-3253689WWM,CDM,3253689WWM,LOCAL,270,RC,,outpatient,,,4611,4149.9,,0.95,,4380.45,Percent of total billed charges,,,0.98,,4518.78,Percent of total billed charges,,,0.95,,4380.45,Percent of total billed charges,,,0.95,,4380.45,Percent of total billed charges,,,0.97,,4472.67,Percent of total billed charges,,,0.96,,4426.56,Percent of total billed charges,,,0.95,,4380.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4380.45,Percent of total billed charges,,4380.45,4518.78,
HC or Mesh Composite 10x8,PX-3253698WWM,CDM,3253698WWM,LOCAL,278,RC,,inpatient,,,2578,2320.2,,0.95,,2449.1,Percent of total billed charges,,,0.98,,2526.44,Percent of total billed charges,,,0.95,,2449.1,Percent of total billed charges,,,0.97,,2500.66,Percent of total billed charges,,,0.97,,2500.66,Percent of total billed charges,,,0.96,,2474.88,Percent of total billed charges,,,0.95,,2449.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2449.1,Percent of total billed charges,,2449.1,2526.44,
HC or Mesh Composite 10x8,PX-3253698WWM,CDM,3253698WWM,LOCAL,278,RC,,outpatient,,,2578,2320.2,,0.95,,2449.1,Percent of total billed charges,,,0.98,,2526.44,Percent of total billed charges,,,0.95,,2449.1,Percent of total billed charges,,,0.95,,2449.1,Percent of total billed charges,,,0.97,,2500.66,Percent of total billed charges,,,0.96,,2474.88,Percent of total billed charges,,,0.95,,2449.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2449.1,Percent of total billed charges,,2449.1,2526.44,
HC or Endo Cutter 45 #Ats45,PX-3253718WWM,CDM,3253718WWM,LOCAL,270,RC,,inpatient,,,649,584.1,,0.95,,616.55,Percent of total billed charges,,,0.98,,636.02,Percent of total billed charges,,,0.95,,616.55,Percent of total billed charges,,,0.97,,629.53,Percent of total billed charges,,,0.97,,629.53,Percent of total billed charges,,,0.96,,623.04,Percent of total billed charges,,,0.95,,616.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,616.55,Percent of total billed charges,,616.55,636.02,
HC or Endo Cutter 45 #Ats45,PX-3253718WWM,CDM,3253718WWM,LOCAL,270,RC,,outpatient,,,649,584.1,,0.95,,616.55,Percent of total billed charges,,,0.98,,636.02,Percent of total billed charges,,,0.95,,616.55,Percent of total billed charges,,,0.95,,616.55,Percent of total billed charges,,,0.97,,629.53,Percent of total billed charges,,,0.96,,623.04,Percent of total billed charges,,,0.95,,616.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,616.55,Percent of total billed charges,,616.55,636.02,
HC or Polyp Trap #00711099,PX-3253692WWM,CDM,3253692WWM,LOCAL,270,RC,,inpatient,,,72,64.8,,0.95,,68.4,Percent of total billed charges,,,0.98,,70.56,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.96,,69.12,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,68.4,Percent of total billed charges,,68.4,70.56,
HC or Polyp Trap #00711099,PX-3253692WWM,CDM,3253692WWM,LOCAL,270,RC,,outpatient,,,72,64.8,,0.95,,68.4,Percent of total billed charges,,,0.98,,70.56,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.96,,69.12,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,68.4,Percent of total billed charges,,68.4,70.56,
HC or Protack #174006,PX-3253695WMM,CDM,3253695WMM,LOCAL,278,RC,,inpatient,,,954,858.6,,0.95,,906.3,Percent of total billed charges,,,0.98,,934.92,Percent of total billed charges,,,0.95,,906.3,Percent of total billed charges,,,0.97,,925.38,Percent of total billed charges,,,0.97,,925.38,Percent of total billed charges,,,0.96,,915.84,Percent of total billed charges,,,0.95,,906.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,906.3,Percent of total billed charges,,906.3,934.92,
HC or Protack #174006,PX-3253695WMM,CDM,3253695WMM,LOCAL,278,RC,,outpatient,,,954,858.6,,0.95,,906.3,Percent of total billed charges,,,0.98,,934.92,Percent of total billed charges,,,0.95,,906.3,Percent of total billed charges,,,0.95,,906.3,Percent of total billed charges,,,0.97,,925.38,Percent of total billed charges,,,0.96,,915.84,Percent of total billed charges,,,0.95,,906.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,906.3,Percent of total billed charges,,906.3,934.92,
HC or Mesh Composite 14x11,PX-3253696WWM,CDM,3253696WWM,LOCAL,278,RC,,inpatient,,,4184,3765.6,,0.95,,3974.8,Percent of total billed charges,,,0.98,,4100.32,Percent of total billed charges,,,0.95,,3974.8,Percent of total billed charges,,,0.97,,4058.48,Percent of total billed charges,,,0.97,,4058.48,Percent of total billed charges,,,0.96,,4016.64,Percent of total billed charges,,,0.95,,3974.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3974.8,Percent of total billed charges,,3974.8,4100.32,
HC or Mesh Composite 14x11,PX-3253696WWM,CDM,3253696WWM,LOCAL,278,RC,,outpatient,,,4184,3765.6,,0.95,,3974.8,Percent of total billed charges,,,0.98,,4100.32,Percent of total billed charges,,,0.95,,3974.8,Percent of total billed charges,,,0.95,,3974.8,Percent of total billed charges,,,0.97,,4058.48,Percent of total billed charges,,,0.96,,4016.64,Percent of total billed charges,,,0.95,,3974.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3974.8,Percent of total billed charges,,3974.8,4100.32,
HC or Mesh Composite 12x8,PX-3253697WWM,CDM,3253697WWM,LOCAL,278,RC,,inpatient,,,3525,3172.5,,0.95,,3348.75,Percent of total billed charges,,,0.98,,3454.5,Percent of total billed charges,,,0.95,,3348.75,Percent of total billed charges,,,0.97,,3419.25,Percent of total billed charges,,,0.97,,3419.25,Percent of total billed charges,,,0.96,,3384,Percent of total billed charges,,,0.95,,3348.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3348.75,Percent of total billed charges,,3348.75,3454.5,
HC or Mesh Composite 12x8,PX-3253697WWM,CDM,3253697WWM,LOCAL,278,RC,,outpatient,,,3525,3172.5,,0.95,,3348.75,Percent of total billed charges,,,0.98,,3454.5,Percent of total billed charges,,,0.95,,3348.75,Percent of total billed charges,,,0.95,,3348.75,Percent of total billed charges,,,0.97,,3419.25,Percent of total billed charges,,,0.96,,3384,Percent of total billed charges,,,0.95,,3348.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3348.75,Percent of total billed charges,,3348.75,3454.5,
HC or Mesh Composite 6x4,PX-3253699WWM,CDM,3253699WWM,LOCAL,278,RC,,inpatient,,,980,882,,0.95,,931,Percent of total billed charges,,,0.98,,960.4,Percent of total billed charges,,,0.95,,931,Percent of total billed charges,,,0.97,,950.6,Percent of total billed charges,,,0.97,,950.6,Percent of total billed charges,,,0.96,,940.8,Percent of total billed charges,,,0.95,,931,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,931,Percent of total billed charges,,931,960.4,
HC or Mesh Composite 6x4,PX-3253699WWM,CDM,3253699WWM,LOCAL,278,RC,,outpatient,,,980,882,,0.95,,931,Percent of total billed charges,,,0.98,,960.4,Percent of total billed charges,,,0.95,,931,Percent of total billed charges,,,0.95,,931,Percent of total billed charges,,,0.97,,950.6,Percent of total billed charges,,,0.96,,940.8,Percent of total billed charges,,,0.95,,931,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,931,Percent of total billed charges,,931,960.4,
HC or Mesh Soft 3x6#0117009,PX-3253700WWM,CDM,3253700WWM,LOCAL,278,RC,,inpatient,,,338,304.2,,0.95,,321.1,Percent of total billed charges,,,0.98,,331.24,Percent of total billed charges,,,0.95,,321.1,Percent of total billed charges,,,0.97,,327.86,Percent of total billed charges,,,0.97,,327.86,Percent of total billed charges,,,0.96,,324.48,Percent of total billed charges,,,0.95,,321.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,321.1,Percent of total billed charges,,321.1,331.24,
HC or Mesh Soft 3x6#0117009,PX-3253700WWM,CDM,3253700WWM,LOCAL,278,RC,,outpatient,,,338,304.2,,0.95,,321.1,Percent of total billed charges,,,0.98,,331.24,Percent of total billed charges,,,0.95,,321.1,Percent of total billed charges,,,0.95,,321.1,Percent of total billed charges,,,0.97,,327.86,Percent of total billed charges,,,0.96,,324.48,Percent of total billed charges,,,0.95,,321.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,321.1,Percent of total billed charges,,321.1,331.24,
HC or Mesh Soft 4x6#0117010,PX-3253701WWM,CDM,3253701WWM,LOCAL,278,RC,,inpatient,,,377,339.3,,0.95,,358.15,Percent of total billed charges,,,0.98,,369.46,Percent of total billed charges,,,0.95,,358.15,Percent of total billed charges,,,0.97,,365.69,Percent of total billed charges,,,0.97,,365.69,Percent of total billed charges,,,0.96,,361.92,Percent of total billed charges,,,0.95,,358.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,358.15,Percent of total billed charges,,358.15,369.46,
HC or Mesh Soft 4x6#0117010,PX-3253701WWM,CDM,3253701WWM,LOCAL,278,RC,,outpatient,,,377,339.3,,0.95,,358.15,Percent of total billed charges,,,0.98,,369.46,Percent of total billed charges,,,0.95,,358.15,Percent of total billed charges,,,0.95,,358.15,Percent of total billed charges,,,0.97,,365.69,Percent of total billed charges,,,0.96,,361.92,Percent of total billed charges,,,0.95,,358.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,358.15,Percent of total billed charges,,358.15,369.46,
HC or Mesh 3dmax MD/Lt,PX-3253702WWM,CDM,3253702WWM,LOCAL,278,RC,,inpatient,,,427,384.3,,0.95,,405.65,Percent of total billed charges,,,0.98,,418.46,Percent of total billed charges,,,0.95,,405.65,Percent of total billed charges,,,0.97,,414.19,Percent of total billed charges,,,0.97,,414.19,Percent of total billed charges,,,0.96,,409.92,Percent of total billed charges,,,0.95,,405.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,405.65,Percent of total billed charges,,405.65,418.46,
HC or Mesh 3dmax MD/Lt,PX-3253702WWM,CDM,3253702WWM,LOCAL,278,RC,,outpatient,,,427,384.3,,0.95,,405.65,Percent of total billed charges,,,0.98,,418.46,Percent of total billed charges,,,0.95,,405.65,Percent of total billed charges,,,0.95,,405.65,Percent of total billed charges,,,0.97,,414.19,Percent of total billed charges,,,0.96,,409.92,Percent of total billed charges,,,0.95,,405.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,405.65,Percent of total billed charges,,405.65,418.46,
HC or Mesh 3dmax MD/Rt,PX-3253703WWM,CDM,3253703WWM,LOCAL,278,RC,,inpatient,,,427,384.3,,0.95,,405.65,Percent of total billed charges,,,0.98,,418.46,Percent of total billed charges,,,0.95,,405.65,Percent of total billed charges,,,0.97,,414.19,Percent of total billed charges,,,0.97,,414.19,Percent of total billed charges,,,0.96,,409.92,Percent of total billed charges,,,0.95,,405.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,405.65,Percent of total billed charges,,405.65,418.46,
HC or Mesh 3dmax MD/Rt,PX-3253703WWM,CDM,3253703WWM,LOCAL,278,RC,,outpatient,,,427,384.3,,0.95,,405.65,Percent of total billed charges,,,0.98,,418.46,Percent of total billed charges,,,0.95,,405.65,Percent of total billed charges,,,0.95,,405.65,Percent of total billed charges,,,0.97,,414.19,Percent of total billed charges,,,0.96,,409.92,Percent of total billed charges,,,0.95,,405.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,405.65,Percent of total billed charges,,405.65,418.46,
HC or Mesh Composix 4x6,PX-3253704WWM,CDM,3253704WWM,LOCAL,278,RC,,inpatient,,,937,843.3,,0.95,,890.15,Percent of total billed charges,,,0.98,,918.26,Percent of total billed charges,,,0.95,,890.15,Percent of total billed charges,,,0.97,,908.89,Percent of total billed charges,,,0.97,,908.89,Percent of total billed charges,,,0.96,,899.52,Percent of total billed charges,,,0.95,,890.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,890.15,Percent of total billed charges,,890.15,918.26,
HC or Mesh Composix 4x6,PX-3253704WWM,CDM,3253704WWM,LOCAL,278,RC,,outpatient,,,937,843.3,,0.95,,890.15,Percent of total billed charges,,,0.98,,918.26,Percent of total billed charges,,,0.95,,890.15,Percent of total billed charges,,,0.95,,890.15,Percent of total billed charges,,,0.97,,908.89,Percent of total billed charges,,,0.96,,899.52,Percent of total billed charges,,,0.95,,890.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,890.15,Percent of total billed charges,,890.15,918.26,
HC or Mesh Composix 6x8,PX-3253705WWM,CDM,3253705WWM,LOCAL,278,RC,,inpatient,,,1480,1332,,0.95,,1406,Percent of total billed charges,,,0.98,,1450.4,Percent of total billed charges,,,0.95,,1406,Percent of total billed charges,,,0.97,,1435.6,Percent of total billed charges,,,0.97,,1435.6,Percent of total billed charges,,,0.96,,1420.8,Percent of total billed charges,,,0.95,,1406,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1406,Percent of total billed charges,,1406,1450.4,
HC or Mesh Composix 6x8,PX-3253705WWM,CDM,3253705WWM,LOCAL,278,RC,,outpatient,,,1480,1332,,0.95,,1406,Percent of total billed charges,,,0.98,,1450.4,Percent of total billed charges,,,0.95,,1406,Percent of total billed charges,,,0.95,,1406,Percent of total billed charges,,,0.97,,1435.6,Percent of total billed charges,,,0.96,,1420.8,Percent of total billed charges,,,0.95,,1406,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1406,Percent of total billed charges,,1406,1450.4,
HC or Mesh Composix 8x10,PX-3253706WWM,CDM,3253706WWM,LOCAL,278,RC,,inpatient,,,3145,2830.5,,0.95,,2987.75,Percent of total billed charges,,,0.98,,3082.1,Percent of total billed charges,,,0.95,,2987.75,Percent of total billed charges,,,0.97,,3050.65,Percent of total billed charges,,,0.97,,3050.65,Percent of total billed charges,,,0.96,,3019.2,Percent of total billed charges,,,0.95,,2987.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2987.75,Percent of total billed charges,,2987.75,3082.1,
HC or Mesh Composix 8x10,PX-3253706WWM,CDM,3253706WWM,LOCAL,278,RC,,outpatient,,,3145,2830.5,,0.95,,2987.75,Percent of total billed charges,,,0.98,,3082.1,Percent of total billed charges,,,0.95,,2987.75,Percent of total billed charges,,,0.95,,2987.75,Percent of total billed charges,,,0.97,,3050.65,Percent of total billed charges,,,0.96,,3019.2,Percent of total billed charges,,,0.95,,2987.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2987.75,Percent of total billed charges,,2987.75,3082.1,
HC or Mesh Composix 10x14,PX-3253707WWM,CDM,3253707WWM,LOCAL,278,RC,,inpatient,,,4143,3728.7,,0.95,,3935.85,Percent of total billed charges,,,0.98,,4060.14,Percent of total billed charges,,,0.95,,3935.85,Percent of total billed charges,,,0.97,,4018.71,Percent of total billed charges,,,0.97,,4018.71,Percent of total billed charges,,,0.96,,3977.28,Percent of total billed charges,,,0.95,,3935.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3935.85,Percent of total billed charges,,3935.85,4060.14,
HC or Mesh Composix 10x14,PX-3253707WWM,CDM,3253707WWM,LOCAL,278,RC,,outpatient,,,4143,3728.7,,0.95,,3935.85,Percent of total billed charges,,,0.98,,4060.14,Percent of total billed charges,,,0.95,,3935.85,Percent of total billed charges,,,0.95,,3935.85,Percent of total billed charges,,,0.97,,4018.71,Percent of total billed charges,,,0.96,,3977.28,Percent of total billed charges,,,0.95,,3935.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3935.85,Percent of total billed charges,,3935.85,4060.14,
HC or Mesh Composix 8x6#Pco2,PX-3253711WWM,CDM,3253711WWM,LOCAL,278,RC,,inpatient,,,1696,1526.4,,0.95,,1611.2,Percent of total billed charges,,,0.98,,1662.08,Percent of total billed charges,,,0.95,,1611.2,Percent of total billed charges,,,0.97,,1645.12,Percent of total billed charges,,,0.97,,1645.12,Percent of total billed charges,,,0.96,,1628.16,Percent of total billed charges,,,0.95,,1611.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1611.2,Percent of total billed charges,,1611.2,1662.08,
HC or Mesh Composix 8x6#Pco2,PX-3253711WWM,CDM,3253711WWM,LOCAL,278,RC,,outpatient,,,1696,1526.4,,0.95,,1611.2,Percent of total billed charges,,,0.98,,1662.08,Percent of total billed charges,,,0.95,,1611.2,Percent of total billed charges,,,0.95,,1611.2,Percent of total billed charges,,,0.97,,1645.12,Percent of total billed charges,,,0.96,,1628.16,Percent of total billed charges,,,0.95,,1611.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1611.2,Percent of total billed charges,,1611.2,1662.08,
HC or Peg Tube 24#Peg24push,PX-3253712WWM,CDM,3253712WWM,LOCAL,270,RC,,inpatient,,,324,291.6,,0.95,,307.8,Percent of total billed charges,,,0.98,,317.52,Percent of total billed charges,,,0.95,,307.8,Percent of total billed charges,,,0.97,,314.28,Percent of total billed charges,,,0.97,,314.28,Percent of total billed charges,,,0.96,,311.04,Percent of total billed charges,,,0.95,,307.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,307.8,Percent of total billed charges,,307.8,317.52,
HC or Peg Tube 24#Peg24push,PX-3253712WWM,CDM,3253712WWM,LOCAL,270,RC,,outpatient,,,324,291.6,,0.95,,307.8,Percent of total billed charges,,,0.98,,317.52,Percent of total billed charges,,,0.95,,307.8,Percent of total billed charges,,,0.95,,307.8,Percent of total billed charges,,,0.97,,314.28,Percent of total billed charges,,,0.96,,311.04,Percent of total billed charges,,,0.95,,307.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,307.8,Percent of total billed charges,,307.8,317.52,
HC or Stein Pin 2.0#18700159,PX-3253713WWM,CDM,3253713WWM,LOCAL,278,RC,,inpatient,,,96,86.4,,0.95,,91.2,Percent of total billed charges,,,0.98,,94.08,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.96,,92.16,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,91.2,Percent of total billed charges,,91.2,94.08,
HC or Stein Pin 2.0#18700159,PX-3253713WWM,CDM,3253713WWM,LOCAL,278,RC,,outpatient,,,96,86.4,,0.95,,91.2,Percent of total billed charges,,,0.98,,94.08,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.96,,92.16,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,91.2,Percent of total billed charges,,91.2,94.08,
HC or Stein Pin 2.4#18700259,PX-3253714WWM,CDM,3253714WWM,LOCAL,278,RC,,inpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
HC or Stein Pin 2.4#18700259,PX-3253714WWM,CDM,3253714WWM,LOCAL,278,RC,,outpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
HC or Stein Pin 2.8#18700359,PX-3253715WWM,CDM,3253715WWM,LOCAL,278,RC,,inpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
HC or Stein Pin 2.8#18700359,PX-3253715WWM,CDM,3253715WWM,LOCAL,278,RC,,outpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
HC or Stein Pin 3.2#18700459,PX-3253716WWM,CDM,3253716WWM,LOCAL,278,RC,,inpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
HC or Stein Pin 3.2#18700459,PX-3253716WWM,CDM,3253716WWM,LOCAL,278,RC,,outpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
HC or Endo Cutter 35#Atb35,PX-3253717WWM,CDM,3253717WWM,LOCAL,270,RC,,inpatient,,,612,550.8,,0.95,,581.4,Percent of total billed charges,,,0.98,,599.76,Percent of total billed charges,,,0.95,,581.4,Percent of total billed charges,,,0.97,,593.64,Percent of total billed charges,,,0.97,,593.64,Percent of total billed charges,,,0.96,,587.52,Percent of total billed charges,,,0.95,,581.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,581.4,Percent of total billed charges,,581.4,599.76,
HC or Endo Cutter 35#Atb35,PX-3253717WWM,CDM,3253717WWM,LOCAL,270,RC,,outpatient,,,612,550.8,,0.95,,581.4,Percent of total billed charges,,,0.98,,599.76,Percent of total billed charges,,,0.95,,581.4,Percent of total billed charges,,,0.95,,581.4,Percent of total billed charges,,,0.97,,593.64,Percent of total billed charges,,,0.96,,587.52,Percent of total billed charges,,,0.95,,581.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,581.4,Percent of total billed charges,,581.4,599.76,
HC or Reload Vasc 35#Tr35w,PX-3253719WWM,CDM,3253719WWM,LOCAL,270,RC,,inpatient,,,308,277.2,,0.95,,292.6,Percent of total billed charges,,,0.98,,301.84,Percent of total billed charges,,,0.95,,292.6,Percent of total billed charges,,,0.97,,298.76,Percent of total billed charges,,,0.97,,298.76,Percent of total billed charges,,,0.96,,295.68,Percent of total billed charges,,,0.95,,292.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,292.6,Percent of total billed charges,,292.6,301.84,
HC or Reload Vasc 35#Tr35w,PX-3253719WWM,CDM,3253719WWM,LOCAL,270,RC,,outpatient,,,308,277.2,,0.95,,292.6,Percent of total billed charges,,,0.98,,301.84,Percent of total billed charges,,,0.95,,292.6,Percent of total billed charges,,,0.95,,292.6,Percent of total billed charges,,,0.97,,298.76,Percent of total billed charges,,,0.96,,295.68,Percent of total billed charges,,,0.95,,292.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,292.6,Percent of total billed charges,,292.6,301.84,
HC or Reload Reg 35 #Tr35b,PX-3253720WWM,CDM,3253720WWM,LOCAL,270,RC,,inpatient,,,300,270,,0.95,,285,Percent of total billed charges,,,0.98,,294,Percent of total billed charges,,,0.95,,285,Percent of total billed charges,,,0.97,,291,Percent of total billed charges,,,0.97,,291,Percent of total billed charges,,,0.96,,288,Percent of total billed charges,,,0.95,,285,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,285,Percent of total billed charges,,285,294,
HC or Reload Reg 35 #Tr35b,PX-3253720WWM,CDM,3253720WWM,LOCAL,270,RC,,outpatient,,,300,270,,0.95,,285,Percent of total billed charges,,,0.98,,294,Percent of total billed charges,,,0.95,,285,Percent of total billed charges,,,0.95,,285,Percent of total billed charges,,,0.97,,291,Percent of total billed charges,,,0.96,,288,Percent of total billed charges,,,0.95,,285,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,285,Percent of total billed charges,,285,294,
HC or Stapler Pph #Pph03,PX-3253721WWM,CDM,3253721WWM,LOCAL,270,RC,,inpatient,,,845,760.5,,0.95,,802.75,Percent of total billed charges,,,0.98,,828.1,Percent of total billed charges,,,0.95,,802.75,Percent of total billed charges,,,0.97,,819.65,Percent of total billed charges,,,0.97,,819.65,Percent of total billed charges,,,0.96,,811.2,Percent of total billed charges,,,0.95,,802.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,802.75,Percent of total billed charges,,802.75,828.1,
HC or Stapler Pph #Pph03,PX-3253721WWM,CDM,3253721WWM,LOCAL,270,RC,,outpatient,,,845,760.5,,0.95,,802.75,Percent of total billed charges,,,0.98,,828.1,Percent of total billed charges,,,0.95,,802.75,Percent of total billed charges,,,0.95,,802.75,Percent of total billed charges,,,0.97,,819.65,Percent of total billed charges,,,0.96,,811.2,Percent of total billed charges,,,0.95,,802.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,802.75,Percent of total billed charges,,802.75,828.1,
HC or Reload Reg 45 #6r45b,PX-3253722WWM,CDM,3253722WWM,LOCAL,270,RC,,inpatient,,,318,286.2,,0.95,,302.1,Percent of total billed charges,,,0.98,,311.64,Percent of total billed charges,,,0.95,,302.1,Percent of total billed charges,,,0.97,,308.46,Percent of total billed charges,,,0.97,,308.46,Percent of total billed charges,,,0.96,,305.28,Percent of total billed charges,,,0.95,,302.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,302.1,Percent of total billed charges,,302.1,311.64,
HC or Reload Reg 45 #6r45b,PX-3253722WWM,CDM,3253722WWM,LOCAL,270,RC,,outpatient,,,318,286.2,,0.95,,302.1,Percent of total billed charges,,,0.98,,311.64,Percent of total billed charges,,,0.95,,302.1,Percent of total billed charges,,,0.95,,302.1,Percent of total billed charges,,,0.97,,308.46,Percent of total billed charges,,,0.96,,305.28,Percent of total billed charges,,,0.95,,302.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,302.1,Percent of total billed charges,,302.1,311.64,
HC or Esoph Dil Ball 15#G319,PX-3253723WWM,CDM,3253723WWM,LOCAL,270,RC,,inpatient,,,493,443.7,,0.95,,468.35,Percent of total billed charges,,,0.98,,483.14,Percent of total billed charges,,,0.95,,468.35,Percent of total billed charges,,,0.97,,478.21,Percent of total billed charges,,,0.97,,478.21,Percent of total billed charges,,,0.96,,473.28,Percent of total billed charges,,,0.95,,468.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,468.35,Percent of total billed charges,,468.35,483.14,
HC or Esoph Dil Ball 15#G319,PX-3253723WWM,CDM,3253723WWM,LOCAL,270,RC,,outpatient,,,493,443.7,,0.95,,468.35,Percent of total billed charges,,,0.98,,483.14,Percent of total billed charges,,,0.95,,468.35,Percent of total billed charges,,,0.95,,468.35,Percent of total billed charges,,,0.97,,478.21,Percent of total billed charges,,,0.96,,473.28,Percent of total billed charges,,,0.95,,468.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,468.35,Percent of total billed charges,,468.35,483.14,
HC or Esoph Dilat Syr #Ds-60,PX-3253724WWM,CDM,3253724WWM,LOCAL,270,RC,,inpatient,,,176,158.4,,0.95,,167.2,Percent of total billed charges,,,0.98,,172.48,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,0.97,,170.72,Percent of total billed charges,,,0.97,,170.72,Percent of total billed charges,,,0.96,,168.96,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,167.2,Percent of total billed charges,,167.2,172.48,
HC or Esoph Dilat Syr #Ds-60,PX-3253724WWM,CDM,3253724WWM,LOCAL,270,RC,,outpatient,,,176,158.4,,0.95,,167.2,Percent of total billed charges,,,0.98,,172.48,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,0.97,,170.72,Percent of total billed charges,,,0.96,,168.96,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,167.2,Percent of total billed charges,,167.2,172.48,
HC or Screw 4.0mm/ 45mm,PX-3253725WWM,CDM,3253725WWM,LOCAL,278,RC,,inpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
HC or Screw 4.0mm/ 45mm,PX-3253725WWM,CDM,3253725WWM,LOCAL,278,RC,,outpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
HC or Screw 4.0mm/ 50mm,PX-3253726WWM,CDM,3253726WWM,LOCAL,278,RC,,inpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
HC or Screw 4.0mm/ 50mm,PX-3253726WWM,CDM,3253726WWM,LOCAL,278,RC,,outpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
HC or Cath Fogarty 3fr#12a08,PX-3253732WWM,CDM,3253732WWM,LOCAL,270,RC,,inpatient,,,271,243.9,,0.95,,257.45,Percent of total billed charges,,,0.98,,265.58,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,0.97,,262.87,Percent of total billed charges,,,0.97,,262.87,Percent of total billed charges,,,0.96,,260.16,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,257.45,Percent of total billed charges,,257.45,265.58,
HC or Cath Fogarty 3fr#12a08,PX-3253732WWM,CDM,3253732WWM,LOCAL,270,RC,,outpatient,,,271,243.9,,0.95,,257.45,Percent of total billed charges,,,0.98,,265.58,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,0.97,,262.87,Percent of total billed charges,,,0.96,,260.16,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,257.45,Percent of total billed charges,,257.45,265.58,
HC or Cath Fogarty 4fr#12a08,PX-3253733WWM,CDM,3253733WWM,LOCAL,270,RC,,inpatient,,,271,243.9,,0.95,,257.45,Percent of total billed charges,,,0.98,,265.58,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,0.97,,262.87,Percent of total billed charges,,,0.97,,262.87,Percent of total billed charges,,,0.96,,260.16,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,257.45,Percent of total billed charges,,257.45,265.58,
HC or Cath Fogarty 4fr#12a08,PX-3253733WWM,CDM,3253733WWM,LOCAL,270,RC,,outpatient,,,271,243.9,,0.95,,257.45,Percent of total billed charges,,,0.98,,265.58,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,0.97,,262.87,Percent of total billed charges,,,0.96,,260.16,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,257.45,Percent of total billed charges,,257.45,265.58,
HC or Cath Fogarty 5fr#12a08,PX-3253734WWM,CDM,3253734WWM,LOCAL,270,RC,,inpatient,,,271,243.9,,0.95,,257.45,Percent of total billed charges,,,0.98,,265.58,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,0.97,,262.87,Percent of total billed charges,,,0.97,,262.87,Percent of total billed charges,,,0.96,,260.16,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,257.45,Percent of total billed charges,,257.45,265.58,
HC or Cath Fogarty 5fr#12a08,PX-3253734WWM,CDM,3253734WWM,LOCAL,270,RC,,outpatient,,,271,243.9,,0.95,,257.45,Percent of total billed charges,,,0.98,,265.58,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,0.97,,262.87,Percent of total billed charges,,,0.96,,260.16,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,257.45,Percent of total billed charges,,257.45,265.58,
HC or Screw 3.5/ 16mm,PX-3253735WWM,CDM,3253735WWM,LOCAL,278,RC,,inpatient,,,173,155.7,,0.95,,164.35,Percent of total billed charges,,,0.98,,169.54,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.96,,166.08,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,164.35,Percent of total billed charges,,164.35,169.54,
HC or Screw 3.5/ 16mm,PX-3253735WWM,CDM,3253735WWM,LOCAL,278,RC,,outpatient,,,173,155.7,,0.95,,164.35,Percent of total billed charges,,,0.98,,169.54,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.96,,166.08,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,164.35,Percent of total billed charges,,164.35,169.54,
HC or Screw 3.5/ 20mm,PX-3253736WWM,CDM,3253736WWM,LOCAL,278,RC,,inpatient,,,173,155.7,,0.95,,164.35,Percent of total billed charges,,,0.98,,169.54,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.96,,166.08,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,164.35,Percent of total billed charges,,164.35,169.54,
HC or Screw 3.5/ 20mm,PX-3253736WWM,CDM,3253736WWM,LOCAL,278,RC,,outpatient,,,173,155.7,,0.95,,164.35,Percent of total billed charges,,,0.98,,169.54,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.96,,166.08,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,164.35,Percent of total billed charges,,164.35,169.54,
HC or Screw 3.5/ 22mm,PX-3253737WWM,CDM,3253737WWM,LOCAL,278,RC,,inpatient,,,173,155.7,,0.95,,164.35,Percent of total billed charges,,,0.98,,169.54,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.96,,166.08,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,164.35,Percent of total billed charges,,164.35,169.54,
HC or Screw 3.5/ 22mm,PX-3253737WWM,CDM,3253737WWM,LOCAL,278,RC,,outpatient,,,173,155.7,,0.95,,164.35,Percent of total billed charges,,,0.98,,169.54,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.96,,166.08,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,164.35,Percent of total billed charges,,164.35,169.54,
HC or Screw 3.5/ 24mm,PX-3253738WWM,CDM,3253738WWM,LOCAL,278,RC,,inpatient,,,173,155.7,,0.95,,164.35,Percent of total billed charges,,,0.98,,169.54,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.96,,166.08,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,164.35,Percent of total billed charges,,164.35,169.54,
HC or Screw 3.5/ 24mm,PX-3253738WWM,CDM,3253738WWM,LOCAL,278,RC,,outpatient,,,173,155.7,,0.95,,164.35,Percent of total billed charges,,,0.98,,169.54,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.96,,166.08,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,164.35,Percent of total billed charges,,164.35,169.54,
HC or Screw 3.5/ 30mm,PX-3253739WWM,CDM,3253739WWM,LOCAL,278,RC,,inpatient,,,173,155.7,,0.95,,164.35,Percent of total billed charges,,,0.98,,169.54,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.96,,166.08,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,164.35,Percent of total billed charges,,164.35,169.54,
HC or Screw 3.5/ 30mm,PX-3253739WWM,CDM,3253739WWM,LOCAL,278,RC,,outpatient,,,173,155.7,,0.95,,164.35,Percent of total billed charges,,,0.98,,169.54,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.96,,166.08,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,164.35,Percent of total billed charges,,164.35,169.54,
HC or Plate 1/3 Tub 6 Hole,PX-3253740WWM,CDM,3253740WWM,LOCAL,278,RC,,inpatient,,,180,162,,0.95,,171,Percent of total billed charges,,,0.98,,176.4,Percent of total billed charges,,,0.95,,171,Percent of total billed charges,,,0.97,,174.6,Percent of total billed charges,,,0.97,,174.6,Percent of total billed charges,,,0.96,,172.8,Percent of total billed charges,,,0.95,,171,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,171,Percent of total billed charges,,171,176.4,
HC or Plate 1/3 Tub 6 Hole,PX-3253740WWM,CDM,3253740WWM,LOCAL,278,RC,,outpatient,,,180,162,,0.95,,171,Percent of total billed charges,,,0.98,,176.4,Percent of total billed charges,,,0.95,,171,Percent of total billed charges,,,0.95,,171,Percent of total billed charges,,,0.97,,174.6,Percent of total billed charges,,,0.96,,172.8,Percent of total billed charges,,,0.95,,171,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,171,Percent of total billed charges,,171,176.4,
HC or Screw 3.5/ 14mm,PX-3253741WWM,CDM,3253741WWM,LOCAL,278,RC,,inpatient,,,173,155.7,,0.95,,164.35,Percent of total billed charges,,,0.98,,169.54,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.96,,166.08,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,164.35,Percent of total billed charges,,164.35,169.54,
HC or Screw 3.5/ 14mm,PX-3253741WWM,CDM,3253741WWM,LOCAL,278,RC,,outpatient,,,173,155.7,,0.95,,164.35,Percent of total billed charges,,,0.98,,169.54,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.96,,166.08,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,164.35,Percent of total billed charges,,164.35,169.54,
HC or Screw 3.5/ 18mm,PX-3253742WWM,CDM,3253742WWM,LOCAL,278,RC,,inpatient,,,173,155.7,,0.95,,164.35,Percent of total billed charges,,,0.98,,169.54,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.96,,166.08,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,164.35,Percent of total billed charges,,164.35,169.54,
HC or Screw 3.5/ 18mm,PX-3253742WWM,CDM,3253742WWM,LOCAL,278,RC,,outpatient,,,173,155.7,,0.95,,164.35,Percent of total billed charges,,,0.98,,169.54,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.96,,166.08,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,164.35,Percent of total billed charges,,164.35,169.54,
HC or Esoph Dil Ball 18#G487,PX-3253743WWM,CDM,3253743WWM,LOCAL,270,RC,,inpatient,,,493,443.7,,0.95,,468.35,Percent of total billed charges,,,0.98,,483.14,Percent of total billed charges,,,0.95,,468.35,Percent of total billed charges,,,0.97,,478.21,Percent of total billed charges,,,0.97,,478.21,Percent of total billed charges,,,0.96,,473.28,Percent of total billed charges,,,0.95,,468.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,468.35,Percent of total billed charges,,468.35,483.14,
HC or Esoph Dil Ball 18#G487,PX-3253743WWM,CDM,3253743WWM,LOCAL,270,RC,,outpatient,,,493,443.7,,0.95,,468.35,Percent of total billed charges,,,0.98,,483.14,Percent of total billed charges,,,0.95,,468.35,Percent of total billed charges,,,0.95,,468.35,Percent of total billed charges,,,0.97,,478.21,Percent of total billed charges,,,0.96,,473.28,Percent of total billed charges,,,0.95,,468.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,468.35,Percent of total billed charges,,468.35,483.14,
HC or Colon Needle#NM-200u-0,PX-3253744WWM,CDM,3253744WWM,LOCAL,270,RC,,inpatient,,,151,135.9,,0.95,,143.45,Percent of total billed charges,,,0.98,,147.98,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,0.97,,146.47,Percent of total billed charges,,,0.97,,146.47,Percent of total billed charges,,,0.96,,144.96,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,143.45,Percent of total billed charges,,143.45,147.98,
HC or Colon Needle#NM-200u-0,PX-3253744WWM,CDM,3253744WWM,LOCAL,270,RC,,outpatient,,,151,135.9,,0.95,,143.45,Percent of total billed charges,,,0.98,,147.98,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,0.97,,146.47,Percent of total billed charges,,,0.96,,144.96,Percent of total billed charges,,,0.95,,143.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,143.45,Percent of total billed charges,,143.45,147.98,
HC or Screw 3.5/ 38mm#2348-0,PX-3253745WWM,CDM,3253745WWM,LOCAL,278,RC,,inpatient,,,173,155.7,,0.95,,164.35,Percent of total billed charges,,,0.98,,169.54,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.96,,166.08,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,164.35,Percent of total billed charges,,164.35,169.54,
HC or Screw 3.5/ 38mm#2348-0,PX-3253745WWM,CDM,3253745WWM,LOCAL,278,RC,,outpatient,,,173,155.7,,0.95,,164.35,Percent of total billed charges,,,0.98,,169.54,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,0.97,,167.81,Percent of total billed charges,,,0.96,,166.08,Percent of total billed charges,,,0.95,,164.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,164.35,Percent of total billed charges,,164.35,169.54,
HC or Cannula Passport 8x40,PX-3253746WWM,CDM,3253746WWM,LOCAL,270,RC,,inpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
HC or Cannula Passport 8x40,PX-3253746WWM,CDM,3253746WWM,LOCAL,270,RC,,outpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
HC or Endo Cutter 45#Ets45,PX-3253747WWM,CDM,3253747WWM,LOCAL,270,RC,,inpatient,,,386,347.4,,0.95,,366.7,Percent of total billed charges,,,0.98,,378.28,Percent of total billed charges,,,0.95,,366.7,Percent of total billed charges,,,0.97,,374.42,Percent of total billed charges,,,0.97,,374.42,Percent of total billed charges,,,0.96,,370.56,Percent of total billed charges,,,0.95,,366.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,366.7,Percent of total billed charges,,366.7,378.28,
HC or Endo Cutter 45#Ets45,PX-3253747WWM,CDM,3253747WWM,LOCAL,270,RC,,outpatient,,,386,347.4,,0.95,,366.7,Percent of total billed charges,,,0.98,,378.28,Percent of total billed charges,,,0.95,,366.7,Percent of total billed charges,,,0.95,,366.7,Percent of total billed charges,,,0.97,,374.42,Percent of total billed charges,,,0.96,,370.56,Percent of total billed charges,,,0.95,,366.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,366.7,Percent of total billed charges,,366.7,378.28,
HC or Needle Veress #007.00,PX-3253748WWM,CDM,3253748WWM,LOCAL,270,RC,,inpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
HC or Needle Veress #007.00,PX-3253748WWM,CDM,3253748WWM,LOCAL,270,RC,,outpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
HC or Mesh Vent Sm #0010301,PX-3253751WWM,CDM,3253751WWM,LOCAL,278,RC,,inpatient,,,1036,932.4,,0.95,,984.2,Percent of total billed charges,,,0.98,,1015.28,Percent of total billed charges,,,0.95,,984.2,Percent of total billed charges,,,0.97,,1004.92,Percent of total billed charges,,,0.97,,1004.92,Percent of total billed charges,,,0.96,,994.56,Percent of total billed charges,,,0.95,,984.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,984.2,Percent of total billed charges,,984.2,1015.28,
HC or Mesh Vent Sm #0010301,PX-3253751WWM,CDM,3253751WWM,LOCAL,278,RC,,outpatient,,,1036,932.4,,0.95,,984.2,Percent of total billed charges,,,0.98,,1015.28,Percent of total billed charges,,,0.95,,984.2,Percent of total billed charges,,,0.95,,984.2,Percent of total billed charges,,,0.97,,1004.92,Percent of total billed charges,,,0.96,,994.56,Percent of total billed charges,,,0.95,,984.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,984.2,Percent of total billed charges,,984.2,1015.28,
HC or Liga Clip Max #El5ml,PX-3253752WWM,CDM,3253752WWM,LOCAL,278,RC,,inpatient,,,380,342,,0.95,,361,Percent of total billed charges,,,0.98,,372.4,Percent of total billed charges,,,0.95,,361,Percent of total billed charges,,,0.97,,368.6,Percent of total billed charges,,,0.97,,368.6,Percent of total billed charges,,,0.96,,364.8,Percent of total billed charges,,,0.95,,361,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,361,Percent of total billed charges,,361,372.4,
HC or Liga Clip Max #El5ml,PX-3253752WWM,CDM,3253752WWM,LOCAL,278,RC,,outpatient,,,380,342,,0.95,,361,Percent of total billed charges,,,0.98,,372.4,Percent of total billed charges,,,0.95,,361,Percent of total billed charges,,,0.95,,361,Percent of total billed charges,,,0.97,,368.6,Percent of total billed charges,,,0.96,,364.8,Percent of total billed charges,,,0.95,,361,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,361,Percent of total billed charges,,361,372.4,
HC or Spot Dye #Gis-44,PX-3253755WWM,CDM,3253755WWM,LOCAL,270,RC,,inpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
HC or Spot Dye #Gis-44,PX-3253755WWM,CDM,3253755WWM,LOCAL,270,RC,,outpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
HC or Screw Cort 4.5mm/24mm,PX-3253762WWM,CDM,3253762WWM,LOCAL,278,RC,,inpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw Cort 4.5mm/24mm,PX-3253762WWM,CDM,3253762WWM,LOCAL,278,RC,,outpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC or Screw Cort 4.5mm/26mm,PX-3253763WWM,CDM,3253763WWM,LOCAL,278,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC or Screw Cort 4.5mm/26mm,PX-3253763WWM,CDM,3253763WWM,LOCAL,278,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC or Screw Cort 3.5mm/20mm,PX-3253764WWM,CDM,3253764WWM,LOCAL,278,RC,,inpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
HC or Screw Cort 3.5mm/20mm,PX-3253764WWM,CDM,3253764WWM,LOCAL,278,RC,,outpatient,,,101,90.9,,0.95,,95.95,Percent of total billed charges,,,0.98,,98.98,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,0.97,,97.97,Percent of total billed charges,,,0.96,,96.96,Percent of total billed charges,,,0.95,,95.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95.95,Percent of total billed charges,,95.95,98.98,
HC or Screw Super Quick#2229,PX-3253770WWM,CDM,3253770WWM,LOCAL,278,RC,,inpatient,,,904,813.6,,0.95,,858.8,Percent of total billed charges,,,0.98,,885.92,Percent of total billed charges,,,0.95,,858.8,Percent of total billed charges,,,0.97,,876.88,Percent of total billed charges,,,0.97,,876.88,Percent of total billed charges,,,0.96,,867.84,Percent of total billed charges,,,0.95,,858.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,858.8,Percent of total billed charges,,858.8,885.92,
HC or Screw Super Quick#2229,PX-3253770WWM,CDM,3253770WWM,LOCAL,278,RC,,outpatient,,,904,813.6,,0.95,,858.8,Percent of total billed charges,,,0.98,,885.92,Percent of total billed charges,,,0.95,,858.8,Percent of total billed charges,,,0.95,,858.8,Percent of total billed charges,,,0.97,,876.88,Percent of total billed charges,,,0.96,,867.84,Percent of total billed charges,,,0.95,,858.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,858.8,Percent of total billed charges,,858.8,885.92,
HC or Needle Injector,PX-3253773WWM,CDM,3253773WWM,LOCAL,272,RC,,inpatient,,,148,133.2,,0.95,,140.6,Percent of total billed charges,,,0.98,,145.04,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.96,,142.08,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,140.6,Percent of total billed charges,,140.6,145.04,
HC or Needle Injector,PX-3253773WWM,CDM,3253773WWM,LOCAL,272,RC,,outpatient,,,148,133.2,,0.95,,140.6,Percent of total billed charges,,,0.98,,145.04,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.96,,142.08,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,140.6,Percent of total billed charges,,140.6,145.04,
HC or Cannula Passport 8x30,PX-3253782WWM,CDM,3253782WWM,LOCAL,270,RC,,inpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
HC or Cannula Passport 8x30,PX-3253782WWM,CDM,3253782WWM,LOCAL,270,RC,,outpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
HC or Blade Strk Lg/Nar #229,PX-3253783WWM,CDM,3253783WWM,LOCAL,270,RC,,inpatient,,,159,143.1,,0.95,,151.05,Percent of total billed charges,,,0.98,,155.82,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,0.97,,154.23,Percent of total billed charges,,,0.97,,154.23,Percent of total billed charges,,,0.96,,152.64,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,151.05,Percent of total billed charges,,151.05,155.82,
HC or Blade Strk Lg/Nar #229,PX-3253783WWM,CDM,3253783WWM,LOCAL,270,RC,,outpatient,,,159,143.1,,0.95,,151.05,Percent of total billed charges,,,0.98,,155.82,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,0.97,,154.23,Percent of total billed charges,,,0.96,,152.64,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,151.05,Percent of total billed charges,,151.05,155.82,
HC or Port Smart CT #Ct75sts,PX-3253784WWM,CDM,3253784WWM,LOCAL,278,RC,,inpatient,,,1108,997.2,,0.95,,1052.6,Percent of total billed charges,,,0.98,,1085.84,Percent of total billed charges,,,0.95,,1052.6,Percent of total billed charges,,,0.97,,1074.76,Percent of total billed charges,,,0.97,,1074.76,Percent of total billed charges,,,0.96,,1063.68,Percent of total billed charges,,,0.95,,1052.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1052.6,Percent of total billed charges,,1052.6,1085.84,
HC or Port Smart CT #Ct75sts,PX-3253784WWM,CDM,3253784WWM,LOCAL,278,RC,,outpatient,,,1108,997.2,,0.95,,1052.6,Percent of total billed charges,,,0.98,,1085.84,Percent of total billed charges,,,0.95,,1052.6,Percent of total billed charges,,,0.95,,1052.6,Percent of total billed charges,,,0.97,,1074.76,Percent of total billed charges,,,0.96,,1063.68,Percent of total billed charges,,,0.95,,1052.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1052.6,Percent of total billed charges,,1052.6,1085.84,
HC or Waffle Table Pad# 1100,PX-3253786WWM,CDM,3253786WWM,LOCAL,270,RC,,inpatient,,,247,222.3,,0.95,,234.65,Percent of total billed charges,,,0.98,,242.06,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.96,,237.12,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,234.65,Percent of total billed charges,,234.65,242.06,
HC or Waffle Table Pad# 1100,PX-3253786WWM,CDM,3253786WWM,LOCAL,270,RC,,outpatient,,,247,222.3,,0.95,,234.65,Percent of total billed charges,,,0.98,,242.06,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.96,,237.12,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,234.65,Percent of total billed charges,,234.65,242.06,
HC or Drain Flat 15fr# Su130,PX-3253788WWM,CDM,3253788WWM,LOCAL,270,RC,,inpatient,,,49,44.1,,0.95,,46.55,Percent of total billed charges,,,0.98,,48.02,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.96,,47.04,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,46.55,Percent of total billed charges,,46.55,48.02,
HC or Drain Flat 15fr# Su130,PX-3253788WWM,CDM,3253788WWM,LOCAL,270,RC,,outpatient,,,49,44.1,,0.95,,46.55,Percent of total billed charges,,,0.98,,48.02,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.96,,47.04,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,46.55,Percent of total billed charges,,46.55,48.02,
HC or Bx Needle 11g #Jbc1211,PX-3253791WWM,CDM,3253791WWM,LOCAL,270,RC,,inpatient,,,406,365.4,,0.95,,385.7,Percent of total billed charges,,,0.98,,397.88,Percent of total billed charges,,,0.95,,385.7,Percent of total billed charges,,,0.97,,393.82,Percent of total billed charges,,,0.97,,393.82,Percent of total billed charges,,,0.96,,389.76,Percent of total billed charges,,,0.95,,385.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,385.7,Percent of total billed charges,,385.7,397.88,
HC or Bx Needle 11g #Jbc1211,PX-3253791WWM,CDM,3253791WWM,LOCAL,270,RC,,outpatient,,,406,365.4,,0.95,,385.7,Percent of total billed charges,,,0.98,,397.88,Percent of total billed charges,,,0.95,,385.7,Percent of total billed charges,,,0.95,,385.7,Percent of total billed charges,,,0.97,,393.82,Percent of total billed charges,,,0.96,,389.76,Percent of total billed charges,,,0.95,,385.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,385.7,Percent of total billed charges,,385.7,397.88,
HC or Blade Strk Xl 19.5mm,PX-3253792WWM,CDM,3253792WWM,LOCAL,270,RC,,inpatient,,,219,197.1,,0.95,,208.05,Percent of total billed charges,,,0.98,,214.62,Percent of total billed charges,,,0.95,,208.05,Percent of total billed charges,,,0.97,,212.43,Percent of total billed charges,,,0.97,,212.43,Percent of total billed charges,,,0.96,,210.24,Percent of total billed charges,,,0.95,,208.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,208.05,Percent of total billed charges,,208.05,214.62,
HC or Blade Strk Xl 19.5mm,PX-3253792WWM,CDM,3253792WWM,LOCAL,270,RC,,outpatient,,,219,197.1,,0.95,,208.05,Percent of total billed charges,,,0.98,,214.62,Percent of total billed charges,,,0.95,,208.05,Percent of total billed charges,,,0.95,,208.05,Percent of total billed charges,,,0.97,,212.43,Percent of total billed charges,,,0.96,,210.24,Percent of total billed charges,,,0.95,,208.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,208.05,Percent of total billed charges,,208.05,214.62,
HC or Blade Strk Lg 13mm,PX-3253793WWM,CDM,3253793WWM,LOCAL,270,RC,,inpatient,,,159,143.1,,0.95,,151.05,Percent of total billed charges,,,0.98,,155.82,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,0.97,,154.23,Percent of total billed charges,,,0.97,,154.23,Percent of total billed charges,,,0.96,,152.64,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,151.05,Percent of total billed charges,,151.05,155.82,
HC or Blade Strk Lg 13mm,PX-3253793WWM,CDM,3253793WWM,LOCAL,270,RC,,outpatient,,,159,143.1,,0.95,,151.05,Percent of total billed charges,,,0.98,,155.82,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,0.97,,154.23,Percent of total billed charges,,,0.96,,152.64,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,151.05,Percent of total billed charges,,151.05,155.82,
HC or Cannula Passport 8x20,PX-3253796WWM,CDM,3253796WWM,LOCAL,270,RC,,inpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
HC or Cannula Passport 8x20,PX-3253796WWM,CDM,3253796WWM,LOCAL,270,RC,,outpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
HC or Cannula Passport 6x30,PX-3253797WWM,CDM,3253797WWM,LOCAL,270,RC,,inpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
HC or Cannula Passport 6x30,PX-3253797WWM,CDM,3253797WWM,LOCAL,270,RC,,outpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
HC or Harmonic Ace #Har36,PX-3253798WWM,CDM,3253798WWM,LOCAL,270,RC,,inpatient,,,1143,1028.7,,0.95,,1085.85,Percent of total billed charges,,,0.98,,1120.14,Percent of total billed charges,,,0.95,,1085.85,Percent of total billed charges,,,0.97,,1108.71,Percent of total billed charges,,,0.97,,1108.71,Percent of total billed charges,,,0.96,,1097.28,Percent of total billed charges,,,0.95,,1085.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1085.85,Percent of total billed charges,,1085.85,1120.14,
HC or Harmonic Ace #Har36,PX-3253798WWM,CDM,3253798WWM,LOCAL,270,RC,,outpatient,,,1143,1028.7,,0.95,,1085.85,Percent of total billed charges,,,0.98,,1120.14,Percent of total billed charges,,,0.95,,1085.85,Percent of total billed charges,,,0.95,,1085.85,Percent of total billed charges,,,0.97,,1108.71,Percent of total billed charges,,,0.96,,1097.28,Percent of total billed charges,,,0.95,,1085.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1085.85,Percent of total billed charges,,1085.85,1120.14,
HC or Harmonic Focus # Fcs9,PX-3253801WWM,CDM,3253801WWM,LOCAL,270,RC,,inpatient,,,1127,1014.3,,0.95,,1070.65,Percent of total billed charges,,,0.98,,1104.46,Percent of total billed charges,,,0.95,,1070.65,Percent of total billed charges,,,0.97,,1093.19,Percent of total billed charges,,,0.97,,1093.19,Percent of total billed charges,,,0.96,,1081.92,Percent of total billed charges,,,0.95,,1070.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1070.65,Percent of total billed charges,,1070.65,1104.46,
HC or Harmonic Focus # Fcs9,PX-3253801WWM,CDM,3253801WWM,LOCAL,270,RC,,outpatient,,,1127,1014.3,,0.95,,1070.65,Percent of total billed charges,,,0.98,,1104.46,Percent of total billed charges,,,0.95,,1070.65,Percent of total billed charges,,,0.95,,1070.65,Percent of total billed charges,,,0.97,,1093.19,Percent of total billed charges,,,0.96,,1081.92,Percent of total billed charges,,,0.95,,1070.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1070.65,Percent of total billed charges,,1070.65,1104.46,
HC Gown Kit Flex # 84003,PX-3253806WWM,CDM,3253806WWM,LOCAL,270,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
HC Gown Kit Flex # 84003,PX-3253806WWM,CDM,3253806WWM,LOCAL,270,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
HC Su Gortex 0 #On07a,PX-3253808WWM,CDM,3253808WWM,LOCAL,270,RC,,inpatient,,,123,110.7,,0.95,,116.85,Percent of total billed charges,,,0.98,,120.54,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.96,,118.08,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,116.85,Percent of total billed charges,,116.85,120.54,
HC Su Gortex 0 #On07a,PX-3253808WWM,CDM,3253808WWM,LOCAL,270,RC,,outpatient,,,123,110.7,,0.95,,116.85,Percent of total billed charges,,,0.98,,120.54,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.96,,118.08,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,116.85,Percent of total billed charges,,116.85,120.54,
HC or Screw Bio 8x28#Ar5028c,PX-3253818WWM,CDM,3253818WWM,LOCAL,278,RC,,inpatient,,,846,761.4,,0.95,,803.7,Percent of total billed charges,,,0.98,,829.08,Percent of total billed charges,,,0.95,,803.7,Percent of total billed charges,,,0.97,,820.62,Percent of total billed charges,,,0.97,,820.62,Percent of total billed charges,,,0.96,,812.16,Percent of total billed charges,,,0.95,,803.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,803.7,Percent of total billed charges,,803.7,829.08,
HC or Screw Bio 8x28#Ar5028c,PX-3253818WWM,CDM,3253818WWM,LOCAL,278,RC,,outpatient,,,846,761.4,,0.95,,803.7,Percent of total billed charges,,,0.98,,829.08,Percent of total billed charges,,,0.95,,803.7,Percent of total billed charges,,,0.95,,803.7,Percent of total billed charges,,,0.97,,820.62,Percent of total billed charges,,,0.96,,812.16,Percent of total billed charges,,,0.95,,803.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,803.7,Percent of total billed charges,,803.7,829.08,
HC or Screw Bio 8x23#Ar1380c,PX-3253825WWM,CDM,3253825WWM,LOCAL,278,RC,,inpatient,,,846,761.4,,0.95,,803.7,Percent of total billed charges,,,0.98,,829.08,Percent of total billed charges,,,0.95,,803.7,Percent of total billed charges,,,0.97,,820.62,Percent of total billed charges,,,0.97,,820.62,Percent of total billed charges,,,0.96,,812.16,Percent of total billed charges,,,0.95,,803.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,803.7,Percent of total billed charges,,803.7,829.08,
HC or Screw Bio 8x23#Ar1380c,PX-3253825WWM,CDM,3253825WWM,LOCAL,278,RC,,outpatient,,,846,761.4,,0.95,,803.7,Percent of total billed charges,,,0.98,,829.08,Percent of total billed charges,,,0.95,,803.7,Percent of total billed charges,,,0.95,,803.7,Percent of total billed charges,,,0.97,,820.62,Percent of total billed charges,,,0.96,,812.16,Percent of total billed charges,,,0.95,,803.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,803.7,Percent of total billed charges,,803.7,829.08,
HC or Liga Clip Sm #Ls100,PX-3253827WWM,CDM,3253827WWM,LOCAL,278,RC,,inpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
HC or Liga Clip Sm #Ls100,PX-3253827WWM,CDM,3253827WWM,LOCAL,278,RC,,outpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
HC or Liga Clip Med #Ls200,PX-3253828WWM,CDM,3253828WWM,LOCAL,278,RC,,inpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
HC or Liga Clip Med #Ls200,PX-3253828WWM,CDM,3253828WWM,LOCAL,278,RC,,outpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
HC or Harmonic Long#Fcs17,PX-3253830WWM,CDM,3253830WWM,LOCAL,270,RC,,inpatient,,,1145,1030.5,,0.95,,1087.75,Percent of total billed charges,,,0.98,,1122.1,Percent of total billed charges,,,0.95,,1087.75,Percent of total billed charges,,,0.97,,1110.65,Percent of total billed charges,,,0.97,,1110.65,Percent of total billed charges,,,0.96,,1099.2,Percent of total billed charges,,,0.95,,1087.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1087.75,Percent of total billed charges,,1087.75,1122.1,
HC or Harmonic Long#Fcs17,PX-3253830WWM,CDM,3253830WWM,LOCAL,270,RC,,outpatient,,,1145,1030.5,,0.95,,1087.75,Percent of total billed charges,,,0.98,,1122.1,Percent of total billed charges,,,0.95,,1087.75,Percent of total billed charges,,,0.95,,1087.75,Percent of total billed charges,,,0.97,,1110.65,Percent of total billed charges,,,0.96,,1099.2,Percent of total billed charges,,,0.95,,1087.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1087.75,Percent of total billed charges,,1087.75,1122.1,
HC or Endo Cutter#Ec45a,PX-3253831WWM,CDM,3253831WWM,LOCAL,270,RC,,inpatient,,,1018,916.2,,0.95,,967.1,Percent of total billed charges,,,0.98,,997.64,Percent of total billed charges,,,0.95,,967.1,Percent of total billed charges,,,0.97,,987.46,Percent of total billed charges,,,0.97,,987.46,Percent of total billed charges,,,0.96,,977.28,Percent of total billed charges,,,0.95,,967.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,967.1,Percent of total billed charges,,967.1,997.64,
HC or Endo Cutter#Ec45a,PX-3253831WWM,CDM,3253831WWM,LOCAL,270,RC,,outpatient,,,1018,916.2,,0.95,,967.1,Percent of total billed charges,,,0.98,,997.64,Percent of total billed charges,,,0.95,,967.1,Percent of total billed charges,,,0.95,,967.1,Percent of total billed charges,,,0.97,,987.46,Percent of total billed charges,,,0.96,,977.28,Percent of total billed charges,,,0.95,,967.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,967.1,Percent of total billed charges,,967.1,997.64,
HC or Reload Vasc #Ecr45w,PX-3253832WWM,CDM,3253832WWM,LOCAL,270,RC,,inpatient,,,358,322.2,,0.95,,340.1,Percent of total billed charges,,,0.98,,350.84,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,0.97,,347.26,Percent of total billed charges,,,0.97,,347.26,Percent of total billed charges,,,0.96,,343.68,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,340.1,Percent of total billed charges,,340.1,350.84,
HC or Reload Vasc #Ecr45w,PX-3253832WWM,CDM,3253832WWM,LOCAL,270,RC,,outpatient,,,358,322.2,,0.95,,340.1,Percent of total billed charges,,,0.98,,350.84,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,0.97,,347.26,Percent of total billed charges,,,0.96,,343.68,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,340.1,Percent of total billed charges,,340.1,350.84,
HC or Reload Reg #Ecr45b,PX-3253833WWM,CDM,3253833WWM,LOCAL,270,RC,,inpatient,,,358,322.2,,0.95,,340.1,Percent of total billed charges,,,0.98,,350.84,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,0.97,,347.26,Percent of total billed charges,,,0.97,,347.26,Percent of total billed charges,,,0.96,,343.68,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,340.1,Percent of total billed charges,,340.1,350.84,
HC or Reload Reg #Ecr45b,PX-3253833WWM,CDM,3253833WWM,LOCAL,270,RC,,outpatient,,,358,322.2,,0.95,,340.1,Percent of total billed charges,,,0.98,,350.84,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,0.97,,347.26,Percent of total billed charges,,,0.96,,343.68,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,340.1,Percent of total billed charges,,340.1,350.84,
HC or Trocar 12 Mm# B12srt,PX-3253840WWM,CDM,3253840WWM,LOCAL,270,RC,,inpatient,,,239,215.1,,0.95,,227.05,Percent of total billed charges,,,0.98,,234.22,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,0.97,,231.83,Percent of total billed charges,,,0.97,,231.83,Percent of total billed charges,,,0.96,,229.44,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,227.05,Percent of total billed charges,,227.05,234.22,
HC or Trocar 12 Mm# B12srt,PX-3253840WWM,CDM,3253840WWM,LOCAL,270,RC,,outpatient,,,239,215.1,,0.95,,227.05,Percent of total billed charges,,,0.98,,234.22,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,0.97,,231.83,Percent of total billed charges,,,0.96,,229.44,Percent of total billed charges,,,0.95,,227.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,227.05,Percent of total billed charges,,227.05,234.22,
HC or Trocar 5 Mm #B5st,PX-3253841WWM,CDM,3253841WWM,LOCAL,270,RC,,inpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
HC or Trocar 5 Mm #B5st,PX-3253841WWM,CDM,3253841WWM,LOCAL,270,RC,,outpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
HC or Endo Flex 45mm #Sc45a,PX-3253842WWM,CDM,3253842WWM,LOCAL,270,RC,,inpatient,,,1018,916.2,,0.95,,967.1,Percent of total billed charges,,,0.98,,997.64,Percent of total billed charges,,,0.95,,967.1,Percent of total billed charges,,,0.97,,987.46,Percent of total billed charges,,,0.97,,987.46,Percent of total billed charges,,,0.96,,977.28,Percent of total billed charges,,,0.95,,967.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,967.1,Percent of total billed charges,,967.1,997.64,
HC or Endo Flex 45mm #Sc45a,PX-3253842WWM,CDM,3253842WWM,LOCAL,270,RC,,outpatient,,,1018,916.2,,0.95,,967.1,Percent of total billed charges,,,0.98,,997.64,Percent of total billed charges,,,0.95,,967.1,Percent of total billed charges,,,0.95,,967.1,Percent of total billed charges,,,0.97,,987.46,Percent of total billed charges,,,0.96,,977.28,Percent of total billed charges,,,0.95,,967.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,967.1,Percent of total billed charges,,967.1,997.64,
HC or Screw 6.5x75 #2347-024,PX-3253843WWM,CDM,3253843WWM,LOCAL,278,RC,,inpatient,,,168,151.2,,0.95,,159.6,Percent of total billed charges,,,0.98,,164.64,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,0.97,,162.96,Percent of total billed charges,,,0.97,,162.96,Percent of total billed charges,,,0.96,,161.28,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,159.6,Percent of total billed charges,,159.6,164.64,
HC or Screw 6.5x75 #2347-024,PX-3253843WWM,CDM,3253843WWM,LOCAL,278,RC,,outpatient,,,168,151.2,,0.95,,159.6,Percent of total billed charges,,,0.98,,164.64,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,0.97,,162.96,Percent of total billed charges,,,0.96,,161.28,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,159.6,Percent of total billed charges,,159.6,164.64,
HC or Screw 6.5x90 #2347-024,PX-3253844WWM,CDM,3253844WWM,LOCAL,278,RC,,inpatient,,,168,151.2,,0.95,,159.6,Percent of total billed charges,,,0.98,,164.64,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,0.97,,162.96,Percent of total billed charges,,,0.97,,162.96,Percent of total billed charges,,,0.96,,161.28,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,159.6,Percent of total billed charges,,159.6,164.64,
HC or Screw 6.5x90 #2347-024,PX-3253844WWM,CDM,3253844WWM,LOCAL,278,RC,,outpatient,,,168,151.2,,0.95,,159.6,Percent of total billed charges,,,0.98,,164.64,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,0.97,,162.96,Percent of total billed charges,,,0.96,,161.28,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,159.6,Percent of total billed charges,,159.6,164.64,
HC or Washer #4900-065-51,PX-3253845WWM,CDM,3253845WWM,LOCAL,278,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
HC or Washer #4900-065-51,PX-3253845WWM,CDM,3253845WWM,LOCAL,278,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
HC or Endostitch 10mm#173016,PX-3253846WWM,CDM,3253846WWM,LOCAL,270,RC,,inpatient,,,662,595.8,,0.95,,628.9,Percent of total billed charges,,,0.98,,648.76,Percent of total billed charges,,,0.95,,628.9,Percent of total billed charges,,,0.97,,642.14,Percent of total billed charges,,,0.97,,642.14,Percent of total billed charges,,,0.96,,635.52,Percent of total billed charges,,,0.95,,628.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,628.9,Percent of total billed charges,,628.9,648.76,
HC or Endostitch 10mm#173016,PX-3253846WWM,CDM,3253846WWM,LOCAL,270,RC,,outpatient,,,662,595.8,,0.95,,628.9,Percent of total billed charges,,,0.98,,648.76,Percent of total billed charges,,,0.95,,628.9,Percent of total billed charges,,,0.95,,628.9,Percent of total billed charges,,,0.97,,642.14,Percent of total billed charges,,,0.96,,635.52,Percent of total billed charges,,,0.95,,628.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,628.9,Percent of total billed charges,,628.9,648.76,
HC or Endostitch Su #170052,PX-3253847WWM,CDM,3253847WWM,LOCAL,270,RC,,inpatient,,,191,171.9,,0.95,,181.45,Percent of total billed charges,,,0.98,,187.18,Percent of total billed charges,,,0.95,,181.45,Percent of total billed charges,,,0.97,,185.27,Percent of total billed charges,,,0.97,,185.27,Percent of total billed charges,,,0.96,,183.36,Percent of total billed charges,,,0.95,,181.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,181.45,Percent of total billed charges,,181.45,187.18,
HC or Endostitch Su #170052,PX-3253847WWM,CDM,3253847WWM,LOCAL,270,RC,,outpatient,,,191,171.9,,0.95,,181.45,Percent of total billed charges,,,0.98,,187.18,Percent of total billed charges,,,0.95,,181.45,Percent of total billed charges,,,0.95,,181.45,Percent of total billed charges,,,0.97,,185.27,Percent of total billed charges,,,0.96,,183.36,Percent of total billed charges,,,0.95,,181.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,181.45,Percent of total billed charges,,181.45,187.18,
HC or Enseal Rnd 5mm#Nseal53,PX-3253849WWM,CDM,3253849WWM,LOCAL,270,RC,,inpatient,,,908,817.2,,0.95,,862.6,Percent of total billed charges,,,0.98,,889.84,Percent of total billed charges,,,0.95,,862.6,Percent of total billed charges,,,0.97,,880.76,Percent of total billed charges,,,0.97,,880.76,Percent of total billed charges,,,0.96,,871.68,Percent of total billed charges,,,0.95,,862.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,862.6,Percent of total billed charges,,862.6,889.84,
HC or Enseal Rnd 5mm#Nseal53,PX-3253849WWM,CDM,3253849WWM,LOCAL,270,RC,,outpatient,,,908,817.2,,0.95,,862.6,Percent of total billed charges,,,0.98,,889.84,Percent of total billed charges,,,0.95,,862.6,Percent of total billed charges,,,0.95,,862.6,Percent of total billed charges,,,0.97,,880.76,Percent of total billed charges,,,0.96,,871.68,Percent of total billed charges,,,0.95,,862.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,862.6,Percent of total billed charges,,862.6,889.84,
HC or Su Vicryl 0 #D9716,PX-3253850WWM,CDM,3253850WWM,LOCAL,270,RC,,inpatient,,,121,108.9,,0.95,,114.95,Percent of total billed charges,,,0.98,,118.58,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.96,,116.16,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114.95,Percent of total billed charges,,114.95,118.58,
HC or Su Vicryl 0 #D9716,PX-3253850WWM,CDM,3253850WWM,LOCAL,270,RC,,outpatient,,,121,108.9,,0.95,,114.95,Percent of total billed charges,,,0.98,,118.58,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.96,,116.16,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114.95,Percent of total billed charges,,114.95,118.58,
HC or Permafix 15 Stap#01130,PX-3253851WWM,CDM,3253851WWM,LOCAL,278,RC,,inpatient,,,839,755.1,,0.95,,797.05,Percent of total billed charges,,,0.98,,822.22,Percent of total billed charges,,,0.95,,797.05,Percent of total billed charges,,,0.97,,813.83,Percent of total billed charges,,,0.97,,813.83,Percent of total billed charges,,,0.96,,805.44,Percent of total billed charges,,,0.95,,797.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,797.05,Percent of total billed charges,,797.05,822.22,
HC or Permafix 15 Stap#01130,PX-3253851WWM,CDM,3253851WWM,LOCAL,278,RC,,outpatient,,,839,755.1,,0.95,,797.05,Percent of total billed charges,,,0.98,,822.22,Percent of total billed charges,,,0.95,,797.05,Percent of total billed charges,,,0.95,,797.05,Percent of total billed charges,,,0.97,,813.83,Percent of total billed charges,,,0.96,,805.44,Percent of total billed charges,,,0.95,,797.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,797.05,Percent of total billed charges,,797.05,822.22,
HC or Rumi Tip 6.7x10#Umg670,PX-3253853WWM,CDM,3253853WWM,LOCAL,270,RC,,inpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
HC or Rumi Tip 6.7x10#Umg670,PX-3253853WWM,CDM,3253853WWM,LOCAL,270,RC,,outpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
HC or Rumi Tip 6.7x8#Umb678,PX-3253854WWM,CDM,3253854WWM,LOCAL,270,RC,,inpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
HC or Rumi Tip 6.7x8#Umb678,PX-3253854WWM,CDM,3253854WWM,LOCAL,270,RC,,outpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
HC or Rumi Tip 6.7x6#Umw676,PX-3253855WWM,CDM,3253855WWM,LOCAL,270,RC,,inpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
HC or Rumi Tip 6.7x6#Umw676,PX-3253855WWM,CDM,3253855WWM,LOCAL,270,RC,,outpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
HC or Rumi Tip 5.1x6#Uml516,PX-3253856WWM,CDM,3253856WWM,LOCAL,270,RC,,inpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
HC or Rumi Tip 5.1x6#Uml516,PX-3253856WWM,CDM,3253856WWM,LOCAL,270,RC,,outpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
HC or Occluder #Cpo-6,PX-3253857WWM,CDM,3253857WWM,LOCAL,270,RC,,inpatient,,,261,234.9,,0.95,,247.95,Percent of total billed charges,,,0.98,,255.78,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,0.97,,253.17,Percent of total billed charges,,,0.97,,253.17,Percent of total billed charges,,,0.96,,250.56,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,247.95,Percent of total billed charges,,247.95,255.78,
HC or Occluder #Cpo-6,PX-3253857WWM,CDM,3253857WWM,LOCAL,270,RC,,outpatient,,,261,234.9,,0.95,,247.95,Percent of total billed charges,,,0.98,,255.78,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,0.97,,253.17,Percent of total billed charges,,,0.96,,250.56,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,247.95,Percent of total billed charges,,247.95,255.78,
HC or Bioswivel Lock 6.25#AR,PX-3253868WWM,CDM,3253868WWM,LOCAL,270,RC,,inpatient,,,1002,901.8,,0.95,,951.9,Percent of total billed charges,,,0.98,,981.96,Percent of total billed charges,,,0.95,,951.9,Percent of total billed charges,,,0.97,,971.94,Percent of total billed charges,,,0.97,,971.94,Percent of total billed charges,,,0.96,,961.92,Percent of total billed charges,,,0.95,,951.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,951.9,Percent of total billed charges,,951.9,981.96,
HC or Bioswivel Lock 6.25#AR,PX-3253868WWM,CDM,3253868WWM,LOCAL,270,RC,,outpatient,,,1002,901.8,,0.95,,951.9,Percent of total billed charges,,,0.98,,981.96,Percent of total billed charges,,,0.95,,951.9,Percent of total billed charges,,,0.95,,951.9,Percent of total billed charges,,,0.97,,971.94,Percent of total billed charges,,,0.96,,961.92,Percent of total billed charges,,,0.95,,951.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,951.9,Percent of total billed charges,,951.9,981.96,
HC or Reamer 6mm #Ar1450,PX-3253869WWM,CDM,3253869WWM,LOCAL,270,RC,,inpatient,,,540,486,,0.95,,513,Percent of total billed charges,,,0.98,,529.2,Percent of total billed charges,,,0.95,,513,Percent of total billed charges,,,0.97,,523.8,Percent of total billed charges,,,0.97,,523.8,Percent of total billed charges,,,0.96,,518.4,Percent of total billed charges,,,0.95,,513,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,513,Percent of total billed charges,,513,529.2,
HC or Reamer 6mm #Ar1450,PX-3253869WWM,CDM,3253869WWM,LOCAL,270,RC,,outpatient,,,540,486,,0.95,,513,Percent of total billed charges,,,0.98,,529.2,Percent of total billed charges,,,0.95,,513,Percent of total billed charges,,,0.95,,513,Percent of total billed charges,,,0.97,,523.8,Percent of total billed charges,,,0.96,,518.4,Percent of total billed charges,,,0.95,,513,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,513,Percent of total billed charges,,513,529.2,
HC or Graft Blade # Gb228rs,PX-3253875WWM,CDM,3253875WWM,LOCAL,270,RC,,inpatient,,,96,86.4,,0.95,,91.2,Percent of total billed charges,,,0.98,,94.08,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.96,,92.16,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,91.2,Percent of total billed charges,,91.2,94.08,
HC or Graft Blade # Gb228rs,PX-3253875WWM,CDM,3253875WWM,LOCAL,270,RC,,outpatient,,,96,86.4,,0.95,,91.2,Percent of total billed charges,,,0.98,,94.08,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.96,,92.16,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,91.2,Percent of total billed charges,,91.2,94.08,
HC or Graft Carr 1:1.5# Ba72,PX-3253876WWM,CDM,3253876WWM,LOCAL,270,RC,,inpatient,,,159,143.1,,0.95,,151.05,Percent of total billed charges,,,0.98,,155.82,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,0.97,,154.23,Percent of total billed charges,,,0.97,,154.23,Percent of total billed charges,,,0.96,,152.64,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,151.05,Percent of total billed charges,,151.05,155.82,
HC or Graft Carr 1:1.5# Ba72,PX-3253876WWM,CDM,3253876WWM,LOCAL,270,RC,,outpatient,,,159,143.1,,0.95,,151.05,Percent of total billed charges,,,0.98,,155.82,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,0.97,,154.23,Percent of total billed charges,,,0.96,,152.64,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,151.05,Percent of total billed charges,,151.05,155.82,
HC or Cutter Lin 75mm# Tlc75,PX-3253881WWM,CDM,3253881WWM,LOCAL,270,RC,,inpatient,,,452,406.8,,0.95,,429.4,Percent of total billed charges,,,0.98,,442.96,Percent of total billed charges,,,0.95,,429.4,Percent of total billed charges,,,0.97,,438.44,Percent of total billed charges,,,0.97,,438.44,Percent of total billed charges,,,0.96,,433.92,Percent of total billed charges,,,0.95,,429.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,429.4,Percent of total billed charges,,429.4,442.96,
HC or Cutter Lin 75mm# Tlc75,PX-3253881WWM,CDM,3253881WWM,LOCAL,270,RC,,outpatient,,,452,406.8,,0.95,,429.4,Percent of total billed charges,,,0.98,,442.96,Percent of total billed charges,,,0.95,,429.4,Percent of total billed charges,,,0.95,,429.4,Percent of total billed charges,,,0.97,,438.44,Percent of total billed charges,,,0.96,,433.92,Percent of total billed charges,,,0.95,,429.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,429.4,Percent of total billed charges,,429.4,442.96,
HC or Cutter Lin Reload#Tcr7,PX-3253882WWM,CDM,3253882WWM,LOCAL,270,RC,,inpatient,,,281,252.9,,0.95,,266.95,Percent of total billed charges,,,0.98,,275.38,Percent of total billed charges,,,0.95,,266.95,Percent of total billed charges,,,0.97,,272.57,Percent of total billed charges,,,0.97,,272.57,Percent of total billed charges,,,0.96,,269.76,Percent of total billed charges,,,0.95,,266.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,266.95,Percent of total billed charges,,266.95,275.38,
HC or Cutter Lin Reload#Tcr7,PX-3253882WWM,CDM,3253882WWM,LOCAL,270,RC,,outpatient,,,281,252.9,,0.95,,266.95,Percent of total billed charges,,,0.98,,275.38,Percent of total billed charges,,,0.95,,266.95,Percent of total billed charges,,,0.95,,266.95,Percent of total billed charges,,,0.97,,272.57,Percent of total billed charges,,,0.96,,269.76,Percent of total billed charges,,,0.95,,266.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,266.95,Percent of total billed charges,,266.95,275.38,
HC or Power Port # 1806060,PX-3253883WWM,CDM,3253883WWM,LOCAL,270,RC,,inpatient,,,917,825.3,,0.95,,871.15,Percent of total billed charges,,,0.98,,898.66,Percent of total billed charges,,,0.95,,871.15,Percent of total billed charges,,,0.97,,889.49,Percent of total billed charges,,,0.97,,889.49,Percent of total billed charges,,,0.96,,880.32,Percent of total billed charges,,,0.95,,871.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,871.15,Percent of total billed charges,,871.15,898.66,
HC or Power Port # 1806060,PX-3253883WWM,CDM,3253883WWM,LOCAL,270,RC,,outpatient,,,917,825.3,,0.95,,871.15,Percent of total billed charges,,,0.98,,898.66,Percent of total billed charges,,,0.95,,871.15,Percent of total billed charges,,,0.95,,871.15,Percent of total billed charges,,,0.97,,889.49,Percent of total billed charges,,,0.96,,880.32,Percent of total billed charges,,,0.95,,871.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,871.15,Percent of total billed charges,,871.15,898.66,
HC or Linear Stapler # Ax55b,PX-3253884WWM,CDM,3253884WWM,LOCAL,270,RC,,inpatient,,,610,549,,0.95,,579.5,Percent of total billed charges,,,0.98,,597.8,Percent of total billed charges,,,0.95,,579.5,Percent of total billed charges,,,0.97,,591.7,Percent of total billed charges,,,0.97,,591.7,Percent of total billed charges,,,0.96,,585.6,Percent of total billed charges,,,0.95,,579.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,579.5,Percent of total billed charges,,579.5,597.8,
HC or Linear Stapler # Ax55b,PX-3253884WWM,CDM,3253884WWM,LOCAL,270,RC,,outpatient,,,610,549,,0.95,,579.5,Percent of total billed charges,,,0.98,,597.8,Percent of total billed charges,,,0.95,,579.5,Percent of total billed charges,,,0.95,,579.5,Percent of total billed charges,,,0.97,,591.7,Percent of total billed charges,,,0.96,,585.6,Percent of total billed charges,,,0.95,,579.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,579.5,Percent of total billed charges,,579.5,597.8,
HC or Enseal Trio# Etrio335h,PX-3253886WWM,CDM,3253886WWM,LOCAL,270,RC,,inpatient,,,1008,907.2,,0.95,,957.6,Percent of total billed charges,,,0.98,,987.84,Percent of total billed charges,,,0.95,,957.6,Percent of total billed charges,,,0.97,,977.76,Percent of total billed charges,,,0.97,,977.76,Percent of total billed charges,,,0.96,,967.68,Percent of total billed charges,,,0.95,,957.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,957.6,Percent of total billed charges,,957.6,987.84,
HC or Enseal Trio# Etrio335h,PX-3253886WWM,CDM,3253886WWM,LOCAL,270,RC,,outpatient,,,1008,907.2,,0.95,,957.6,Percent of total billed charges,,,0.98,,987.84,Percent of total billed charges,,,0.95,,957.6,Percent of total billed charges,,,0.95,,957.6,Percent of total billed charges,,,0.97,,977.76,Percent of total billed charges,,,0.96,,967.68,Percent of total billed charges,,,0.95,,957.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,957.6,Percent of total billed charges,,957.6,987.84,
HC or Peek Pushloc#AR-1923ps,PX-3253894WWM,CDM,3253894WWM,LOCAL,270,RC,,inpatient,,,894,804.6,,0.95,,849.3,Percent of total billed charges,,,0.98,,876.12,Percent of total billed charges,,,0.95,,849.3,Percent of total billed charges,,,0.97,,867.18,Percent of total billed charges,,,0.97,,867.18,Percent of total billed charges,,,0.96,,858.24,Percent of total billed charges,,,0.95,,849.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,849.3,Percent of total billed charges,,849.3,876.12,
HC or Peek Pushloc#AR-1923ps,PX-3253894WWM,CDM,3253894WWM,LOCAL,270,RC,,outpatient,,,894,804.6,,0.95,,849.3,Percent of total billed charges,,,0.98,,876.12,Percent of total billed charges,,,0.95,,849.3,Percent of total billed charges,,,0.95,,849.3,Percent of total billed charges,,,0.97,,867.18,Percent of total billed charges,,,0.96,,858.24,Percent of total billed charges,,,0.95,,849.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,849.3,Percent of total billed charges,,849.3,876.12,
HC or Peek Corkscrew 4.5#AR-,PX-3253895WWM,CDM,3253895WWM,LOCAL,270,RC,,inpatient,,,749,674.1,,0.95,,711.55,Percent of total billed charges,,,0.98,,734.02,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,0.97,,726.53,Percent of total billed charges,,,0.97,,726.53,Percent of total billed charges,,,0.96,,719.04,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,711.55,Percent of total billed charges,,711.55,734.02,
HC or Peek Corkscrew 4.5#AR-,PX-3253895WWM,CDM,3253895WWM,LOCAL,270,RC,,outpatient,,,749,674.1,,0.95,,711.55,Percent of total billed charges,,,0.98,,734.02,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,0.97,,726.53,Percent of total billed charges,,,0.96,,719.04,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,711.55,Percent of total billed charges,,711.55,734.02,
HC or Su Anchor Peek 5.5#AR-,PX-3253896WWM,CDM,3253896WWM,LOCAL,270,RC,,inpatient,,,999,899.1,,0.95,,949.05,Percent of total billed charges,,,0.98,,979.02,Percent of total billed charges,,,0.95,,949.05,Percent of total billed charges,,,0.97,,969.03,Percent of total billed charges,,,0.97,,969.03,Percent of total billed charges,,,0.96,,959.04,Percent of total billed charges,,,0.95,,949.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,949.05,Percent of total billed charges,,949.05,979.02,
HC or Su Anchor Peek 5.5#AR-,PX-3253896WWM,CDM,3253896WWM,LOCAL,270,RC,,outpatient,,,999,899.1,,0.95,,949.05,Percent of total billed charges,,,0.98,,979.02,Percent of total billed charges,,,0.95,,949.05,Percent of total billed charges,,,0.95,,949.05,Percent of total billed charges,,,0.97,,969.03,Percent of total billed charges,,,0.96,,959.04,Percent of total billed charges,,,0.95,,949.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,949.05,Percent of total billed charges,,949.05,979.02,
HC or Su Anchor Peek 4.75#AR,PX-3253897WWM,CDM,3253897WWM,LOCAL,270,RC,,inpatient,,,999,899.1,,0.95,,949.05,Percent of total billed charges,,,0.98,,979.02,Percent of total billed charges,,,0.95,,949.05,Percent of total billed charges,,,0.97,,969.03,Percent of total billed charges,,,0.97,,969.03,Percent of total billed charges,,,0.96,,959.04,Percent of total billed charges,,,0.95,,949.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,949.05,Percent of total billed charges,,949.05,979.02,
HC or Su Anchor Peek 4.75#AR,PX-3253897WWM,CDM,3253897WWM,LOCAL,270,RC,,outpatient,,,999,899.1,,0.95,,949.05,Percent of total billed charges,,,0.98,,979.02,Percent of total billed charges,,,0.95,,949.05,Percent of total billed charges,,,0.95,,949.05,Percent of total billed charges,,,0.97,,969.03,Percent of total billed charges,,,0.96,,959.04,Percent of total billed charges,,,0.95,,949.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,949.05,Percent of total billed charges,,949.05,979.02,
HC or Su Anchor Corkscrew#AR,PX-3253898WWM,CDM,3253898WWM,LOCAL,270,RC,,inpatient,,,749,674.1,,0.95,,711.55,Percent of total billed charges,,,0.98,,734.02,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,0.97,,726.53,Percent of total billed charges,,,0.97,,726.53,Percent of total billed charges,,,0.96,,719.04,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,711.55,Percent of total billed charges,,711.55,734.02,
HC or Su Anchor Corkscrew#AR,PX-3253898WWM,CDM,3253898WWM,LOCAL,270,RC,,outpatient,,,749,674.1,,0.95,,711.55,Percent of total billed charges,,,0.98,,734.02,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,0.97,,726.53,Percent of total billed charges,,,0.96,,719.04,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,711.55,Percent of total billed charges,,711.55,734.02,
HC or Su Anchor Peek 4.75#AR,PX-3253899WWM,CDM,3253899WWM,LOCAL,270,RC,,inpatient,,,935,841.5,,0.95,,888.25,Percent of total billed charges,,,0.98,,916.3,Percent of total billed charges,,,0.95,,888.25,Percent of total billed charges,,,0.97,,906.95,Percent of total billed charges,,,0.97,,906.95,Percent of total billed charges,,,0.96,,897.6,Percent of total billed charges,,,0.95,,888.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,888.25,Percent of total billed charges,,888.25,916.3,
HC or Su Anchor Peek 4.75#AR,PX-3253899WWM,CDM,3253899WWM,LOCAL,270,RC,,outpatient,,,935,841.5,,0.95,,888.25,Percent of total billed charges,,,0.98,,916.3,Percent of total billed charges,,,0.95,,888.25,Percent of total billed charges,,,0.95,,888.25,Percent of total billed charges,,,0.97,,906.95,Percent of total billed charges,,,0.96,,897.6,Percent of total billed charges,,,0.95,,888.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,888.25,Percent of total billed charges,,888.25,916.3,
HC or Plate 7 Hole#AR-8943t-,PX-3253901WWM,CDM,3253901WWM,LOCAL,270,RC,,inpatient,,,960,864,,0.95,,912,Percent of total billed charges,,,0.98,,940.8,Percent of total billed charges,,,0.95,,912,Percent of total billed charges,,,0.97,,931.2,Percent of total billed charges,,,0.97,,931.2,Percent of total billed charges,,,0.96,,921.6,Percent of total billed charges,,,0.95,,912,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,912,Percent of total billed charges,,912,940.8,
HC or Plate 7 Hole#AR-8943t-,PX-3253901WWM,CDM,3253901WWM,LOCAL,270,RC,,outpatient,,,960,864,,0.95,,912,Percent of total billed charges,,,0.98,,940.8,Percent of total billed charges,,,0.95,,912,Percent of total billed charges,,,0.95,,912,Percent of total billed charges,,,0.97,,931.2,Percent of total billed charges,,,0.96,,921.6,Percent of total billed charges,,,0.95,,912,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,912,Percent of total billed charges,,912,940.8,
HC or Tightrope#AR-8921cds,PX-3253902WWM,CDM,3253902WWM,LOCAL,270,RC,,inpatient,,,1397,1257.3,,0.95,,1327.15,Percent of total billed charges,,,0.98,,1369.06,Percent of total billed charges,,,0.95,,1327.15,Percent of total billed charges,,,0.97,,1355.09,Percent of total billed charges,,,0.97,,1355.09,Percent of total billed charges,,,0.96,,1341.12,Percent of total billed charges,,,0.95,,1327.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1327.15,Percent of total billed charges,,1327.15,1369.06,
HC or Tightrope#AR-8921cds,PX-3253902WWM,CDM,3253902WWM,LOCAL,270,RC,,outpatient,,,1397,1257.3,,0.95,,1327.15,Percent of total billed charges,,,0.98,,1369.06,Percent of total billed charges,,,0.95,,1327.15,Percent of total billed charges,,,0.95,,1327.15,Percent of total billed charges,,,0.97,,1355.09,Percent of total billed charges,,,0.96,,1341.12,Percent of total billed charges,,,0.95,,1327.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1327.15,Percent of total billed charges,,1327.15,1369.06,
HC or Screw Loc 3.5x12#AR-88,PX-3253903WWM,CDM,3253903WWM,LOCAL,270,RC,,inpatient,,,416,374.4,,0.95,,395.2,Percent of total billed charges,,,0.98,,407.68,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,0.97,,403.52,Percent of total billed charges,,,0.97,,403.52,Percent of total billed charges,,,0.96,,399.36,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,395.2,Percent of total billed charges,,395.2,407.68,
HC or Screw Loc 3.5x12#AR-88,PX-3253903WWM,CDM,3253903WWM,LOCAL,270,RC,,outpatient,,,416,374.4,,0.95,,395.2,Percent of total billed charges,,,0.98,,407.68,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,0.97,,403.52,Percent of total billed charges,,,0.96,,399.36,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,395.2,Percent of total billed charges,,395.2,407.68,
HC or Screw Loc 3.5x14#AR-88,PX-3253904WWM,CDM,3253904WWM,LOCAL,270,RC,,inpatient,,,334,300.6,,0.95,,317.3,Percent of total billed charges,,,0.98,,327.32,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,0.97,,323.98,Percent of total billed charges,,,0.97,,323.98,Percent of total billed charges,,,0.96,,320.64,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,317.3,Percent of total billed charges,,317.3,327.32,
HC or Screw Loc 3.5x14#AR-88,PX-3253904WWM,CDM,3253904WWM,LOCAL,270,RC,,outpatient,,,334,300.6,,0.95,,317.3,Percent of total billed charges,,,0.98,,327.32,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,0.97,,323.98,Percent of total billed charges,,,0.96,,320.64,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,317.3,Percent of total billed charges,,317.3,327.32,
HC or Screw Cort 3.5x18#AR-8,PX-3253905WWM,CDM,3253905WWM,LOCAL,270,RC,,inpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
HC or Screw Cort 3.5x18#AR-8,PX-3253905WWM,CDM,3253905WWM,LOCAL,270,RC,,outpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
HC or Screw Cann 4x50#AR-884,PX-3253906WWM,CDM,3253906WWM,LOCAL,270,RC,,inpatient,,,455,409.5,,0.95,,432.25,Percent of total billed charges,,,0.98,,445.9,Percent of total billed charges,,,0.95,,432.25,Percent of total billed charges,,,0.97,,441.35,Percent of total billed charges,,,0.97,,441.35,Percent of total billed charges,,,0.96,,436.8,Percent of total billed charges,,,0.95,,432.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,432.25,Percent of total billed charges,,432.25,445.9,
HC or Screw Cann 4x50#AR-884,PX-3253906WWM,CDM,3253906WWM,LOCAL,270,RC,,outpatient,,,455,409.5,,0.95,,432.25,Percent of total billed charges,,,0.98,,445.9,Percent of total billed charges,,,0.95,,432.25,Percent of total billed charges,,,0.95,,432.25,Percent of total billed charges,,,0.97,,441.35,Percent of total billed charges,,,0.96,,436.8,Percent of total billed charges,,,0.95,,432.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,432.25,Percent of total billed charges,,432.25,445.9,
HC or Drill Bit Cali 2.5#AR-,PX-3253907WWM,CDM,3253907WWM,LOCAL,270,RC,,inpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
HC or Drill Bit Cali 2.5#AR-,PX-3253907WWM,CDM,3253907WWM,LOCAL,270,RC,,outpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
HC or Drill Bit Cann 2.6#AR-,PX-3253908WWM,CDM,3253908WWM,LOCAL,270,RC,,inpatient,,,304,273.6,,0.95,,288.8,Percent of total billed charges,,,0.98,,297.92,Percent of total billed charges,,,0.95,,288.8,Percent of total billed charges,,,0.97,,294.88,Percent of total billed charges,,,0.97,,294.88,Percent of total billed charges,,,0.96,,291.84,Percent of total billed charges,,,0.95,,288.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,288.8,Percent of total billed charges,,288.8,297.92,
HC or Drill Bit Cann 2.6#AR-,PX-3253908WWM,CDM,3253908WWM,LOCAL,270,RC,,outpatient,,,304,273.6,,0.95,,288.8,Percent of total billed charges,,,0.98,,297.92,Percent of total billed charges,,,0.95,,288.8,Percent of total billed charges,,,0.95,,288.8,Percent of total billed charges,,,0.97,,294.88,Percent of total billed charges,,,0.96,,291.84,Percent of total billed charges,,,0.95,,288.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,288.8,Percent of total billed charges,,288.8,297.92,
HC or Drill Bit 2.5#AR-8943-,PX-3253909WWM,CDM,3253909WWM,LOCAL,270,RC,,inpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
HC or Drill Bit 2.5#AR-8943-,PX-3253909WWM,CDM,3253909WWM,LOCAL,270,RC,,outpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
HC or Drill Bit 3.5#AR-4160-,PX-3253910WWM,CDM,3253910WWM,LOCAL,270,RC,,inpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
HC or Drill Bit 3.5#AR-4160-,PX-3253910WWM,CDM,3253910WWM,LOCAL,270,RC,,outpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
HC or Guidewire 1.35mm#AR-89,PX-3253911WWM,CDM,3253911WWM,LOCAL,270,RC,,inpatient,,,123,110.7,,0.95,,116.85,Percent of total billed charges,,,0.98,,120.54,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.96,,118.08,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,116.85,Percent of total billed charges,,116.85,120.54,
HC or Guidewire 1.35mm#AR-89,PX-3253911WWM,CDM,3253911WWM,LOCAL,270,RC,,outpatient,,,123,110.7,,0.95,,116.85,Percent of total billed charges,,,0.98,,120.54,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.96,,118.08,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,116.85,Percent of total billed charges,,116.85,120.54,
HC or Aggres Plus 4.0#375-54,PX-3253912WWM,CDM,3253912WWM,LOCAL,270,RC,,inpatient,,,212,190.8,,0.95,,201.4,Percent of total billed charges,,,0.98,,207.76,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,0.97,,205.64,Percent of total billed charges,,,0.97,,205.64,Percent of total billed charges,,,0.96,,203.52,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,201.4,Percent of total billed charges,,201.4,207.76,
HC or Aggres Plus 4.0#375-54,PX-3253912WWM,CDM,3253912WWM,LOCAL,270,RC,,outpatient,,,212,190.8,,0.95,,201.4,Percent of total billed charges,,,0.98,,207.76,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,0.97,,205.64,Percent of total billed charges,,,0.96,,203.52,Percent of total billed charges,,,0.95,,201.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,201.4,Percent of total billed charges,,201.4,207.76,
HC or Endo Reload 45m#Ecr45d,PX-3253913WWM,CDM,3253913WWM,LOCAL,270,RC,,inpatient,,,358,322.2,,0.95,,340.1,Percent of total billed charges,,,0.98,,350.84,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,0.97,,347.26,Percent of total billed charges,,,0.97,,347.26,Percent of total billed charges,,,0.96,,343.68,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,340.1,Percent of total billed charges,,340.1,350.84,
HC or Endo Reload 45m#Ecr45d,PX-3253913WWM,CDM,3253913WWM,LOCAL,270,RC,,outpatient,,,358,322.2,,0.95,,340.1,Percent of total billed charges,,,0.98,,350.84,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,0.97,,347.26,Percent of total billed charges,,,0.96,,343.68,Percent of total billed charges,,,0.95,,340.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,340.1,Percent of total billed charges,,340.1,350.84,
HC or Enseal Trio #Etrio345h,PX-3253914WWM,CDM,3253914WWM,LOCAL,270,RC,,inpatient,,,1121,1008.9,,0.95,,1064.95,Percent of total billed charges,,,0.98,,1098.58,Percent of total billed charges,,,0.95,,1064.95,Percent of total billed charges,,,0.97,,1087.37,Percent of total billed charges,,,0.97,,1087.37,Percent of total billed charges,,,0.96,,1076.16,Percent of total billed charges,,,0.95,,1064.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1064.95,Percent of total billed charges,,1064.95,1098.58,
HC or Enseal Trio #Etrio345h,PX-3253914WWM,CDM,3253914WWM,LOCAL,270,RC,,outpatient,,,1121,1008.9,,0.95,,1064.95,Percent of total billed charges,,,0.98,,1098.58,Percent of total billed charges,,,0.95,,1064.95,Percent of total billed charges,,,0.95,,1064.95,Percent of total billed charges,,,0.97,,1087.37,Percent of total billed charges,,,0.96,,1076.16,Percent of total billed charges,,,0.95,,1064.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1064.95,Percent of total billed charges,,1064.95,1098.58,
HC or Tubing Patient#AR-6421,PX-3253915WWM,CDM,3253915WWM,LOCAL,270,RC,,inpatient,,,144,129.6,,0.95,,136.8,Percent of total billed charges,,,0.98,,141.12,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,0.97,,139.68,Percent of total billed charges,,,0.97,,139.68,Percent of total billed charges,,,0.96,,138.24,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,136.8,Percent of total billed charges,,136.8,141.12,
HC or Tubing Patient#AR-6421,PX-3253915WWM,CDM,3253915WWM,LOCAL,270,RC,,outpatient,,,144,129.6,,0.95,,136.8,Percent of total billed charges,,,0.98,,141.12,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,0.97,,139.68,Percent of total billed charges,,,0.96,,138.24,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,136.8,Percent of total billed charges,,136.8,141.12,
HC or Dissect Cur#AR-8400cds,PX-3253916WWM,CDM,3253916WWM,LOCAL,270,RC,,inpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
HC or Dissect Cur#AR-8400cds,PX-3253916WWM,CDM,3253916WWM,LOCAL,270,RC,,outpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
HC or Ablator 90#AR-9803a-90,PX-3253917WWM,CDM,3253917WWM,LOCAL,270,RC,,inpatient,,,461,414.9,,0.95,,437.95,Percent of total billed charges,,,0.98,,451.78,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,0.97,,447.17,Percent of total billed charges,,,0.97,,447.17,Percent of total billed charges,,,0.96,,442.56,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,437.95,Percent of total billed charges,,437.95,451.78,
HC or Ablator 90#AR-9803a-90,PX-3253917WWM,CDM,3253917WWM,LOCAL,270,RC,,outpatient,,,461,414.9,,0.95,,437.95,Percent of total billed charges,,,0.98,,451.78,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,0.97,,447.17,Percent of total billed charges,,,0.96,,442.56,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,437.95,Percent of total billed charges,,437.95,451.78,
HC or Tubing Pump #AR-6411,PX-3253918WWM,CDM,3253918WWM,LOCAL,270,RC,,inpatient,,,240,216,,0.95,,228,Percent of total billed charges,,,0.98,,235.2,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,0.97,,232.8,Percent of total billed charges,,,0.97,,232.8,Percent of total billed charges,,,0.96,,230.4,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,228,Percent of total billed charges,,228,235.2,
HC or Tubing Pump #AR-6411,PX-3253918WWM,CDM,3253918WWM,LOCAL,270,RC,,outpatient,,,240,216,,0.95,,228,Percent of total billed charges,,,0.98,,235.2,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,0.97,,232.8,Percent of total billed charges,,,0.96,,230.4,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,228,Percent of total billed charges,,228,235.2,
HC or Screw Teno #AR-1580ps,PX-3253919WWM,CDM,3253919WWM,LOCAL,270,RC,,inpatient,,,863,776.7,,0.95,,819.85,Percent of total billed charges,,,0.98,,845.74,Percent of total billed charges,,,0.95,,819.85,Percent of total billed charges,,,0.97,,837.11,Percent of total billed charges,,,0.97,,837.11,Percent of total billed charges,,,0.96,,828.48,Percent of total billed charges,,,0.95,,819.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,819.85,Percent of total billed charges,,819.85,845.74,
HC or Screw Teno #AR-1580ps,PX-3253919WWM,CDM,3253919WWM,LOCAL,270,RC,,outpatient,,,863,776.7,,0.95,,819.85,Percent of total billed charges,,,0.98,,845.74,Percent of total billed charges,,,0.95,,819.85,Percent of total billed charges,,,0.95,,819.85,Percent of total billed charges,,,0.97,,837.11,Percent of total billed charges,,,0.96,,828.48,Percent of total billed charges,,,0.95,,819.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,819.85,Percent of total billed charges,,819.85,845.74,
HC or Reamer Head#AR-1407.5,PX-3253920WWM,CDM,3253920WWM,LOCAL,270,RC,,inpatient,,,566,509.4,,0.95,,537.7,Percent of total billed charges,,,0.98,,554.68,Percent of total billed charges,,,0.95,,537.7,Percent of total billed charges,,,0.97,,549.02,Percent of total billed charges,,,0.97,,549.02,Percent of total billed charges,,,0.96,,543.36,Percent of total billed charges,,,0.95,,537.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,537.7,Percent of total billed charges,,537.7,554.68,
HC or Reamer Head#AR-1407.5,PX-3253920WWM,CDM,3253920WWM,LOCAL,270,RC,,outpatient,,,566,509.4,,0.95,,537.7,Percent of total billed charges,,,0.98,,554.68,Percent of total billed charges,,,0.95,,537.7,Percent of total billed charges,,,0.95,,537.7,Percent of total billed charges,,,0.97,,549.02,Percent of total billed charges,,,0.96,,543.36,Percent of total billed charges,,,0.95,,537.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,537.7,Percent of total billed charges,,537.7,554.68,
HC or Lasso R 45#AR-6068-45r,PX-3253921WWM,CDM,3253921WWM,LOCAL,270,RC,,inpatient,,,421,378.9,,0.95,,399.95,Percent of total billed charges,,,0.98,,412.58,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,0.97,,408.37,Percent of total billed charges,,,0.97,,408.37,Percent of total billed charges,,,0.96,,404.16,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,399.95,Percent of total billed charges,,399.95,412.58,
HC or Lasso R 45#AR-6068-45r,PX-3253921WWM,CDM,3253921WWM,LOCAL,270,RC,,outpatient,,,421,378.9,,0.95,,399.95,Percent of total billed charges,,,0.98,,412.58,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,0.97,,408.37,Percent of total billed charges,,,0.96,,404.16,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,399.95,Percent of total billed charges,,399.95,412.58,
HC or Lasso R 90#AR-6068-90r,PX-3253922WWM,CDM,3253922WWM,LOCAL,270,RC,,inpatient,,,421,378.9,,0.95,,399.95,Percent of total billed charges,,,0.98,,412.58,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,0.97,,408.37,Percent of total billed charges,,,0.97,,408.37,Percent of total billed charges,,,0.96,,404.16,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,399.95,Percent of total billed charges,,399.95,412.58,
HC or Lasso R 90#AR-6068-90r,PX-3253922WWM,CDM,3253922WWM,LOCAL,270,RC,,outpatient,,,421,378.9,,0.95,,399.95,Percent of total billed charges,,,0.98,,412.58,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,0.97,,408.37,Percent of total billed charges,,,0.96,,404.16,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,399.95,Percent of total billed charges,,399.95,412.58,
HC or Pushloc Kit#AR-1923ds,PX-3253923WWM,CDM,3253923WWM,LOCAL,270,RC,,inpatient,,,461,414.9,,0.95,,437.95,Percent of total billed charges,,,0.98,,451.78,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,0.97,,447.17,Percent of total billed charges,,,0.97,,447.17,Percent of total billed charges,,,0.96,,442.56,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,437.95,Percent of total billed charges,,437.95,451.78,
HC or Pushloc Kit#AR-1923ds,PX-3253923WWM,CDM,3253923WWM,LOCAL,270,RC,,outpatient,,,461,414.9,,0.95,,437.95,Percent of total billed charges,,,0.98,,451.78,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,0.97,,447.17,Percent of total billed charges,,,0.96,,442.56,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,437.95,Percent of total billed charges,,437.95,451.78,
HC or Lasso L 45#AR-6068-45l,PX-3253924WWM,CDM,3253924WWM,LOCAL,270,RC,,inpatient,,,421,378.9,,0.95,,399.95,Percent of total billed charges,,,0.98,,412.58,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,0.97,,408.37,Percent of total billed charges,,,0.97,,408.37,Percent of total billed charges,,,0.96,,404.16,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,399.95,Percent of total billed charges,,399.95,412.58,
HC or Lasso L 45#AR-6068-45l,PX-3253924WWM,CDM,3253924WWM,LOCAL,270,RC,,outpatient,,,421,378.9,,0.95,,399.95,Percent of total billed charges,,,0.98,,412.58,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,0.97,,408.37,Percent of total billed charges,,,0.96,,404.16,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,399.95,Percent of total billed charges,,399.95,412.58,
HC or Lasso St 90#AR-6068-90,PX-3253925WWM,CDM,3253925WWM,LOCAL,270,RC,,inpatient,,,421,378.9,,0.95,,399.95,Percent of total billed charges,,,0.98,,412.58,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,0.97,,408.37,Percent of total billed charges,,,0.97,,408.37,Percent of total billed charges,,,0.96,,404.16,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,399.95,Percent of total billed charges,,399.95,412.58,
HC or Lasso St 90#AR-6068-90,PX-3253925WWM,CDM,3253925WWM,LOCAL,270,RC,,outpatient,,,421,378.9,,0.95,,399.95,Percent of total billed charges,,,0.98,,412.58,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,0.97,,408.37,Percent of total billed charges,,,0.96,,404.16,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,399.95,Percent of total billed charges,,399.95,412.58,
HC or Trocar #2b5lt,PX-3253926WWM,CDM,3253926WWM,LOCAL,270,RC,,inpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
HC or Trocar #2b5lt,PX-3253926WWM,CDM,3253926WWM,LOCAL,270,RC,,outpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
HC or Trocar Sleeve #2cb5lt,PX-3253927WWM,CDM,3253927WWM,LOCAL,270,RC,,inpatient,,,142,127.8,,0.95,,134.9,Percent of total billed charges,,,0.98,,139.16,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,0.97,,137.74,Percent of total billed charges,,,0.97,,137.74,Percent of total billed charges,,,0.96,,136.32,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,134.9,Percent of total billed charges,,134.9,139.16,
HC or Trocar Sleeve #2cb5lt,PX-3253927WWM,CDM,3253927WWM,LOCAL,270,RC,,outpatient,,,142,127.8,,0.95,,134.9,Percent of total billed charges,,,0.98,,139.16,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,0.97,,137.74,Percent of total billed charges,,,0.96,,136.32,Percent of total billed charges,,,0.95,,134.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,134.9,Percent of total billed charges,,134.9,139.16,
HC or Lasso L 90#AR-6068-90l,PX-3253928WWM,CDM,3253928WWM,LOCAL,270,RC,,inpatient,,,421,378.9,,0.95,,399.95,Percent of total billed charges,,,0.98,,412.58,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,0.97,,408.37,Percent of total billed charges,,,0.97,,408.37,Percent of total billed charges,,,0.96,,404.16,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,399.95,Percent of total billed charges,,399.95,412.58,
HC or Lasso L 90#AR-6068-90l,PX-3253928WWM,CDM,3253928WWM,LOCAL,270,RC,,outpatient,,,421,378.9,,0.95,,399.95,Percent of total billed charges,,,0.98,,412.58,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,0.97,,408.37,Percent of total billed charges,,,0.96,,404.16,Percent of total billed charges,,,0.95,,399.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,399.95,Percent of total billed charges,,399.95,412.58,
HC or Excalibur# AR-8400ex,PX-3253929WWM,CDM,3253929WWM,LOCAL,270,RC,,inpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
HC or Excalibur# AR-8400ex,PX-3253929WWM,CDM,3253929WWM,LOCAL,270,RC,,outpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
HC or Burr Clear#AR-8500coe,PX-3253930WWM,CDM,3253930WWM,LOCAL,270,RC,,inpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
HC or Burr Clear#AR-8500coe,PX-3253930WWM,CDM,3253930WWM,LOCAL,270,RC,,outpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
HC or Plate 4 Hole#AR-8943bl,PX-3253931WWM,CDM,3253931WWM,LOCAL,270,RC,,inpatient,,,1246,1121.4,,0.95,,1183.7,Percent of total billed charges,,,0.98,,1221.08,Percent of total billed charges,,,0.95,,1183.7,Percent of total billed charges,,,0.97,,1208.62,Percent of total billed charges,,,0.97,,1208.62,Percent of total billed charges,,,0.96,,1196.16,Percent of total billed charges,,,0.95,,1183.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1183.7,Percent of total billed charges,,1183.7,1221.08,
HC or Plate 4 Hole#AR-8943bl,PX-3253931WWM,CDM,3253931WWM,LOCAL,270,RC,,outpatient,,,1246,1121.4,,0.95,,1183.7,Percent of total billed charges,,,0.98,,1221.08,Percent of total billed charges,,,0.95,,1183.7,Percent of total billed charges,,,0.95,,1183.7,Percent of total billed charges,,,0.97,,1208.62,Percent of total billed charges,,,0.96,,1196.16,Percent of total billed charges,,,0.95,,1183.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1183.7,Percent of total billed charges,,1183.7,1221.08,
HC or Drill Bit #AR-8943-16,PX-3253932WWM,CDM,3253932WWM,LOCAL,270,RC,,inpatient,,,253,227.7,,0.95,,240.35,Percent of total billed charges,,,0.98,,247.94,Percent of total billed charges,,,0.95,,240.35,Percent of total billed charges,,,0.97,,245.41,Percent of total billed charges,,,0.97,,245.41,Percent of total billed charges,,,0.96,,242.88,Percent of total billed charges,,,0.95,,240.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,240.35,Percent of total billed charges,,240.35,247.94,
HC or Drill Bit #AR-8943-16,PX-3253932WWM,CDM,3253932WWM,LOCAL,270,RC,,outpatient,,,253,227.7,,0.95,,240.35,Percent of total billed charges,,,0.98,,247.94,Percent of total billed charges,,,0.95,,240.35,Percent of total billed charges,,,0.95,,240.35,Percent of total billed charges,,,0.97,,245.41,Percent of total billed charges,,,0.96,,242.88,Percent of total billed charges,,,0.95,,240.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,240.35,Percent of total billed charges,,240.35,247.94,
HC or Screw Lock#AR-8827l-12,PX-3253933WWM,CDM,3253933WWM,LOCAL,270,RC,,inpatient,,,316,284.4,,0.95,,300.2,Percent of total billed charges,,,0.98,,309.68,Percent of total billed charges,,,0.95,,300.2,Percent of total billed charges,,,0.97,,306.52,Percent of total billed charges,,,0.97,,306.52,Percent of total billed charges,,,0.96,,303.36,Percent of total billed charges,,,0.95,,300.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,300.2,Percent of total billed charges,,300.2,309.68,
HC or Screw Lock#AR-8827l-12,PX-3253933WWM,CDM,3253933WWM,LOCAL,270,RC,,outpatient,,,316,284.4,,0.95,,300.2,Percent of total billed charges,,,0.98,,309.68,Percent of total billed charges,,,0.95,,300.2,Percent of total billed charges,,,0.95,,300.2,Percent of total billed charges,,,0.97,,306.52,Percent of total billed charges,,,0.96,,303.36,Percent of total billed charges,,,0.95,,300.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,300.2,Percent of total billed charges,,300.2,309.68,
HC or Screw Lock#AR-8827l-16,PX-3253934WWM,CDM,3253934WWM,LOCAL,270,RC,,inpatient,,,316,284.4,,0.95,,300.2,Percent of total billed charges,,,0.98,,309.68,Percent of total billed charges,,,0.95,,300.2,Percent of total billed charges,,,0.97,,306.52,Percent of total billed charges,,,0.97,,306.52,Percent of total billed charges,,,0.96,,303.36,Percent of total billed charges,,,0.95,,300.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,300.2,Percent of total billed charges,,300.2,309.68,
HC or Screw Lock#AR-8827l-16,PX-3253934WWM,CDM,3253934WWM,LOCAL,270,RC,,outpatient,,,316,284.4,,0.95,,300.2,Percent of total billed charges,,,0.98,,309.68,Percent of total billed charges,,,0.95,,300.2,Percent of total billed charges,,,0.95,,300.2,Percent of total billed charges,,,0.97,,306.52,Percent of total billed charges,,,0.96,,303.36,Percent of total billed charges,,,0.95,,300.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,300.2,Percent of total billed charges,,300.2,309.68,
HC or Screw Lock#AR-8827l-18,PX-3253935WWM,CDM,3253935WWM,LOCAL,270,RC,,inpatient,,,316,284.4,,0.95,,300.2,Percent of total billed charges,,,0.98,,309.68,Percent of total billed charges,,,0.95,,300.2,Percent of total billed charges,,,0.97,,306.52,Percent of total billed charges,,,0.97,,306.52,Percent of total billed charges,,,0.96,,303.36,Percent of total billed charges,,,0.95,,300.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,300.2,Percent of total billed charges,,300.2,309.68,
HC or Screw Lock#AR-8827l-18,PX-3253935WWM,CDM,3253935WWM,LOCAL,270,RC,,outpatient,,,316,284.4,,0.95,,300.2,Percent of total billed charges,,,0.98,,309.68,Percent of total billed charges,,,0.95,,300.2,Percent of total billed charges,,,0.95,,300.2,Percent of total billed charges,,,0.97,,306.52,Percent of total billed charges,,,0.96,,303.36,Percent of total billed charges,,,0.95,,300.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,300.2,Percent of total billed charges,,300.2,309.68,
HC or Screw Lock#AR-8835l-16,PX-3253936WWM,CDM,3253936WWM,LOCAL,270,RC,,inpatient,,,334,300.6,,0.95,,317.3,Percent of total billed charges,,,0.98,,327.32,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,0.97,,323.98,Percent of total billed charges,,,0.97,,323.98,Percent of total billed charges,,,0.96,,320.64,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,317.3,Percent of total billed charges,,317.3,327.32,
HC or Screw Lock#AR-8835l-16,PX-3253936WWM,CDM,3253936WWM,LOCAL,270,RC,,outpatient,,,334,300.6,,0.95,,317.3,Percent of total billed charges,,,0.98,,327.32,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,0.97,,323.98,Percent of total billed charges,,,0.96,,320.64,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,317.3,Percent of total billed charges,,317.3,327.32,
HC or Screw Lock#AR-8835l-20,PX-3253937WWM,CDM,3253937WWM,LOCAL,270,RC,,inpatient,,,334,300.6,,0.95,,317.3,Percent of total billed charges,,,0.98,,327.32,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,0.97,,323.98,Percent of total billed charges,,,0.97,,323.98,Percent of total billed charges,,,0.96,,320.64,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,317.3,Percent of total billed charges,,317.3,327.32,
HC or Screw Lock#AR-8835l-20,PX-3253937WWM,CDM,3253937WWM,LOCAL,270,RC,,outpatient,,,334,300.6,,0.95,,317.3,Percent of total billed charges,,,0.98,,327.32,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,0.97,,323.98,Percent of total billed charges,,,0.96,,320.64,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,317.3,Percent of total billed charges,,317.3,327.32,
HC or Cannula #AR-6592-08-50,PX-3253938WWM,CDM,3253938WWM,LOCAL,270,RC,,inpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
HC or Cannula #AR-6592-08-50,PX-3253938WWM,CDM,3253938WWM,LOCAL,270,RC,,outpatient,,,169,152.1,,0.95,,160.55,Percent of total billed charges,,,0.98,,165.62,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,0.97,,163.93,Percent of total billed charges,,,0.96,,162.24,Percent of total billed charges,,,0.95,,160.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,160.55,Percent of total billed charges,,160.55,165.62,
HC or Synergy Combo#Snghk2,PX-3253939WWM,CDM,3253939WWM,LOCAL,270,RC,,inpatient,,,786,707.4,,0.95,,746.7,Percent of total billed charges,,,0.98,,770.28,Percent of total billed charges,,,0.95,,746.7,Percent of total billed charges,,,0.97,,762.42,Percent of total billed charges,,,0.97,,762.42,Percent of total billed charges,,,0.96,,754.56,Percent of total billed charges,,,0.95,,746.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,746.7,Percent of total billed charges,,746.7,770.28,
HC or Synergy Combo#Snghk2,PX-3253939WWM,CDM,3253939WWM,LOCAL,270,RC,,outpatient,,,786,707.4,,0.95,,746.7,Percent of total billed charges,,,0.98,,770.28,Percent of total billed charges,,,0.95,,746.7,Percent of total billed charges,,,0.95,,746.7,Percent of total billed charges,,,0.97,,762.42,Percent of total billed charges,,,0.96,,754.56,Percent of total billed charges,,,0.95,,746.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,746.7,Percent of total billed charges,,746.7,770.28,
HC or Ablator 90#AR-9705a-90,PX-3253940WWM,CDM,3253940WWM,LOCAL,270,RC,,inpatient,,,488,439.2,,0.95,,463.6,Percent of total billed charges,,,0.98,,478.24,Percent of total billed charges,,,0.95,,463.6,Percent of total billed charges,,,0.97,,473.36,Percent of total billed charges,,,0.97,,473.36,Percent of total billed charges,,,0.96,,468.48,Percent of total billed charges,,,0.95,,463.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,463.6,Percent of total billed charges,,463.6,478.24,
HC or Ablator 90#AR-9705a-90,PX-3253940WWM,CDM,3253940WWM,LOCAL,270,RC,,outpatient,,,488,439.2,,0.95,,463.6,Percent of total billed charges,,,0.98,,478.24,Percent of total billed charges,,,0.95,,463.6,Percent of total billed charges,,,0.95,,463.6,Percent of total billed charges,,,0.97,,473.36,Percent of total billed charges,,,0.96,,468.48,Percent of total billed charges,,,0.95,,463.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,463.6,Percent of total billed charges,,463.6,478.24,
HC or Tubing Pump#AR-6410,PX-3253941WWM,CDM,3253941WWM,LOCAL,270,RC,,inpatient,,,240,216,,0.95,,228,Percent of total billed charges,,,0.98,,235.2,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,0.97,,232.8,Percent of total billed charges,,,0.97,,232.8,Percent of total billed charges,,,0.96,,230.4,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,228,Percent of total billed charges,,228,235.2,
HC or Tubing Pump#AR-6410,PX-3253941WWM,CDM,3253941WWM,LOCAL,270,RC,,outpatient,,,240,216,,0.95,,228,Percent of total billed charges,,,0.98,,235.2,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,0.97,,232.8,Percent of total billed charges,,,0.96,,230.4,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,228,Percent of total billed charges,,228,235.2,
HC or Reamer Core#AR-1224s,PX-3253942WWM,CDM,3253942WWM,LOCAL,270,RC,,inpatient,,,620,558,,0.95,,589,Percent of total billed charges,,,0.98,,607.6,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.96,,595.2,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,589,Percent of total billed charges,,589,607.6,
HC or Reamer Core#AR-1224s,PX-3253942WWM,CDM,3253942WWM,LOCAL,270,RC,,outpatient,,,620,558,,0.95,,589,Percent of total billed charges,,,0.98,,607.6,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.96,,595.2,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,589,Percent of total billed charges,,589,607.6,
HC or Reamer Low# AR-1410lp,PX-3253943WWM,CDM,3253943WWM,LOCAL,270,RC,,inpatient,,,589,530.1,,0.95,,559.55,Percent of total billed charges,,,0.98,,577.22,Percent of total billed charges,,,0.95,,559.55,Percent of total billed charges,,,0.97,,571.33,Percent of total billed charges,,,0.97,,571.33,Percent of total billed charges,,,0.96,,565.44,Percent of total billed charges,,,0.95,,559.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,559.55,Percent of total billed charges,,559.55,577.22,
HC or Reamer Low# AR-1410lp,PX-3253943WWM,CDM,3253943WWM,LOCAL,270,RC,,outpatient,,,589,530.1,,0.95,,559.55,Percent of total billed charges,,,0.98,,577.22,Percent of total billed charges,,,0.95,,559.55,Percent of total billed charges,,,0.95,,559.55,Percent of total billed charges,,,0.97,,571.33,Percent of total billed charges,,,0.96,,565.44,Percent of total billed charges,,,0.95,,559.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,559.55,Percent of total billed charges,,559.55,577.22,
HC or Reamer Head#AR-1407,PX-3253944WWM,CDM,3253944WWM,LOCAL,270,RC,,inpatient,,,566,509.4,,0.95,,537.7,Percent of total billed charges,,,0.98,,554.68,Percent of total billed charges,,,0.95,,537.7,Percent of total billed charges,,,0.97,,549.02,Percent of total billed charges,,,0.97,,549.02,Percent of total billed charges,,,0.96,,543.36,Percent of total billed charges,,,0.95,,537.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,537.7,Percent of total billed charges,,537.7,554.68,
HC or Reamer Head#AR-1407,PX-3253944WWM,CDM,3253944WWM,LOCAL,270,RC,,outpatient,,,566,509.4,,0.95,,537.7,Percent of total billed charges,,,0.98,,554.68,Percent of total billed charges,,,0.95,,537.7,Percent of total billed charges,,,0.95,,537.7,Percent of total billed charges,,,0.97,,549.02,Percent of total billed charges,,,0.96,,543.36,Percent of total billed charges,,,0.95,,537.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,537.7,Percent of total billed charges,,537.7,554.68,
HC or Swivelock #AR-1662bc-8,PX-3253945WWM,CDM,3253945WWM,LOCAL,270,RC,,inpatient,,,920,828,,0.95,,874,Percent of total billed charges,,,0.98,,901.6,Percent of total billed charges,,,0.95,,874,Percent of total billed charges,,,0.97,,892.4,Percent of total billed charges,,,0.97,,892.4,Percent of total billed charges,,,0.96,,883.2,Percent of total billed charges,,,0.95,,874,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,874,Percent of total billed charges,,874,901.6,
HC or Swivelock #AR-1662bc-8,PX-3253945WWM,CDM,3253945WWM,LOCAL,270,RC,,outpatient,,,920,828,,0.95,,874,Percent of total billed charges,,,0.98,,901.6,Percent of total billed charges,,,0.95,,874,Percent of total billed charges,,,0.95,,874,Percent of total billed charges,,,0.97,,892.4,Percent of total billed charges,,,0.96,,883.2,Percent of total billed charges,,,0.95,,874,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,874,Percent of total billed charges,,874,901.6,
HC or Fiberwire 2-0#AR-7220,PX-3253946WWM,CDM,3253946WWM,LOCAL,270,RC,,inpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
HC or Fiberwire 2-0#AR-7220,PX-3253946WWM,CDM,3253946WWM,LOCAL,270,RC,,outpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
HC or Pushloc Mini#Ar1322dsl,PX-3253947WWM,CDM,3253947WWM,LOCAL,270,RC,,inpatient,,,461,414.9,,0.95,,437.95,Percent of total billed charges,,,0.98,,451.78,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,0.97,,447.17,Percent of total billed charges,,,0.97,,447.17,Percent of total billed charges,,,0.96,,442.56,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,437.95,Percent of total billed charges,,437.95,451.78,
HC or Pushloc Mini#Ar1322dsl,PX-3253947WWM,CDM,3253947WWM,LOCAL,270,RC,,outpatient,,,461,414.9,,0.95,,437.95,Percent of total billed charges,,,0.98,,451.78,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,0.97,,447.17,Percent of total billed charges,,,0.96,,442.56,Percent of total billed charges,,,0.95,,437.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,437.95,Percent of total billed charges,,437.95,451.78,
HC or Pushloc Peek#Ar8825p,PX-3253948WWM,CDM,3253948WWM,LOCAL,270,RC,,inpatient,,,894,804.6,,0.95,,849.3,Percent of total billed charges,,,0.98,,876.12,Percent of total billed charges,,,0.95,,849.3,Percent of total billed charges,,,0.97,,867.18,Percent of total billed charges,,,0.97,,867.18,Percent of total billed charges,,,0.96,,858.24,Percent of total billed charges,,,0.95,,849.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,849.3,Percent of total billed charges,,849.3,876.12,
HC or Pushloc Peek#Ar8825p,PX-3253948WWM,CDM,3253948WWM,LOCAL,270,RC,,outpatient,,,894,804.6,,0.95,,849.3,Percent of total billed charges,,,0.98,,876.12,Percent of total billed charges,,,0.95,,849.3,Percent of total billed charges,,,0.95,,849.3,Percent of total billed charges,,,0.97,,867.18,Percent of total billed charges,,,0.96,,858.24,Percent of total billed charges,,,0.95,,849.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,849.3,Percent of total billed charges,,849.3,876.12,
HC or Screw 3.5x12#Cs12000,PX-3253949WWM,CDM,3253949WWM,LOCAL,270,RC,,inpatient,,,285,256.5,,0.95,,270.75,Percent of total billed charges,,,0.98,,279.3,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.96,,273.6,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,270.75,Percent of total billed charges,,270.75,279.3,
HC or Screw 3.5x12#Cs12000,PX-3253949WWM,CDM,3253949WWM,LOCAL,270,RC,,outpatient,,,285,256.5,,0.95,,270.75,Percent of total billed charges,,,0.98,,279.3,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.96,,273.6,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,270.75,Percent of total billed charges,,270.75,279.3,
HC or Screw 3.5x14 #Cs14000,PX-3253950WWM,CDM,3253950WWM,LOCAL,270,RC,,inpatient,,,285,256.5,,0.95,,270.75,Percent of total billed charges,,,0.98,,279.3,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.96,,273.6,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,270.75,Percent of total billed charges,,270.75,279.3,
HC or Screw 3.5x14 #Cs14000,PX-3253950WWM,CDM,3253950WWM,LOCAL,270,RC,,outpatient,,,285,256.5,,0.95,,270.75,Percent of total billed charges,,,0.98,,279.3,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.96,,273.6,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,270.75,Percent of total billed charges,,270.75,279.3,
HC or Drill Bit 2.5# Db25,PX-3253951WWM,CDM,3253951WWM,LOCAL,270,RC,,inpatient,,,313,281.7,,0.95,,297.35,Percent of total billed charges,,,0.98,,306.74,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,0.97,,303.61,Percent of total billed charges,,,0.97,,303.61,Percent of total billed charges,,,0.96,,300.48,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,297.35,Percent of total billed charges,,297.35,306.74,
HC or Drill Bit 2.5# Db25,PX-3253951WWM,CDM,3253951WWM,LOCAL,270,RC,,outpatient,,,313,281.7,,0.95,,297.35,Percent of total billed charges,,,0.98,,306.74,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,0.97,,303.61,Percent of total billed charges,,,0.96,,300.48,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,297.35,Percent of total billed charges,,297.35,306.74,
HC or Dvr Anatomic# Dvranl,PX-3253952WWM,CDM,3253952WWM,LOCAL,270,RC,,inpatient,,,1973,1775.7,,0.95,,1874.35,Percent of total billed charges,,,0.98,,1933.54,Percent of total billed charges,,,0.95,,1874.35,Percent of total billed charges,,,0.97,,1913.81,Percent of total billed charges,,,0.97,,1913.81,Percent of total billed charges,,,0.96,,1894.08,Percent of total billed charges,,,0.95,,1874.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1874.35,Percent of total billed charges,,1874.35,1933.54,
HC or Dvr Anatomic# Dvranl,PX-3253952WWM,CDM,3253952WWM,LOCAL,270,RC,,outpatient,,,1973,1775.7,,0.95,,1874.35,Percent of total billed charges,,,0.98,,1933.54,Percent of total billed charges,,,0.95,,1874.35,Percent of total billed charges,,,0.95,,1874.35,Percent of total billed charges,,,0.97,,1913.81,Percent of total billed charges,,,0.96,,1894.08,Percent of total billed charges,,,0.95,,1874.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1874.35,Percent of total billed charges,,1874.35,1933.54,
HC or Drill Bit 2.0# Fdb20,PX-3253953WWM,CDM,3253953WWM,LOCAL,270,RC,,inpatient,,,313,281.7,,0.95,,297.35,Percent of total billed charges,,,0.98,,306.74,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,0.97,,303.61,Percent of total billed charges,,,0.97,,303.61,Percent of total billed charges,,,0.96,,300.48,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,297.35,Percent of total billed charges,,297.35,306.74,
HC or Drill Bit 2.0# Fdb20,PX-3253953WWM,CDM,3253953WWM,LOCAL,270,RC,,outpatient,,,313,281.7,,0.95,,297.35,Percent of total billed charges,,,0.98,,306.74,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,0.97,,303.61,Percent of total billed charges,,,0.96,,300.48,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,297.35,Percent of total billed charges,,297.35,306.74,
HC or Peg Full 2.5x16# Fp16,PX-3253954WWM,CDM,3253954WWM,LOCAL,270,RC,,inpatient,,,285,256.5,,0.95,,270.75,Percent of total billed charges,,,0.98,,279.3,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.96,,273.6,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,270.75,Percent of total billed charges,,270.75,279.3,
HC or Peg Full 2.5x16# Fp16,PX-3253954WWM,CDM,3253954WWM,LOCAL,270,RC,,outpatient,,,285,256.5,,0.95,,270.75,Percent of total billed charges,,,0.98,,279.3,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.96,,273.6,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,270.75,Percent of total billed charges,,270.75,279.3,
HC or Peg Full 2.5x18# Fp18,PX-3253955WWM,CDM,3253955WWM,LOCAL,270,RC,,inpatient,,,285,256.5,,0.95,,270.75,Percent of total billed charges,,,0.98,,279.3,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.96,,273.6,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,270.75,Percent of total billed charges,,270.75,279.3,
HC or Peg Full 2.5x18# Fp18,PX-3253955WWM,CDM,3253955WWM,LOCAL,270,RC,,outpatient,,,285,256.5,,0.95,,270.75,Percent of total billed charges,,,0.98,,279.3,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.96,,273.6,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,270.75,Percent of total billed charges,,270.75,279.3,
HC or Peg Full 2.5x20# Fp20,PX-3253956WWM,CDM,3253956WWM,LOCAL,270,RC,,inpatient,,,285,256.5,,0.95,,270.75,Percent of total billed charges,,,0.98,,279.3,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.96,,273.6,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,270.75,Percent of total billed charges,,270.75,279.3,
HC or Peg Full 2.5x20# Fp20,PX-3253956WWM,CDM,3253956WWM,LOCAL,270,RC,,outpatient,,,285,256.5,,0.95,,270.75,Percent of total billed charges,,,0.98,,279.3,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.96,,273.6,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,270.75,Percent of total billed charges,,270.75,279.3,
HC or Peg Full 2.5x22 #Fp22,PX-3253957WWM,CDM,3253957WWM,LOCAL,270,RC,,inpatient,,,285,256.5,,0.95,,270.75,Percent of total billed charges,,,0.98,,279.3,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.96,,273.6,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,270.75,Percent of total billed charges,,270.75,279.3,
HC or Peg Full 2.5x22 #Fp22,PX-3253957WWM,CDM,3253957WWM,LOCAL,270,RC,,outpatient,,,285,256.5,,0.95,,270.75,Percent of total billed charges,,,0.98,,279.3,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.96,,273.6,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,270.75,Percent of total billed charges,,270.75,279.3,
HC or Peg Full 2.5x26 #Fp26,PX-3253958WWM,CDM,3253958WWM,LOCAL,270,RC,,inpatient,,,285,256.5,,0.95,,270.75,Percent of total billed charges,,,0.98,,279.3,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.96,,273.6,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,270.75,Percent of total billed charges,,270.75,279.3,
HC or Peg Full 2.5x26 #Fp26,PX-3253958WWM,CDM,3253958WWM,LOCAL,270,RC,,outpatient,,,285,256.5,,0.95,,270.75,Percent of total billed charges,,,0.98,,279.3,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,0.97,,276.45,Percent of total billed charges,,,0.96,,273.6,Percent of total billed charges,,,0.95,,270.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,270.75,Percent of total billed charges,,270.75,279.3,
HC or K Wire 1.6 #Kw062ss,PX-3253959WWM,CDM,3253959WWM,LOCAL,270,RC,,inpatient,,,132,118.8,,0.95,,125.4,Percent of total billed charges,,,0.98,,129.36,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.96,,126.72,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,125.4,Percent of total billed charges,,125.4,129.36,
HC or K Wire 1.6 #Kw062ss,PX-3253959WWM,CDM,3253959WWM,LOCAL,270,RC,,outpatient,,,132,118.8,,0.95,,125.4,Percent of total billed charges,,,0.98,,129.36,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.96,,126.72,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,125.4,Percent of total billed charges,,125.4,129.36,
HC or Peg Thread #1312-11-124,PX-3253960WWM,CDM,3253960WWM,LOCAL,270,RC,,inpatient,,,503,452.7,,0.95,,477.85,Percent of total billed charges,,,0.98,,492.94,Percent of total billed charges,,,0.95,,477.85,Percent of total billed charges,,,0.97,,487.91,Percent of total billed charges,,,0.97,,487.91,Percent of total billed charges,,,0.96,,482.88,Percent of total billed charges,,,0.95,,477.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,477.85,Percent of total billed charges,,477.85,492.94,
HC or Peg Thread #1312-11-124,PX-3253960WWM,CDM,3253960WWM,LOCAL,270,RC,,outpatient,,,503,452.7,,0.95,,477.85,Percent of total billed charges,,,0.98,,492.94,Percent of total billed charges,,,0.95,,477.85,Percent of total billed charges,,,0.95,,477.85,Percent of total billed charges,,,0.97,,487.91,Percent of total billed charges,,,0.96,,482.88,Percent of total billed charges,,,0.95,,477.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,477.85,Percent of total billed charges,,477.85,492.94,
HC or Peg Thread #1312-11-126,PX-3253961WWM,CDM,3253961WWM,LOCAL,270,RC,,inpatient,,,503,452.7,,0.95,,477.85,Percent of total billed charges,,,0.98,,492.94,Percent of total billed charges,,,0.95,,477.85,Percent of total billed charges,,,0.97,,487.91,Percent of total billed charges,,,0.97,,487.91,Percent of total billed charges,,,0.96,,482.88,Percent of total billed charges,,,0.95,,477.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,477.85,Percent of total billed charges,,477.85,492.94,
HC or Peg Thread #1312-11-126,PX-3253961WWM,CDM,3253961WWM,LOCAL,270,RC,,outpatient,,,503,452.7,,0.95,,477.85,Percent of total billed charges,,,0.98,,492.94,Percent of total billed charges,,,0.95,,477.85,Percent of total billed charges,,,0.95,,477.85,Percent of total billed charges,,,0.97,,487.91,Percent of total billed charges,,,0.96,,482.88,Percent of total billed charges,,,0.95,,477.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,477.85,Percent of total billed charges,,477.85,492.94,
HC or Enseal Trio #Etrio325h,PX-3253963WWM,CDM,3253963WWM,LOCAL,270,RC,,inpatient,,,841,756.9,,0.95,,798.95,Percent of total billed charges,,,0.98,,824.18,Percent of total billed charges,,,0.95,,798.95,Percent of total billed charges,,,0.97,,815.77,Percent of total billed charges,,,0.97,,815.77,Percent of total billed charges,,,0.96,,807.36,Percent of total billed charges,,,0.95,,798.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,798.95,Percent of total billed charges,,798.95,824.18,
HC or Enseal Trio #Etrio325h,PX-3253963WWM,CDM,3253963WWM,LOCAL,270,RC,,outpatient,,,841,756.9,,0.95,,798.95,Percent of total billed charges,,,0.98,,824.18,Percent of total billed charges,,,0.95,,798.95,Percent of total billed charges,,,0.95,,798.95,Percent of total billed charges,,,0.97,,815.77,Percent of total billed charges,,,0.96,,807.36,Percent of total billed charges,,,0.95,,798.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,798.95,Percent of total billed charges,,798.95,824.18,
HC or Dissector # AR-7300ds,PX-3253965WWM,CDM,3253965WWM,LOCAL,270,RC,,inpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
HC or Dissector # AR-7300ds,PX-3253965WWM,CDM,3253965WWM,LOCAL,270,RC,,outpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
HC or Burr Round #AR-7300rbe,PX-3253966WWM,CDM,3253966WWM,LOCAL,270,RC,,inpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
HC or Burr Round #AR-7300rbe,PX-3253966WWM,CDM,3253966WWM,LOCAL,270,RC,,outpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
HC or Enseal Tissue#Nsealx22,PX-3253967WWM,CDM,3253967WWM,LOCAL,270,RC,,inpatient,,,1381,1242.9,,0.95,,1311.95,Percent of total billed charges,,,0.98,,1353.38,Percent of total billed charges,,,0.95,,1311.95,Percent of total billed charges,,,0.97,,1339.57,Percent of total billed charges,,,0.97,,1339.57,Percent of total billed charges,,,0.96,,1325.76,Percent of total billed charges,,,0.95,,1311.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1311.95,Percent of total billed charges,,1311.95,1353.38,
HC or Enseal Tissue#Nsealx22,PX-3253967WWM,CDM,3253967WWM,LOCAL,270,RC,,outpatient,,,1381,1242.9,,0.95,,1311.95,Percent of total billed charges,,,0.98,,1353.38,Percent of total billed charges,,,0.95,,1311.95,Percent of total billed charges,,,0.95,,1311.95,Percent of total billed charges,,,0.97,,1339.57,Percent of total billed charges,,,0.96,,1325.76,Percent of total billed charges,,,0.95,,1311.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1311.95,Percent of total billed charges,,1311.95,1353.38,
HC or Cath 18fr #361218,PX-3253968WWM,CDM,3253968WWM,LOCAL,270,RC,,inpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
HC or Cath 18fr #361218,PX-3253968WWM,CDM,3253968WWM,LOCAL,270,RC,,outpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
HC or Cath 22 Fr #361222,PX-3253969WWM,CDM,3253969WWM,LOCAL,270,RC,,inpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
HC or Cath 22 Fr #361222,PX-3253969WWM,CDM,3253969WWM,LOCAL,270,RC,,outpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
HC or Cath 26fr #361226,PX-3253970WWM,CDM,3253970WWM,LOCAL,270,RC,,inpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
HC or Cath 26fr #361226,PX-3253970WWM,CDM,3253970WWM,LOCAL,270,RC,,outpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
HC or Cath 30fr # 361230,PX-3253971WWM,CDM,3253971WWM,LOCAL,270,RC,,inpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
HC or Cath 30fr # 361230,PX-3253971WWM,CDM,3253971WWM,LOCAL,270,RC,,outpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
HC or Cath 34fr #361234,PX-3253972WWM,CDM,3253972WWM,LOCAL,270,RC,,inpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
HC or Cath 34fr #361234,PX-3253972WWM,CDM,3253972WWM,LOCAL,270,RC,,outpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
HC or Cath 36fr # 361236,PX-3253973WWM,CDM,3253973WWM,LOCAL,270,RC,,inpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
HC or Cath 36fr # 361236,PX-3253973WWM,CDM,3253973WWM,LOCAL,270,RC,,outpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
HC or Swivelock #Ar1662psl-7,PX-3253974WWM,CDM,3253974WWM,LOCAL,270,RC,,inpatient,,,1073,965.7,,0.95,,1019.35,Percent of total billed charges,,,0.98,,1051.54,Percent of total billed charges,,,0.95,,1019.35,Percent of total billed charges,,,0.97,,1040.81,Percent of total billed charges,,,0.97,,1040.81,Percent of total billed charges,,,0.96,,1030.08,Percent of total billed charges,,,0.95,,1019.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1019.35,Percent of total billed charges,,1019.35,1051.54,
HC or Swivelock #Ar1662psl-7,PX-3253974WWM,CDM,3253974WWM,LOCAL,270,RC,,outpatient,,,1073,965.7,,0.95,,1019.35,Percent of total billed charges,,,0.98,,1051.54,Percent of total billed charges,,,0.95,,1019.35,Percent of total billed charges,,,0.95,,1019.35,Percent of total billed charges,,,0.97,,1040.81,Percent of total billed charges,,,0.96,,1030.08,Percent of total billed charges,,,0.95,,1019.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1019.35,Percent of total billed charges,,1019.35,1051.54,
HC or Fiberloop #Ar7234c,PX-3253975WWM,CDM,3253975WWM,LOCAL,270,RC,,inpatient,,,178,160.2,,0.95,,169.1,Percent of total billed charges,,,0.98,,174.44,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,0.97,,172.66,Percent of total billed charges,,,0.97,,172.66,Percent of total billed charges,,,0.96,,170.88,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,169.1,Percent of total billed charges,,169.1,174.44,
HC or Fiberloop #Ar7234c,PX-3253975WWM,CDM,3253975WWM,LOCAL,270,RC,,outpatient,,,178,160.2,,0.95,,169.1,Percent of total billed charges,,,0.98,,174.44,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,0.97,,172.66,Percent of total billed charges,,,0.96,,170.88,Percent of total billed charges,,,0.95,,169.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,169.1,Percent of total billed charges,,169.1,174.44,
HC or Plate #Ar8943br-04,PX-3253976WWM,CDM,3253976WWM,LOCAL,270,RC,,inpatient,,,1551,1395.9,,0.95,,1473.45,Percent of total billed charges,,,0.98,,1519.98,Percent of total billed charges,,,0.95,,1473.45,Percent of total billed charges,,,0.97,,1504.47,Percent of total billed charges,,,0.97,,1504.47,Percent of total billed charges,,,0.96,,1488.96,Percent of total billed charges,,,0.95,,1473.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1473.45,Percent of total billed charges,,1473.45,1519.98,
HC or Plate #Ar8943br-04,PX-3253976WWM,CDM,3253976WWM,LOCAL,270,RC,,outpatient,,,1551,1395.9,,0.95,,1473.45,Percent of total billed charges,,,0.98,,1519.98,Percent of total billed charges,,,0.95,,1473.45,Percent of total billed charges,,,0.95,,1473.45,Percent of total billed charges,,,0.97,,1504.47,Percent of total billed charges,,,0.96,,1488.96,Percent of total billed charges,,,0.95,,1473.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1473.45,Percent of total billed charges,,1473.45,1519.98,
HC or Screw Lock #Ar8827l-14,PX-3253977WWM,CDM,3253977WWM,LOCAL,270,RC,,inpatient,,,395,355.5,,0.95,,375.25,Percent of total billed charges,,,0.98,,387.1,Percent of total billed charges,,,0.95,,375.25,Percent of total billed charges,,,0.97,,383.15,Percent of total billed charges,,,0.97,,383.15,Percent of total billed charges,,,0.96,,379.2,Percent of total billed charges,,,0.95,,375.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,375.25,Percent of total billed charges,,375.25,387.1,
HC or Screw Lock #Ar8827l-14,PX-3253977WWM,CDM,3253977WWM,LOCAL,270,RC,,outpatient,,,395,355.5,,0.95,,375.25,Percent of total billed charges,,,0.98,,387.1,Percent of total billed charges,,,0.95,,375.25,Percent of total billed charges,,,0.95,,375.25,Percent of total billed charges,,,0.97,,383.15,Percent of total billed charges,,,0.96,,379.2,Percent of total billed charges,,,0.95,,375.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,375.25,Percent of total billed charges,,375.25,387.1,
HC or Reamer Low #Ar1409lp,PX-3253978WWM,CDM,3253978WWM,LOCAL,270,RC,,inpatient,,,735,661.5,,0.95,,698.25,Percent of total billed charges,,,0.98,,720.3,Percent of total billed charges,,,0.95,,698.25,Percent of total billed charges,,,0.97,,712.95,Percent of total billed charges,,,0.97,,712.95,Percent of total billed charges,,,0.96,,705.6,Percent of total billed charges,,,0.95,,698.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,698.25,Percent of total billed charges,,698.25,720.3,
HC or Reamer Low #Ar1409lp,PX-3253978WWM,CDM,3253978WWM,LOCAL,270,RC,,outpatient,,,735,661.5,,0.95,,698.25,Percent of total billed charges,,,0.98,,720.3,Percent of total billed charges,,,0.95,,698.25,Percent of total billed charges,,,0.95,,698.25,Percent of total billed charges,,,0.97,,712.95,Percent of total billed charges,,,0.96,,705.6,Percent of total billed charges,,,0.95,,698.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,698.25,Percent of total billed charges,,698.25,720.3,
HC or Meniscal Cinch#AR-4500,PX-3253979WWM,CDM,3253979WWM,LOCAL,270,RC,,inpatient,,,863,776.7,,0.95,,819.85,Percent of total billed charges,,,0.98,,845.74,Percent of total billed charges,,,0.95,,819.85,Percent of total billed charges,,,0.97,,837.11,Percent of total billed charges,,,0.97,,837.11,Percent of total billed charges,,,0.96,,828.48,Percent of total billed charges,,,0.95,,819.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,819.85,Percent of total billed charges,,819.85,845.74,
HC or Meniscal Cinch#AR-4500,PX-3253979WWM,CDM,3253979WWM,LOCAL,270,RC,,outpatient,,,863,776.7,,0.95,,819.85,Percent of total billed charges,,,0.98,,845.74,Percent of total billed charges,,,0.95,,819.85,Percent of total billed charges,,,0.95,,819.85,Percent of total billed charges,,,0.97,,837.11,Percent of total billed charges,,,0.96,,828.48,Percent of total billed charges,,,0.95,,819.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,819.85,Percent of total billed charges,,819.85,845.74,
HC or Plate 7 Hole #AR-8943c,PX-3253990WWM,CDM,3253990WWM,LOCAL,270,RC,,inpatient,,,1479,1331.1,,0.95,,1405.05,Percent of total billed charges,,,0.98,,1449.42,Percent of total billed charges,,,0.95,,1405.05,Percent of total billed charges,,,0.97,,1434.63,Percent of total billed charges,,,0.97,,1434.63,Percent of total billed charges,,,0.96,,1419.84,Percent of total billed charges,,,0.95,,1405.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1405.05,Percent of total billed charges,,1405.05,1449.42,
HC or Plate 7 Hole #AR-8943c,PX-3253990WWM,CDM,3253990WWM,LOCAL,270,RC,,outpatient,,,1479,1331.1,,0.95,,1405.05,Percent of total billed charges,,,0.98,,1449.42,Percent of total billed charges,,,0.95,,1405.05,Percent of total billed charges,,,0.95,,1405.05,Percent of total billed charges,,,0.97,,1434.63,Percent of total billed charges,,,0.96,,1419.84,Percent of total billed charges,,,0.95,,1405.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1405.05,Percent of total billed charges,,1405.05,1449.42,
HC or Screw Cort 3.5x12#AR-8,PX-3253991WWM,CDM,3253991WWM,LOCAL,270,RC,,inpatient,,,186,167.4,,0.95,,176.7,Percent of total billed charges,,,0.98,,182.28,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.96,,178.56,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,176.7,Percent of total billed charges,,176.7,182.28,
HC or Screw Cort 3.5x12#AR-8,PX-3253991WWM,CDM,3253991WWM,LOCAL,270,RC,,outpatient,,,186,167.4,,0.95,,176.7,Percent of total billed charges,,,0.98,,182.28,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.96,,178.56,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,176.7,Percent of total billed charges,,176.7,182.28,
HC or Screw Lock 3.5x16#AR-8,PX-3253992WWM,CDM,3253992WWM,LOCAL,270,RC,,inpatient,,,416,374.4,,0.95,,395.2,Percent of total billed charges,,,0.98,,407.68,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,0.97,,403.52,Percent of total billed charges,,,0.97,,403.52,Percent of total billed charges,,,0.96,,399.36,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,395.2,Percent of total billed charges,,395.2,407.68,
HC or Screw Lock 3.5x16#AR-8,PX-3253992WWM,CDM,3253992WWM,LOCAL,270,RC,,outpatient,,,416,374.4,,0.95,,395.2,Percent of total billed charges,,,0.98,,407.68,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,0.97,,403.52,Percent of total billed charges,,,0.96,,399.36,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,395.2,Percent of total billed charges,,395.2,407.68,
HC or Plate 4 Hole#AR-8943br,PX-3253993WWM,CDM,3253993WWM,LOCAL,270,RC,,inpatient,,,1551,1395.9,,0.95,,1473.45,Percent of total billed charges,,,0.98,,1519.98,Percent of total billed charges,,,0.95,,1473.45,Percent of total billed charges,,,0.97,,1504.47,Percent of total billed charges,,,0.97,,1504.47,Percent of total billed charges,,,0.96,,1488.96,Percent of total billed charges,,,0.95,,1473.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1473.45,Percent of total billed charges,,1473.45,1519.98,
HC or Plate 4 Hole#AR-8943br,PX-3253993WWM,CDM,3253993WWM,LOCAL,270,RC,,outpatient,,,1551,1395.9,,0.95,,1473.45,Percent of total billed charges,,,0.98,,1519.98,Percent of total billed charges,,,0.95,,1473.45,Percent of total billed charges,,,0.95,,1473.45,Percent of total billed charges,,,0.97,,1504.47,Percent of total billed charges,,,0.96,,1488.96,Percent of total billed charges,,,0.95,,1473.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1473.45,Percent of total billed charges,,1473.45,1519.98,
HC or Screw Long 4x60#Ar8840,PX-3253994WWM,CDM,3253994WWM,LOCAL,270,RC,,inpatient,,,186,167.4,,0.95,,176.7,Percent of total billed charges,,,0.98,,182.28,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.96,,178.56,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,176.7,Percent of total billed charges,,176.7,182.28,
HC or Screw Long 4x60#Ar8840,PX-3253994WWM,CDM,3253994WWM,LOCAL,270,RC,,outpatient,,,186,167.4,,0.95,,176.7,Percent of total billed charges,,,0.98,,182.28,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,0.97,,180.42,Percent of total billed charges,,,0.96,,178.56,Percent of total billed charges,,,0.95,,176.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,176.7,Percent of total billed charges,,176.7,182.28,
HC or Screw Cort 3.5x14#AR-8,PX-3253995WWM,CDM,3253995WWM,LOCAL,270,RC,,inpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
HC or Screw Cort 3.5x14#AR-8,PX-3253995WWM,CDM,3253995WWM,LOCAL,270,RC,,outpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
HC or Screw Cann 4x60#AR-884,PX-3253996WWM,CDM,3253996WWM,LOCAL,270,RC,,inpatient,,,566,509.4,,0.95,,537.7,Percent of total billed charges,,,0.98,,554.68,Percent of total billed charges,,,0.95,,537.7,Percent of total billed charges,,,0.97,,549.02,Percent of total billed charges,,,0.97,,549.02,Percent of total billed charges,,,0.96,,543.36,Percent of total billed charges,,,0.95,,537.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,537.7,Percent of total billed charges,,537.7,554.68,
HC or Screw Cann 4x60#AR-884,PX-3253996WWM,CDM,3253996WWM,LOCAL,270,RC,,outpatient,,,566,509.4,,0.95,,537.7,Percent of total billed charges,,,0.98,,554.68,Percent of total billed charges,,,0.95,,537.7,Percent of total billed charges,,,0.95,,537.7,Percent of total billed charges,,,0.97,,549.02,Percent of total billed charges,,,0.96,,543.36,Percent of total billed charges,,,0.95,,537.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,537.7,Percent of total billed charges,,537.7,554.68,
HC or Stapler Prox #Ax55b,PX-3253997WWM,CDM,3253997WWM,LOCAL,270,RC,,inpatient,,,483,434.7,,0.95,,458.85,Percent of total billed charges,,,0.98,,473.34,Percent of total billed charges,,,0.95,,458.85,Percent of total billed charges,,,0.97,,468.51,Percent of total billed charges,,,0.97,,468.51,Percent of total billed charges,,,0.96,,463.68,Percent of total billed charges,,,0.95,,458.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,458.85,Percent of total billed charges,,458.85,473.34,
HC or Stapler Prox #Ax55b,PX-3253997WWM,CDM,3253997WWM,LOCAL,270,RC,,outpatient,,,483,434.7,,0.95,,458.85,Percent of total billed charges,,,0.98,,473.34,Percent of total billed charges,,,0.95,,458.85,Percent of total billed charges,,,0.95,,458.85,Percent of total billed charges,,,0.97,,468.51,Percent of total billed charges,,,0.96,,463.68,Percent of total billed charges,,,0.95,,458.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,458.85,Percent of total billed charges,,458.85,473.34,
HC or Plate #02-111-531,PX-3253998WWM,CDM,3253998WWM,LOCAL,270,RC,,inpatient,,,2297,2067.3,,0.95,,2182.15,Percent of total billed charges,,,0.98,,2251.06,Percent of total billed charges,,,0.95,,2182.15,Percent of total billed charges,,,0.97,,2228.09,Percent of total billed charges,,,0.97,,2228.09,Percent of total billed charges,,,0.96,,2205.12,Percent of total billed charges,,,0.95,,2182.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2182.15,Percent of total billed charges,,2182.15,2251.06,
HC or Plate #02-111-531,PX-3253998WWM,CDM,3253998WWM,LOCAL,270,RC,,outpatient,,,2297,2067.3,,0.95,,2182.15,Percent of total billed charges,,,0.98,,2251.06,Percent of total billed charges,,,0.95,,2182.15,Percent of total billed charges,,,0.95,,2182.15,Percent of total billed charges,,,0.97,,2228.09,Percent of total billed charges,,,0.96,,2205.12,Percent of total billed charges,,,0.95,,2182.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2182.15,Percent of total billed charges,,2182.15,2251.06,
HC or Screw 2.4x12#02-210-11,PX-3253999WWM,CDM,3253999WWM,LOCAL,270,RC,,inpatient,,,416,374.4,,0.95,,395.2,Percent of total billed charges,,,0.98,,407.68,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,0.97,,403.52,Percent of total billed charges,,,0.97,,403.52,Percent of total billed charges,,,0.96,,399.36,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,395.2,Percent of total billed charges,,395.2,407.68,
HC or Screw 2.4x12#02-210-11,PX-3253999WWM,CDM,3253999WWM,LOCAL,270,RC,,outpatient,,,416,374.4,,0.95,,395.2,Percent of total billed charges,,,0.98,,407.68,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,0.97,,403.52,Percent of total billed charges,,,0.96,,399.36,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,395.2,Percent of total billed charges,,395.2,407.68,
HC or Screw 2.4x20#02-210-12,PX-3254000WWM,CDM,3254000WWM,LOCAL,270,RC,,inpatient,,,416,374.4,,0.95,,395.2,Percent of total billed charges,,,0.98,,407.68,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,0.97,,403.52,Percent of total billed charges,,,0.97,,403.52,Percent of total billed charges,,,0.96,,399.36,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,395.2,Percent of total billed charges,,395.2,407.68,
HC or Screw 2.4x20#02-210-12,PX-3254000WWM,CDM,3254000WWM,LOCAL,270,RC,,outpatient,,,416,374.4,,0.95,,395.2,Percent of total billed charges,,,0.98,,407.68,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,0.97,,403.52,Percent of total billed charges,,,0.96,,399.36,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,395.2,Percent of total billed charges,,395.2,407.68,
HC or Screw 2.4x22#02-210-12,PX-3254001WWM,CDM,3254001WWM,LOCAL,270,RC,,inpatient,,,416,374.4,,0.95,,395.2,Percent of total billed charges,,,0.98,,407.68,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,0.97,,403.52,Percent of total billed charges,,,0.97,,403.52,Percent of total billed charges,,,0.96,,399.36,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,395.2,Percent of total billed charges,,395.2,407.68,
HC or Screw 2.4x22#02-210-12,PX-3254001WWM,CDM,3254001WWM,LOCAL,270,RC,,outpatient,,,416,374.4,,0.95,,395.2,Percent of total billed charges,,,0.98,,407.68,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,0.97,,403.52,Percent of total billed charges,,,0.96,,399.36,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,395.2,Percent of total billed charges,,395.2,407.68,
HC or Screw Cort 2.7x12#202,PX-3254002WWM,CDM,3254002WWM,LOCAL,270,RC,,inpatient,,,177,159.3,,0.95,,168.15,Percent of total billed charges,,,0.98,,173.46,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.96,,169.92,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,168.15,Percent of total billed charges,,168.15,173.46,
HC or Screw Cort 2.7x12#202,PX-3254002WWM,CDM,3254002WWM,LOCAL,270,RC,,outpatient,,,177,159.3,,0.95,,168.15,Percent of total billed charges,,,0.98,,173.46,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,0.97,,171.69,Percent of total billed charges,,,0.96,,169.92,Percent of total billed charges,,,0.95,,168.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,168.15,Percent of total billed charges,,168.15,173.46,
HC or Drill Bit 1.8#310-509,PX-3254003WWM,CDM,3254003WWM,LOCAL,270,RC,,inpatient,,,471,423.9,,0.95,,447.45,Percent of total billed charges,,,0.98,,461.58,Percent of total billed charges,,,0.95,,447.45,Percent of total billed charges,,,0.97,,456.87,Percent of total billed charges,,,0.97,,456.87,Percent of total billed charges,,,0.96,,452.16,Percent of total billed charges,,,0.95,,447.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,447.45,Percent of total billed charges,,447.45,461.58,
HC or Drill Bit 1.8#310-509,PX-3254003WWM,CDM,3254003WWM,LOCAL,270,RC,,outpatient,,,471,423.9,,0.95,,447.45,Percent of total billed charges,,,0.98,,461.58,Percent of total billed charges,,,0.95,,447.45,Percent of total billed charges,,,0.95,,447.45,Percent of total billed charges,,,0.97,,456.87,Percent of total billed charges,,,0.96,,452.16,Percent of total billed charges,,,0.95,,447.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,447.45,Percent of total billed charges,,447.45,461.58,
HC or K-Wire 1.25#292-12e,PX-3254004WWM,CDM,3254004WWM,LOCAL,270,RC,,inpatient,,,72,64.8,,0.95,,68.4,Percent of total billed charges,,,0.98,,70.56,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.96,,69.12,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,68.4,Percent of total billed charges,,68.4,70.56,
HC or K-Wire 1.25#292-12e,PX-3254004WWM,CDM,3254004WWM,LOCAL,270,RC,,outpatient,,,72,64.8,,0.95,,68.4,Percent of total billed charges,,,0.98,,70.56,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.96,,69.12,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,68.4,Percent of total billed charges,,68.4,70.56,
HC or Screw Tenodesis 7x23,PX-3254005WWM,CDM,3254005WWM,LOCAL,270,RC,,inpatient,,,806,725.4,,0.95,,765.7,Percent of total billed charges,,,0.98,,789.88,Percent of total billed charges,,,0.95,,765.7,Percent of total billed charges,,,0.97,,781.82,Percent of total billed charges,,,0.97,,781.82,Percent of total billed charges,,,0.96,,773.76,Percent of total billed charges,,,0.95,,765.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,765.7,Percent of total billed charges,,765.7,789.88,
HC or Screw Tenodesis 7x23,PX-3254005WWM,CDM,3254005WWM,LOCAL,270,RC,,outpatient,,,806,725.4,,0.95,,765.7,Percent of total billed charges,,,0.98,,789.88,Percent of total billed charges,,,0.95,,765.7,Percent of total billed charges,,,0.95,,765.7,Percent of total billed charges,,,0.97,,781.82,Percent of total billed charges,,,0.96,,773.76,Percent of total billed charges,,,0.95,,765.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,765.7,Percent of total billed charges,,765.7,789.88,
HC or Screw Bone 34mm#At2-S3,PX-3254007WWM,CDM,3254007WWM,LOCAL,270,RC,,inpatient,,,1032,928.8,,0.95,,980.4,Percent of total billed charges,,,0.98,,1011.36,Percent of total billed charges,,,0.95,,980.4,Percent of total billed charges,,,0.97,,1001.04,Percent of total billed charges,,,0.97,,1001.04,Percent of total billed charges,,,0.96,,990.72,Percent of total billed charges,,,0.95,,980.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,980.4,Percent of total billed charges,,980.4,1011.36,
HC or Screw Bone 34mm#At2-S3,PX-3254007WWM,CDM,3254007WWM,LOCAL,270,RC,,outpatient,,,1032,928.8,,0.95,,980.4,Percent of total billed charges,,,0.98,,1011.36,Percent of total billed charges,,,0.95,,980.4,Percent of total billed charges,,,0.95,,980.4,Percent of total billed charges,,,0.97,,1001.04,Percent of total billed charges,,,0.96,,990.72,Percent of total billed charges,,,0.95,,980.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,980.4,Percent of total billed charges,,980.4,1011.36,
HC or Screw Bone 40mm#Am-004,PX-3254008WWM,CDM,3254008WWM,LOCAL,270,RC,,inpatient,,,936,842.4,,0.95,,889.2,Percent of total billed charges,,,0.98,,917.28,Percent of total billed charges,,,0.95,,889.2,Percent of total billed charges,,,0.97,,907.92,Percent of total billed charges,,,0.97,,907.92,Percent of total billed charges,,,0.96,,898.56,Percent of total billed charges,,,0.95,,889.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,889.2,Percent of total billed charges,,889.2,917.28,
HC or Screw Bone 40mm#Am-004,PX-3254008WWM,CDM,3254008WWM,LOCAL,270,RC,,outpatient,,,936,842.4,,0.95,,889.2,Percent of total billed charges,,,0.98,,917.28,Percent of total billed charges,,,0.95,,889.2,Percent of total billed charges,,,0.95,,889.2,Percent of total billed charges,,,0.97,,907.92,Percent of total billed charges,,,0.96,,898.56,Percent of total billed charges,,,0.95,,889.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,889.2,Percent of total billed charges,,889.2,917.28,
HC or Screw Bone 45mm#Am-004,PX-3254009WWM,CDM,3254009WWM,LOCAL,270,RC,,inpatient,,,936,842.4,,0.95,,889.2,Percent of total billed charges,,,0.98,,917.28,Percent of total billed charges,,,0.95,,889.2,Percent of total billed charges,,,0.97,,907.92,Percent of total billed charges,,,0.97,,907.92,Percent of total billed charges,,,0.96,,898.56,Percent of total billed charges,,,0.95,,889.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,889.2,Percent of total billed charges,,889.2,917.28,
HC or Screw Bone 45mm#Am-004,PX-3254009WWM,CDM,3254009WWM,LOCAL,270,RC,,outpatient,,,936,842.4,,0.95,,889.2,Percent of total billed charges,,,0.98,,917.28,Percent of total billed charges,,,0.95,,889.2,Percent of total billed charges,,,0.95,,889.2,Percent of total billed charges,,,0.97,,907.92,Percent of total billed charges,,,0.96,,898.56,Percent of total billed charges,,,0.95,,889.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,889.2,Percent of total billed charges,,889.2,917.28,
HC or Drill Acutrak#At2-2515,PX-3254010WWM,CDM,3254010WWM,LOCAL,270,RC,,inpatient,,,688,619.2,,0.95,,653.6,Percent of total billed charges,,,0.98,,674.24,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,0.97,,667.36,Percent of total billed charges,,,0.97,,667.36,Percent of total billed charges,,,0.96,,660.48,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,653.6,Percent of total billed charges,,653.6,674.24,
HC or Drill Acutrak#At2-2515,PX-3254010WWM,CDM,3254010WWM,LOCAL,270,RC,,outpatient,,,688,619.2,,0.95,,653.6,Percent of total billed charges,,,0.98,,674.24,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,0.97,,667.36,Percent of total billed charges,,,0.96,,660.48,Percent of total billed charges,,,0.95,,653.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,653.6,Percent of total billed charges,,653.6,674.24,
HC or Screw Teno #AR-1590ps,PX-3254011WWM,CDM,3254011WWM,LOCAL,270,RC,,inpatient,,,749,674.1,,0.95,,711.55,Percent of total billed charges,,,0.98,,734.02,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,0.97,,726.53,Percent of total billed charges,,,0.97,,726.53,Percent of total billed charges,,,0.96,,719.04,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,711.55,Percent of total billed charges,,711.55,734.02,
HC or Screw Teno #AR-1590ps,PX-3254011WWM,CDM,3254011WWM,LOCAL,270,RC,,outpatient,,,749,674.1,,0.95,,711.55,Percent of total billed charges,,,0.98,,734.02,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,0.97,,726.53,Percent of total billed charges,,,0.96,,719.04,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,711.55,Percent of total billed charges,,711.55,734.02,
HC or Reamer Head# AR-1408,PX-3254012WWM,CDM,3254012WWM,LOCAL,270,RC,,inpatient,,,566,509.4,,0.95,,537.7,Percent of total billed charges,,,0.98,,554.68,Percent of total billed charges,,,0.95,,537.7,Percent of total billed charges,,,0.97,,549.02,Percent of total billed charges,,,0.97,,549.02,Percent of total billed charges,,,0.96,,543.36,Percent of total billed charges,,,0.95,,537.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,537.7,Percent of total billed charges,,537.7,554.68,
HC or Reamer Head# AR-1408,PX-3254012WWM,CDM,3254012WWM,LOCAL,270,RC,,outpatient,,,566,509.4,,0.95,,537.7,Percent of total billed charges,,,0.98,,554.68,Percent of total billed charges,,,0.95,,537.7,Percent of total billed charges,,,0.95,,537.7,Percent of total billed charges,,,0.97,,549.02,Percent of total billed charges,,,0.96,,543.36,Percent of total billed charges,,,0.95,,537.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,537.7,Percent of total billed charges,,537.7,554.68,
HC or Plate 10 Hole#Ar8943c,PX-3254013WWM,CDM,3254013WWM,LOCAL,270,RC,,inpatient,,,1174,1056.6,,0.95,,1115.3,Percent of total billed charges,,,0.98,,1150.52,Percent of total billed charges,,,0.95,,1115.3,Percent of total billed charges,,,0.97,,1138.78,Percent of total billed charges,,,0.97,,1138.78,Percent of total billed charges,,,0.96,,1127.04,Percent of total billed charges,,,0.95,,1115.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1115.3,Percent of total billed charges,,1115.3,1150.52,
HC or Plate 10 Hole#Ar8943c,PX-3254013WWM,CDM,3254013WWM,LOCAL,270,RC,,outpatient,,,1174,1056.6,,0.95,,1115.3,Percent of total billed charges,,,0.98,,1150.52,Percent of total billed charges,,,0.95,,1115.3,Percent of total billed charges,,,0.95,,1115.3,Percent of total billed charges,,,0.97,,1138.78,Percent of total billed charges,,,0.96,,1127.04,Percent of total billed charges,,,0.95,,1115.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1115.3,Percent of total billed charges,,1115.3,1150.52,
HC or Wire Guide #Ws-2009st,PX-3254020WWM,CDM,3254020WWM,LOCAL,270,RC,,inpatient,,,123,110.7,,0.95,,116.85,Percent of total billed charges,,,0.98,,120.54,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.96,,118.08,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,116.85,Percent of total billed charges,,116.85,120.54,
HC or Wire Guide #Ws-2009st,PX-3254020WWM,CDM,3254020WWM,LOCAL,270,RC,,outpatient,,,123,110.7,,0.95,,116.85,Percent of total billed charges,,,0.98,,120.54,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.96,,118.08,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,116.85,Percent of total billed charges,,116.85,120.54,
HC or Wire Guide #Wt-1606stt,PX-3254021WWM,CDM,3254021WWM,LOCAL,270,RC,,inpatient,,,187,168.3,,0.95,,177.65,Percent of total billed charges,,,0.98,,183.26,Percent of total billed charges,,,0.95,,177.65,Percent of total billed charges,,,0.97,,181.39,Percent of total billed charges,,,0.97,,181.39,Percent of total billed charges,,,0.96,,179.52,Percent of total billed charges,,,0.95,,177.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,177.65,Percent of total billed charges,,177.65,183.26,
HC or Wire Guide #Wt-1606stt,PX-3254021WWM,CDM,3254021WWM,LOCAL,270,RC,,outpatient,,,187,168.3,,0.95,,177.65,Percent of total billed charges,,,0.98,,183.26,Percent of total billed charges,,,0.95,,177.65,Percent of total billed charges,,,0.95,,177.65,Percent of total billed charges,,,0.97,,181.39,Percent of total billed charges,,,0.96,,179.52,Percent of total billed charges,,,0.95,,177.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,177.65,Percent of total billed charges,,177.65,183.26,
HC or Screw Teno #AR-1540ps,PX-3254026WWM,CDM,3254026WWM,LOCAL,270,RC,,inpatient,,,749,674.1,,0.95,,711.55,Percent of total billed charges,,,0.98,,734.02,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,0.97,,726.53,Percent of total billed charges,,,0.97,,726.53,Percent of total billed charges,,,0.96,,719.04,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,711.55,Percent of total billed charges,,711.55,734.02,
HC or Screw Teno #AR-1540ps,PX-3254026WWM,CDM,3254026WWM,LOCAL,270,RC,,outpatient,,,749,674.1,,0.95,,711.55,Percent of total billed charges,,,0.98,,734.02,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,0.97,,726.53,Percent of total billed charges,,,0.96,,719.04,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,711.55,Percent of total billed charges,,711.55,734.02,
HC or Screw Teno #AR-1547ps,PX-3254027WWM,CDM,3254027WWM,LOCAL,270,RC,,inpatient,,,749,674.1,,0.95,,711.55,Percent of total billed charges,,,0.98,,734.02,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,0.97,,726.53,Percent of total billed charges,,,0.97,,726.53,Percent of total billed charges,,,0.96,,719.04,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,711.55,Percent of total billed charges,,711.55,734.02,
HC or Screw Teno #AR-1547ps,PX-3254027WWM,CDM,3254027WWM,LOCAL,270,RC,,outpatient,,,749,674.1,,0.95,,711.55,Percent of total billed charges,,,0.98,,734.02,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,0.97,,726.53,Percent of total billed charges,,,0.96,,719.04,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,711.55,Percent of total billed charges,,711.55,734.02,
HC or Screw Teno #AR-1555ps,PX-3254028WWM,CDM,3254028WWM,LOCAL,270,RC,,inpatient,,,749,674.1,,0.95,,711.55,Percent of total billed charges,,,0.98,,734.02,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,0.97,,726.53,Percent of total billed charges,,,0.97,,726.53,Percent of total billed charges,,,0.96,,719.04,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,711.55,Percent of total billed charges,,711.55,734.02,
HC or Screw Teno #AR-1555ps,PX-3254028WWM,CDM,3254028WWM,LOCAL,270,RC,,outpatient,,,749,674.1,,0.95,,711.55,Percent of total billed charges,,,0.98,,734.02,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,0.97,,726.53,Percent of total billed charges,,,0.96,,719.04,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,711.55,Percent of total billed charges,,711.55,734.02,
HC or Screw Teno #AR-1562ps,PX-3254029WWM,CDM,3254029WWM,LOCAL,270,RC,,inpatient,,,749,674.1,,0.95,,711.55,Percent of total billed charges,,,0.98,,734.02,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,0.97,,726.53,Percent of total billed charges,,,0.97,,726.53,Percent of total billed charges,,,0.96,,719.04,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,711.55,Percent of total billed charges,,711.55,734.02,
HC or Screw Teno #AR-1562ps,PX-3254029WWM,CDM,3254029WWM,LOCAL,270,RC,,outpatient,,,749,674.1,,0.95,,711.55,Percent of total billed charges,,,0.98,,734.02,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,0.97,,726.53,Percent of total billed charges,,,0.96,,719.04,Percent of total billed charges,,,0.95,,711.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,711.55,Percent of total billed charges,,711.55,734.02,
HC or Tight Rope #AR-8926ss,PX-3254034WWM,CDM,3254034WWM,LOCAL,270,RC,,inpatient,,,2395,2155.5,,0.95,,2275.25,Percent of total billed charges,,,0.98,,2347.1,Percent of total billed charges,,,0.95,,2275.25,Percent of total billed charges,,,0.97,,2323.15,Percent of total billed charges,,,0.97,,2323.15,Percent of total billed charges,,,0.96,,2299.2,Percent of total billed charges,,,0.95,,2275.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2275.25,Percent of total billed charges,,2275.25,2347.1,
HC or Tight Rope #AR-8926ss,PX-3254034WWM,CDM,3254034WWM,LOCAL,270,RC,,outpatient,,,2395,2155.5,,0.95,,2275.25,Percent of total billed charges,,,0.98,,2347.1,Percent of total billed charges,,,0.95,,2275.25,Percent of total billed charges,,,0.95,,2275.25,Percent of total billed charges,,,0.97,,2323.15,Percent of total billed charges,,,0.96,,2299.2,Percent of total billed charges,,,0.95,,2275.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2275.25,Percent of total billed charges,,2275.25,2347.1,
HC or Screw Lock#AR-8827l-10,PX-3254035WWM,CDM,3254035WWM,LOCAL,270,RC,,inpatient,,,395,355.5,,0.95,,375.25,Percent of total billed charges,,,0.98,,387.1,Percent of total billed charges,,,0.95,,375.25,Percent of total billed charges,,,0.97,,383.15,Percent of total billed charges,,,0.97,,383.15,Percent of total billed charges,,,0.96,,379.2,Percent of total billed charges,,,0.95,,375.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,375.25,Percent of total billed charges,,375.25,387.1,
HC or Screw Lock#AR-8827l-10,PX-3254035WWM,CDM,3254035WWM,LOCAL,270,RC,,outpatient,,,395,355.5,,0.95,,375.25,Percent of total billed charges,,,0.98,,387.1,Percent of total billed charges,,,0.95,,375.25,Percent of total billed charges,,,0.95,,375.25,Percent of total billed charges,,,0.97,,383.15,Percent of total billed charges,,,0.96,,379.2,Percent of total billed charges,,,0.95,,375.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,375.25,Percent of total billed charges,,375.25,387.1,
HC or Screw Cann 4x55#Ar8840,PX-3254036WWM,CDM,3254036WWM,LOCAL,270,RC,,inpatient,,,566,509.4,,0.95,,537.7,Percent of total billed charges,,,0.98,,554.68,Percent of total billed charges,,,0.95,,537.7,Percent of total billed charges,,,0.97,,549.02,Percent of total billed charges,,,0.97,,549.02,Percent of total billed charges,,,0.96,,543.36,Percent of total billed charges,,,0.95,,537.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,537.7,Percent of total billed charges,,537.7,554.68,
HC or Screw Cann 4x55#Ar8840,PX-3254036WWM,CDM,3254036WWM,LOCAL,270,RC,,outpatient,,,566,509.4,,0.95,,537.7,Percent of total billed charges,,,0.98,,554.68,Percent of total billed charges,,,0.95,,537.7,Percent of total billed charges,,,0.95,,537.7,Percent of total billed charges,,,0.97,,549.02,Percent of total billed charges,,,0.96,,543.36,Percent of total billed charges,,,0.95,,537.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,537.7,Percent of total billed charges,,537.7,554.68,
HC or Screw 2.7x8#Dc2825008,PX-3254038WWM,CDM,3254038WWM,LOCAL,270,RC,,inpatient,,,445,400.5,,0.95,,422.75,Percent of total billed charges,,,0.98,,436.1,Percent of total billed charges,,,0.95,,422.75,Percent of total billed charges,,,0.97,,431.65,Percent of total billed charges,,,0.97,,431.65,Percent of total billed charges,,,0.96,,427.2,Percent of total billed charges,,,0.95,,422.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,422.75,Percent of total billed charges,,422.75,436.1,
HC or Screw 2.7x8#Dc2825008,PX-3254038WWM,CDM,3254038WWM,LOCAL,270,RC,,outpatient,,,445,400.5,,0.95,,422.75,Percent of total billed charges,,,0.98,,436.1,Percent of total billed charges,,,0.95,,422.75,Percent of total billed charges,,,0.95,,422.75,Percent of total billed charges,,,0.97,,431.65,Percent of total billed charges,,,0.96,,427.2,Percent of total billed charges,,,0.95,,422.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,422.75,Percent of total billed charges,,422.75,436.1,
HC or Screw 2.7x10#Dc2825010,PX-3254039WWM,CDM,3254039WWM,LOCAL,270,RC,,inpatient,,,445,400.5,,0.95,,422.75,Percent of total billed charges,,,0.98,,436.1,Percent of total billed charges,,,0.95,,422.75,Percent of total billed charges,,,0.97,,431.65,Percent of total billed charges,,,0.97,,431.65,Percent of total billed charges,,,0.96,,427.2,Percent of total billed charges,,,0.95,,422.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,422.75,Percent of total billed charges,,422.75,436.1,
HC or Screw 2.7x10#Dc2825010,PX-3254039WWM,CDM,3254039WWM,LOCAL,270,RC,,outpatient,,,445,400.5,,0.95,,422.75,Percent of total billed charges,,,0.98,,436.1,Percent of total billed charges,,,0.95,,422.75,Percent of total billed charges,,,0.95,,422.75,Percent of total billed charges,,,0.97,,431.65,Percent of total billed charges,,,0.96,,427.2,Percent of total billed charges,,,0.95,,422.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,422.75,Percent of total billed charges,,422.75,436.1,
HC or Screw 2.7x12#Dc2825012,PX-3254040WWM,CDM,3254040WWM,LOCAL,270,RC,,inpatient,,,445,400.5,,0.95,,422.75,Percent of total billed charges,,,0.98,,436.1,Percent of total billed charges,,,0.95,,422.75,Percent of total billed charges,,,0.97,,431.65,Percent of total billed charges,,,0.97,,431.65,Percent of total billed charges,,,0.96,,427.2,Percent of total billed charges,,,0.95,,422.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,422.75,Percent of total billed charges,,422.75,436.1,
HC or Screw 2.7x12#Dc2825012,PX-3254040WWM,CDM,3254040WWM,LOCAL,270,RC,,outpatient,,,445,400.5,,0.95,,422.75,Percent of total billed charges,,,0.98,,436.1,Percent of total billed charges,,,0.95,,422.75,Percent of total billed charges,,,0.95,,422.75,Percent of total billed charges,,,0.97,,431.65,Percent of total billed charges,,,0.96,,427.2,Percent of total billed charges,,,0.95,,422.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,422.75,Percent of total billed charges,,422.75,436.1,
HC or Screw 2.7x14#Dc2825014,PX-3254041WWM,CDM,3254041WWM,LOCAL,270,RC,,inpatient,,,445,400.5,,0.95,,422.75,Percent of total billed charges,,,0.98,,436.1,Percent of total billed charges,,,0.95,,422.75,Percent of total billed charges,,,0.97,,431.65,Percent of total billed charges,,,0.97,,431.65,Percent of total billed charges,,,0.96,,427.2,Percent of total billed charges,,,0.95,,422.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,422.75,Percent of total billed charges,,422.75,436.1,
HC or Screw 2.7x14#Dc2825014,PX-3254041WWM,CDM,3254041WWM,LOCAL,270,RC,,outpatient,,,445,400.5,,0.95,,422.75,Percent of total billed charges,,,0.98,,436.1,Percent of total billed charges,,,0.95,,422.75,Percent of total billed charges,,,0.95,,422.75,Percent of total billed charges,,,0.97,,431.65,Percent of total billed charges,,,0.96,,427.2,Percent of total billed charges,,,0.95,,422.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,422.75,Percent of total billed charges,,422.75,436.1,
HC or Screw Nl 2.7x10#Dc2825,PX-3254042WWM,CDM,3254042WWM,LOCAL,270,RC,,inpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
HC or Screw Nl 2.7x10#Dc2825,PX-3254042WWM,CDM,3254042WWM,LOCAL,270,RC,,outpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
HC or Pin 1.1mm #Dc4212,PX-3254043WWM,CDM,3254043WWM,LOCAL,270,RC,,inpatient,,,216,194.4,,0.95,,205.2,Percent of total billed charges,,,0.98,,211.68,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,0.97,,209.52,Percent of total billed charges,,,0.97,,209.52,Percent of total billed charges,,,0.96,,207.36,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,205.2,Percent of total billed charges,,205.2,211.68,
HC or Pin 1.1mm #Dc4212,PX-3254043WWM,CDM,3254043WWM,LOCAL,270,RC,,outpatient,,,216,194.4,,0.95,,205.2,Percent of total billed charges,,,0.98,,211.68,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,0.97,,209.52,Percent of total billed charges,,,0.96,,207.36,Percent of total billed charges,,,0.95,,205.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,205.2,Percent of total billed charges,,205.2,211.68,
HC or Drill Bit #Dc6106,PX-3254044WWM,CDM,3254044WWM,LOCAL,270,RC,,inpatient,,,359,323.1,,0.95,,341.05,Percent of total billed charges,,,0.98,,351.82,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,0.97,,348.23,Percent of total billed charges,,,0.97,,348.23,Percent of total billed charges,,,0.96,,344.64,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,341.05,Percent of total billed charges,,341.05,351.82,
HC or Drill Bit #Dc6106,PX-3254044WWM,CDM,3254044WWM,LOCAL,270,RC,,outpatient,,,359,323.1,,0.95,,341.05,Percent of total billed charges,,,0.98,,351.82,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,0.97,,348.23,Percent of total billed charges,,,0.96,,344.64,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,341.05,Percent of total billed charges,,341.05,351.82,
HC or K-Wire 1.1 #No2228012,PX-3254045WWM,CDM,3254045WWM,LOCAL,270,RC,,inpatient,,,164,147.6,,0.95,,155.8,Percent of total billed charges,,,0.98,,160.72,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.96,,157.44,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,155.8,Percent of total billed charges,,155.8,160.72,
HC or K-Wire 1.1 #No2228012,PX-3254045WWM,CDM,3254045WWM,LOCAL,270,RC,,outpatient,,,164,147.6,,0.95,,155.8,Percent of total billed charges,,,0.98,,160.72,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.96,,157.44,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,155.8,Percent of total billed charges,,155.8,160.72,
HC or Tigerstick #AR-7209t,PX-3254046WWM,CDM,3254046WWM,LOCAL,270,RC,,inpatient,,,261,234.9,,0.95,,247.95,Percent of total billed charges,,,0.98,,255.78,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,0.97,,253.17,Percent of total billed charges,,,0.97,,253.17,Percent of total billed charges,,,0.96,,250.56,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,247.95,Percent of total billed charges,,247.95,255.78,
HC or Tigerstick #AR-7209t,PX-3254046WWM,CDM,3254046WWM,LOCAL,270,RC,,outpatient,,,261,234.9,,0.95,,247.95,Percent of total billed charges,,,0.98,,255.78,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,0.97,,253.17,Percent of total billed charges,,,0.96,,250.56,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,247.95,Percent of total billed charges,,247.95,255.78,
HC or Flipcutter #AR-1204af,PX-3254047WWM,CDM,3254047WWM,LOCAL,270,RC,,inpatient,,,917,825.3,,0.95,,871.15,Percent of total billed charges,,,0.98,,898.66,Percent of total billed charges,,,0.95,,871.15,Percent of total billed charges,,,0.97,,889.49,Percent of total billed charges,,,0.97,,889.49,Percent of total billed charges,,,0.96,,880.32,Percent of total billed charges,,,0.95,,871.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,871.15,Percent of total billed charges,,871.15,898.66,
HC or Flipcutter #AR-1204af,PX-3254047WWM,CDM,3254047WWM,LOCAL,270,RC,,outpatient,,,917,825.3,,0.95,,871.15,Percent of total billed charges,,,0.98,,898.66,Percent of total billed charges,,,0.95,,871.15,Percent of total billed charges,,,0.95,,871.15,Percent of total billed charges,,,0.97,,889.49,Percent of total billed charges,,,0.96,,880.32,Percent of total billed charges,,,0.95,,871.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,871.15,Percent of total billed charges,,871.15,898.66,
HC or Tightrope Acl#AR-1588r,PX-3254048WWM,CDM,3254048WWM,LOCAL,270,RC,,inpatient,,,1033,929.7,,0.95,,981.35,Percent of total billed charges,,,0.98,,1012.34,Percent of total billed charges,,,0.95,,981.35,Percent of total billed charges,,,0.97,,1002.01,Percent of total billed charges,,,0.97,,1002.01,Percent of total billed charges,,,0.96,,991.68,Percent of total billed charges,,,0.95,,981.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,981.35,Percent of total billed charges,,981.35,1012.34,
HC or Tightrope Acl#AR-1588r,PX-3254048WWM,CDM,3254048WWM,LOCAL,270,RC,,outpatient,,,1033,929.7,,0.95,,981.35,Percent of total billed charges,,,0.98,,1012.34,Percent of total billed charges,,,0.95,,981.35,Percent of total billed charges,,,0.95,,981.35,Percent of total billed charges,,,0.97,,1002.01,Percent of total billed charges,,,0.96,,991.68,Percent of total billed charges,,,0.95,,981.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,981.35,Percent of total billed charges,,981.35,1012.34,
HC or Tissue #43917000,PX-3254049WWM,CDM,3254049WWM,LOCAL,270,RC,,inpatient,,,3842,3457.8,,0.95,,3649.9,Percent of total billed charges,,,0.98,,3765.16,Percent of total billed charges,,,0.95,,3649.9,Percent of total billed charges,,,0.97,,3726.74,Percent of total billed charges,,,0.97,,3726.74,Percent of total billed charges,,,0.96,,3688.32,Percent of total billed charges,,,0.95,,3649.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3649.9,Percent of total billed charges,,3649.9,3765.16,
HC or Tissue #43917000,PX-3254049WWM,CDM,3254049WWM,LOCAL,270,RC,,outpatient,,,3842,3457.8,,0.95,,3649.9,Percent of total billed charges,,,0.98,,3765.16,Percent of total billed charges,,,0.95,,3649.9,Percent of total billed charges,,,0.95,,3649.9,Percent of total billed charges,,,0.97,,3726.74,Percent of total billed charges,,,0.96,,3688.32,Percent of total billed charges,,,0.95,,3649.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3649.9,Percent of total billed charges,,3649.9,3765.16,
HC or Plate Loc #Ar8943t-08,PX-3254051WWM,CDM,3254051WWM,LOCAL,270,RC,,inpatient,,,997,897.3,,0.95,,947.15,Percent of total billed charges,,,0.98,,977.06,Percent of total billed charges,,,0.95,,947.15,Percent of total billed charges,,,0.97,,967.09,Percent of total billed charges,,,0.97,,967.09,Percent of total billed charges,,,0.96,,957.12,Percent of total billed charges,,,0.95,,947.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,947.15,Percent of total billed charges,,947.15,977.06,
HC or Plate Loc #Ar8943t-08,PX-3254051WWM,CDM,3254051WWM,LOCAL,270,RC,,outpatient,,,997,897.3,,0.95,,947.15,Percent of total billed charges,,,0.98,,977.06,Percent of total billed charges,,,0.95,,947.15,Percent of total billed charges,,,0.95,,947.15,Percent of total billed charges,,,0.97,,967.09,Percent of total billed charges,,,0.96,,957.12,Percent of total billed charges,,,0.95,,947.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,947.15,Percent of total billed charges,,947.15,977.06,
HC or Screw 3.5x10#Ar8835-10,PX-3254052WWM,CDM,3254052WWM,LOCAL,270,RC,,inpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
HC or Screw 3.5x10#Ar8835-10,PX-3254052WWM,CDM,3254052WWM,LOCAL,270,RC,,outpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
HC or Screw Loc 3.5x10#Ar883,PX-3254053WWM,CDM,3254053WWM,LOCAL,270,RC,,inpatient,,,416,374.4,,0.95,,395.2,Percent of total billed charges,,,0.98,,407.68,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,0.97,,403.52,Percent of total billed charges,,,0.97,,403.52,Percent of total billed charges,,,0.96,,399.36,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,395.2,Percent of total billed charges,,395.2,407.68,
HC or Screw Loc 3.5x10#Ar883,PX-3254053WWM,CDM,3254053WWM,LOCAL,270,RC,,outpatient,,,416,374.4,,0.95,,395.2,Percent of total billed charges,,,0.98,,407.68,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,0.97,,403.52,Percent of total billed charges,,,0.96,,399.36,Percent of total billed charges,,,0.95,,395.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,395.2,Percent of total billed charges,,395.2,407.68,
HC or Grasper FB #00711175,PX-3254054WWM,CDM,3254054WWM,LOCAL,270,RC,,inpatient,,,359,323.1,,0.95,,341.05,Percent of total billed charges,,,0.98,,351.82,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,0.97,,348.23,Percent of total billed charges,,,0.97,,348.23,Percent of total billed charges,,,0.96,,344.64,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,341.05,Percent of total billed charges,,341.05,351.82,
HC or Grasper FB #00711175,PX-3254054WWM,CDM,3254054WWM,LOCAL,270,RC,,outpatient,,,359,323.1,,0.95,,341.05,Percent of total billed charges,,,0.98,,351.82,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,0.97,,348.23,Percent of total billed charges,,,0.96,,344.64,Percent of total billed charges,,,0.95,,341.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,341.05,Percent of total billed charges,,341.05,351.82,
HC or Secure Strap #Strap25,PX-3254068WWM,CDM,3254068WWM,LOCAL,270,RC,,inpatient,,,1077,969.3,,0.95,,1023.15,Percent of total billed charges,,,0.98,,1055.46,Percent of total billed charges,,,0.95,,1023.15,Percent of total billed charges,,,0.97,,1044.69,Percent of total billed charges,,,0.97,,1044.69,Percent of total billed charges,,,0.96,,1033.92,Percent of total billed charges,,,0.95,,1023.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1023.15,Percent of total billed charges,,1023.15,1055.46,
HC or Secure Strap #Strap25,PX-3254068WWM,CDM,3254068WWM,LOCAL,270,RC,,outpatient,,,1077,969.3,,0.95,,1023.15,Percent of total billed charges,,,0.98,,1055.46,Percent of total billed charges,,,0.95,,1023.15,Percent of total billed charges,,,0.95,,1023.15,Percent of total billed charges,,,0.97,,1044.69,Percent of total billed charges,,,0.96,,1033.92,Percent of total billed charges,,,0.95,,1023.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1023.15,Percent of total billed charges,,1023.15,1055.46,
HC or Tape Labral #AR-7276,PX-3254075WWM,CDM,3254075WWM,LOCAL,270,RC,,inpatient,,,258,232.2,,0.95,,245.1,Percent of total billed charges,,,0.98,,252.84,Percent of total billed charges,,,0.95,,245.1,Percent of total billed charges,,,0.97,,250.26,Percent of total billed charges,,,0.97,,250.26,Percent of total billed charges,,,0.96,,247.68,Percent of total billed charges,,,0.95,,245.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,245.1,Percent of total billed charges,,245.1,252.84,
HC or Tape Labral #AR-7276,PX-3254075WWM,CDM,3254075WWM,LOCAL,270,RC,,outpatient,,,258,232.2,,0.95,,245.1,Percent of total billed charges,,,0.98,,252.84,Percent of total billed charges,,,0.95,,245.1,Percent of total billed charges,,,0.95,,245.1,Percent of total billed charges,,,0.97,,250.26,Percent of total billed charges,,,0.96,,247.68,Percent of total billed charges,,,0.95,,245.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,245.1,Percent of total billed charges,,245.1,252.84,
HC or Implant Toe #375-0001,PX-3259194WWM,CDM,3259194WWM,LOCAL,278,RC,,inpatient,,,2148,1933.2,,0.95,,2040.6,Percent of total billed charges,,,0.98,,2105.04,Percent of total billed charges,,,0.95,,2040.6,Percent of total billed charges,,,0.97,,2083.56,Percent of total billed charges,,,0.97,,2083.56,Percent of total billed charges,,,0.96,,2062.08,Percent of total billed charges,,,0.95,,2040.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2040.6,Percent of total billed charges,,2040.6,2105.04,
HC or Implant Toe #375-0001,PX-3259194WWM,CDM,3259194WWM,LOCAL,278,RC,,outpatient,,,2148,1933.2,,0.95,,2040.6,Percent of total billed charges,,,0.98,,2105.04,Percent of total billed charges,,,0.95,,2040.6,Percent of total billed charges,,,0.95,,2040.6,Percent of total billed charges,,,0.97,,2083.56,Percent of total billed charges,,,0.96,,2062.08,Percent of total billed charges,,,0.95,,2040.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2040.6,Percent of total billed charges,,2040.6,2105.04,
HC Fmp 30ml,PX-3261000WWM,CDM,3261000WWM,LOCAL,270,RC,,inpatient,,,1479,1331.1,,0.95,,1405.05,Percent of total billed charges,,,0.98,,1449.42,Percent of total billed charges,,,0.95,,1405.05,Percent of total billed charges,,,0.97,,1434.63,Percent of total billed charges,,,0.97,,1434.63,Percent of total billed charges,,,0.96,,1419.84,Percent of total billed charges,,,0.95,,1405.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1405.05,Percent of total billed charges,,1405.05,1449.42,
HC Fmp 30ml,PX-3261000WWM,CDM,3261000WWM,LOCAL,270,RC,,outpatient,,,1479,1331.1,,0.95,,1405.05,Percent of total billed charges,,,0.98,,1449.42,Percent of total billed charges,,,0.95,,1405.05,Percent of total billed charges,,,0.95,,1405.05,Percent of total billed charges,,,0.97,,1434.63,Percent of total billed charges,,,0.96,,1419.84,Percent of total billed charges,,,0.95,,1405.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1405.05,Percent of total billed charges,,1405.05,1449.42,
"Test by nucleic acid for Strep, amplified probe",PX-30016339,CDM,87653,CPT,306,RC,,inpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
"Test by nucleic acid for Strep, amplified probe",PX-30016339,CDM,87653,CPT,306,RC,,outpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
HC Ambulance Response/Treatment-No Transport,PX-54010144,CDM,A0998,HCPCS,540,RC,,inpatient,,,740,666,,0.95,,703,Percent of total billed charges,,,0.98,,725.2,Percent of total billed charges,,,0.95,,703,Percent of total billed charges,,,0.97,,717.8,Percent of total billed charges,,,0.97,,717.8,Percent of total billed charges,,,0.96,,710.4,Percent of total billed charges,,,0.95,,703,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,703,Percent of total billed charges,,703,725.2,
HC Ambulance Response/Treatment-No Transport,PX-54010144,CDM,A0998,HCPCS,540,RC,,outpatient,,,740,666,,0.95,,703,Percent of total billed charges,,,0.98,,725.2,Percent of total billed charges,,,0.95,,703,Percent of total billed charges,,,0.95,,703,Percent of total billed charges,,,0.97,,717.8,Percent of total billed charges,,,0.96,,710.4,Percent of total billed charges,,,0.95,,703,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,703,Percent of total billed charges,,703,725.2,
Galactokinase (enzyme) level,PX-30017090,CDM,82759,CPT,301,RC,,inpatient,,,96,86.4,,0.95,,91.2,Percent of total billed charges,,,0.98,,94.08,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.96,,92.16,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,91.2,Percent of total billed charges,,91.2,94.08,
Galactokinase (enzyme) level,PX-30017090,CDM,82759,CPT,301,RC,,outpatient,,,96,86.4,,0.95,,91.2,Percent of total billed charges,,,0.98,,94.08,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,0.97,,93.12,Percent of total billed charges,,,0.96,,92.16,Percent of total billed charges,,,0.95,,91.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,91.2,Percent of total billed charges,,91.2,94.08,
Foreign body removal in ear canal under anesthesia,PX-45014053,CDM,69205,CPT,450,RC,,inpatient,,,696,626.4,,0.95,,661.2,Percent of total billed charges,,,0.98,,682.08,Percent of total billed charges,,,0.95,,661.2,Percent of total billed charges,,,0.97,,675.12,Percent of total billed charges,,,0.97,,675.12,Percent of total billed charges,,,0.96,,668.16,Percent of total billed charges,,,0.95,,661.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,661.2,Percent of total billed charges,,661.2,3950,
Foreign body removal in ear canal under anesthesia,PX-45014053,CDM,69205,CPT,450,RC,,outpatient,,,696,626.4,,0.95,,661.2,Percent of total billed charges,,,0.98,,682.08,Percent of total billed charges,,,0.95,,661.2,Percent of total billed charges,,,0.95,,661.2,Percent of total billed charges,,,0.97,,675.12,Percent of total billed charges,,,0.96,,668.16,Percent of total billed charges,,,0.95,,661.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,661.2,Percent of total billed charges,,661.2,3950,
Manipulation of wrist under anesthesia,PX-45014054,CDM,25259,CPT,450,RC,,inpatient,,,1564,1407.6,,0.95,,1485.8,Percent of total billed charges,,,0.98,,1532.72,Percent of total billed charges,,,0.95,,1485.8,Percent of total billed charges,,,0.97,,1517.08,Percent of total billed charges,,,0.97,,1517.08,Percent of total billed charges,,,0.96,,1501.44,Percent of total billed charges,,,0.95,,1485.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1485.8,Percent of total billed charges,,1485.8,3950,
Manipulation of wrist under anesthesia,PX-45014054,CDM,25259,CPT,450,RC,,outpatient,,,1564,1407.6,,0.95,,1485.8,Percent of total billed charges,,,0.98,,1532.72,Percent of total billed charges,,,0.95,,1485.8,Percent of total billed charges,,,0.95,,1485.8,Percent of total billed charges,,,0.97,,1517.08,Percent of total billed charges,,,0.96,,1501.44,Percent of total billed charges,,,0.95,,1485.8,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1485.8,Percent of total billed charges,,1485.8,3950,
Treat broken eye bone,PX-45014055,CDM,21406,CPT,450,RC,,inpatient,,,5842,5257.8,,0.95,,5549.9,Percent of total billed charges,,,0.98,,5725.16,Percent of total billed charges,,,0.95,,5549.9,Percent of total billed charges,,,0.97,,5666.74,Percent of total billed charges,,,0.97,,5666.74,Percent of total billed charges,,,0.96,,5608.32,Percent of total billed charges,,,0.95,,5549.9,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,5549.9,Percent of total billed charges,,3950,5725.16,
Treat broken eye bone,PX-45014055,CDM,21406,CPT,450,RC,,outpatient,,,5842,5257.8,,0.95,,5549.9,Percent of total billed charges,,,0.98,,5725.16,Percent of total billed charges,,,0.95,,5549.9,Percent of total billed charges,,,0.95,,5549.9,Percent of total billed charges,,,0.97,,5666.74,Percent of total billed charges,,,0.96,,5608.32,Percent of total billed charges,,,0.95,,5549.9,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,5549.9,Percent of total billed charges,,3950,5725.16,
HC PR ED 65270 Repair of Eye Wound Cdm,PX-98110949,CDM,65270,CPT,981,RC,,inpatient,,,804,723.6,,0.95,,763.8,Percent of total billed charges,,,0.98,,787.92,Percent of total billed charges,,,0.95,,763.8,Percent of total billed charges,,,0.97,,779.88,Percent of total billed charges,,,0.97,,779.88,Percent of total billed charges,,,0.96,,771.84,Percent of total billed charges,,,0.95,,763.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,763.8,Percent of total billed charges,,763.8,787.92,
HC PR ED 65270 Repair of Eye Wound Cdm,PX-98110949,CDM,65270,CPT,981,RC,,outpatient,,,804,723.6,,0.95,,763.8,Percent of total billed charges,,,0.98,,787.92,Percent of total billed charges,,,0.95,,763.8,Percent of total billed charges,,,0.95,,763.8,Percent of total billed charges,,,0.97,,779.88,Percent of total billed charges,,,0.96,,771.84,Percent of total billed charges,,,0.95,,763.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,763.8,Percent of total billed charges,,763.8,787.92,
HC PR ED 27256 Tx Hip Dislocation W/O Anesth W/O Man Cdm,PX-98110950,CDM,27256,CPT,981,RC,,inpatient,,,1476,1328.4,,0.95,,1402.2,Percent of total billed charges,,,0.98,,1446.48,Percent of total billed charges,,,0.95,,1402.2,Percent of total billed charges,,,0.97,,1431.72,Percent of total billed charges,,,0.97,,1431.72,Percent of total billed charges,,,0.96,,1416.96,Percent of total billed charges,,,0.95,,1402.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1402.2,Percent of total billed charges,,1402.2,1446.48,
HC PR ED 27256 Tx Hip Dislocation W/O Anesth W/O Man Cdm,PX-98110950,CDM,27256,CPT,981,RC,,outpatient,,,1476,1328.4,,0.95,,1402.2,Percent of total billed charges,,,0.98,,1446.48,Percent of total billed charges,,,0.95,,1402.2,Percent of total billed charges,,,0.95,,1402.2,Percent of total billed charges,,,0.97,,1431.72,Percent of total billed charges,,,0.96,,1416.96,Percent of total billed charges,,,0.95,,1402.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1402.2,Percent of total billed charges,,1402.2,1446.48,
Removal of growth in soft tissue of ear canal,PX-45014056,CDM,69145,CPT,450,RC,,inpatient,,,969,872.1,,0.95,,920.55,Percent of total billed charges,,,0.98,,949.62,Percent of total billed charges,,,0.95,,920.55,Percent of total billed charges,,,0.97,,939.93,Percent of total billed charges,,,0.97,,939.93,Percent of total billed charges,,,0.96,,930.24,Percent of total billed charges,,,0.95,,920.55,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,920.55,Percent of total billed charges,,920.55,3950,
Removal of growth in soft tissue of ear canal,PX-45014056,CDM,69145,CPT,450,RC,,outpatient,,,969,872.1,,0.95,,920.55,Percent of total billed charges,,,0.98,,949.62,Percent of total billed charges,,,0.95,,920.55,Percent of total billed charges,,,0.95,,920.55,Percent of total billed charges,,,0.97,,939.93,Percent of total billed charges,,,0.96,,930.24,Percent of total billed charges,,,0.95,,920.55,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,920.55,Percent of total billed charges,,920.55,3950,
Other service or procedure on lung,PX-41010412,CDM,94799,CPT,410,RC,,inpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
Other service or procedure on lung,PX-41010412,CDM,94799,CPT,410,RC,,outpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
HC OB Brst Pump Manual#67100,PX-3250072WWM,CDM,3250072WWM,LOCAL,270,RC,,inpatient,,,148,133.2,,0.95,,140.6,Percent of total billed charges,,,0.98,,145.04,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.96,,142.08,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,140.6,Percent of total billed charges,,140.6,145.04,
HC OB Brst Pump Manual#67100,PX-3250072WWM,CDM,3250072WWM,LOCAL,270,RC,,outpatient,,,148,133.2,,0.95,,140.6,Percent of total billed charges,,,0.98,,145.04,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.96,,142.08,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,140.6,Percent of total billed charges,,140.6,145.04,
HC Cast Shoe S #140503,PX-3250124WWM,CDM,3250124WWM,LOCAL,270,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
HC Cast Shoe S #140503,PX-3250124WWM,CDM,3250124WWM,LOCAL,270,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
HC Cast Shoe Xs #140502,PX-3250128WWM,CDM,3250128WWM,LOCAL,270,RC,,inpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
HC Cast Shoe Xs #140502,PX-3250128WWM,CDM,3250128WWM,LOCAL,270,RC,,outpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
HC Cath Foley 10/3 #0165pl10,PX-3250132WWM,CDM,3250132WWM,LOCAL,270,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
HC Cath Foley 10/3 #0165pl10,PX-3250132WWM,CDM,3250132WWM,LOCAL,270,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
HC Cath Foley 14fr/5cc165814,PX-3250133WWM,CDM,3250133WWM,LOCAL,270,RC,,inpatient,,,45,40.5,,0.95,,42.75,Percent of total billed charges,,,0.98,,44.1,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.96,,43.2,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,42.75,Percent of total billed charges,,42.75,44.1,
HC Cath Foley 14fr/5cc165814,PX-3250133WWM,CDM,3250133WWM,LOCAL,270,RC,,outpatient,,,45,40.5,,0.95,,42.75,Percent of total billed charges,,,0.98,,44.1,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.96,,43.2,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,42.75,Percent of total billed charges,,42.75,44.1,
HC Cath Foley 18fr/5cc#33618,PX-3250135WWM,CDM,3250135WWM,LOCAL,270,RC,,inpatient,,,55,49.5,,0.95,,52.25,Percent of total billed charges,,,0.98,,53.9,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.96,,52.8,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,52.25,Percent of total billed charges,,52.25,53.9,
HC Cath Foley 18fr/5cc#33618,PX-3250135WWM,CDM,3250135WWM,LOCAL,270,RC,,outpatient,,,55,49.5,,0.95,,52.25,Percent of total billed charges,,,0.98,,53.9,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.96,,52.8,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,52.25,Percent of total billed charges,,52.25,53.9,
HC Cath Foley 10/30 #165810,PX-3250141WWM,CDM,3250141WWM,LOCAL,270,RC,,inpatient,,,49,44.1,,0.95,,46.55,Percent of total billed charges,,,0.98,,48.02,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.96,,47.04,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,46.55,Percent of total billed charges,,46.55,48.02,
HC Cath Foley 10/30 #165810,PX-3250141WWM,CDM,3250141WWM,LOCAL,270,RC,,outpatient,,,49,44.1,,0.95,,46.55,Percent of total billed charges,,,0.98,,48.02,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.96,,47.04,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,46.55,Percent of total billed charges,,46.55,48.02,
HC Cath Foley 20/30 #166820,PX-3250146WWM,CDM,3250146WWM,LOCAL,270,RC,,inpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
HC Cath Foley 20/30 #166820,PX-3250146WWM,CDM,3250146WWM,LOCAL,270,RC,,outpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
HC Cath Foley 22fr/30#126622,PX-3250147WWM,CDM,3250147WWM,LOCAL,270,RC,,inpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
HC Cath Foley 22fr/30#126622,PX-3250147WWM,CDM,3250147WWM,LOCAL,270,RC,,outpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
HC Cath Foley 28fr/30#266728,PX-3250150WWM,CDM,3250150WWM,LOCAL,270,RC,,inpatient,,,43,38.7,,0.95,,40.85,Percent of total billed charges,,,0.98,,42.14,Percent of total billed charges,,,0.95,,40.85,Percent of total billed charges,,,0.97,,41.71,Percent of total billed charges,,,0.97,,41.71,Percent of total billed charges,,,0.96,,41.28,Percent of total billed charges,,,0.95,,40.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,40.85,Percent of total billed charges,,40.85,42.14,
HC Cath Foley 28fr/30#266728,PX-3250150WWM,CDM,3250150WWM,LOCAL,270,RC,,outpatient,,,43,38.7,,0.95,,40.85,Percent of total billed charges,,,0.98,,42.14,Percent of total billed charges,,,0.95,,40.85,Percent of total billed charges,,,0.95,,40.85,Percent of total billed charges,,,0.97,,41.71,Percent of total billed charges,,,0.96,,41.28,Percent of total billed charges,,,0.95,,40.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,40.85,Percent of total billed charges,,40.85,42.14,
HC Cath Coude 16fr,PX-3250156WWM,CDM,3250156WWM,LOCAL,270,RC,,inpatient,,,107,96.3,,0.95,,101.65,Percent of total billed charges,,,0.98,,104.86,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.96,,102.72,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,101.65,Percent of total billed charges,,101.65,104.86,
HC Cath Coude 16fr,PX-3250156WWM,CDM,3250156WWM,LOCAL,270,RC,,outpatient,,,107,96.3,,0.95,,101.65,Percent of total billed charges,,,0.98,,104.86,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.96,,102.72,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,101.65,Percent of total billed charges,,101.65,104.86,
HC Cath Coude 18fr,PX-3250157WWM,CDM,3250157WWM,LOCAL,270,RC,,inpatient,,,117,105.3,,0.95,,111.15,Percent of total billed charges,,,0.98,,114.66,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.96,,112.32,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,111.15,Percent of total billed charges,,111.15,114.66,
HC Cath Coude 18fr,PX-3250157WWM,CDM,3250157WWM,LOCAL,270,RC,,outpatient,,,117,105.3,,0.95,,111.15,Percent of total billed charges,,,0.98,,114.66,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.96,,112.32,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,111.15,Percent of total billed charges,,111.15,114.66,
HC Cath Female Kit #0035380,PX-3250164WWM,CDM,3250164WWM,LOCAL,270,RC,,inpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
HC Cath Female Kit #0035380,PX-3250164WWM,CDM,3250164WWM,LOCAL,270,RC,,outpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
HC Cath 3way Irr 18f 7688185,PX-3250166WWM,CDM,3250166WWM,LOCAL,270,RC,,inpatient,,,36,32.4,,0.95,,34.2,Percent of total billed charges,,,0.98,,35.28,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.96,,34.56,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,34.2,Percent of total billed charges,,34.2,35.28,
HC Cath 3way Irr 18f 7688185,PX-3250166WWM,CDM,3250166WWM,LOCAL,270,RC,,outpatient,,,36,32.4,,0.95,,34.2,Percent of total billed charges,,,0.98,,35.28,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.96,,34.56,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,34.2,Percent of total billed charges,,34.2,35.28,
HC Cath Fol/Tray 16fr#899616,PX-3250170WWM,CDM,3250170WWM,LOCAL,270,RC,,inpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
HC Cath Fol/Tray 16fr#899616,PX-3250170WWM,CDM,3250170WWM,LOCAL,270,RC,,outpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
HC Cath Strght 16fr #772416,PX-3250171WWM,CDM,3250171WWM,LOCAL,270,RC,,inpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
HC Cath Strght 16fr #772416,PX-3250171WWM,CDM,3250171WWM,LOCAL,270,RC,,outpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
HC Collar Cervical Sm #4050,PX-3250172WWM,CDM,3250172WWM,LOCAL,270,RC,,inpatient,,,30,27,,0.95,,28.5,Percent of total billed charges,,,0.98,,29.4,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,0.97,,29.1,Percent of total billed charges,,,0.97,,29.1,Percent of total billed charges,,,0.96,,28.8,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,28.5,Percent of total billed charges,,28.5,29.4,
HC Collar Cervical Sm #4050,PX-3250172WWM,CDM,3250172WWM,LOCAL,270,RC,,outpatient,,,30,27,,0.95,,28.5,Percent of total billed charges,,,0.98,,29.4,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,0.97,,29.1,Percent of total billed charges,,,0.96,,28.8,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,28.5,Percent of total billed charges,,28.5,29.4,
HC Collar Cervical M #4051,PX-3250173WWM,CDM,3250173WWM,LOCAL,270,RC,,inpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
HC Collar Cervical M #4051,PX-3250173WWM,CDM,3250173WWM,LOCAL,270,RC,,outpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
HC Clavical Brace MD #151489,PX-3250178WWM,CDM,3250178WWM,LOCAL,270,RC,,inpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
HC Clavical Brace MD #151489,PX-3250178WWM,CDM,3250178WWM,LOCAL,270,RC,,outpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
HC Clavical Brace Lg #152677,PX-3250179WWM,CDM,3250179WWM,LOCAL,270,RC,,inpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
HC Clavical Brace Lg #152677,PX-3250179WWM,CDM,3250179WWM,LOCAL,270,RC,,outpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
"HC Tape Medipore 3"" #2963",PX-3250188WWM,CDM,3250188WWM,LOCAL,270,RC,,inpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
"HC Tape Medipore 3"" #2963",PX-3250188WWM,CDM,3250188WWM,LOCAL,270,RC,,outpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
HC Irrig Cysto/Blad #2c4040,PX-3250253WWM,CDM,3250253WWM,LOCAL,270,RC,,inpatient,,,36,32.4,,0.95,,34.2,Percent of total billed charges,,,0.98,,35.28,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.96,,34.56,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,34.2,Percent of total billed charges,,34.2,35.28,
HC Irrig Cysto/Blad #2c4040,PX-3250253WWM,CDM,3250253WWM,LOCAL,270,RC,,outpatient,,,36,32.4,,0.95,,34.2,Percent of total billed charges,,,0.98,,35.28,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.96,,34.56,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,34.2,Percent of total billed charges,,34.2,35.28,
HC Tray Lumbar Punct#4301csp,PX-3250257WWM,CDM,3250257WWM,LOCAL,270,RC,,inpatient,,,98,88.2,,0.95,,93.1,Percent of total billed charges,,,0.98,,96.04,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,0.97,,95.06,Percent of total billed charges,,,0.97,,95.06,Percent of total billed charges,,,0.96,,94.08,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,93.1,Percent of total billed charges,,93.1,96.04,
HC Tray Lumbar Punct#4301csp,PX-3250257WWM,CDM,3250257WWM,LOCAL,270,RC,,outpatient,,,98,88.2,,0.95,,93.1,Percent of total billed charges,,,0.98,,96.04,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,0.97,,95.06,Percent of total billed charges,,,0.96,,94.08,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,93.1,Percent of total billed charges,,93.1,96.04,
HC Pleur-Evac #A7000,PX-3250277WWM,CDM,3250277WWM,LOCAL,270,RC,,inpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
HC Pleur-Evac #A7000,PX-3250277WWM,CDM,3250277WWM,LOCAL,270,RC,,outpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
HC Sling Arm W/Loop #104j-L,PX-3250305WWM,CDM,3250305WWM,LOCAL,270,RC,,inpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
HC Sling Arm W/Loop #104j-L,PX-3250305WWM,CDM,3250305WWM,LOCAL,270,RC,,outpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
HC Specimen Trap 40cc,PX-3250309WWM,CDM,3250309WWM,LOCAL,270,RC,,inpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
HC Specimen Trap 40cc,PX-3250309WWM,CDM,3250309WWM,LOCAL,270,RC,,outpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
HC Splint W/F Xs/L #210122,PX-3250326WWM,CDM,3250326WWM,LOCAL,270,RC,,inpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC Splint W/F Xs/L #210122,PX-3250326WWM,CDM,3250326WWM,LOCAL,270,RC,,outpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC Splint W/F S/L #,PX-3250327WWM,CDM,3250327WWM,LOCAL,270,RC,,inpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC Splint W/F S/L #,PX-3250327WWM,CDM,3250327WWM,LOCAL,270,RC,,outpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC Splint W/F S/R #2101-13,PX-3250328WWM,CDM,3250328WWM,LOCAL,270,RC,,inpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC Splint W/F S/R #2101-13,PX-3250328WWM,CDM,3250328WWM,LOCAL,270,RC,,outpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC Splint W/F M/L #Tx990408,PX-3250329WWM,CDM,3250329WWM,LOCAL,270,RC,,inpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC Splint W/F M/L #Tx990408,PX-3250329WWM,CDM,3250329WWM,LOCAL,270,RC,,outpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC Splint W/F M/R #217075,PX-3250330WWM,CDM,3250330WWM,LOCAL,270,RC,,inpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC Splint W/F M/R #217075,PX-3250330WWM,CDM,3250330WWM,LOCAL,270,RC,,outpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC Splint W/F L/L #210125,PX-3250331WWM,CDM,3250331WWM,LOCAL,270,RC,,inpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC Splint W/F L/L #210125,PX-3250331WWM,CDM,3250331WWM,LOCAL,270,RC,,outpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC Splint W/F Lg/R #210115,PX-3250332WWM,CDM,3250332WWM,LOCAL,270,RC,,inpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC Splint W/F Lg/R #210115,PX-3250332WWM,CDM,3250332WWM,LOCAL,270,RC,,outpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC Splint W/F Xl/R #210116,PX-3250333WWM,CDM,3250333WWM,LOCAL,270,RC,,inpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC Splint W/F Xl/R #210116,PX-3250333WWM,CDM,3250333WWM,LOCAL,270,RC,,outpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC Splint W/F Xl/L#210126,PX-3250334WWM,CDM,3250334WWM,LOCAL,270,RC,,inpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC Splint W/F Xl/L#210126,PX-3250334WWM,CDM,3250334WWM,LOCAL,270,RC,,outpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC Splint Fgr 4pro S #190363,PX-3250339WWM,CDM,3250339WWM,LOCAL,270,RC,,inpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19,Percent of total billed charges,,19,19.6,
HC Splint Fgr 4pro S #190363,PX-3250339WWM,CDM,3250339WWM,LOCAL,270,RC,,outpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,19,Percent of total billed charges,,19,19.6,
HC Ted Sox Medium/Short#3310,PX-3250441WWM,CDM,3250441WWM,LOCAL,270,RC,,inpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
HC Ted Sox Medium/Short#3310,PX-3250441WWM,CDM,3250441WWM,LOCAL,270,RC,,outpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
HC Ted Sox Large/Short #3634,PX-3250442WWM,CDM,3250442WWM,LOCAL,270,RC,,inpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
HC Ted Sox Large/Short #3634,PX-3250442WWM,CDM,3250442WWM,LOCAL,270,RC,,outpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
HC Tray Thorocentesis,PX-3250446WWM,CDM,3250446WWM,LOCAL,270,RC,,inpatient,,,136,122.4,,0.95,,129.2,Percent of total billed charges,,,0.98,,133.28,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,0.97,,131.92,Percent of total billed charges,,,0.97,,131.92,Percent of total billed charges,,,0.96,,130.56,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,129.2,Percent of total billed charges,,129.2,133.28,
HC Tray Thorocentesis,PX-3250446WWM,CDM,3250446WWM,LOCAL,270,RC,,outpatient,,,136,122.4,,0.95,,129.2,Percent of total billed charges,,,0.98,,133.28,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,0.97,,131.92,Percent of total billed charges,,,0.96,,130.56,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,129.2,Percent of total billed charges,,129.2,133.28,
HC Trocar Cath 28fr #565044,PX-3250453WWM,CDM,3250453WWM,LOCAL,270,RC,,inpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
HC Trocar Cath 28fr #565044,PX-3250453WWM,CDM,3250453WWM,LOCAL,270,RC,,outpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
HC Urinary Drain Bags #3057,PX-3250456WWM,CDM,3250456WWM,LOCAL,270,RC,,inpatient,,,22,19.8,,0.95,,20.9,Percent of total billed charges,,,0.98,,21.56,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.96,,21.12,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,20.9,Percent of total billed charges,,20.9,21.56,
HC Urinary Drain Bags #3057,PX-3250456WWM,CDM,3250456WWM,LOCAL,270,RC,,outpatient,,,22,19.8,,0.95,,20.9,Percent of total billed charges,,,0.98,,21.56,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.96,,21.12,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,20.9,Percent of total billed charges,,20.9,21.56,
HC Urine Meter #153202,PX-3250457WWM,CDM,3250457WWM,LOCAL,270,RC,,inpatient,,,72,64.8,,0.95,,68.4,Percent of total billed charges,,,0.98,,70.56,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.96,,69.12,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,68.4,Percent of total billed charges,,68.4,70.56,
HC Urine Meter #153202,PX-3250457WWM,CDM,3250457WWM,LOCAL,270,RC,,outpatient,,,72,64.8,,0.95,,68.4,Percent of total billed charges,,,0.98,,70.56,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.96,,69.12,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,68.4,Percent of total billed charges,,68.4,70.56,
HC Urinary Leg Dr M #150102,PX-3250458WWM,CDM,3250458WWM,LOCAL,270,RC,,inpatient,,,28,25.2,,0.95,,26.6,Percent of total billed charges,,,0.98,,27.44,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.96,,26.88,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,26.6,Percent of total billed charges,,26.6,27.44,
HC Urinary Leg Dr M #150102,PX-3250458WWM,CDM,3250458WWM,LOCAL,270,RC,,outpatient,,,28,25.2,,0.95,,26.6,Percent of total billed charges,,,0.98,,27.44,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.96,,26.88,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,26.6,Percent of total billed charges,,26.6,27.44,
HC Cath Kit Infant #0035630,PX-3250474WWM,CDM,3250474WWM,LOCAL,270,RC,,inpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
HC Cath Kit Infant #0035630,PX-3250474WWM,CDM,3250474WWM,LOCAL,270,RC,,outpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
HC Straps Leg Bag #162310,PX-3250539WWM,CDM,3250539WWM,LOCAL,270,RC,,inpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
HC Straps Leg Bag #162310,PX-3250539WWM,CDM,3250539WWM,LOCAL,270,RC,,outpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
"HC Elastoplast 4""",PX-3250585WWM,CDM,3250585WWM,LOCAL,270,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
"HC Elastoplast 4""",PX-3250585WWM,CDM,3250585WWM,LOCAL,270,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC Tube Ss Reflux Val#266197,PX-3250615WWM,CDM,3250615WWM,LOCAL,270,RC,,inpatient,,,31,27.9,,0.95,,29.45,Percent of total billed charges,,,0.98,,30.38,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.96,,29.76,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,29.45,Percent of total billed charges,,29.45,30.38,
HC Tube Ss Reflux Val#266197,PX-3250615WWM,CDM,3250615WWM,LOCAL,270,RC,,outpatient,,,31,27.9,,0.95,,29.45,Percent of total billed charges,,,0.98,,30.38,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.96,,29.76,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,29.45,Percent of total billed charges,,29.45,30.38,
HC Air Walk Cast Sm #Aw0400b,PX-3250628WWM,CDM,3250628WWM,LOCAL,270,RC,,inpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
HC Air Walk Cast Sm #Aw0400b,PX-3250628WWM,CDM,3250628WWM,LOCAL,270,RC,,outpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
HC OB Tube Asp/Meconi#N0101,PX-3250652WWM,CDM,3250652WWM,LOCAL,270,RC,,inpatient,,,30,27,,0.95,,28.5,Percent of total billed charges,,,0.98,,29.4,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,0.97,,29.1,Percent of total billed charges,,,0.97,,29.1,Percent of total billed charges,,,0.96,,28.8,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,28.5,Percent of total billed charges,,28.5,29.4,
HC OB Tube Asp/Meconi#N0101,PX-3250652WWM,CDM,3250652WWM,LOCAL,270,RC,,outpatient,,,30,27,,0.95,,28.5,Percent of total billed charges,,,0.98,,29.4,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,0.97,,29.1,Percent of total billed charges,,,0.96,,28.8,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,28.5,Percent of total billed charges,,28.5,29.4,
HC Specimen Trap 10fr#Smt910,PX-3250689WWM,CDM,3250689WWM,LOCAL,270,RC,,inpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
HC Specimen Trap 10fr#Smt910,PX-3250689WWM,CDM,3250689WWM,LOCAL,270,RC,,outpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
HC Rapid Rhino 5.5 Ant #Rr550,PX-3250728WWM,CDM,3250728WWM,LOCAL,270,RC,,inpatient,,,158,142.2,,0.95,,150.1,Percent of total billed charges,,,0.98,,154.84,Percent of total billed charges,,,0.95,,150.1,Percent of total billed charges,,,0.97,,153.26,Percent of total billed charges,,,0.97,,153.26,Percent of total billed charges,,,0.96,,151.68,Percent of total billed charges,,,0.95,,150.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,150.1,Percent of total billed charges,,150.1,154.84,
HC Rapid Rhino 5.5 Ant #Rr550,PX-3250728WWM,CDM,3250728WWM,LOCAL,270,RC,,outpatient,,,158,142.2,,0.95,,150.1,Percent of total billed charges,,,0.98,,154.84,Percent of total billed charges,,,0.95,,150.1,Percent of total billed charges,,,0.95,,150.1,Percent of total billed charges,,,0.97,,153.26,Percent of total billed charges,,,0.96,,151.68,Percent of total billed charges,,,0.95,,150.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,150.1,Percent of total billed charges,,150.1,154.84,
HC Rapid Rhino 7.5 a/P#Rr750,PX-3250729WWM,CDM,3250729WWM,LOCAL,270,RC,,inpatient,,,166,149.4,,0.95,,157.7,Percent of total billed charges,,,0.98,,162.68,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.96,,159.36,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,157.7,Percent of total billed charges,,157.7,162.68,
HC Rapid Rhino 7.5 a/P#Rr750,PX-3250729WWM,CDM,3250729WWM,LOCAL,270,RC,,outpatient,,,166,149.4,,0.95,,157.7,Percent of total billed charges,,,0.98,,162.68,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,0.97,,161.02,Percent of total billed charges,,,0.96,,159.36,Percent of total billed charges,,,0.95,,157.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,157.7,Percent of total billed charges,,157.7,162.68,
HC Morgan Lens,PX-3250772WWM,CDM,3250772WWM,LOCAL,270,RC,,inpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
HC Morgan Lens,PX-3250772WWM,CDM,3250772WWM,LOCAL,270,RC,,outpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
HC Ted Sox Knee L/Long #7594,PX-3250773WWM,CDM,3250773WWM,LOCAL,270,RC,,inpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
HC Ted Sox Knee L/Long #7594,PX-3250773WWM,CDM,3250773WWM,LOCAL,270,RC,,outpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
HC Rt Sensor Infant #I20,PX-3250802WWM,CDM,3250802WWM,LOCAL,270,RC,,inpatient,,,81,72.9,,0.95,,76.95,Percent of total billed charges,,,0.98,,79.38,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.96,,77.76,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76.95,Percent of total billed charges,,76.95,79.38,
HC Rt Sensor Infant #I20,PX-3250802WWM,CDM,3250802WWM,LOCAL,270,RC,,outpatient,,,81,72.9,,0.95,,76.95,Percent of total billed charges,,,0.98,,79.38,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.96,,77.76,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76.95,Percent of total billed charges,,76.95,79.38,
HC Splint Ankle Gel#79-97865,PX-3250805WWM,CDM,3250805WWM,LOCAL,270,RC,,inpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
HC Splint Ankle Gel#79-97865,PX-3250805WWM,CDM,3250805WWM,LOCAL,270,RC,,outpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
HC Tray Lumbar/Infant#4302cs,PX-3250817WWM,CDM,3250817WWM,LOCAL,270,RC,,inpatient,,,85,76.5,,0.95,,80.75,Percent of total billed charges,,,0.98,,83.3,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.96,,81.6,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,80.75,Percent of total billed charges,,80.75,83.3,
HC Tray Lumbar/Infant#4302cs,PX-3250817WWM,CDM,3250817WWM,LOCAL,270,RC,,outpatient,,,85,76.5,,0.95,,80.75,Percent of total billed charges,,,0.98,,83.3,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.96,,81.6,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,80.75,Percent of total billed charges,,80.75,83.3,
HC Cath Coude 14fr,PX-3252013WWM,CDM,3252013WWM,LOCAL,270,RC,,inpatient,,,107,96.3,,0.95,,101.65,Percent of total billed charges,,,0.98,,104.86,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.96,,102.72,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,101.65,Percent of total billed charges,,101.65,104.86,
HC Cath Coude 14fr,PX-3252013WWM,CDM,3252013WWM,LOCAL,270,RC,,outpatient,,,107,96.3,,0.95,,101.65,Percent of total billed charges,,,0.98,,104.86,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.96,,102.72,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,101.65,Percent of total billed charges,,101.65,104.86,
HC Central Line 3 L#Ak14703a,PX-3252512WWM,CDM,3252512WWM,LOCAL,270,RC,,inpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
HC Central Line 3 L#Ak14703a,PX-3252512WWM,CDM,3252512WWM,LOCAL,270,RC,,outpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
HC Drsg Kaltostat Rope#8117,PX-3252541WWM,CDM,3252541WWM,LOCAL,270,RC,,inpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
HC Drsg Kaltostat Rope#8117,PX-3252541WWM,CDM,3252541WWM,LOCAL,270,RC,,outpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
HC Cath Foley 16fr5cc#165816,PX-3252551WWM,CDM,3252551WWM,LOCAL,270,RC,,inpatient,,,49,44.1,,0.95,,46.55,Percent of total billed charges,,,0.98,,48.02,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.96,,47.04,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,46.55,Percent of total billed charges,,46.55,48.02,
HC Cath Foley 16fr5cc#165816,PX-3252551WWM,CDM,3252551WWM,LOCAL,270,RC,,outpatient,,,49,44.1,,0.95,,46.55,Percent of total billed charges,,,0.98,,48.02,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,0.97,,47.53,Percent of total billed charges,,,0.96,,47.04,Percent of total billed charges,,,0.95,,46.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,46.55,Percent of total billed charges,,46.55,48.02,
HC Cath Foley 12fr6cc#165812,PX-3252552WWM,CDM,3252552WWM,LOCAL,270,RC,,inpatient,,,45,40.5,,0.95,,42.75,Percent of total billed charges,,,0.98,,44.1,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.96,,43.2,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,42.75,Percent of total billed charges,,42.75,44.1,
HC Cath Foley 12fr6cc#165812,PX-3252552WWM,CDM,3252552WWM,LOCAL,270,RC,,outpatient,,,45,40.5,,0.95,,42.75,Percent of total billed charges,,,0.98,,44.1,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.96,,43.2,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,42.75,Percent of total billed charges,,42.75,44.1,
HC Ted Sox Xlg/Lng #3182,PX-3252563WWM,CDM,3252563WWM,LOCAL,270,RC,,inpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
HC Ted Sox Xlg/Lng #3182,PX-3252563WWM,CDM,3252563WWM,LOCAL,270,RC,,outpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
HC Ted Sox Xlg/Reg #3181,PX-3252564WWM,CDM,3252564WWM,LOCAL,270,RC,,inpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
HC Ted Sox Xlg/Reg #3181,PX-3252564WWM,CDM,3252564WWM,LOCAL,270,RC,,outpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
HC Ted Sox Sm/Reg #3130,PX-3252566WWM,CDM,3252566WWM,LOCAL,270,RC,,inpatient,,,55,49.5,,0.95,,52.25,Percent of total billed charges,,,0.98,,53.9,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.96,,52.8,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,52.25,Percent of total billed charges,,52.25,53.9,
HC Ted Sox Sm/Reg #3130,PX-3252566WWM,CDM,3252566WWM,LOCAL,270,RC,,outpatient,,,55,49.5,,0.95,,52.25,Percent of total billed charges,,,0.98,,53.9,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.96,,52.8,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,52.25,Percent of total billed charges,,52.25,53.9,
HC Ted Sox Med/Lng #3549,PX-3252567WWM,CDM,3252567WWM,LOCAL,270,RC,,inpatient,,,45,40.5,,0.95,,42.75,Percent of total billed charges,,,0.98,,44.1,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.96,,43.2,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,42.75,Percent of total billed charges,,42.75,44.1,
HC Ted Sox Med/Lng #3549,PX-3252567WWM,CDM,3252567WWM,LOCAL,270,RC,,outpatient,,,45,40.5,,0.95,,42.75,Percent of total billed charges,,,0.98,,44.1,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.96,,43.2,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,42.75,Percent of total billed charges,,42.75,44.1,
HC Ted Sox Med/Reg #3416,PX-3252568WWM,CDM,3252568WWM,LOCAL,270,RC,,inpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
HC Ted Sox Med/Reg #3416,PX-3252568WWM,CDM,3252568WWM,LOCAL,270,RC,,outpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
HC Ted Sox Lrg/Lng #3856,PX-3252569WWM,CDM,3252569WWM,LOCAL,270,RC,,inpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
HC Ted Sox Lrg/Lng #3856,PX-3252569WWM,CDM,3252569WWM,LOCAL,270,RC,,outpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
HC Ted Sox Lrg/Reg #3728,PX-3252570WWM,CDM,3252570WWM,LOCAL,270,RC,,inpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
HC Ted Sox Lrg/Reg #3728,PX-3252570WWM,CDM,3252570WWM,LOCAL,270,RC,,outpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
HC Specimen Trap 8fr #Smt808,PX-3252571WWM,CDM,3252571WWM,LOCAL,270,RC,,inpatient,,,58,52.2,,0.95,,55.1,Percent of total billed charges,,,0.98,,56.84,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,0.97,,56.26,Percent of total billed charges,,,0.97,,56.26,Percent of total billed charges,,,0.96,,55.68,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,55.1,Percent of total billed charges,,55.1,56.84,
HC Specimen Trap 8fr #Smt808,PX-3252571WWM,CDM,3252571WWM,LOCAL,270,RC,,outpatient,,,58,52.2,,0.95,,55.1,Percent of total billed charges,,,0.98,,56.84,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,0.97,,56.26,Percent of total billed charges,,,0.96,,55.68,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,55.1,Percent of total billed charges,,55.1,56.84,
HC Air Walk Cast Lg#Aw0800bl,PX-3252586WWM,CDM,3252586WWM,LOCAL,270,RC,,inpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
HC Air Walk Cast Lg#Aw0800bl,PX-3252586WWM,CDM,3252586WWM,LOCAL,270,RC,,outpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
HC Air Walk Cast MD# Aw0600b,PX-3252587WWM,CDM,3252587WWM,LOCAL,270,RC,,inpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
HC Air Walk Cast MD# Aw0600b,PX-3252587WWM,CDM,3252587WWM,LOCAL,270,RC,,outpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
HC Bag Ambu Chld/Inf#5302150,PX-3252611WWM,CDM,3252611WWM,LOCAL,270,RC,,inpatient,,,159,143.1,,0.95,,151.05,Percent of total billed charges,,,0.98,,155.82,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,0.97,,154.23,Percent of total billed charges,,,0.97,,154.23,Percent of total billed charges,,,0.96,,152.64,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,151.05,Percent of total billed charges,,151.05,155.82,
HC Bag Ambu Chld/Inf#5302150,PX-3252611WWM,CDM,3252611WWM,LOCAL,270,RC,,outpatient,,,159,143.1,,0.95,,151.05,Percent of total billed charges,,,0.98,,155.82,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,0.97,,154.23,Percent of total billed charges,,,0.96,,152.64,Percent of total billed charges,,,0.95,,151.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,151.05,Percent of total billed charges,,151.05,155.82,
HC Bag Ambu Adlt#520611000,PX-3252612WWM,CDM,3252612WWM,LOCAL,270,RC,,inpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
HC Bag Ambu Adlt#520611000,PX-3252612WWM,CDM,3252612WWM,LOCAL,270,RC,,outpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
HC Splint Thumb Xl/L #3080,PX-3252674WWM,CDM,3252674WWM,LOCAL,270,RC,,inpatient,,,117,105.3,,0.95,,111.15,Percent of total billed charges,,,0.98,,114.66,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.96,,112.32,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,111.15,Percent of total billed charges,,111.15,114.66,
HC Splint Thumb Xl/L #3080,PX-3252674WWM,CDM,3252674WWM,LOCAL,270,RC,,outpatient,,,117,105.3,,0.95,,111.15,Percent of total billed charges,,,0.98,,114.66,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.96,,112.32,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,111.15,Percent of total billed charges,,111.15,114.66,
HC Splint Thumb Lg/L #3070,PX-3252675WWM,CDM,3252675WWM,LOCAL,270,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
HC Splint Thumb Lg/L #3070,PX-3252675WWM,CDM,3252675WWM,LOCAL,270,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
HC Splint Thumb Lg/R #3170,PX-3252676WWM,CDM,3252676WWM,LOCAL,270,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
HC Splint Thumb Lg/R #3170,PX-3252676WWM,CDM,3252676WWM,LOCAL,270,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
HC Splint Thumb Sm/L #3030,PX-3252678WWM,CDM,3252678WWM,LOCAL,270,RC,,inpatient,,,117,105.3,,0.95,,111.15,Percent of total billed charges,,,0.98,,114.66,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.96,,112.32,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,111.15,Percent of total billed charges,,111.15,114.66,
HC Splint Thumb Sm/L #3030,PX-3252678WWM,CDM,3252678WWM,LOCAL,270,RC,,outpatient,,,117,105.3,,0.95,,111.15,Percent of total billed charges,,,0.98,,114.66,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.96,,112.32,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,111.15,Percent of total billed charges,,111.15,114.66,
HC Splint Thumb Med /L #3050,PX-3252679WWM,CDM,3252679WWM,LOCAL,270,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
HC Splint Thumb Med /L #3050,PX-3252679WWM,CDM,3252679WWM,LOCAL,270,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
HC Splint Thumb Med/R #3150,PX-3252680WWM,CDM,3252680WWM,LOCAL,270,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
HC Splint Thumb Med/R #3150,PX-3252680WWM,CDM,3252680WWM,LOCAL,270,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
HC Clavical Brace Xs #152678,PX-3252683WWM,CDM,3252683WWM,LOCAL,270,RC,,inpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
HC Clavical Brace Xs #152678,PX-3252683WWM,CDM,3252683WWM,LOCAL,270,RC,,outpatient,,,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
HC Sling Arm W/Loop Xl105j-X,PX-3252691WWM,CDM,3252691WWM,LOCAL,270,RC,,inpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
HC Sling Arm W/Loop Xl105j-X,PX-3252691WWM,CDM,3252691WWM,LOCAL,270,RC,,outpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
HC Sling Arm W/Loop M 105j-M,PX-3252693WWM,CDM,3252693WWM,LOCAL,270,RC,,inpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
HC Sling Arm W/Loop M 105j-M,PX-3252693WWM,CDM,3252693WWM,LOCAL,270,RC,,outpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
HC Sling Arm W/Loop S 105j-S,PX-3252694WWM,CDM,3252694WWM,LOCAL,270,RC,,inpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
HC Sling Arm W/Loop S 105j-S,PX-3252694WWM,CDM,3252694WWM,LOCAL,270,RC,,outpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
HC Sling Arm Ped #104sm,PX-3252696WWM,CDM,3252696WWM,LOCAL,270,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC Sling Arm Ped #104sm,PX-3252696WWM,CDM,3252696WWM,LOCAL,270,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC Immobl Shoulder M #331004,PX-3252703WWM,CDM,3252703WWM,LOCAL,270,RC,,inpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95,Percent of total billed charges,,95,98,
HC Immobl Shoulder M #331004,PX-3252703WWM,CDM,3252703WWM,LOCAL,270,RC,,outpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95,Percent of total billed charges,,95,98,
HC Immobl Shoulder Xl#331006,PX-3252705WWM,CDM,3252705WWM,LOCAL,270,RC,,inpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95,Percent of total billed charges,,95,98,
HC Immobl Shoulder Xl#331006,PX-3252705WWM,CDM,3252705WWM,LOCAL,270,RC,,outpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95,Percent of total billed charges,,95,98,
HC Rt Acapella #26-21-1530,PX-3252806WWM,CDM,3252806WWM,LOCAL,270,RC,,inpatient,,,196,176.4,,0.95,,186.2,Percent of total billed charges,,,0.98,,192.08,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,0.97,,190.12,Percent of total billed charges,,,0.97,,190.12,Percent of total billed charges,,,0.96,,188.16,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,186.2,Percent of total billed charges,,186.2,192.08,
HC Rt Acapella #26-21-1530,PX-3252806WWM,CDM,3252806WWM,LOCAL,270,RC,,outpatient,,,196,176.4,,0.95,,186.2,Percent of total billed charges,,,0.98,,192.08,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,0.97,,190.12,Percent of total billed charges,,,0.96,,188.16,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,186.2,Percent of total billed charges,,186.2,192.08,
HC Ted Sox Knee Sm/Reg #7071,PX-3252824WWM,CDM,3252824WWM,LOCAL,270,RC,,inpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
HC Ted Sox Knee Sm/Reg #7071,PX-3252824WWM,CDM,3252824WWM,LOCAL,270,RC,,outpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
HC Ted Sox Knee M/Reg #7115,PX-3252826WWM,CDM,3252826WWM,LOCAL,270,RC,,inpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
HC Ted Sox Knee M/Reg #7115,PX-3252826WWM,CDM,3252826WWM,LOCAL,270,RC,,outpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
HC Ted Sox Knee M/Long #7480,PX-3252827WWM,CDM,3252827WWM,LOCAL,270,RC,,inpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
HC Ted Sox Knee M/Long #7480,PX-3252827WWM,CDM,3252827WWM,LOCAL,270,RC,,outpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
HC Ted Sox Knee L/Reg #7203,PX-3252828WWM,CDM,3252828WWM,LOCAL,270,RC,,inpatient,,,28,25.2,,0.95,,26.6,Percent of total billed charges,,,0.98,,27.44,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.96,,26.88,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,26.6,Percent of total billed charges,,26.6,27.44,
HC Ted Sox Knee L/Reg #7203,PX-3252828WWM,CDM,3252828WWM,LOCAL,270,RC,,outpatient,,,28,25.2,,0.95,,26.6,Percent of total billed charges,,,0.98,,27.44,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.96,,26.88,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,26.6,Percent of total billed charges,,26.6,27.44,
HC Drsg Polymem 4x4 #5044,PX-3252829WWM,CDM,3252829WWM,LOCAL,270,RC,,inpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
HC Drsg Polymem 4x4 #5044,PX-3252829WWM,CDM,3252829WWM,LOCAL,270,RC,,outpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
HC Ted Sox Knee Xl/Reg#7604,PX-3252830WWM,CDM,3252830WWM,LOCAL,270,RC,,inpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
HC Ted Sox Knee Xl/Reg#7604,PX-3252830WWM,CDM,3252830WWM,LOCAL,270,RC,,outpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
HC Ted Sox Knee Xl/Long#7802,PX-3252831WWM,CDM,3252831WWM,LOCAL,270,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC Ted Sox Knee Xl/Long#7802,PX-3252831WWM,CDM,3252831WWM,LOCAL,270,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC Stomahesive #183910,PX-3252842WWM,CDM,3252842WWM,LOCAL,270,RC,,inpatient,,,98,88.2,,0.95,,93.1,Percent of total billed charges,,,0.98,,96.04,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,0.97,,95.06,Percent of total billed charges,,,0.97,,95.06,Percent of total billed charges,,,0.96,,94.08,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,93.1,Percent of total billed charges,,93.1,96.04,
HC Stomahesive #183910,PX-3252842WWM,CDM,3252842WWM,LOCAL,270,RC,,outpatient,,,98,88.2,,0.95,,93.1,Percent of total billed charges,,,0.98,,96.04,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,0.97,,95.06,Percent of total billed charges,,,0.96,,94.08,Percent of total billed charges,,,0.95,,93.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,93.1,Percent of total billed charges,,93.1,96.04,
HC Rt E-Z Wraps Ear Pro#1016,PX-3252863WWM,CDM,3252863WWM,LOCAL,270,RC,,inpatient,,,9,8.1,,0.95,,8.55,Percent of total billed charges,,,0.98,,8.82,Percent of total billed charges,,,0.95,,8.55,Percent of total billed charges,,,0.97,,8.73,Percent of total billed charges,,,0.97,,8.73,Percent of total billed charges,,,0.96,,8.64,Percent of total billed charges,,,0.95,,8.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,8.55,Percent of total billed charges,,8.55,8.82,
HC Rt E-Z Wraps Ear Pro#1016,PX-3252863WWM,CDM,3252863WWM,LOCAL,270,RC,,outpatient,,,9,8.1,,0.95,,8.55,Percent of total billed charges,,,0.98,,8.82,Percent of total billed charges,,,0.95,,8.55,Percent of total billed charges,,,0.95,,8.55,Percent of total billed charges,,,0.97,,8.73,Percent of total billed charges,,,0.96,,8.64,Percent of total billed charges,,,0.95,,8.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,8.55,Percent of total billed charges,,8.55,8.82,
HC Rt Aerochamber #79710,PX-3252869WWM,CDM,3252869WWM,LOCAL,270,RC,,inpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
HC Rt Aerochamber #79710,PX-3252869WWM,CDM,3252869WWM,LOCAL,270,RC,,outpatient,,,61,54.9,,0.95,,57.95,Percent of total billed charges,,,0.98,,59.78,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,0.97,,59.17,Percent of total billed charges,,,0.96,,58.56,Percent of total billed charges,,,0.95,,57.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,57.95,Percent of total billed charges,,57.95,59.78,
HC OB Para/Puden Blk #4540a,PX-3252893WWM,CDM,3252893WWM,LOCAL,270,RC,,inpatient,,,46,41.4,,0.95,,43.7,Percent of total billed charges,,,0.98,,45.08,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,0.97,,44.62,Percent of total billed charges,,,0.97,,44.62,Percent of total billed charges,,,0.96,,44.16,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,43.7,Percent of total billed charges,,43.7,45.08,
HC OB Para/Puden Blk #4540a,PX-3252893WWM,CDM,3252893WWM,LOCAL,270,RC,,outpatient,,,46,41.4,,0.95,,43.7,Percent of total billed charges,,,0.98,,45.08,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,0.97,,44.62,Percent of total billed charges,,,0.96,,44.16,Percent of total billed charges,,,0.95,,43.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,43.7,Percent of total billed charges,,43.7,45.08,
HC Rt Incentive Spirometer,PX-3252894WWM,CDM,3252894WWM,LOCAL,270,RC,,inpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
HC Rt Incentive Spirometer,PX-3252894WWM,CDM,3252894WWM,LOCAL,270,RC,,outpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
HC OB Koala Intr/Cathipc5000,PX-3252900WWM,CDM,3252900WWM,LOCAL,270,RC,,inpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
HC OB Koala Intr/Cathipc5000,PX-3252900WWM,CDM,3252900WWM,LOCAL,270,RC,,outpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
HC Immobl Shoulder L #331005,PX-3252908WWM,CDM,3252908WWM,LOCAL,270,RC,,inpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95,Percent of total billed charges,,95,98,
HC Immobl Shoulder L #331005,PX-3252908WWM,CDM,3252908WWM,LOCAL,270,RC,,outpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,95,Percent of total billed charges,,95,98,
HC OB Cath Umbil 3.5#160218,PX-3252916WWM,CDM,3252916WWM,LOCAL,270,RC,,inpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
HC OB Cath Umbil 3.5#160218,PX-3252916WWM,CDM,3252916WWM,LOCAL,270,RC,,outpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
HC Air Walk Cast Xl #Aw1000b,PX-3252925WWM,CDM,3252925WWM,LOCAL,270,RC,,inpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
HC Air Walk Cast Xl #Aw1000b,PX-3252925WWM,CDM,3252925WWM,LOCAL,270,RC,,outpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
HC OB Sensor Spo2 #1002,PX-3252937WWM,CDM,3252937WWM,LOCAL,270,RC,,inpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
HC OB Sensor Spo2 #1002,PX-3252937WWM,CDM,3252937WWM,LOCAL,270,RC,,outpatient,,,59,53.1,,0.95,,56.05,Percent of total billed charges,,,0.98,,57.82,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,0.97,,57.23,Percent of total billed charges,,,0.96,,56.64,Percent of total billed charges,,,0.95,,56.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,56.05,Percent of total billed charges,,56.05,57.82,
HC Cath Fol/Tray 18 #907318,PX-3252938WWM,CDM,3252938WWM,LOCAL,270,RC,,inpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
HC Cath Fol/Tray 18 #907318,PX-3252938WWM,CDM,3252938WWM,LOCAL,270,RC,,outpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
HC Cath Fol/Tray 16fr#907316,PX-3252939WWM,CDM,3252939WWM,LOCAL,270,RC,,inpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
HC Cath Fol/Tray 16fr#907316,PX-3252939WWM,CDM,3252939WWM,LOCAL,270,RC,,outpatient,,,111,99.9,,0.95,,105.45,Percent of total billed charges,,,0.98,,108.78,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,0.97,,107.67,Percent of total billed charges,,,0.96,,106.56,Percent of total billed charges,,,0.95,,105.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,105.45,Percent of total billed charges,,105.45,108.78,
HC Drsg Alldress 6x6#265346,PX-3252950WWM,CDM,3252950WWM,LOCAL,270,RC,,inpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
HC Drsg Alldress 6x6#265346,PX-3252950WWM,CDM,3252950WWM,LOCAL,270,RC,,outpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
HC Drsg Alldress 4x4#265324,PX-3252951WWM,CDM,3252951WWM,LOCAL,270,RC,,inpatient,,,12,10.8,,0.95,,11.4,Percent of total billed charges,,,0.98,,11.76,Percent of total billed charges,,,0.95,,11.4,Percent of total billed charges,,,0.97,,11.64,Percent of total billed charges,,,0.97,,11.64,Percent of total billed charges,,,0.96,,11.52,Percent of total billed charges,,,0.95,,11.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,11.4,Percent of total billed charges,,11.4,11.76,
HC Drsg Alldress 4x4#265324,PX-3252951WWM,CDM,3252951WWM,LOCAL,270,RC,,outpatient,,,12,10.8,,0.95,,11.4,Percent of total billed charges,,,0.98,,11.76,Percent of total billed charges,,,0.95,,11.4,Percent of total billed charges,,,0.95,,11.4,Percent of total billed charges,,,0.97,,11.64,Percent of total billed charges,,,0.96,,11.52,Percent of total billed charges,,,0.95,,11.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,11.4,Percent of total billed charges,,11.4,11.76,
HC Rt Peak Flow Meter #96510,PX-3252956WWM,CDM,3252956WWM,LOCAL,270,RC,,inpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
HC Rt Peak Flow Meter #96510,PX-3252956WWM,CDM,3252956WWM,LOCAL,270,RC,,outpatient,,,78,70.2,,0.95,,74.1,Percent of total billed charges,,,0.98,,76.44,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,0.97,,75.66,Percent of total billed charges,,,0.96,,74.88,Percent of total billed charges,,,0.95,,74.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,74.1,Percent of total billed charges,,74.1,76.44,
HC OB Scalp Electrod#7000aao,PX-3252958WWM,CDM,3252958WWM,LOCAL,270,RC,,inpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
HC OB Scalp Electrod#7000aao,PX-3252958WWM,CDM,3252958WWM,LOCAL,270,RC,,outpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
HC Cast Shoe M #140504,PX-3252964WWM,CDM,3252964WWM,LOCAL,270,RC,,inpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
HC Cast Shoe M #140504,PX-3252964WWM,CDM,3252964WWM,LOCAL,270,RC,,outpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
HC Rt Co2 Detect #Easy Capii,PX-3252980WWM,CDM,3252980WWM,LOCAL,270,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
HC Rt Co2 Detect #Easy Capii,PX-3252980WWM,CDM,3252980WWM,LOCAL,270,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
HC Cath 3way Irr 22f#7688227,PX-3252987WWM,CDM,3252987WWM,LOCAL,270,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC Cath 3way Irr 22f#7688227,PX-3252987WWM,CDM,3252987WWM,LOCAL,270,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC OB Newborn Screening,PX-3253001WWM,CDM,3253001WWM,LOCAL,270,RC,,inpatient,,,214,192.6,,0.95,,203.3,Percent of total billed charges,,,0.98,,209.72,Percent of total billed charges,,,0.95,,203.3,Percent of total billed charges,,,0.97,,207.58,Percent of total billed charges,,,0.97,,207.58,Percent of total billed charges,,,0.96,,205.44,Percent of total billed charges,,,0.95,,203.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,203.3,Percent of total billed charges,,203.3,209.72,
HC OB Newborn Screening,PX-3253001WWM,CDM,3253001WWM,LOCAL,270,RC,,outpatient,,,214,192.6,,0.95,,203.3,Percent of total billed charges,,,0.98,,209.72,Percent of total billed charges,,,0.95,,203.3,Percent of total billed charges,,,0.95,,203.3,Percent of total billed charges,,,0.97,,207.58,Percent of total billed charges,,,0.96,,205.44,Percent of total billed charges,,,0.95,,203.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,203.3,Percent of total billed charges,,203.3,209.72,
HC Cath 3 Way 16fr,PX-3253023WWM,CDM,3253023WWM,LOCAL,270,RC,,inpatient,,,117,105.3,,0.95,,111.15,Percent of total billed charges,,,0.98,,114.66,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.96,,112.32,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,111.15,Percent of total billed charges,,111.15,114.66,
HC Cath 3 Way 16fr,PX-3253023WWM,CDM,3253023WWM,LOCAL,270,RC,,outpatient,,,117,105.3,,0.95,,111.15,Percent of total billed charges,,,0.98,,114.66,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.96,,112.32,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,111.15,Percent of total billed charges,,111.15,114.66,
HC Venaflow Calf Cuff,PX-3253029WWM,CDM,3253029WWM,LOCAL,270,RC,,inpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
HC Venaflow Calf Cuff,PX-3253029WWM,CDM,3253029WWM,LOCAL,270,RC,,outpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
HC Cath Foley Meter 16fr,PX-3253041WWM,CDM,3253041WWM,LOCAL,270,RC,,inpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
HC Cath Foley Meter 16fr,PX-3253041WWM,CDM,3253041WWM,LOCAL,270,RC,,outpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
"HC Tape Medipore 6""",PX-3253076WWM,CDM,3253076WWM,LOCAL,270,RC,,inpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
"HC Tape Medipore 6""",PX-3253076WWM,CDM,3253076WWM,LOCAL,270,RC,,outpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
HC Electrode Quik Combo 2pk,PX-3253105WWM,CDM,3253105WWM,LOCAL,270,RC,,inpatient,,,135,121.5,,0.95,,128.25,Percent of total billed charges,,,0.98,,132.3,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,0.97,,130.95,Percent of total billed charges,,,0.97,,130.95,Percent of total billed charges,,,0.96,,129.6,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,128.25,Percent of total billed charges,,128.25,132.3,
HC Electrode Quik Combo 2pk,PX-3253105WWM,CDM,3253105WWM,LOCAL,270,RC,,outpatient,,,135,121.5,,0.95,,128.25,Percent of total billed charges,,,0.98,,132.3,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,0.97,,130.95,Percent of total billed charges,,,0.96,,129.6,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,128.25,Percent of total billed charges,,128.25,132.3,
HC Rt Ped Aerochamb Mask,PX-3253126WWM,CDM,3253126WWM,LOCAL,270,RC,,inpatient,,,130,117,,0.95,,123.5,Percent of total billed charges,,,0.98,,127.4,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.96,,124.8,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,123.5,Percent of total billed charges,,123.5,127.4,
HC Rt Ped Aerochamb Mask,PX-3253126WWM,CDM,3253126WWM,LOCAL,270,RC,,outpatient,,,130,117,,0.95,,123.5,Percent of total billed charges,,,0.98,,127.4,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,0.97,,126.1,Percent of total billed charges,,,0.96,,124.8,Percent of total billed charges,,,0.95,,123.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,123.5,Percent of total billed charges,,123.5,127.4,
HC Rt Neo Aerochamb Mask,PX-3253127WWM,CDM,3253127WWM,LOCAL,270,RC,,inpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
HC Rt Neo Aerochamb Mask,PX-3253127WWM,CDM,3253127WWM,LOCAL,270,RC,,outpatient,,,77,69.3,,0.95,,73.15,Percent of total billed charges,,,0.98,,75.46,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,0.97,,74.69,Percent of total billed charges,,,0.96,,73.92,Percent of total billed charges,,,0.95,,73.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,73.15,Percent of total billed charges,,73.15,75.46,
HC Rt Oximizer Cannula#P-224,PX-3253137WWM,CDM,3253137WWM,LOCAL,270,RC,,inpatient,,,170,153,,0.95,,161.5,Percent of total billed charges,,,0.98,,166.6,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,0.97,,164.9,Percent of total billed charges,,,0.97,,164.9,Percent of total billed charges,,,0.96,,163.2,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,161.5,Percent of total billed charges,,161.5,166.6,
HC Rt Oximizer Cannula#P-224,PX-3253137WWM,CDM,3253137WWM,LOCAL,270,RC,,outpatient,,,170,153,,0.95,,161.5,Percent of total billed charges,,,0.98,,166.6,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,0.97,,164.9,Percent of total billed charges,,,0.96,,163.2,Percent of total billed charges,,,0.95,,161.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,161.5,Percent of total billed charges,,161.5,166.6,
HC Peep Valve #199002020,PX-3253139WWM,CDM,3253139WWM,LOCAL,270,RC,,inpatient,,,30,27,,0.95,,28.5,Percent of total billed charges,,,0.98,,29.4,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,0.97,,29.1,Percent of total billed charges,,,0.97,,29.1,Percent of total billed charges,,,0.96,,28.8,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,28.5,Percent of total billed charges,,28.5,29.4,
HC Peep Valve #199002020,PX-3253139WWM,CDM,3253139WWM,LOCAL,270,RC,,outpatient,,,30,27,,0.95,,28.5,Percent of total billed charges,,,0.98,,29.4,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,0.97,,29.1,Percent of total billed charges,,,0.96,,28.8,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,28.5,Percent of total billed charges,,28.5,29.4,
HC Splnt Rib Blt Sm#13760305,PX-3253147WWM,CDM,3253147WWM,LOCAL,270,RC,,inpatient,,,63,56.7,,0.95,,59.85,Percent of total billed charges,,,0.98,,61.74,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.96,,60.48,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,59.85,Percent of total billed charges,,59.85,61.74,
HC Splnt Rib Blt Sm#13760305,PX-3253147WWM,CDM,3253147WWM,LOCAL,270,RC,,outpatient,,,63,56.7,,0.95,,59.85,Percent of total billed charges,,,0.98,,61.74,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,0.97,,61.11,Percent of total billed charges,,,0.96,,60.48,Percent of total billed charges,,,0.95,,59.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,59.85,Percent of total billed charges,,59.85,61.74,
HC Splnt Rib Blt MD#13760306,PX-3253148WWM,CDM,3253148WWM,LOCAL,270,RC,,inpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
HC Splnt Rib Blt MD#13760306,PX-3253148WWM,CDM,3253148WWM,LOCAL,270,RC,,outpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
HC Splnt Rib Blt Lg#13760307,PX-3253149WWM,CDM,3253149WWM,LOCAL,270,RC,,inpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
HC Splnt Rib Blt Lg#13760307,PX-3253149WWM,CDM,3253149WWM,LOCAL,270,RC,,outpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
HC Splnt Rib Blt Xl#13760308,PX-3253150WWM,CDM,3253150WWM,LOCAL,270,RC,,inpatient,,,55,49.5,,0.95,,52.25,Percent of total billed charges,,,0.98,,53.9,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.96,,52.8,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,52.25,Percent of total billed charges,,52.25,53.9,
HC Splnt Rib Blt Xl#13760308,PX-3253150WWM,CDM,3253150WWM,LOCAL,270,RC,,outpatient,,,55,49.5,,0.95,,52.25,Percent of total billed charges,,,0.98,,53.9,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,0.97,,53.35,Percent of total billed charges,,,0.96,,52.8,Percent of total billed charges,,,0.95,,52.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,52.25,Percent of total billed charges,,52.25,53.9,
HC IV Picc 4 #3174108d,PX-3253162WWM,CDM,3253162WWM,LOCAL,270,RC,,inpatient,,,528,475.2,,0.95,,501.6,Percent of total billed charges,,,0.98,,517.44,Percent of total billed charges,,,0.95,,501.6,Percent of total billed charges,,,0.97,,512.16,Percent of total billed charges,,,0.97,,512.16,Percent of total billed charges,,,0.96,,506.88,Percent of total billed charges,,,0.95,,501.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,501.6,Percent of total billed charges,,501.6,517.44,
HC IV Picc 4 #3174108d,PX-3253162WWM,CDM,3253162WWM,LOCAL,270,RC,,outpatient,,,528,475.2,,0.95,,501.6,Percent of total billed charges,,,0.98,,517.44,Percent of total billed charges,,,0.95,,501.6,Percent of total billed charges,,,0.95,,501.6,Percent of total billed charges,,,0.97,,512.16,Percent of total billed charges,,,0.96,,506.88,Percent of total billed charges,,,0.95,,501.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,501.6,Percent of total billed charges,,501.6,517.44,
"HC Tape Medipore 2"" #2962",PX-3253258WWM,CDM,3253258WWM,LOCAL,270,RC,,inpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
"HC Tape Medipore 2"" #2962",PX-3253258WWM,CDM,3253258WWM,LOCAL,270,RC,,outpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
"HC Tape Medipore 4"" #2964",PX-3253259WWM,CDM,3253259WWM,LOCAL,270,RC,,inpatient,,,45,40.5,,0.95,,42.75,Percent of total billed charges,,,0.98,,44.1,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.96,,43.2,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,42.75,Percent of total billed charges,,42.75,44.1,
"HC Tape Medipore 4"" #2964",PX-3253259WWM,CDM,3253259WWM,LOCAL,270,RC,,outpatient,,,45,40.5,,0.95,,42.75,Percent of total billed charges,,,0.98,,44.1,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.96,,43.2,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,42.75,Percent of total billed charges,,42.75,44.1,
HC Rt Acapella Lo #26-21-101,PX-3253278WWM,CDM,3253278WWM,LOCAL,270,RC,,inpatient,,,196,176.4,,0.95,,186.2,Percent of total billed charges,,,0.98,,192.08,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,0.97,,190.12,Percent of total billed charges,,,0.97,,190.12,Percent of total billed charges,,,0.96,,188.16,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,186.2,Percent of total billed charges,,186.2,192.08,
HC Rt Acapella Lo #26-21-101,PX-3253278WWM,CDM,3253278WWM,LOCAL,270,RC,,outpatient,,,196,176.4,,0.95,,186.2,Percent of total billed charges,,,0.98,,192.08,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,0.97,,190.12,Percent of total billed charges,,,0.96,,188.16,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,186.2,Percent of total billed charges,,186.2,192.08,
HC Rt Nebulizer Lg Vol,PX-3253293WWM,CDM,3253293WWM,LOCAL,270,RC,,inpatient,,,36,32.4,,0.95,,34.2,Percent of total billed charges,,,0.98,,35.28,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.96,,34.56,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,34.2,Percent of total billed charges,,34.2,35.28,
HC Rt Nebulizer Lg Vol,PX-3253293WWM,CDM,3253293WWM,LOCAL,270,RC,,outpatient,,,36,32.4,,0.95,,34.2,Percent of total billed charges,,,0.98,,35.28,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.96,,34.56,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,34.2,Percent of total billed charges,,34.2,35.28,
"HC Cast Tape Purpl 3""",PX-3253319WWM,CDM,3253319WWM,LOCAL,270,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
"HC Cast Tape Purpl 3""",PX-3253319WWM,CDM,3253319WWM,LOCAL,270,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
"HC Cast Tape Lt Blu 3""",PX-3253321WWM,CDM,3253321WWM,LOCAL,270,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
"HC Cast Tape Lt Blu 3""",PX-3253321WWM,CDM,3253321WWM,LOCAL,270,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC Pt Heel Lift Sm #Nc57187-,PX-3253333WWM,CDM,3253333WWM,LOCAL,270,RC,,inpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
HC Pt Heel Lift Sm #Nc57187-,PX-3253333WWM,CDM,3253333WWM,LOCAL,270,RC,,outpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
HC Pt Heel Lift Med#Nc57187-,PX-3253334WWM,CDM,3253334WWM,LOCAL,270,RC,,inpatient,,,45,40.5,,0.95,,42.75,Percent of total billed charges,,,0.98,,44.1,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.96,,43.2,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,42.75,Percent of total billed charges,,42.75,44.1,
HC Pt Heel Lift Med#Nc57187-,PX-3253334WWM,CDM,3253334WWM,LOCAL,270,RC,,outpatient,,,45,40.5,,0.95,,42.75,Percent of total billed charges,,,0.98,,44.1,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,0.97,,43.65,Percent of total billed charges,,,0.96,,43.2,Percent of total billed charges,,,0.95,,42.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,42.75,Percent of total billed charges,,42.75,44.1,
HC Suct Irrigator Pulsed,PX-3253380WWM,CDM,3253380WWM,LOCAL,270,RC,,inpatient,,,209,188.1,,0.95,,198.55,Percent of total billed charges,,,0.98,,204.82,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.96,,200.64,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,198.55,Percent of total billed charges,,198.55,204.82,
HC Suct Irrigator Pulsed,PX-3253380WWM,CDM,3253380WWM,LOCAL,270,RC,,outpatient,,,209,188.1,,0.95,,198.55,Percent of total billed charges,,,0.98,,204.82,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.96,,200.64,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,198.55,Percent of total billed charges,,198.55,204.82,
HC Suct Tube Attach #9785,PX-3253395WWM,CDM,3253395WWM,LOCAL,270,RC,,inpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
HC Suct Tube Attach #9785,PX-3253395WWM,CDM,3253395WWM,LOCAL,270,RC,,outpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
HC Pt Splint L/Sm #Nc81020-1,PX-3253402WWM,CDM,3253402WWM,LOCAL,270,RC,,inpatient,,,121,108.9,,0.95,,114.95,Percent of total billed charges,,,0.98,,118.58,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.96,,116.16,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114.95,Percent of total billed charges,,114.95,118.58,
HC Pt Splint L/Sm #Nc81020-1,PX-3253402WWM,CDM,3253402WWM,LOCAL,270,RC,,outpatient,,,121,108.9,,0.95,,114.95,Percent of total billed charges,,,0.98,,118.58,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.96,,116.16,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114.95,Percent of total billed charges,,114.95,118.58,
HC Pt Splint L/Lg #Nc81020-5,PX-3253406WWM,CDM,3253406WWM,LOCAL,270,RC,,inpatient,,,121,108.9,,0.95,,114.95,Percent of total billed charges,,,0.98,,118.58,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.96,,116.16,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114.95,Percent of total billed charges,,114.95,118.58,
HC Pt Splint L/Lg #Nc81020-5,PX-3253406WWM,CDM,3253406WWM,LOCAL,270,RC,,outpatient,,,121,108.9,,0.95,,114.95,Percent of total billed charges,,,0.98,,118.58,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.96,,116.16,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114.95,Percent of total billed charges,,114.95,118.58,
HC Cath 3 Way Irri 24fr,PX-3253414WWM,CDM,3253414WWM,LOCAL,270,RC,,inpatient,,,58,52.2,,0.95,,55.1,Percent of total billed charges,,,0.98,,56.84,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,0.97,,56.26,Percent of total billed charges,,,0.97,,56.26,Percent of total billed charges,,,0.96,,55.68,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,55.1,Percent of total billed charges,,55.1,56.84,
HC Cath 3 Way Irri 24fr,PX-3253414WWM,CDM,3253414WWM,LOCAL,270,RC,,outpatient,,,58,52.2,,0.95,,55.1,Percent of total billed charges,,,0.98,,56.84,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,0.97,,56.26,Percent of total billed charges,,,0.96,,55.68,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,55.1,Percent of total billed charges,,55.1,56.84,
HC Calmoseptine #0799000102,PX-3253417WWM,CDM,3253417WWM,LOCAL,270,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC Calmoseptine #0799000102,PX-3253417WWM,CDM,3253417WWM,LOCAL,270,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC Drsg Biopatch #Et3152,PX-3253419WWM,CDM,3253419WWM,LOCAL,270,RC,,inpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
HC Drsg Biopatch #Et3152,PX-3253419WWM,CDM,3253419WWM,LOCAL,270,RC,,outpatient,,,52,46.8,,0.95,,49.4,Percent of total billed charges,,,0.98,,50.96,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,0.97,,50.44,Percent of total billed charges,,,0.96,,49.92,Percent of total billed charges,,,0.95,,49.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,49.4,Percent of total billed charges,,49.4,50.96,
HC IV Cl Secure #Cv0220,PX-3253420WWM,CDM,3253420WWM,LOCAL,270,RC,,inpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
HC IV Cl Secure #Cv0220,PX-3253420WWM,CDM,3253420WWM,LOCAL,270,RC,,outpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,47.5,Percent of total billed charges,,47.5,49,
HC IV Picc Secure #Vppdfp,PX-3253421WWM,CDM,3253421WWM,LOCAL,270,RC,,inpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
HC IV Picc Secure #Vppdfp,PX-3253421WWM,CDM,3253421WWM,LOCAL,270,RC,,outpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
HC OB Mityvac #10058,PX-3253459WWM,CDM,3253459WWM,LOCAL,270,RC,,inpatient,,,195,175.5,,0.95,,185.25,Percent of total billed charges,,,0.98,,191.1,Percent of total billed charges,,,0.95,,185.25,Percent of total billed charges,,,0.97,,189.15,Percent of total billed charges,,,0.97,,189.15,Percent of total billed charges,,,0.96,,187.2,Percent of total billed charges,,,0.95,,185.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,185.25,Percent of total billed charges,,185.25,191.1,
HC OB Mityvac #10058,PX-3253459WWM,CDM,3253459WWM,LOCAL,270,RC,,outpatient,,,195,175.5,,0.95,,185.25,Percent of total billed charges,,,0.98,,191.1,Percent of total billed charges,,,0.95,,185.25,Percent of total billed charges,,,0.95,,185.25,Percent of total billed charges,,,0.97,,189.15,Percent of total billed charges,,,0.96,,187.2,Percent of total billed charges,,,0.95,,185.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,185.25,Percent of total billed charges,,185.25,191.1,
HC Pt Sock Aid 1 #Nc26600,PX-3253469WWM,CDM,3253469WWM,LOCAL,270,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC Pt Sock Aid 1 #Nc26600,PX-3253469WWM,CDM,3253469WWM,LOCAL,270,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC Pt Ez Reach W/ Lock,PX-3253474WWM,CDM,3253474WWM,LOCAL,270,RC,,inpatient,,,86,77.4,,0.95,,81.7,Percent of total billed charges,,,0.98,,84.28,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,0.97,,83.42,Percent of total billed charges,,,0.97,,83.42,Percent of total billed charges,,,0.96,,82.56,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,81.7,Percent of total billed charges,,81.7,84.28,
HC Pt Ez Reach W/ Lock,PX-3253474WWM,CDM,3253474WWM,LOCAL,270,RC,,outpatient,,,86,77.4,,0.95,,81.7,Percent of total billed charges,,,0.98,,84.28,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,0.97,,83.42,Percent of total billed charges,,,0.96,,82.56,Percent of total billed charges,,,0.95,,81.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,81.7,Percent of total billed charges,,81.7,84.28,
HC Feed Bag #No199547,PX-3253491WWM,CDM,3253491WWM,LOCAL,270,RC,,inpatient,,,31,27.9,,0.95,,29.45,Percent of total billed charges,,,0.98,,30.38,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.96,,29.76,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,29.45,Percent of total billed charges,,29.45,30.38,
HC Feed Bag #No199547,PX-3253491WWM,CDM,3253491WWM,LOCAL,270,RC,,outpatient,,,31,27.9,,0.95,,29.45,Percent of total billed charges,,,0.98,,30.38,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.96,,29.76,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,29.45,Percent of total billed charges,,29.45,30.38,
"HC Cast Tape Purpl 2""",PX-3253504WWM,CDM,3253504WWM,LOCAL,270,RC,,inpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
"HC Cast Tape Purpl 2""",PX-3253504WWM,CDM,3253504WWM,LOCAL,270,RC,,outpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
"HC Cast Tape Lt Blu 2""",PX-3253505WWM,CDM,3253505WWM,LOCAL,270,RC,,inpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
"HC Cast Tape Lt Blu 2""",PX-3253505WWM,CDM,3253505WWM,LOCAL,270,RC,,outpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
HC Pt Overdor Tract#Nc92610,PX-3253518WWM,CDM,3253518WWM,LOCAL,270,RC,,inpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
HC Pt Overdor Tract#Nc92610,PX-3253518WWM,CDM,3253518WWM,LOCAL,270,RC,,outpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
HC Tubing Hot Line #L-70,PX-3253556WWM,CDM,3253556WWM,LOCAL,270,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
HC Tubing Hot Line #L-70,PX-3253556WWM,CDM,3253556WWM,LOCAL,270,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
HC Drsg Barrier Cream#M3355,PX-3253648WWM,CDM,3253648WWM,LOCAL,270,RC,,inpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
HC Drsg Barrier Cream#M3355,PX-3253648WWM,CDM,3253648WWM,LOCAL,270,RC,,outpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
HC Drsg Hydro Sacral#M90007,PX-3253650WWM,CDM,3253650WWM,LOCAL,270,RC,,inpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
HC Drsg Hydro Sacral#M90007,PX-3253650WWM,CDM,3253650WWM,LOCAL,270,RC,,outpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
"HC Splint Knee 16"" #D1160917",PX-3253656WWM,CDM,3253656WWM,LOCAL,270,RC,,inpatient,,,125,112.5,,0.95,,118.75,Percent of total billed charges,,,0.98,,122.5,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.96,,120,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,118.75,Percent of total billed charges,,118.75,122.5,
"HC Splint Knee 16"" #D1160917",PX-3253656WWM,CDM,3253656WWM,LOCAL,270,RC,,outpatient,,,125,112.5,,0.95,,118.75,Percent of total billed charges,,,0.98,,122.5,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.96,,120,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,118.75,Percent of total billed charges,,118.75,122.5,
HC IV Picc 5 Fr #3275108d,PX-3253667WWM,CDM,3253667WWM,LOCAL,270,RC,,inpatient,,,482,433.8,,0.95,,457.9,Percent of total billed charges,,,0.98,,472.36,Percent of total billed charges,,,0.95,,457.9,Percent of total billed charges,,,0.97,,467.54,Percent of total billed charges,,,0.97,,467.54,Percent of total billed charges,,,0.96,,462.72,Percent of total billed charges,,,0.95,,457.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,457.9,Percent of total billed charges,,457.9,472.36,
HC IV Picc 5 Fr #3275108d,PX-3253667WWM,CDM,3253667WWM,LOCAL,270,RC,,outpatient,,,482,433.8,,0.95,,457.9,Percent of total billed charges,,,0.98,,472.36,Percent of total billed charges,,,0.95,,457.9,Percent of total billed charges,,,0.95,,457.9,Percent of total billed charges,,,0.97,,467.54,Percent of total billed charges,,,0.96,,462.72,Percent of total billed charges,,,0.95,,457.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,457.9,Percent of total billed charges,,457.9,472.36,
HC Wound Vac & Supplies,PX-3253673WWM,CDM,3253673WWM,LOCAL,270,RC,,inpatient,,,237,213.3,,0.95,,225.15,Percent of total billed charges,,,0.98,,232.26,Percent of total billed charges,,,0.95,,225.15,Percent of total billed charges,,,0.97,,229.89,Percent of total billed charges,,,0.97,,229.89,Percent of total billed charges,,,0.96,,227.52,Percent of total billed charges,,,0.95,,225.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,225.15,Percent of total billed charges,,225.15,232.26,
HC Wound Vac & Supplies,PX-3253673WWM,CDM,3253673WWM,LOCAL,270,RC,,outpatient,,,237,213.3,,0.95,,225.15,Percent of total billed charges,,,0.98,,232.26,Percent of total billed charges,,,0.95,,225.15,Percent of total billed charges,,,0.95,,225.15,Percent of total billed charges,,,0.97,,229.89,Percent of total billed charges,,,0.96,,227.52,Percent of total billed charges,,,0.95,,225.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,225.15,Percent of total billed charges,,225.15,232.26,
HC Abd Binder Med #79-89045,PX-3253708WWM,CDM,3253708WWM,LOCAL,270,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
HC Abd Binder Med #79-89045,PX-3253708WWM,CDM,3253708WWM,LOCAL,270,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
HC Abd Binder Lg #79-89047,PX-3253709WWM,CDM,3253709WWM,LOCAL,270,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
HC Abd Binder Lg #79-89047,PX-3253709WWM,CDM,3253709WWM,LOCAL,270,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
HC Abd Binder Xlg #79-89048,PX-3253710WWM,CDM,3253710WWM,LOCAL,270,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
HC Abd Binder Xlg #79-89048,PX-3253710WWM,CDM,3253710WWM,LOCAL,270,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
HC Pt Overdor Pull Ext#Nc520,PX-3253727WWM,CDM,3253727WWM,LOCAL,270,RC,,inpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
HC Pt Overdor Pull Ext#Nc520,PX-3253727WWM,CDM,3253727WWM,LOCAL,270,RC,,outpatient,,,57,51.3,,0.95,,54.15,Percent of total billed charges,,,0.98,,55.86,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,0.97,,55.29,Percent of total billed charges,,,0.96,,54.72,Percent of total billed charges,,,0.95,,54.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,54.15,Percent of total billed charges,,54.15,55.86,
HC Pt Ez Reach Light#Nc28522,PX-3253756WWM,CDM,3253756WWM,LOCAL,270,RC,,inpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
HC Pt Ez Reach Light#Nc28522,PX-3253756WWM,CDM,3253756WWM,LOCAL,270,RC,,outpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
HC Pt Sock Aid #Nc28600,PX-3253757WWM,CDM,3253757WWM,LOCAL,270,RC,,inpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
HC Pt Sock Aid #Nc28600,PX-3253757WWM,CDM,3253757WWM,LOCAL,270,RC,,outpatient,,,56,50.4,,0.95,,53.2,Percent of total billed charges,,,0.98,,54.88,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,0.97,,54.32,Percent of total billed charges,,,0.96,,53.76,Percent of total billed charges,,,0.95,,53.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,53.2,Percent of total billed charges,,53.2,54.88,
HC Rt Sensor Sp02 #M1133a,PX-3253759WWM,CDM,3253759WWM,LOCAL,270,RC,,inpatient,,,72,64.8,,0.95,,68.4,Percent of total billed charges,,,0.98,,70.56,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.96,,69.12,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,68.4,Percent of total billed charges,,68.4,70.56,
HC Rt Sensor Sp02 #M1133a,PX-3253759WWM,CDM,3253759WWM,LOCAL,270,RC,,outpatient,,,72,64.8,,0.95,,68.4,Percent of total billed charges,,,0.98,,70.56,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,0.97,,69.84,Percent of total billed charges,,,0.96,,69.12,Percent of total billed charges,,,0.95,,68.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,68.4,Percent of total billed charges,,68.4,70.56,
HC Wrist Restraint #2528-1,PX-3253760WWM,CDM,3253760WWM,LOCAL,270,RC,,inpatient,,,28,25.2,,0.95,,26.6,Percent of total billed charges,,,0.98,,27.44,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.96,,26.88,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,26.6,Percent of total billed charges,,26.6,27.44,
HC Wrist Restraint #2528-1,PX-3253760WWM,CDM,3253760WWM,LOCAL,270,RC,,outpatient,,,28,25.2,,0.95,,26.6,Percent of total billed charges,,,0.98,,27.44,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.96,,26.88,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,26.6,Percent of total billed charges,,26.6,27.44,
HC Pt Cold Pack #Nc70532,PX-3253774WWM,CDM,3253774WWM,LOCAL,270,RC,,inpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
HC Pt Cold Pack #Nc70532,PX-3253774WWM,CDM,3253774WWM,LOCAL,270,RC,,outpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
HC Waffle Heel Elevator #345,PX-3253787WWM,CDM,3253787WWM,LOCAL,270,RC,,inpatient,,,150,135,,0.95,,142.5,Percent of total billed charges,,,0.98,,147,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,0.97,,145.5,Percent of total billed charges,,,0.97,,145.5,Percent of total billed charges,,,0.96,,144,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,142.5,Percent of total billed charges,,142.5,147,
HC Waffle Heel Elevator #345,PX-3253787WWM,CDM,3253787WWM,LOCAL,270,RC,,outpatient,,,150,135,,0.95,,142.5,Percent of total billed charges,,,0.98,,147,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,0.97,,145.5,Percent of total billed charges,,,0.96,,144,Percent of total billed charges,,,0.95,,142.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,142.5,Percent of total billed charges,,142.5,147,
HC Thoracic Vent 13 Fr# Tv13,PX-3253789WWM,CDM,3253789WWM,LOCAL,270,RC,,inpatient,,,620,558,,0.95,,589,Percent of total billed charges,,,0.98,,607.6,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.96,,595.2,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,589,Percent of total billed charges,,589,607.6,
HC Thoracic Vent 13 Fr# Tv13,PX-3253789WWM,CDM,3253789WWM,LOCAL,270,RC,,outpatient,,,620,558,,0.95,,589,Percent of total billed charges,,,0.98,,607.6,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.96,,595.2,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,589,Percent of total billed charges,,589,607.6,
HC Blanket Under #63500,PX-3253803WWM,CDM,3253803WWM,LOCAL,270,RC,,inpatient,,,134,120.6,,0.95,,127.3,Percent of total billed charges,,,0.98,,131.32,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,0.97,,129.98,Percent of total billed charges,,,0.97,,129.98,Percent of total billed charges,,,0.96,,128.64,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,127.3,Percent of total billed charges,,127.3,131.32,
HC Blanket Under #63500,PX-3253803WWM,CDM,3253803WWM,LOCAL,270,RC,,outpatient,,,134,120.6,,0.95,,127.3,Percent of total billed charges,,,0.98,,131.32,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,0.97,,129.98,Percent of total billed charges,,,0.96,,128.64,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,127.3,Percent of total billed charges,,127.3,131.32,
HC Blanket Full # 30000,PX-3253804WWM,CDM,3253804WWM,LOCAL,270,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC Blanket Full # 30000,PX-3253804WWM,CDM,3253804WWM,LOCAL,270,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC Blanket Multi # 31500,PX-3253805WWM,CDM,3253805WWM,LOCAL,270,RC,,inpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
HC Blanket Multi # 31500,PX-3253805WWM,CDM,3253805WWM,LOCAL,270,RC,,outpatient,,,42,37.8,,0.95,,39.9,Percent of total billed charges,,,0.98,,41.16,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,0.97,,40.74,Percent of total billed charges,,,0.96,,40.32,Percent of total billed charges,,,0.95,,39.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,39.9,Percent of total billed charges,,39.9,41.16,
HC Drsg Hydro Sqr 4x4#M90002,PX-3253809WWM,CDM,3253809WWM,LOCAL,270,RC,,inpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
HC Drsg Hydro Sqr 4x4#M90002,PX-3253809WWM,CDM,3253809WWM,LOCAL,270,RC,,outpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
HC Drsg Hydro Ovl 4x5#M90001,PX-3253810WWM,CDM,3253810WWM,LOCAL,270,RC,,inpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
HC Drsg Hydro Ovl 4x5#M90001,PX-3253810WWM,CDM,3253810WWM,LOCAL,270,RC,,outpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
HC Drsg Hydro Thin 4x4#M9002,PX-3253811WWM,CDM,3253811WWM,LOCAL,270,RC,,inpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
HC Drsg Hydro Thin 4x4#M9002,PX-3253811WWM,CDM,3253811WWM,LOCAL,270,RC,,outpatient,,,26,23.4,,0.95,,24.7,Percent of total billed charges,,,0.98,,25.48,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,0.97,,25.22,Percent of total billed charges,,,0.96,,24.96,Percent of total billed charges,,,0.95,,24.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,24.7,Percent of total billed charges,,24.7,25.48,
HC Drsg Hydro Thin 4x5#M9002,PX-3253812WWM,CDM,3253812WWM,LOCAL,270,RC,,inpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
HC Drsg Hydro Thin 4x5#M9002,PX-3253812WWM,CDM,3253812WWM,LOCAL,270,RC,,outpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
HC Drsg Mepitel Soft 3x4#Mhc,PX-3253813WWM,CDM,3253813WWM,LOCAL,270,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC Drsg Mepitel Soft 3x4#Mhc,PX-3253813WWM,CDM,3253813WWM,LOCAL,270,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC Drsg Mepitel Soft 2x3#Mhc,PX-3253814WWM,CDM,3253814WWM,LOCAL,270,RC,,inpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
HC Drsg Mepitel Soft 2x3#Mhc,PX-3253814WWM,CDM,3253814WWM,LOCAL,270,RC,,outpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
HC Oxygen per Day,PX-3253817WWM,CDM,3253817WWM,LOCAL,270,RC,,inpatient,,,254,228.6,,0.95,,241.3,Percent of total billed charges,,,0.98,,248.92,Percent of total billed charges,,,0.95,,241.3,Percent of total billed charges,,,0.97,,246.38,Percent of total billed charges,,,0.97,,246.38,Percent of total billed charges,,,0.96,,243.84,Percent of total billed charges,,,0.95,,241.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,241.3,Percent of total billed charges,,241.3,248.92,
HC Oxygen per Day,PX-3253817WWM,CDM,3253817WWM,LOCAL,270,RC,,outpatient,,,254,228.6,,0.95,,241.3,Percent of total billed charges,,,0.98,,248.92,Percent of total billed charges,,,0.95,,241.3,Percent of total billed charges,,,0.95,,241.3,Percent of total billed charges,,,0.97,,246.38,Percent of total billed charges,,,0.96,,243.84,Percent of total billed charges,,,0.95,,241.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,241.3,Percent of total billed charges,,241.3,248.92,
HC Philips Et Co2 Vent #M192,PX-3253834WWM,CDM,3253834WWM,LOCAL,270,RC,,inpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
HC Philips Et Co2 Vent #M192,PX-3253834WWM,CDM,3253834WWM,LOCAL,270,RC,,outpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
HC Philips Et Co2 Ped#M2524a,PX-3253836WWM,CDM,3253836WWM,LOCAL,270,RC,,inpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
HC Philips Et Co2 Ped#M2524a,PX-3253836WWM,CDM,3253836WWM,LOCAL,270,RC,,outpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
HC Allaris Et Co2 #010433,PX-3253837WWM,CDM,3253837WWM,LOCAL,270,RC,,inpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
HC Allaris Et Co2 #010433,PX-3253837WWM,CDM,3253837WWM,LOCAL,270,RC,,outpatient,,,105,94.5,,0.95,,99.75,Percent of total billed charges,,,0.98,,102.9,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,0.97,,101.85,Percent of total billed charges,,,0.96,,100.8,Percent of total billed charges,,,0.95,,99.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,99.75,Percent of total billed charges,,99.75,102.9,
HC an Tray Epidural #Sd18td,PX-3253839WWM,CDM,3253839WWM,LOCAL,270,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
HC an Tray Epidural #Sd18td,PX-3253839WWM,CDM,3253839WWM,LOCAL,270,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
HC Cath Temp Prob 16fr#21096,PX-3253852WWM,CDM,3253852WWM,LOCAL,270,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
HC Cath Temp Prob 16fr#21096,PX-3253852WWM,CDM,3253852WWM,LOCAL,270,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
HC Drsg Medihoney # 31515,PX-3253865WWM,CDM,3253865WWM,LOCAL,270,RC,,inpatient,,,87,78.3,,0.95,,82.65,Percent of total billed charges,,,0.98,,85.26,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.96,,83.52,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,82.65,Percent of total billed charges,,82.65,85.26,
HC Drsg Medihoney # 31515,PX-3253865WWM,CDM,3253865WWM,LOCAL,270,RC,,outpatient,,,87,78.3,,0.95,,82.65,Percent of total billed charges,,,0.98,,85.26,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.96,,83.52,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,82.65,Percent of total billed charges,,82.65,85.26,
"HC Pt Shoehorn 24"" #Nc65632",PX-3253866WWM,CDM,3253866WWM,LOCAL,270,RC,,inpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
"HC Pt Shoehorn 24"" #Nc65632",PX-3253866WWM,CDM,3253866WWM,LOCAL,270,RC,,outpatient,,,39,35.1,,0.95,,37.05,Percent of total billed charges,,,0.98,,38.22,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,0.97,,37.83,Percent of total billed charges,,,0.96,,37.44,Percent of total billed charges,,,0.95,,37.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,37.05,Percent of total billed charges,,37.05,38.22,
HC Lopez Valve #B0056000,PX-3253867WWM,CDM,3253867WWM,LOCAL,270,RC,,inpatient,,,28,25.2,,0.95,,26.6,Percent of total billed charges,,,0.98,,27.44,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.96,,26.88,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,26.6,Percent of total billed charges,,26.6,27.44,
HC Lopez Valve #B0056000,PX-3253867WWM,CDM,3253867WWM,LOCAL,270,RC,,outpatient,,,28,25.2,,0.95,,26.6,Percent of total billed charges,,,0.98,,27.44,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.96,,26.88,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,26.6,Percent of total billed charges,,26.6,27.44,
"HC Splint Knee 19"" #D1190917",PX-3253874WWM,CDM,3253874WWM,LOCAL,270,RC,,inpatient,,,121,108.9,,0.95,,114.95,Percent of total billed charges,,,0.98,,118.58,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.96,,116.16,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114.95,Percent of total billed charges,,114.95,118.58,
"HC Splint Knee 19"" #D1190917",PX-3253874WWM,CDM,3253874WWM,LOCAL,270,RC,,outpatient,,,121,108.9,,0.95,,114.95,Percent of total billed charges,,,0.98,,118.58,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.96,,116.16,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114.95,Percent of total billed charges,,114.95,118.58,
HC Pt Foot Up Lg #Nc81022-2,PX-3253878WWM,CDM,3253878WWM,LOCAL,270,RC,,inpatient,,,248,223.2,,0.95,,235.6,Percent of total billed charges,,,0.98,,243.04,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,0.97,,240.56,Percent of total billed charges,,,0.97,,240.56,Percent of total billed charges,,,0.96,,238.08,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,235.6,Percent of total billed charges,,235.6,243.04,
HC Pt Foot Up Lg #Nc81022-2,PX-3253878WWM,CDM,3253878WWM,LOCAL,270,RC,,outpatient,,,248,223.2,,0.95,,235.6,Percent of total billed charges,,,0.98,,243.04,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,0.97,,240.56,Percent of total billed charges,,,0.96,,238.08,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,235.6,Percent of total billed charges,,235.6,243.04,
HC Pt Foot Up Xlg #Nc81022-3,PX-3253879WWM,CDM,3253879WWM,LOCAL,270,RC,,inpatient,,,248,223.2,,0.95,,235.6,Percent of total billed charges,,,0.98,,243.04,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,0.97,,240.56,Percent of total billed charges,,,0.97,,240.56,Percent of total billed charges,,,0.96,,238.08,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,235.6,Percent of total billed charges,,235.6,243.04,
HC Pt Foot Up Xlg #Nc81022-3,PX-3253879WWM,CDM,3253879WWM,LOCAL,270,RC,,outpatient,,,248,223.2,,0.95,,235.6,Percent of total billed charges,,,0.98,,243.04,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,0.97,,240.56,Percent of total billed charges,,,0.96,,238.08,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,235.6,Percent of total billed charges,,235.6,243.04,
HC OB Brst Pump Dbl#67116-06,PX-3253880WWM,CDM,3253880WWM,LOCAL,270,RC,,inpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
HC OB Brst Pump Dbl#67116-06,PX-3253880WWM,CDM,3253880WWM,LOCAL,270,RC,,outpatient,,,182,163.8,,0.95,,172.9,Percent of total billed charges,,,0.98,,178.36,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,0.97,,176.54,Percent of total billed charges,,,0.96,,174.72,Percent of total billed charges,,,0.95,,172.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,172.9,Percent of total billed charges,,172.9,178.36,
HC OB Tp Resus #10-50810,PX-3253964WWM,CDM,3253964WWM,LOCAL,270,RC,,inpatient,,,125,112.5,,0.95,,118.75,Percent of total billed charges,,,0.98,,122.5,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.96,,120,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,118.75,Percent of total billed charges,,118.75,122.5,
HC OB Tp Resus #10-50810,PX-3253964WWM,CDM,3253964WWM,LOCAL,270,RC,,outpatient,,,125,112.5,,0.95,,118.75,Percent of total billed charges,,,0.98,,122.5,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.96,,120,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,118.75,Percent of total billed charges,,118.75,122.5,
HC Collar Vista Adt#79-83370,PX-3253981WWM,CDM,3253981WWM,LOCAL,270,RC,,inpatient,,,199,179.1,,0.95,,189.05,Percent of total billed charges,,,0.98,,195.02,Percent of total billed charges,,,0.95,,189.05,Percent of total billed charges,,,0.97,,193.03,Percent of total billed charges,,,0.97,,193.03,Percent of total billed charges,,,0.96,,191.04,Percent of total billed charges,,,0.95,,189.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,189.05,Percent of total billed charges,,189.05,195.02,
HC Collar Vista Adt#79-83370,PX-3253981WWM,CDM,3253981WWM,LOCAL,270,RC,,outpatient,,,199,179.1,,0.95,,189.05,Percent of total billed charges,,,0.98,,195.02,Percent of total billed charges,,,0.95,,189.05,Percent of total billed charges,,,0.95,,189.05,Percent of total billed charges,,,0.97,,193.03,Percent of total billed charges,,,0.96,,191.04,Percent of total billed charges,,,0.95,,189.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,189.05,Percent of total billed charges,,189.05,195.02,
HC Collar Vista Ped 2#79-832,PX-3253983WWM,CDM,3253983WWM,LOCAL,270,RC,,inpatient,,,209,188.1,,0.95,,198.55,Percent of total billed charges,,,0.98,,204.82,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.96,,200.64,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,198.55,Percent of total billed charges,,198.55,204.82,
HC Collar Vista Ped 2#79-832,PX-3253983WWM,CDM,3253983WWM,LOCAL,270,RC,,outpatient,,,209,188.1,,0.95,,198.55,Percent of total billed charges,,,0.98,,204.82,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.96,,200.64,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,198.55,Percent of total billed charges,,198.55,204.82,
HC Collar Vista Ped 3#79-832,PX-3253984WWM,CDM,3253984WWM,LOCAL,270,RC,,inpatient,,,209,188.1,,0.95,,198.55,Percent of total billed charges,,,0.98,,204.82,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.96,,200.64,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,198.55,Percent of total billed charges,,198.55,204.82,
HC Collar Vista Ped 3#79-832,PX-3253984WWM,CDM,3253984WWM,LOCAL,270,RC,,outpatient,,,209,188.1,,0.95,,198.55,Percent of total billed charges,,,0.98,,204.82,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.96,,200.64,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,198.55,Percent of total billed charges,,198.55,204.82,
HC Skin Dermabond #Dnx12,PX-3253987WWM,CDM,3253987WWM,LOCAL,270,RC,,inpatient,,,125,112.5,,0.95,,118.75,Percent of total billed charges,,,0.98,,122.5,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.96,,120,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,118.75,Percent of total billed charges,,118.75,122.5,
HC Skin Dermabond #Dnx12,PX-3253987WWM,CDM,3253987WWM,LOCAL,270,RC,,outpatient,,,125,112.5,,0.95,,118.75,Percent of total billed charges,,,0.98,,122.5,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.96,,120,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,118.75,Percent of total billed charges,,118.75,122.5,
HC Air Walk Ank Sm#79-95523,PX-3254015WWM,CDM,3254015WWM,LOCAL,270,RC,,inpatient,,,148,133.2,,0.95,,140.6,Percent of total billed charges,,,0.98,,145.04,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.96,,142.08,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,140.6,Percent of total billed charges,,140.6,145.04,
HC Air Walk Ank Sm#79-95523,PX-3254015WWM,CDM,3254015WWM,LOCAL,270,RC,,outpatient,,,148,133.2,,0.95,,140.6,Percent of total billed charges,,,0.98,,145.04,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.96,,142.08,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,140.6,Percent of total billed charges,,140.6,145.04,
HC Air Walk Ank MD#79-95525,PX-3254016WWM,CDM,3254016WWM,LOCAL,270,RC,,inpatient,,,148,133.2,,0.95,,140.6,Percent of total billed charges,,,0.98,,145.04,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.96,,142.08,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,140.6,Percent of total billed charges,,140.6,145.04,
HC Air Walk Ank MD#79-95525,PX-3254016WWM,CDM,3254016WWM,LOCAL,270,RC,,outpatient,,,148,133.2,,0.95,,140.6,Percent of total billed charges,,,0.98,,145.04,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.96,,142.08,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,140.6,Percent of total billed charges,,140.6,145.04,
HC Air Walk Ank Lg#79-95527,PX-3254017WWM,CDM,3254017WWM,LOCAL,270,RC,,inpatient,,,148,133.2,,0.95,,140.6,Percent of total billed charges,,,0.98,,145.04,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.96,,142.08,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,140.6,Percent of total billed charges,,140.6,145.04,
HC Air Walk Ank Lg#79-95527,PX-3254017WWM,CDM,3254017WWM,LOCAL,270,RC,,outpatient,,,148,133.2,,0.95,,140.6,Percent of total billed charges,,,0.98,,145.04,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,0.97,,143.56,Percent of total billed charges,,,0.96,,142.08,Percent of total billed charges,,,0.95,,140.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,140.6,Percent of total billed charges,,140.6,145.04,
HC Drsg Compression #M2094,PX-3254025WWM,CDM,3254025WWM,LOCAL,270,RC,,inpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC Drsg Compression #M2094,PX-3254025WWM,CDM,3254025WWM,LOCAL,270,RC,,outpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC Drsg Allevyn 5x5#66000805,PX-3254031WWM,CDM,3254031WWM,LOCAL,270,RC,,inpatient,,,36,32.4,,0.95,,34.2,Percent of total billed charges,,,0.98,,35.28,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.96,,34.56,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,34.2,Percent of total billed charges,,34.2,35.28,
HC Drsg Allevyn 5x5#66000805,PX-3254031WWM,CDM,3254031WWM,LOCAL,270,RC,,outpatient,,,36,32.4,,0.95,,34.2,Percent of total billed charges,,,0.98,,35.28,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.96,,34.56,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,34.2,Percent of total billed charges,,34.2,35.28,
HC Drsg Allevyn 9x9#66800506,PX-3254033WWM,CDM,3254033WWM,LOCAL,270,RC,,inpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
HC Drsg Allevyn 9x9#66800506,PX-3254033WWM,CDM,3254033WWM,LOCAL,270,RC,,outpatient,,,64,57.6,,0.95,,60.8,Percent of total billed charges,,,0.98,,62.72,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,0.97,,62.08,Percent of total billed charges,,,0.96,,61.44,Percent of total billed charges,,,0.95,,60.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,60.8,Percent of total billed charges,,60.8,62.72,
HC Drsg Normlgel # 52567,PX-3254050WWM,CDM,3254050WWM,LOCAL,270,RC,,inpatient,,,28,25.2,,0.95,,26.6,Percent of total billed charges,,,0.98,,27.44,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.96,,26.88,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,26.6,Percent of total billed charges,,26.6,27.44,
HC Drsg Normlgel # 52567,PX-3254050WWM,CDM,3254050WWM,LOCAL,270,RC,,outpatient,,,28,25.2,,0.95,,26.6,Percent of total billed charges,,,0.98,,27.44,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.96,,26.88,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,26.6,Percent of total billed charges,,26.6,27.44,
HC Drsg Compression Lite # M2794,PX-3254055WWM,CDM,3254055WWM,LOCAL,270,RC,,inpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC Drsg Compression Lite # M2794,PX-3254055WWM,CDM,3254055WWM,LOCAL,270,RC,,outpatient,,,74,66.6,,0.95,,70.3,Percent of total billed charges,,,0.98,,72.52,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,0.97,,71.78,Percent of total billed charges,,,0.96,,71.04,Percent of total billed charges,,,0.95,,70.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,70.3,Percent of total billed charges,,70.3,72.52,
HC Heelbo Sm # 12059,PX-3254057WWM,CDM,3254057WWM,LOCAL,270,RC,,inpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
HC Heelbo Sm # 12059,PX-3254057WWM,CDM,3254057WWM,LOCAL,270,RC,,outpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
HC Heelbo MD # 802-12060,PX-3254058WWM,CDM,3254058WWM,LOCAL,270,RC,,inpatient,,,191,171.9,,0.95,,181.45,Percent of total billed charges,,,0.98,,187.18,Percent of total billed charges,,,0.95,,181.45,Percent of total billed charges,,,0.97,,185.27,Percent of total billed charges,,,0.97,,185.27,Percent of total billed charges,,,0.96,,183.36,Percent of total billed charges,,,0.95,,181.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,181.45,Percent of total billed charges,,181.45,187.18,
HC Heelbo MD # 802-12060,PX-3254058WWM,CDM,3254058WWM,LOCAL,270,RC,,outpatient,,,191,171.9,,0.95,,181.45,Percent of total billed charges,,,0.98,,187.18,Percent of total billed charges,,,0.95,,181.45,Percent of total billed charges,,,0.95,,181.45,Percent of total billed charges,,,0.97,,185.27,Percent of total billed charges,,,0.96,,183.36,Percent of total billed charges,,,0.95,,181.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,181.45,Percent of total billed charges,,181.45,187.18,
HC Heelbo Lg #802-12061,PX-3254059WWM,CDM,3254059WWM,LOCAL,270,RC,,inpatient,,,191,171.9,,0.95,,181.45,Percent of total billed charges,,,0.98,,187.18,Percent of total billed charges,,,0.95,,181.45,Percent of total billed charges,,,0.97,,185.27,Percent of total billed charges,,,0.97,,185.27,Percent of total billed charges,,,0.96,,183.36,Percent of total billed charges,,,0.95,,181.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,181.45,Percent of total billed charges,,181.45,187.18,
HC Heelbo Lg #802-12061,PX-3254059WWM,CDM,3254059WWM,LOCAL,270,RC,,outpatient,,,191,171.9,,0.95,,181.45,Percent of total billed charges,,,0.98,,187.18,Percent of total billed charges,,,0.95,,181.45,Percent of total billed charges,,,0.95,,181.45,Percent of total billed charges,,,0.97,,185.27,Percent of total billed charges,,,0.96,,183.36,Percent of total billed charges,,,0.95,,181.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,181.45,Percent of total billed charges,,181.45,187.18,
HC Drsg Tegaderm Silver 4x5 # M90501,PX-3254060WWM,CDM,3254060WWM,LOCAL,270,RC,,inpatient,,,48,43.2,,0.95,,45.6,Percent of total billed charges,,,0.98,,47.04,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.96,,46.08,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,45.6,Percent of total billed charges,,45.6,47.04,
HC Drsg Tegaderm Silver 4x5 # M90501,PX-3254060WWM,CDM,3254060WWM,LOCAL,270,RC,,outpatient,,,48,43.2,,0.95,,45.6,Percent of total billed charges,,,0.98,,47.04,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,0.97,,46.56,Percent of total billed charges,,,0.96,,46.08,Percent of total billed charges,,,0.95,,45.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,45.6,Percent of total billed charges,,45.6,47.04,
HC Drsg Tegagen Alginate 4x4 # M90112,PX-3254061WWM,CDM,3254061WWM,LOCAL,270,RC,,inpatient,,,28,25.2,,0.95,,26.6,Percent of total billed charges,,,0.98,,27.44,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.96,,26.88,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,26.6,Percent of total billed charges,,26.6,27.44,
HC Drsg Tegagen Alginate 4x4 # M90112,PX-3254061WWM,CDM,3254061WWM,LOCAL,270,RC,,outpatient,,,28,25.2,,0.95,,26.6,Percent of total billed charges,,,0.98,,27.44,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,0.97,,27.16,Percent of total billed charges,,,0.96,,26.88,Percent of total billed charges,,,0.95,,26.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,26.6,Percent of total billed charges,,26.6,27.44,
HC Drsg Tegagen Alginate Rope # M90120,PX-3254062WWM,CDM,3254062WWM,LOCAL,270,RC,,inpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC Drsg Tegagen Alginate Rope # M90120,PX-3254062WWM,CDM,3254062WWM,LOCAL,270,RC,,outpatient,,,38,34.2,,0.95,,36.1,Percent of total billed charges,,,0.98,,37.24,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,0.97,,36.86,Percent of total billed charges,,,0.96,,36.48,Percent of total billed charges,,,0.95,,36.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,36.1,Percent of total billed charges,,36.1,37.24,
HC Drsg Acticoat 4x4 #66800406,PX-3254063WWM,CDM,3254063WWM,LOCAL,270,RC,,inpatient,,,44,39.6,,0.95,,41.8,Percent of total billed charges,,,0.98,,43.12,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,0.97,,42.68,Percent of total billed charges,,,0.97,,42.68,Percent of total billed charges,,,0.96,,42.24,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,41.8,Percent of total billed charges,,41.8,43.12,
HC Drsg Acticoat 4x4 #66800406,PX-3254063WWM,CDM,3254063WWM,LOCAL,270,RC,,outpatient,,,44,39.6,,0.95,,41.8,Percent of total billed charges,,,0.98,,43.12,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,0.97,,42.68,Percent of total billed charges,,,0.96,,42.24,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,41.8,Percent of total billed charges,,41.8,43.12,
HC Drsg Nonadhes Foam # M90601,PX-3254064WWM,CDM,3254064WWM,LOCAL,270,RC,,inpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
HC Drsg Nonadhes Foam # M90601,PX-3254064WWM,CDM,3254064WWM,LOCAL,270,RC,,outpatient,,,33,29.7,,0.95,,31.35,Percent of total billed charges,,,0.98,,32.34,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,0.97,,32.01,Percent of total billed charges,,,0.96,,31.68,Percent of total billed charges,,,0.95,,31.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,31.35,Percent of total billed charges,,31.35,32.34,
HC or Stapler Rld Hernia # 174007,PX-3254069WWM,CDM,3254069WWM,LOCAL,270,RC,,inpatient,,,336,302.4,,0.95,,319.2,Percent of total billed charges,,,0.98,,329.28,Percent of total billed charges,,,0.95,,319.2,Percent of total billed charges,,,0.97,,325.92,Percent of total billed charges,,,0.97,,325.92,Percent of total billed charges,,,0.96,,322.56,Percent of total billed charges,,,0.95,,319.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,319.2,Percent of total billed charges,,319.2,329.28,
HC or Stapler Rld Hernia # 174007,PX-3254069WWM,CDM,3254069WWM,LOCAL,270,RC,,outpatient,,,336,302.4,,0.95,,319.2,Percent of total billed charges,,,0.98,,329.28,Percent of total billed charges,,,0.95,,319.2,Percent of total billed charges,,,0.95,,319.2,Percent of total billed charges,,,0.97,,325.92,Percent of total billed charges,,,0.96,,322.56,Percent of total billed charges,,,0.95,,319.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,319.2,Percent of total billed charges,,319.2,329.28,
HC Bag Bvm Adult # 10-56069,PX-3254070WWM,CDM,3254070WWM,LOCAL,270,RC,,inpatient,,,126,113.4,,0.95,,119.7,Percent of total billed charges,,,0.98,,123.48,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.96,,120.96,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,119.7,Percent of total billed charges,,119.7,123.48,
HC Bag Bvm Adult # 10-56069,PX-3254070WWM,CDM,3254070WWM,LOCAL,270,RC,,outpatient,,,126,113.4,,0.95,,119.7,Percent of total billed charges,,,0.98,,123.48,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,0.97,,122.22,Percent of total billed charges,,,0.96,,120.96,Percent of total billed charges,,,0.95,,119.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,119.7,Percent of total billed charges,,119.7,123.48,
HC Sitz Bath,PX-3257145WWM,CDM,3257145WWM,LOCAL,270,RC,,inpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
HC Sitz Bath,PX-3257145WWM,CDM,3257145WWM,LOCAL,270,RC,,outpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
HC Splint Thumb Xl/R #3180,PX-3258000WWM,CDM,3258000WWM,LOCAL,270,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
HC Splint Thumb Xl/R #3180,PX-3258000WWM,CDM,3258000WWM,LOCAL,270,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
HC Suct Tube Conn 10'#036290,PX-3252633WWM,CDM,3252633WWM,LOCAL,270,RC,,inpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
HC Suct Tube Conn 10'#036290,PX-3252633WWM,CDM,3252633WWM,LOCAL,270,RC,,outpatient,,,25,22.5,,0.95,,23.75,Percent of total billed charges,,,0.98,,24.5,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,0.97,,24.25,Percent of total billed charges,,,0.96,,24,Percent of total billed charges,,,0.95,,23.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,23.75,Percent of total billed charges,,23.75,24.5,
HC or Screw Arthrex 8x25,PX-3253566WWM,CDM,3253566WWM,LOCAL,278,RC,,inpatient,,,383,344.7,,0.95,,363.85,Percent of total billed charges,,,0.98,,375.34,Percent of total billed charges,,,0.95,,363.85,Percent of total billed charges,,,0.97,,371.51,Percent of total billed charges,,,0.97,,371.51,Percent of total billed charges,,,0.96,,367.68,Percent of total billed charges,,,0.95,,363.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,363.85,Percent of total billed charges,,363.85,375.34,
HC or Screw Arthrex 8x25,PX-3253566WWM,CDM,3253566WWM,LOCAL,278,RC,,outpatient,,,383,344.7,,0.95,,363.85,Percent of total billed charges,,,0.98,,375.34,Percent of total billed charges,,,0.95,,363.85,Percent of total billed charges,,,0.95,,363.85,Percent of total billed charges,,,0.97,,371.51,Percent of total billed charges,,,0.96,,367.68,Percent of total billed charges,,,0.95,,363.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,363.85,Percent of total billed charges,,363.85,375.34,
HC or Allograft Tend No Bone,PX-3253643WWM,CDM,3253643WWM,LOCAL,278,RC,,inpatient,,,1726,1553.4,,0.95,,1639.7,Percent of total billed charges,,,0.98,,1691.48,Percent of total billed charges,,,0.95,,1639.7,Percent of total billed charges,,,0.97,,1674.22,Percent of total billed charges,,,0.97,,1674.22,Percent of total billed charges,,,0.96,,1656.96,Percent of total billed charges,,,0.95,,1639.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1639.7,Percent of total billed charges,,1639.7,1691.48,
HC or Allograft Tend No Bone,PX-3253643WWM,CDM,3253643WWM,LOCAL,278,RC,,outpatient,,,1726,1553.4,,0.95,,1639.7,Percent of total billed charges,,,0.98,,1691.48,Percent of total billed charges,,,0.95,,1639.7,Percent of total billed charges,,,0.95,,1639.7,Percent of total billed charges,,,0.97,,1674.22,Percent of total billed charges,,,0.96,,1656.96,Percent of total billed charges,,,0.95,,1639.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1639.7,Percent of total billed charges,,1639.7,1691.48,
HC Orthotic - Foot Insert - Right,PX-4090101WWM,CDM,L3010,HCPCS,278,RC,,inpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
HC Orthotic - Foot Insert - Right,PX-4090101WWM,CDM,L3010,HCPCS,278,RC,,outpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
HC Orthotics - Foot Insert,PX-4090102WWM,CDM,L3010,HCPCS,278,RC,,inpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
HC Orthotics - Foot Insert,PX-4090102WWM,CDM,L3010,HCPCS,278,RC,,outpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
HC Cpm per Day,PX-4090201WWM,CDM,E0935,HCPCS,270,RC,,inpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC Cpm per Day,PX-4090201WWM,CDM,E0935,HCPCS,270,RC,,outpatient,,,110,99,,0.95,,104.5,Percent of total billed charges,,,0.98,,107.8,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,0.97,,106.7,Percent of total billed charges,,,0.96,,105.6,Percent of total billed charges,,,0.95,,104.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,104.5,Percent of total billed charges,,104.5,107.8,
HC PR Dinoprostone Vag Insert,PX-98311191,CDM,98311191,LOCAL,983,RC,,inpatient,,,913,821.7,,0.95,,867.35,Percent of total billed charges,,,0.98,,894.74,Percent of total billed charges,,,0.95,,867.35,Percent of total billed charges,,,0.97,,885.61,Percent of total billed charges,,,0.97,,885.61,Percent of total billed charges,,,0.96,,876.48,Percent of total billed charges,,,0.95,,867.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,867.35,Percent of total billed charges,,867.35,894.74,
HC PR Dinoprostone Vag Insert,PX-98311191,CDM,98311191,LOCAL,983,RC,,outpatient,,,913,821.7,,0.95,,867.35,Percent of total billed charges,,,0.98,,894.74,Percent of total billed charges,,,0.95,,867.35,Percent of total billed charges,,,0.95,,867.35,Percent of total billed charges,,,0.97,,885.61,Percent of total billed charges,,,0.96,,876.48,Percent of total billed charges,,,0.95,,867.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,867.35,Percent of total billed charges,,867.35,894.74,
HC PR Hydrocodone/Acet Tab (5/3,PX-98311198,CDM,98311198,LOCAL,983,RC,,inpatient,,,8,7.2,,0.95,,7.6,Percent of total billed charges,,,0.98,,7.84,Percent of total billed charges,,,0.95,,7.6,Percent of total billed charges,,,0.97,,7.76,Percent of total billed charges,,,0.97,,7.76,Percent of total billed charges,,,0.96,,7.68,Percent of total billed charges,,,0.95,,7.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,7.6,Percent of total billed charges,,7.6,7.84,
HC PR Hydrocodone/Acet Tab (5/3,PX-98311198,CDM,98311198,LOCAL,983,RC,,outpatient,,,8,7.2,,0.95,,7.6,Percent of total billed charges,,,0.98,,7.84,Percent of total billed charges,,,0.95,,7.6,Percent of total billed charges,,,0.95,,7.6,Percent of total billed charges,,,0.97,,7.76,Percent of total billed charges,,,0.96,,7.68,Percent of total billed charges,,,0.95,,7.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,7.6,Percent of total billed charges,,7.6,7.84,
Ipratropium & Albuterol,PX-98311199,CDM,98311199,LOCAL,983,RC,,inpatient,,,14,12.6,,0.95,,13.3,Percent of total billed charges,,,0.98,,13.72,Percent of total billed charges,,,0.95,,13.3,Percent of total billed charges,,,0.97,,13.58,Percent of total billed charges,,,0.97,,13.58,Percent of total billed charges,,,0.96,,13.44,Percent of total billed charges,,,0.95,,13.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,13.3,Percent of total billed charges,,13.3,13.72,
Ipratropium & Albuterol,PX-98311199,CDM,98311199,LOCAL,983,RC,,outpatient,,,14,12.6,,0.95,,13.3,Percent of total billed charges,,,0.98,,13.72,Percent of total billed charges,,,0.95,,13.3,Percent of total billed charges,,,0.95,,13.3,Percent of total billed charges,,,0.97,,13.58,Percent of total billed charges,,,0.96,,13.44,Percent of total billed charges,,,0.95,,13.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,13.3,Percent of total billed charges,,13.3,13.72,
HC PR IV-Sod Chloride 0.9 % (1,PX-98311200,CDM,98311200,LOCAL,983,RC,,inpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
HC PR IV-Sod Chloride 0.9 % (1,PX-98311200,CDM,98311200,LOCAL,983,RC,,outpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
HC PR IV-Sod Chloride 0.9% (50,PX-98311201,CDM,98311201,LOCAL,983,RC,,inpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR IV-Sod Chloride 0.9% (50,PX-98311201,CDM,98311201,LOCAL,983,RC,,outpatient,,,106,95.4,,0.95,,100.7,Percent of total billed charges,,,0.98,,103.88,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,0.97,,102.82,Percent of total billed charges,,,0.96,,101.76,Percent of total billed charges,,,0.95,,100.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,100.7,Percent of total billed charges,,100.7,103.88,
HC PR Lidocaine Jelly Urojet,PX-98311204,CDM,98311204,LOCAL,983,RC,,inpatient,,,44,39.6,,0.95,,41.8,Percent of total billed charges,,,0.98,,43.12,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,0.97,,42.68,Percent of total billed charges,,,0.97,,42.68,Percent of total billed charges,,,0.96,,42.24,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,41.8,Percent of total billed charges,,41.8,43.12,
HC PR Lidocaine Jelly Urojet,PX-98311204,CDM,98311204,LOCAL,983,RC,,outpatient,,,44,39.6,,0.95,,41.8,Percent of total billed charges,,,0.98,,43.12,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,0.97,,42.68,Percent of total billed charges,,,0.96,,42.24,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,41.8,Percent of total billed charges,,41.8,43.12,
HC PR Lorazepam Tab (0.5 Mg),PX-98311205,CDM,98311205,LOCAL,983,RC,,inpatient,,,8,7.2,,0.95,,7.6,Percent of total billed charges,,,0.98,,7.84,Percent of total billed charges,,,0.95,,7.6,Percent of total billed charges,,,0.97,,7.76,Percent of total billed charges,,,0.97,,7.76,Percent of total billed charges,,,0.96,,7.68,Percent of total billed charges,,,0.95,,7.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,7.6,Percent of total billed charges,,7.6,7.84,
HC PR Lorazepam Tab (0.5 Mg),PX-98311205,CDM,98311205,LOCAL,983,RC,,outpatient,,,8,7.2,,0.95,,7.6,Percent of total billed charges,,,0.98,,7.84,Percent of total billed charges,,,0.95,,7.6,Percent of total billed charges,,,0.95,,7.6,Percent of total billed charges,,,0.97,,7.76,Percent of total billed charges,,,0.96,,7.68,Percent of total billed charges,,,0.95,,7.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,7.6,Percent of total billed charges,,7.6,7.84,
HC PR Ondansetron Odt Tab (4 Mg,PX-98311209,CDM,98311209,LOCAL,983,RC,,inpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
HC PR Ondansetron Odt Tab (4 Mg,PX-98311209,CDM,98311209,LOCAL,983,RC,,outpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
HC Cataract Surgery Pack,PX-3216795WWM,CDM,V2632,HCPCS,276,RC,,inpatient,,,1961,1764.9,,0.95,,1862.95,Percent of total billed charges,,,0.98,,1921.78,Percent of total billed charges,,,0.95,,1862.95,Percent of total billed charges,,,0.97,,1902.17,Percent of total billed charges,,,0.97,,1902.17,Percent of total billed charges,,,0.96,,1882.56,Percent of total billed charges,,,0.95,,1862.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1862.95,Percent of total billed charges,,1862.95,1921.78,
HC Cataract Surgery Pack,PX-3216795WWM,CDM,V2632,HCPCS,276,RC,,outpatient,,,1961,1764.9,,0.95,,1862.95,Percent of total billed charges,,,0.98,,1921.78,Percent of total billed charges,,,0.95,,1862.95,Percent of total billed charges,,,0.95,,1862.95,Percent of total billed charges,,,0.97,,1902.17,Percent of total billed charges,,,0.96,,1882.56,Percent of total billed charges,,,0.95,,1862.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1862.95,Percent of total billed charges,,1862.95,1921.78,
HC Ostomy Wafer #3738,PX-3253108WWM,CDM,3253108WWM,LOCAL,270,RC,,inpatient,,,85,76.5,,0.95,,80.75,Percent of total billed charges,,,0.98,,83.3,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.96,,81.6,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,80.75,Percent of total billed charges,,80.75,83.3,
HC Ostomy Wafer #3738,PX-3253108WWM,CDM,3253108WWM,LOCAL,270,RC,,outpatient,,,85,76.5,,0.95,,80.75,Percent of total billed charges,,,0.98,,83.3,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,0.97,,82.45,Percent of total billed charges,,,0.96,,81.6,Percent of total billed charges,,,0.95,,80.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,80.75,Percent of total billed charges,,80.75,83.3,
HC Ostomy Paste #79300,PX-3253767WWM,CDM,3253767WWM,LOCAL,270,RC,,inpatient,,,36,32.4,,0.95,,34.2,Percent of total billed charges,,,0.98,,35.28,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.96,,34.56,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,34.2,Percent of total billed charges,,34.2,35.28,
HC Ostomy Paste #79300,PX-3253767WWM,CDM,3253767WWM,LOCAL,270,RC,,outpatient,,,36,32.4,,0.95,,34.2,Percent of total billed charges,,,0.98,,35.28,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,0.97,,34.92,Percent of total billed charges,,,0.96,,34.56,Percent of total billed charges,,,0.95,,34.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,34.2,Percent of total billed charges,,34.2,35.28,
HC Ostomy Deodorant #78500,PX-3253768WWM,CDM,3253768WWM,LOCAL,270,RC,,inpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
HC Ostomy Deodorant #78500,PX-3253768WWM,CDM,3253768WWM,LOCAL,270,RC,,outpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
HC Waffle Mattres Overlay#10,PX-3253785WWM,CDM,3253785WWM,LOCAL,270,RC,,inpatient,,,164,147.6,,0.95,,155.8,Percent of total billed charges,,,0.98,,160.72,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.96,,157.44,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,155.8,Percent of total billed charges,,155.8,160.72,
HC Waffle Mattres Overlay#10,PX-3253785WWM,CDM,3253785WWM,LOCAL,270,RC,,outpatient,,,164,147.6,,0.95,,155.8,Percent of total billed charges,,,0.98,,160.72,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,0.97,,159.08,Percent of total billed charges,,,0.96,,157.44,Percent of total billed charges,,,0.95,,155.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,155.8,Percent of total billed charges,,155.8,160.72,
HC Ostomy Powder #Hl7906a,PX-3254030WWM,CDM,3254030WWM,LOCAL,270,RC,,inpatient,,,22,19.8,,0.95,,20.9,Percent of total billed charges,,,0.98,,21.56,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.96,,21.12,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,20.9,Percent of total billed charges,,20.9,21.56,
HC Ostomy Powder #Hl7906a,PX-3254030WWM,CDM,3254030WWM,LOCAL,270,RC,,outpatient,,,22,19.8,,0.95,,20.9,Percent of total billed charges,,,0.98,,21.56,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,0.97,,21.34,Percent of total billed charges,,,0.96,,21.12,Percent of total billed charges,,,0.95,,20.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,20.9,Percent of total billed charges,,20.9,21.56,
HC Ostomy Pouch #18373a,PX-4153766WWM,CDM,4153766WWM,LOCAL,270,RC,,inpatient,,,8,7.2,,0.95,,7.6,Percent of total billed charges,,,0.98,,7.84,Percent of total billed charges,,,0.95,,7.6,Percent of total billed charges,,,0.97,,7.76,Percent of total billed charges,,,0.97,,7.76,Percent of total billed charges,,,0.96,,7.68,Percent of total billed charges,,,0.95,,7.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,7.6,Percent of total billed charges,,7.6,7.84,
HC Ostomy Pouch #18373a,PX-4153766WWM,CDM,4153766WWM,LOCAL,270,RC,,outpatient,,,8,7.2,,0.95,,7.6,Percent of total billed charges,,,0.98,,7.84,Percent of total billed charges,,,0.95,,7.6,Percent of total billed charges,,,0.95,,7.6,Percent of total billed charges,,,0.97,,7.76,Percent of total billed charges,,,0.96,,7.68,Percent of total billed charges,,,0.95,,7.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,7.6,Percent of total billed charges,,7.6,7.84,
HC Ostomy Pouch #18403,PX-4153769WWM,CDM,4153769WWM,LOCAL,270,RC,,inpatient,,,18,16.2,,0.95,,17.1,Percent of total billed charges,,,0.98,,17.64,Percent of total billed charges,,,0.95,,17.1,Percent of total billed charges,,,0.97,,17.46,Percent of total billed charges,,,0.97,,17.46,Percent of total billed charges,,,0.96,,17.28,Percent of total billed charges,,,0.95,,17.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,17.1,Percent of total billed charges,,17.1,17.64,
HC Ostomy Pouch #18403,PX-4153769WWM,CDM,4153769WWM,LOCAL,270,RC,,outpatient,,,18,16.2,,0.95,,17.1,Percent of total billed charges,,,0.98,,17.64,Percent of total billed charges,,,0.95,,17.1,Percent of total billed charges,,,0.95,,17.1,Percent of total billed charges,,,0.97,,17.46,Percent of total billed charges,,,0.96,,17.28,Percent of total billed charges,,,0.95,,17.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,17.1,Percent of total billed charges,,17.1,17.64,
HC Set-Baxter Male Luer Lock,PX-4170199WWM,CDM,4170199WWM,LOCAL,272,RC,,inpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
HC Set-Baxter Male Luer Lock,PX-4170199WWM,CDM,4170199WWM,LOCAL,272,RC,,outpatient,,,62,55.8,,0.95,,58.9,Percent of total billed charges,,,0.98,,60.76,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,0.97,,60.14,Percent of total billed charges,,,0.96,,59.52,Percent of total billed charges,,,0.95,,58.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,58.9,Percent of total billed charges,,58.9,60.76,
HC Cab per Mile Over 67 Mile,PX-54010145,CDM,54010145,LOCAL,540,RC,,inpatient,,,4,3.6,,0.95,,3.8,Percent of total billed charges,,,0.98,,3.92,Percent of total billed charges,,,0.95,,3.8,Percent of total billed charges,,,0.97,,3.88,Percent of total billed charges,,,0.97,,3.88,Percent of total billed charges,,,0.96,,3.84,Percent of total billed charges,,,0.95,,3.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3.8,Percent of total billed charges,,3.8,3.92,
HC Cab per Mile Over 67 Mile,PX-54010145,CDM,54010145,LOCAL,540,RC,,outpatient,,,4,3.6,,0.95,,3.8,Percent of total billed charges,,,0.98,,3.92,Percent of total billed charges,,,0.95,,3.8,Percent of total billed charges,,,0.95,,3.8,Percent of total billed charges,,,0.97,,3.88,Percent of total billed charges,,,0.96,,3.84,Percent of total billed charges,,,0.95,,3.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3.8,Percent of total billed charges,,3.8,3.92,
HC Cabulance per Mile,PX-54010146,CDM,54010146,LOCAL,540,RC,,inpatient,,,641,576.9,,0.95,,608.95,Percent of total billed charges,,,0.98,,628.18,Percent of total billed charges,,,0.95,,608.95,Percent of total billed charges,,,0.97,,621.77,Percent of total billed charges,,,0.97,,621.77,Percent of total billed charges,,,0.96,,615.36,Percent of total billed charges,,,0.95,,608.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,608.95,Percent of total billed charges,,608.95,628.18,
HC Cabulance per Mile,PX-54010146,CDM,54010146,LOCAL,540,RC,,outpatient,,,641,576.9,,0.95,,608.95,Percent of total billed charges,,,0.98,,628.18,Percent of total billed charges,,,0.95,,608.95,Percent of total billed charges,,,0.95,,608.95,Percent of total billed charges,,,0.97,,621.77,Percent of total billed charges,,,0.96,,615.36,Percent of total billed charges,,,0.95,,608.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,608.95,Percent of total billed charges,,608.95,628.18,
Manipulation of elbow under anesthesia,PX-45010109,CDM,24300,CPT,450,RC,,inpatient,,,1456,1310.4,,0.95,,1383.2,Percent of total billed charges,,,0.98,,1426.88,Percent of total billed charges,,,0.95,,1383.2,Percent of total billed charges,,,0.97,,1412.32,Percent of total billed charges,,,0.97,,1412.32,Percent of total billed charges,,,0.96,,1397.76,Percent of total billed charges,,,0.95,,1383.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1383.2,Percent of total billed charges,,1383.2,3950,
Manipulation of elbow under anesthesia,PX-45010109,CDM,24300,CPT,450,RC,,outpatient,,,1456,1310.4,,0.95,,1383.2,Percent of total billed charges,,,0.98,,1426.88,Percent of total billed charges,,,0.95,,1383.2,Percent of total billed charges,,,0.95,,1383.2,Percent of total billed charges,,,0.97,,1412.32,Percent of total billed charges,,,0.96,,1397.76,Percent of total billed charges,,,0.95,,1383.2,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,1383.2,Percent of total billed charges,,1383.2,3950,
HC Su Vicryl Endo Loop#Ej10g,PX-3252548WWM,CDM,3252548WWM,LOCAL,270,RC,,inpatient,,,174,156.6,,0.95,,165.3,Percent of total billed charges,,,0.98,,170.52,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,0.97,,168.78,Percent of total billed charges,,,0.97,,168.78,Percent of total billed charges,,,0.96,,167.04,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,165.3,Percent of total billed charges,,165.3,170.52,
HC Su Vicryl Endo Loop#Ej10g,PX-3252548WWM,CDM,3252548WWM,LOCAL,270,RC,,outpatient,,,174,156.6,,0.95,,165.3,Percent of total billed charges,,,0.98,,170.52,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,0.97,,168.78,Percent of total billed charges,,,0.96,,167.04,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,165.3,Percent of total billed charges,,165.3,170.52,
HC Fiberwire #2 #AR-7200,PX-3253061WWM,CDM,3253061WWM,LOCAL,270,RC,,inpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
HC Fiberwire #2 #AR-7200,PX-3253061WWM,CDM,3253061WWM,LOCAL,270,RC,,outpatient,,,124,111.6,,0.95,,117.8,Percent of total billed charges,,,0.98,,121.52,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,0.97,,120.28,Percent of total billed charges,,,0.96,,119.04,Percent of total billed charges,,,0.95,,117.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,117.8,Percent of total billed charges,,117.8,121.52,
HC Stapler Endo Hernia,PX-3254074WWM,CDM,3254074WWM,LOCAL,270,RC,,inpatient,,,792,712.8,,0.95,,752.4,Percent of total billed charges,,,0.98,,776.16,Percent of total billed charges,,,0.95,,752.4,Percent of total billed charges,,,0.97,,768.24,Percent of total billed charges,,,0.97,,768.24,Percent of total billed charges,,,0.96,,760.32,Percent of total billed charges,,,0.95,,752.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,752.4,Percent of total billed charges,,752.4,776.16,
HC Stapler Endo Hernia,PX-3254074WWM,CDM,3254074WWM,LOCAL,270,RC,,outpatient,,,792,712.8,,0.95,,752.4,Percent of total billed charges,,,0.98,,776.16,Percent of total billed charges,,,0.95,,752.4,Percent of total billed charges,,,0.95,,752.4,Percent of total billed charges,,,0.97,,768.24,Percent of total billed charges,,,0.96,,760.32,Percent of total billed charges,,,0.95,,752.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,752.4,Percent of total billed charges,,752.4,776.16,
HC Shoulder Susp #Dynjshoulder,PX-3254076WWM,CDM,3254076WWM,LOCAL,270,RC,,inpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
HC Shoulder Susp #Dynjshoulder,PX-3254076WWM,CDM,3254076WWM,LOCAL,270,RC,,outpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
HC Tenodesis Swiveloc AR-1662PSL-7,PX-3254078WWM,CDM,C1713,HCPCS,278,RC,,inpatient,,,799,719.1,,0.95,,759.05,Percent of total billed charges,,,0.98,,783.02,Percent of total billed charges,,,0.95,,759.05,Percent of total billed charges,,,0.97,,775.03,Percent of total billed charges,,,0.97,,775.03,Percent of total billed charges,,,0.96,,767.04,Percent of total billed charges,,,0.95,,759.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,759.05,Percent of total billed charges,,759.05,783.02,
HC Tenodesis Swiveloc AR-1662PSL-7,PX-3254078WWM,CDM,C1713,HCPCS,278,RC,,outpatient,,,799,719.1,,0.95,,759.05,Percent of total billed charges,,,0.98,,783.02,Percent of total billed charges,,,0.95,,759.05,Percent of total billed charges,,,0.95,,759.05,Percent of total billed charges,,,0.97,,775.03,Percent of total billed charges,,,0.96,,767.04,Percent of total billed charges,,,0.95,,759.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,759.05,Percent of total billed charges,,759.05,783.02,
HC Tenodesis Swiveloc AR-1662PSL-8,PX-3254079WWM,CDM,C1713,HCPCS,278,RC,,inpatient,,,799,719.1,,0.95,,759.05,Percent of total billed charges,,,0.98,,783.02,Percent of total billed charges,,,0.95,,759.05,Percent of total billed charges,,,0.97,,775.03,Percent of total billed charges,,,0.97,,775.03,Percent of total billed charges,,,0.96,,767.04,Percent of total billed charges,,,0.95,,759.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,759.05,Percent of total billed charges,,759.05,783.02,
HC Tenodesis Swiveloc AR-1662PSL-8,PX-3254079WWM,CDM,C1713,HCPCS,278,RC,,outpatient,,,799,719.1,,0.95,,759.05,Percent of total billed charges,,,0.98,,783.02,Percent of total billed charges,,,0.95,,759.05,Percent of total billed charges,,,0.95,,759.05,Percent of total billed charges,,,0.97,,775.03,Percent of total billed charges,,,0.96,,767.04,Percent of total billed charges,,,0.95,,759.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,759.05,Percent of total billed charges,,759.05,783.02,
HC Tenodesis Swiveloc AR-1662PSL-9,PX-3254080WWM,CDM,C1713,HCPCS,278,RC,,inpatient,,,799,719.1,,0.95,,759.05,Percent of total billed charges,,,0.98,,783.02,Percent of total billed charges,,,0.95,,759.05,Percent of total billed charges,,,0.97,,775.03,Percent of total billed charges,,,0.97,,775.03,Percent of total billed charges,,,0.96,,767.04,Percent of total billed charges,,,0.95,,759.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,759.05,Percent of total billed charges,,759.05,783.02,
HC Tenodesis Swiveloc AR-1662PSL-9,PX-3254080WWM,CDM,C1713,HCPCS,278,RC,,outpatient,,,799,719.1,,0.95,,759.05,Percent of total billed charges,,,0.98,,783.02,Percent of total billed charges,,,0.95,,759.05,Percent of total billed charges,,,0.95,,759.05,Percent of total billed charges,,,0.97,,775.03,Percent of total billed charges,,,0.96,,767.04,Percent of total billed charges,,,0.95,,759.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,759.05,Percent of total billed charges,,759.05,783.02,
HC Speedbridge Implant AR-2600SBS-4,PX-3254081WWM,CDM,C1713,HCPCS,278,RC,,inpatient,,,3429,3086.1,,0.95,,3257.55,Percent of total billed charges,,,0.98,,3360.42,Percent of total billed charges,,,0.95,,3257.55,Percent of total billed charges,,,0.97,,3326.13,Percent of total billed charges,,,0.97,,3326.13,Percent of total billed charges,,,0.96,,3291.84,Percent of total billed charges,,,0.95,,3257.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3257.55,Percent of total billed charges,,3257.55,3360.42,
HC Speedbridge Implant AR-2600SBS-4,PX-3254081WWM,CDM,C1713,HCPCS,278,RC,,outpatient,,,3429,3086.1,,0.95,,3257.55,Percent of total billed charges,,,0.98,,3360.42,Percent of total billed charges,,,0.95,,3257.55,Percent of total billed charges,,,0.95,,3257.55,Percent of total billed charges,,,0.97,,3326.13,Percent of total billed charges,,,0.96,,3291.84,Percent of total billed charges,,,0.95,,3257.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,3257.55,Percent of total billed charges,,3257.55,3360.42,
HC Suture Anchor AR-2324BCC,PX-3254082WWM,CDM,C1713,HCPCS,278,RC,,inpatient,,,1052,946.8,,0.95,,999.4,Percent of total billed charges,,,0.98,,1030.96,Percent of total billed charges,,,0.95,,999.4,Percent of total billed charges,,,0.97,,1020.44,Percent of total billed charges,,,0.97,,1020.44,Percent of total billed charges,,,0.96,,1009.92,Percent of total billed charges,,,0.95,,999.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,999.4,Percent of total billed charges,,999.4,1030.96,
HC Suture Anchor AR-2324BCC,PX-3254082WWM,CDM,C1713,HCPCS,278,RC,,outpatient,,,1052,946.8,,0.95,,999.4,Percent of total billed charges,,,0.98,,1030.96,Percent of total billed charges,,,0.95,,999.4,Percent of total billed charges,,,0.95,,999.4,Percent of total billed charges,,,0.97,,1020.44,Percent of total billed charges,,,0.96,,1009.92,Percent of total billed charges,,,0.95,,999.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,999.4,Percent of total billed charges,,999.4,1030.96,
HC Torpedo 5mm AR-8500TD,PX-3254083WWM,CDM,3254083WWM,LOCAL,272,RC,,inpatient,,,265,238.5,,0.95,,251.75,Percent of total billed charges,,,0.98,,259.7,Percent of total billed charges,,,0.95,,251.75,Percent of total billed charges,,,0.97,,257.05,Percent of total billed charges,,,0.97,,257.05,Percent of total billed charges,,,0.96,,254.4,Percent of total billed charges,,,0.95,,251.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,251.75,Percent of total billed charges,,251.75,259.7,
HC Torpedo 5mm AR-8500TD,PX-3254083WWM,CDM,3254083WWM,LOCAL,272,RC,,outpatient,,,265,238.5,,0.95,,251.75,Percent of total billed charges,,,0.98,,259.7,Percent of total billed charges,,,0.95,,251.75,Percent of total billed charges,,,0.95,,251.75,Percent of total billed charges,,,0.97,,257.05,Percent of total billed charges,,,0.96,,254.4,Percent of total billed charges,,,0.95,,251.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,251.75,Percent of total billed charges,,251.75,259.7,
HC R&B-Semi-Private Respite Level 2,PX-12010022,CDM,12010022,LOCAL,120,RC,,inpatient,,,333,299.7,,0.95,,316.35,Percent of total billed charges,,,0.98,,326.34,Percent of total billed charges,,,0.95,,316.35,Percent of total billed charges,,,0.97,,323.01,Percent of total billed charges,,,0.97,,323.01,Percent of total billed charges,,,0.96,,319.68,Percent of total billed charges,,,0.95,,316.35,Percent of total billed charges,,,,,,,,,0.95,,316.35,Percent of total billed charges,,316.35,326.34,
HC R&B-Semi-Private Respite Level 2,PX-12010022,CDM,12010022,LOCAL,120,RC,,outpatient,,,333,299.7,,0.95,,316.35,Percent of total billed charges,,,0.98,,326.34,Percent of total billed charges,,,0.95,,316.35,Percent of total billed charges,,,0.95,,316.35,Percent of total billed charges,,,0.97,,323.01,Percent of total billed charges,,,0.96,,319.68,Percent of total billed charges,,,0.95,,316.35,Percent of total billed charges,,,,,,,,,0.95,,316.35,Percent of total billed charges,,316.35,326.34,
Place stabilizing device for broken forearm bone,PX-45010138,CDM,25606,CPT,450,RC,,inpatient,,,4246,3821.4,,0.95,,4033.7,Percent of total billed charges,,,0.98,,4161.08,Percent of total billed charges,,,0.95,,4033.7,Percent of total billed charges,,,0.97,,4118.62,Percent of total billed charges,,,0.97,,4118.62,Percent of total billed charges,,,0.96,,4076.16,Percent of total billed charges,,,0.95,,4033.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,4033.7,Percent of total billed charges,,3950,4161.08,
Place stabilizing device for broken forearm bone,PX-45010138,CDM,25606,CPT,450,RC,,outpatient,,,4246,3821.4,,0.95,,4033.7,Percent of total billed charges,,,0.98,,4161.08,Percent of total billed charges,,,0.95,,4033.7,Percent of total billed charges,,,0.95,,4033.7,Percent of total billed charges,,,0.97,,4118.62,Percent of total billed charges,,,0.96,,4076.16,Percent of total billed charges,,,0.95,,4033.7,Percent of total billed charges,,3950,,,,Per Diem,Per Diem,,0.95,,4033.7,Percent of total billed charges,,3950,4161.08,
Infectious agent drug susceptibility analysis,PX-30012388,CDM,87900,CPT,306,RC,,inpatient,,,445,400.5,,0.95,,422.75,Percent of total billed charges,,,0.98,,436.1,Percent of total billed charges,,,0.95,,422.75,Percent of total billed charges,,,0.97,,431.65,Percent of total billed charges,,,0.97,,431.65,Percent of total billed charges,,,0.96,,427.2,Percent of total billed charges,,,0.95,,422.75,Percent of total billed charges,,,,,,,,,0.95,,422.75,Percent of total billed charges,,422.75,436.1,
Infectious agent drug susceptibility analysis,PX-30012388,CDM,87900,CPT,306,RC,,outpatient,,,445,400.5,,0.95,,422.75,Percent of total billed charges,,,0.98,,436.1,Percent of total billed charges,,,0.95,,422.75,Percent of total billed charges,,,0.95,,422.75,Percent of total billed charges,,,0.97,,431.65,Percent of total billed charges,,,0.96,,427.2,Percent of total billed charges,,,0.95,,422.75,Percent of total billed charges,,,,,,,,,0.95,,422.75,Percent of total billed charges,,422.75,436.1,
HC Eucerin,PX-4170368WWM,CDM,4170368WWM,LOCAL,270,RC,,inpatient,,,44,39.6,,0.95,,41.8,Percent of total billed charges,,,0.98,,43.12,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,0.97,,42.68,Percent of total billed charges,,,0.97,,42.68,Percent of total billed charges,,,0.96,,42.24,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,41.8,Percent of total billed charges,,41.8,43.12,
HC Eucerin,PX-4170368WWM,CDM,4170368WWM,LOCAL,270,RC,,outpatient,,,44,39.6,,0.95,,41.8,Percent of total billed charges,,,0.98,,43.12,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,0.97,,42.68,Percent of total billed charges,,,0.96,,42.24,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,41.8,Percent of total billed charges,,41.8,43.12,
HC Aquaphor,PX-4171309WWM,CDM,4171309WWM,LOCAL,270,RC,,inpatient,,,44,39.6,,0.95,,41.8,Percent of total billed charges,,,0.98,,43.12,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,0.97,,42.68,Percent of total billed charges,,,0.97,,42.68,Percent of total billed charges,,,0.96,,42.24,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,41.8,Percent of total billed charges,,41.8,43.12,
HC Aquaphor,PX-4171309WWM,CDM,4171309WWM,LOCAL,270,RC,,outpatient,,,44,39.6,,0.95,,41.8,Percent of total billed charges,,,0.98,,43.12,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,0.97,,42.68,Percent of total billed charges,,,0.96,,42.24,Percent of total billed charges,,,0.95,,41.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,41.8,Percent of total billed charges,,41.8,43.12,
HC PR 99157 Mod Sed Other Phys/Qhp Each Addl 15 Mins,PX-96910983,CDM,64488,CPT,963,RC,,inpatient,,,240,216,,0.95,,228,Percent of total billed charges,,,0.98,,235.2,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,0.97,,232.8,Percent of total billed charges,,,0.97,,232.8,Percent of total billed charges,,,0.96,,230.4,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,228,Percent of total billed charges,,228,235.2,
HC PR 99157 Mod Sed Other Phys/Qhp Each Addl 15 Mins,PX-96910983,CDM,64488,CPT,963,RC,,outpatient,,,240,216,,0.95,,228,Percent of total billed charges,,,0.98,,235.2,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,0.97,,232.8,Percent of total billed charges,,,0.96,,230.4,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,228,Percent of total billed charges,,228,235.2,
HC Ambulance Ground per Mile,PX-54010001,CDM,A0425,HCPCS,540,RC,,inpatient,,,30,27,,0.95,,28.5,Percent of total billed charges,,,0.98,,29.4,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,0.97,,29.1,Percent of total billed charges,,,0.97,,29.1,Percent of total billed charges,,,0.96,,28.8,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,28.5,Percent of total billed charges,,28.5,29.4,
HC Ambulance Ground per Mile,PX-54010001,CDM,A0425,HCPCS,540,RC,,outpatient,,,30,27,,0.95,,28.5,Percent of total billed charges,,,0.98,,29.4,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,0.97,,29.1,Percent of total billed charges,,,0.96,,28.8,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,28.5,Percent of total billed charges,,28.5,29.4,
HC Ambulance Ground Als Non Emerg,PX-54010002,CDM,A0426,HCPCS,540,RC,,inpatient,,,1184,1065.6,,0.95,,1124.8,Percent of total billed charges,,,0.98,,1160.32,Percent of total billed charges,,,0.95,,1124.8,Percent of total billed charges,,,0.97,,1148.48,Percent of total billed charges,,,0.97,,1148.48,Percent of total billed charges,,,0.96,,1136.64,Percent of total billed charges,,,0.95,,1124.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1124.8,Percent of total billed charges,,1124.8,1160.32,
HC Ambulance Ground Als Non Emerg,PX-54010002,CDM,A0426,HCPCS,540,RC,,outpatient,,,1184,1065.6,,0.95,,1124.8,Percent of total billed charges,,,0.98,,1160.32,Percent of total billed charges,,,0.95,,1124.8,Percent of total billed charges,,,0.95,,1124.8,Percent of total billed charges,,,0.97,,1148.48,Percent of total billed charges,,,0.96,,1136.64,Percent of total billed charges,,,0.95,,1124.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1124.8,Percent of total billed charges,,1124.8,1160.32,
HC Ambulance Ground Als1 Emrgency,PX-54010003,CDM,A0427,HCPCS,540,RC,,inpatient,,,2042,1837.8,,0.95,,1939.9,Percent of total billed charges,,,0.98,,2001.16,Percent of total billed charges,,,0.95,,1939.9,Percent of total billed charges,,,0.97,,1980.74,Percent of total billed charges,,,0.97,,1980.74,Percent of total billed charges,,,0.96,,1960.32,Percent of total billed charges,,,0.95,,1939.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1939.9,Percent of total billed charges,,1939.9,2001.16,
HC Ambulance Ground Als1 Emrgency,PX-54010003,CDM,A0427,HCPCS,540,RC,,outpatient,,,2042,1837.8,,0.95,,1939.9,Percent of total billed charges,,,0.98,,2001.16,Percent of total billed charges,,,0.95,,1939.9,Percent of total billed charges,,,0.95,,1939.9,Percent of total billed charges,,,0.97,,1980.74,Percent of total billed charges,,,0.96,,1960.32,Percent of total billed charges,,,0.95,,1939.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1939.9,Percent of total billed charges,,1939.9,2001.16,
HC Ambulance Ground Bls Non Emerg,PX-54010004,CDM,A0428,HCPCS,540,RC,,inpatient,,,1033,929.7,,0.95,,981.35,Percent of total billed charges,,,0.98,,1012.34,Percent of total billed charges,,,0.95,,981.35,Percent of total billed charges,,,0.97,,1002.01,Percent of total billed charges,,,0.97,,1002.01,Percent of total billed charges,,,0.96,,991.68,Percent of total billed charges,,,0.95,,981.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,981.35,Percent of total billed charges,,981.35,1012.34,
HC Ambulance Ground Bls Non Emerg,PX-54010004,CDM,A0428,HCPCS,540,RC,,outpatient,,,1033,929.7,,0.95,,981.35,Percent of total billed charges,,,0.98,,1012.34,Percent of total billed charges,,,0.95,,981.35,Percent of total billed charges,,,0.95,,981.35,Percent of total billed charges,,,0.97,,1002.01,Percent of total billed charges,,,0.96,,991.68,Percent of total billed charges,,,0.95,,981.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,981.35,Percent of total billed charges,,981.35,1012.34,
HC Ambulance Ground Bls Emergency,PX-54010005,CDM,A0429,HCPCS,540,RC,,inpatient,,,1336,1202.4,,0.95,,1269.2,Percent of total billed charges,,,0.98,,1309.28,Percent of total billed charges,,,0.95,,1269.2,Percent of total billed charges,,,0.97,,1295.92,Percent of total billed charges,,,0.97,,1295.92,Percent of total billed charges,,,0.96,,1282.56,Percent of total billed charges,,,0.95,,1269.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1269.2,Percent of total billed charges,,1269.2,1309.28,
HC Ambulance Ground Bls Emergency,PX-54010005,CDM,A0429,HCPCS,540,RC,,outpatient,,,1336,1202.4,,0.95,,1269.2,Percent of total billed charges,,,0.98,,1309.28,Percent of total billed charges,,,0.95,,1269.2,Percent of total billed charges,,,0.95,,1269.2,Percent of total billed charges,,,0.97,,1295.92,Percent of total billed charges,,,0.96,,1282.56,Percent of total billed charges,,,0.95,,1269.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,1269.2,Percent of total billed charges,,1269.2,1309.28,
HC Ambulance Ground Als2 Emrgency,PX-54010008,CDM,A0433,HCPCS,540,RC,,inpatient,,,2577,2319.3,,0.95,,2448.15,Percent of total billed charges,,,0.98,,2525.46,Percent of total billed charges,,,0.95,,2448.15,Percent of total billed charges,,,0.97,,2499.69,Percent of total billed charges,,,0.97,,2499.69,Percent of total billed charges,,,0.96,,2473.92,Percent of total billed charges,,,0.95,,2448.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2448.15,Percent of total billed charges,,2448.15,2525.46,
HC Ambulance Ground Als2 Emrgency,PX-54010008,CDM,A0433,HCPCS,540,RC,,outpatient,,,2577,2319.3,,0.95,,2448.15,Percent of total billed charges,,,0.98,,2525.46,Percent of total billed charges,,,0.95,,2448.15,Percent of total billed charges,,,0.95,,2448.15,Percent of total billed charges,,,0.97,,2499.69,Percent of total billed charges,,,0.96,,2473.92,Percent of total billed charges,,,0.95,,2448.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,2448.15,Percent of total billed charges,,2448.15,2525.46,
HC Specialty Care Transport,PX-54010009,CDM,A0434,HCPCS,540,RC,,inpatient,,,4473,4025.7,,0.95,,4249.35,Percent of total billed charges,,,0.98,,4383.54,Percent of total billed charges,,,0.95,,4249.35,Percent of total billed charges,,,0.97,,4338.81,Percent of total billed charges,,,0.97,,4338.81,Percent of total billed charges,,,0.96,,4294.08,Percent of total billed charges,,,0.95,,4249.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4249.35,Percent of total billed charges,,4249.35,4383.54,
HC Specialty Care Transport,PX-54010009,CDM,A0434,HCPCS,540,RC,,outpatient,,,4473,4025.7,,0.95,,4249.35,Percent of total billed charges,,,0.98,,4383.54,Percent of total billed charges,,,0.95,,4249.35,Percent of total billed charges,,,0.95,,4249.35,Percent of total billed charges,,,0.97,,4338.81,Percent of total billed charges,,,0.96,,4294.08,Percent of total billed charges,,,0.95,,4249.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4249.35,Percent of total billed charges,,4249.35,4383.54,
Test for screening hearing,PX-47010002,CDM,92551,CPT,470,RC,,inpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
Test for screening hearing,PX-47010002,CDM,92551,CPT,470,RC,,outpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
Place ear probe for computerized Measure repeated sounds,PX-47110026,CDM,92588,CPT,471,RC,,inpatient,,,232,208.8,,0.95,,220.4,Percent of total billed charges,,,0.98,,227.36,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,0.97,,225.04,Percent of total billed charges,,,0.97,,225.04,Percent of total billed charges,,,0.96,,222.72,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,220.4,Percent of total billed charges,,220.4,227.36,
Place ear probe for computerized Measure repeated sounds,PX-47110026,CDM,92588,CPT,471,RC,,outpatient,,,232,208.8,,0.95,,220.4,Percent of total billed charges,,,0.98,,227.36,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,0.97,,225.04,Percent of total billed charges,,,0.96,,222.72,Percent of total billed charges,,,0.95,,220.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,220.4,Percent of total billed charges,,220.4,227.36,
HC Skills Train Grp Iop Ohp 15 Min,PX-90410002,CDM,H2014,HCPCS,904,RC,,inpatient,,,82,73.8,,0.95,,77.9,Percent of total billed charges,,,0.98,,80.36,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,0.97,,79.54,Percent of total billed charges,,,0.97,,79.54,Percent of total billed charges,,,0.96,,78.72,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,77.9,Percent of total billed charges,,77.9,80.36,
HC Skills Train Grp Iop Ohp 15 Min,PX-90410002,CDM,H2014,HCPCS,904,RC,,outpatient,,,82,73.8,,0.95,,77.9,Percent of total billed charges,,,0.98,,80.36,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,0.97,,79.54,Percent of total billed charges,,,0.96,,78.72,Percent of total billed charges,,,0.95,,77.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,77.9,Percent of total billed charges,,77.9,80.36,
HC PR 90882 Environmental Manipulation,PX-96910452,CDM,90882,CPT,983,RC,,inpatient,,,304,273.6,,0.95,,288.8,Percent of total billed charges,,,0.98,,297.92,Percent of total billed charges,,,0.95,,288.8,Percent of total billed charges,,,0.97,,294.88,Percent of total billed charges,,,0.97,,294.88,Percent of total billed charges,,,0.96,,291.84,Percent of total billed charges,,,0.95,,288.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,288.8,Percent of total billed charges,,288.8,297.92,
HC PR 90882 Environmental Manipulation,PX-96910452,CDM,90882,CPT,983,RC,,outpatient,,,304,273.6,,0.95,,288.8,Percent of total billed charges,,,0.98,,297.92,Percent of total billed charges,,,0.95,,288.8,Percent of total billed charges,,,0.95,,288.8,Percent of total billed charges,,,0.97,,294.88,Percent of total billed charges,,,0.96,,291.84,Percent of total billed charges,,,0.95,,288.8,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,288.8,Percent of total billed charges,,288.8,297.92,
New office or other outpatient visit Level 2,PX-76110002,CDM,99202,CPT,761,RC,,inpatient,,,209,188.1,,0.95,,198.55,Percent of total billed charges,,,0.98,,204.82,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.96,,200.64,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,198.55,Percent of total billed charges,,198.55,204.82,
New office or other outpatient visit Level 2,PX-76110002,CDM,99202,CPT,761,RC,,outpatient,,,209,188.1,,0.95,,198.55,Percent of total billed charges,,,0.98,,204.82,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,0.97,,202.73,Percent of total billed charges,,,0.96,,200.64,Percent of total billed charges,,,0.95,,198.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,198.55,Percent of total billed charges,,198.55,204.82,
New office or other outpatient visit Level 3,PX-76110003,CDM,99203,CPT,761,RC,,inpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
New office or other outpatient visit Level 3,PX-76110003,CDM,99203,CPT,761,RC,,outpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
New office or other outpatient visit Level 4,PX-76110004,CDM,99204,CPT,761,RC,,inpatient,,,407,366.3,,0.95,,386.65,Percent of total billed charges,,,0.98,,398.86,Percent of total billed charges,,,0.95,,386.65,Percent of total billed charges,,,0.97,,394.79,Percent of total billed charges,,,0.97,,394.79,Percent of total billed charges,,,0.96,,390.72,Percent of total billed charges,,,0.95,,386.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,386.65,Percent of total billed charges,,386.65,398.86,
New office or other outpatient visit Level 4,PX-76110004,CDM,99204,CPT,761,RC,,outpatient,,,407,366.3,,0.95,,386.65,Percent of total billed charges,,,0.98,,398.86,Percent of total billed charges,,,0.95,,386.65,Percent of total billed charges,,,0.95,,386.65,Percent of total billed charges,,,0.97,,394.79,Percent of total billed charges,,,0.96,,390.72,Percent of total billed charges,,,0.95,,386.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,386.65,Percent of total billed charges,,386.65,398.86,
Established office or other outpatient visit L1,PX-76110006,CDM,99211,CPT,761,RC,,inpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
Established office or other outpatient visit L1,PX-76110006,CDM,99211,CPT,761,RC,,outpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
Established office or other outpatient visit L5,PX-76110021,CDM,99215,CPT,761,RC,,inpatient,,,430,387,,0.95,,408.5,Percent of total billed charges,,,0.98,,421.4,Percent of total billed charges,,,0.95,,408.5,Percent of total billed charges,,,0.97,,417.1,Percent of total billed charges,,,0.97,,417.1,Percent of total billed charges,,,0.96,,412.8,Percent of total billed charges,,,0.95,,408.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,408.5,Percent of total billed charges,,408.5,421.4,
Established office or other outpatient visit L5,PX-76110021,CDM,99215,CPT,761,RC,,outpatient,,,430,387,,0.95,,408.5,Percent of total billed charges,,,0.98,,421.4,Percent of total billed charges,,,0.95,,408.5,Percent of total billed charges,,,0.95,,408.5,Percent of total billed charges,,,0.97,,417.1,Percent of total billed charges,,,0.96,,412.8,Percent of total billed charges,,,0.95,,408.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,408.5,Percent of total billed charges,,408.5,421.4,
Established office or other outpatient visit L2,PX-76110039,CDM,99212,CPT,761,RC,,inpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
Established office or other outpatient visit L2,PX-76110039,CDM,99212,CPT,761,RC,,outpatient,,,114,102.6,,0.95,,108.3,Percent of total billed charges,,,0.98,,111.72,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,0.97,,110.58,Percent of total billed charges,,,0.96,,109.44,Percent of total billed charges,,,0.95,,108.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,108.3,Percent of total billed charges,,108.3,111.72,
Established office or other outpatient visit L3,PX-76110040,CDM,99213,CPT,761,RC,,inpatient,,,189,170.1,,0.95,,179.55,Percent of total billed charges,,,0.98,,185.22,Percent of total billed charges,,,0.95,,179.55,Percent of total billed charges,,,0.97,,183.33,Percent of total billed charges,,,0.97,,183.33,Percent of total billed charges,,,0.96,,181.44,Percent of total billed charges,,,0.95,,179.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,179.55,Percent of total billed charges,,179.55,185.22,
Established office or other outpatient visit L3,PX-76110040,CDM,99213,CPT,761,RC,,outpatient,,,189,170.1,,0.95,,179.55,Percent of total billed charges,,,0.98,,185.22,Percent of total billed charges,,,0.95,,179.55,Percent of total billed charges,,,0.95,,179.55,Percent of total billed charges,,,0.97,,183.33,Percent of total billed charges,,,0.96,,181.44,Percent of total billed charges,,,0.95,,179.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,179.55,Percent of total billed charges,,179.55,185.22,
Established office or other outpatient visit L4,PX-76110041,CDM,99214,CPT,761,RC,,inpatient,,,291,261.9,,0.95,,276.45,Percent of total billed charges,,,0.98,,285.18,Percent of total billed charges,,,0.95,,276.45,Percent of total billed charges,,,0.97,,282.27,Percent of total billed charges,,,0.97,,282.27,Percent of total billed charges,,,0.96,,279.36,Percent of total billed charges,,,0.95,,276.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,276.45,Percent of total billed charges,,276.45,285.18,
Established office or other outpatient visit L4,PX-76110041,CDM,99214,CPT,761,RC,,outpatient,,,291,261.9,,0.95,,276.45,Percent of total billed charges,,,0.98,,285.18,Percent of total billed charges,,,0.95,,276.45,Percent of total billed charges,,,0.95,,276.45,Percent of total billed charges,,,0.97,,282.27,Percent of total billed charges,,,0.96,,279.36,Percent of total billed charges,,,0.95,,276.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,276.45,Percent of total billed charges,,276.45,285.18,
"Smoking/tobacco use intensive counseling, 4-10 m",PX-94010003,CDM,99406,CPT,942,RC,,inpatient,,,54,48.6,,0.95,,51.3,Percent of total billed charges,,,0.98,,52.92,Percent of total billed charges,,,0.95,,51.3,Percent of total billed charges,,,0.97,,52.38,Percent of total billed charges,,,0.97,,52.38,Percent of total billed charges,,,0.96,,51.84,Percent of total billed charges,,,0.95,,51.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,51.3,Percent of total billed charges,,51.3,52.92,
"Smoking/tobacco use intensive counseling, 4-10 m",PX-94010003,CDM,99406,CPT,942,RC,,outpatient,,,54,48.6,,0.95,,51.3,Percent of total billed charges,,,0.98,,52.92,Percent of total billed charges,,,0.95,,51.3,Percent of total billed charges,,,0.95,,51.3,Percent of total billed charges,,,0.97,,52.38,Percent of total billed charges,,,0.96,,51.84,Percent of total billed charges,,,0.95,,51.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,51.3,Percent of total billed charges,,51.3,52.92,
Other evaluation and management service,PX-51010063,CDM,99499,CPT,510,RC,,inpatient,,,40,36,,0.95,,38,Percent of total billed charges,,,0.98,,39.2,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.96,,38.4,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,,,,,,,0.95,,38,Percent of total billed charges,,38,39.2,
Other evaluation and management service,PX-51010063,CDM,99499,CPT,510,RC,,outpatient,,,40,36,,0.95,,38,Percent of total billed charges,,,0.98,,39.2,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,0.97,,38.8,Percent of total billed charges,,,0.96,,38.4,Percent of total billed charges,,,0.95,,38,Percent of total billed charges,,,,,,,,,0.95,,38,Percent of total billed charges,,38,39.2,
Behav Chng Smoking 3-10 Min,PX-96010015,CDM,99406,CPT,960,RC,,inpatient,,,54,48.6,,0.95,,51.3,Percent of total billed charges,,,0.98,,52.92,Percent of total billed charges,,,0.95,,51.3,Percent of total billed charges,,,0.97,,52.38,Percent of total billed charges,,,0.97,,52.38,Percent of total billed charges,,,0.96,,51.84,Percent of total billed charges,,,0.95,,51.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,51.3,Percent of total billed charges,,51.3,52.92,
Behav Chng Smoking 3-10 Min,PX-96010015,CDM,99406,CPT,960,RC,,outpatient,,,54,48.6,,0.95,,51.3,Percent of total billed charges,,,0.98,,52.92,Percent of total billed charges,,,0.95,,51.3,Percent of total billed charges,,,0.95,,51.3,Percent of total billed charges,,,0.97,,52.38,Percent of total billed charges,,,0.96,,51.84,Percent of total billed charges,,,0.95,,51.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,51.3,Percent of total billed charges,,51.3,52.92,
HC PR 99407 Behav Chng Smoking > 10 Min,PX-96010017,CDM,99407,CPT,960,RC,,inpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
HC PR 99407 Behav Chng Smoking > 10 Min,PX-96010017,CDM,99407,CPT,960,RC,,outpatient,,,103,92.7,,0.95,,97.85,Percent of total billed charges,,,0.98,,100.94,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,0.97,,99.91,Percent of total billed charges,,,0.96,,98.88,Percent of total billed charges,,,0.95,,97.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,97.85,Percent of total billed charges,,97.85,100.94,
HC PR 99304 Initial Nursing Facility Care Sf/Low Mdm 25 Min Cdm,PX-96910101,CDM,99304,CPT,983,RC,,inpatient,,,256,230.4,,0.95,,243.2,Percent of total billed charges,,,0.98,,250.88,Percent of total billed charges,,,0.95,,243.2,Percent of total billed charges,,,0.97,,248.32,Percent of total billed charges,,,0.97,,248.32,Percent of total billed charges,,,0.96,,245.76,Percent of total billed charges,,,0.95,,243.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,243.2,Percent of total billed charges,,243.2,250.88,
HC PR 99304 Initial Nursing Facility Care Sf/Low Mdm 25 Min Cdm,PX-96910101,CDM,99304,CPT,983,RC,,outpatient,,,256,230.4,,0.95,,243.2,Percent of total billed charges,,,0.98,,250.88,Percent of total billed charges,,,0.95,,243.2,Percent of total billed charges,,,0.95,,243.2,Percent of total billed charges,,,0.97,,248.32,Percent of total billed charges,,,0.96,,245.76,Percent of total billed charges,,,0.95,,243.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,243.2,Percent of total billed charges,,243.2,250.88,
HC PR 99305 Initial Nursing Facility Care Mod Mdm 35 Minutes Cdm,PX-96910102,CDM,99305,CPT,983,RC,,inpatient,,,347,312.3,,0.95,,329.65,Percent of total billed charges,,,0.98,,340.06,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,0.97,,336.59,Percent of total billed charges,,,0.97,,336.59,Percent of total billed charges,,,0.96,,333.12,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,329.65,Percent of total billed charges,,329.65,340.06,
HC PR 99305 Initial Nursing Facility Care Mod Mdm 35 Minutes Cdm,PX-96910102,CDM,99305,CPT,983,RC,,outpatient,,,347,312.3,,0.95,,329.65,Percent of total billed charges,,,0.98,,340.06,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,0.97,,336.59,Percent of total billed charges,,,0.96,,333.12,Percent of total billed charges,,,0.95,,329.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,329.65,Percent of total billed charges,,329.65,340.06,
Initial Nursing Facility Care Hi Mdm 50 Minutes,PX-96910103,CDM,99306,CPT,983,RC,,inpatient,,,442,397.8,,0.95,,419.9,Percent of total billed charges,,,0.98,,433.16,Percent of total billed charges,,,0.95,,419.9,Percent of total billed charges,,,0.97,,428.74,Percent of total billed charges,,,0.97,,428.74,Percent of total billed charges,,,0.96,,424.32,Percent of total billed charges,,,0.95,,419.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,419.9,Percent of total billed charges,,419.9,433.16,
Initial Nursing Facility Care Hi Mdm 50 Minutes,PX-96910103,CDM,99306,CPT,983,RC,,outpatient,,,442,397.8,,0.95,,419.9,Percent of total billed charges,,,0.98,,433.16,Percent of total billed charges,,,0.95,,419.9,Percent of total billed charges,,,0.95,,419.9,Percent of total billed charges,,,0.97,,428.74,Percent of total billed charges,,,0.96,,424.32,Percent of total billed charges,,,0.95,,419.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,419.9,Percent of total billed charges,,419.9,433.16,
HC PR 99307 Sbsq Nursing Facility Care Sf Mdm 10 Minutes Cdm,PX-96910104,CDM,99307,CPT,983,RC,,inpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
HC PR 99307 Sbsq Nursing Facility Care Sf Mdm 10 Minutes Cdm,PX-96910104,CDM,99307,CPT,983,RC,,outpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
HC PR 99309 Sbsq Nursing Facility Care Mod Mdm 30 Minutes Cdm,PX-96910106,CDM,99309,CPT,983,RC,,inpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
HC PR 99309 Sbsq Nursing Facility Care Mod Mdm 30 Minutes Cdm,PX-96910106,CDM,99309,CPT,983,RC,,outpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
HC PR 99315 Nursing Facility Dschrg Mgmt 30 Min/< Tot Time Cdm,PX-96910108,CDM,99315,CPT,983,RC,,inpatient,,,199,179.1,,0.95,,189.05,Percent of total billed charges,,,0.98,,195.02,Percent of total billed charges,,,0.95,,189.05,Percent of total billed charges,,,0.97,,193.03,Percent of total billed charges,,,0.97,,193.03,Percent of total billed charges,,,0.96,,191.04,Percent of total billed charges,,,0.95,,189.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,189.05,Percent of total billed charges,,189.05,195.02,
HC PR 99315 Nursing Facility Dschrg Mgmt 30 Min/< Tot Time Cdm,PX-96910108,CDM,99315,CPT,983,RC,,outpatient,,,199,179.1,,0.95,,189.05,Percent of total billed charges,,,0.98,,195.02,Percent of total billed charges,,,0.95,,189.05,Percent of total billed charges,,,0.95,,189.05,Percent of total billed charges,,,0.97,,193.03,Percent of total billed charges,,,0.96,,191.04,Percent of total billed charges,,,0.95,,189.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,189.05,Percent of total billed charges,,189.05,195.02,
HC PR 99316 Nursing Facility Dschrg Mgmt 30 Min+ Tot Time Cdm,PX-96910109,CDM,99316,CPT,983,RC,,inpatient,,,320,288,,0.95,,304,Percent of total billed charges,,,0.98,,313.6,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,0.97,,310.4,Percent of total billed charges,,,0.97,,310.4,Percent of total billed charges,,,0.96,,307.2,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,304,Percent of total billed charges,,304,313.6,
HC PR 99316 Nursing Facility Dschrg Mgmt 30 Min+ Tot Time Cdm,PX-96910109,CDM,99316,CPT,983,RC,,outpatient,,,320,288,,0.95,,304,Percent of total billed charges,,,0.98,,313.6,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,0.97,,310.4,Percent of total billed charges,,,0.96,,307.2,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,304,Percent of total billed charges,,304,313.6,
HC PR 99347 Home/Res Visit Est Patient Sf Mdm 20 Minutes Cdm,PX-96910122,CDM,99347,CPT,983,RC,,inpatient,,,237,213.3,,0.95,,225.15,Percent of total billed charges,,,0.98,,232.26,Percent of total billed charges,,,0.95,,225.15,Percent of total billed charges,,,0.97,,229.89,Percent of total billed charges,,,0.97,,229.89,Percent of total billed charges,,,0.96,,227.52,Percent of total billed charges,,,0.95,,225.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,225.15,Percent of total billed charges,,225.15,232.26,
HC PR 99347 Home/Res Visit Est Patient Sf Mdm 20 Minutes Cdm,PX-96910122,CDM,99347,CPT,983,RC,,outpatient,,,237,213.3,,0.95,,225.15,Percent of total billed charges,,,0.98,,232.26,Percent of total billed charges,,,0.95,,225.15,Percent of total billed charges,,,0.95,,225.15,Percent of total billed charges,,,0.97,,229.89,Percent of total billed charges,,,0.96,,227.52,Percent of total billed charges,,,0.95,,225.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,225.15,Percent of total billed charges,,225.15,232.26,
HC PR 99348 Home/Res Visit Est Patient Low Mdm 30 Minutes Cdm,PX-96910123,CDM,99348,CPT,983,RC,,inpatient,,,248,223.2,,0.95,,235.6,Percent of total billed charges,,,0.98,,243.04,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,0.97,,240.56,Percent of total billed charges,,,0.97,,240.56,Percent of total billed charges,,,0.96,,238.08,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,235.6,Percent of total billed charges,,235.6,243.04,
HC PR 99348 Home/Res Visit Est Patient Low Mdm 30 Minutes Cdm,PX-96910123,CDM,99348,CPT,983,RC,,outpatient,,,248,223.2,,0.95,,235.6,Percent of total billed charges,,,0.98,,243.04,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,0.97,,240.56,Percent of total billed charges,,,0.96,,238.08,Percent of total billed charges,,,0.95,,235.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,235.6,Percent of total billed charges,,235.6,243.04,
HC PR 99349 Home/Res Visit Est Patient Mod Mdm 40 Minutes Cdm,PX-96910124,CDM,99349,CPT,983,RC,,inpatient,,,340,306,,0.95,,323,Percent of total billed charges,,,0.98,,333.2,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.96,,326.4,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,323,Percent of total billed charges,,323,333.2,
HC PR 99349 Home/Res Visit Est Patient Mod Mdm 40 Minutes Cdm,PX-96910124,CDM,99349,CPT,983,RC,,outpatient,,,340,306,,0.95,,323,Percent of total billed charges,,,0.98,,333.2,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,0.97,,329.8,Percent of total billed charges,,,0.96,,326.4,Percent of total billed charges,,,0.95,,323,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,323,Percent of total billed charges,,323,333.2,
HC PR 99350 Home/Res Visit Est Patient High Mdm 60 Minutes Cdm,PX-96910125,CDM,99350,CPT,983,RC,,inpatient,,,452,406.8,,0.95,,429.4,Percent of total billed charges,,,0.98,,442.96,Percent of total billed charges,,,0.95,,429.4,Percent of total billed charges,,,0.97,,438.44,Percent of total billed charges,,,0.97,,438.44,Percent of total billed charges,,,0.96,,433.92,Percent of total billed charges,,,0.95,,429.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,429.4,Percent of total billed charges,,429.4,442.96,
HC PR 99350 Home/Res Visit Est Patient High Mdm 60 Minutes Cdm,PX-96910125,CDM,99350,CPT,983,RC,,outpatient,,,452,406.8,,0.95,,429.4,Percent of total billed charges,,,0.98,,442.96,Percent of total billed charges,,,0.95,,429.4,Percent of total billed charges,,,0.95,,429.4,Percent of total billed charges,,,0.97,,438.44,Percent of total billed charges,,,0.96,,433.92,Percent of total billed charges,,,0.95,,429.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,429.4,Percent of total billed charges,,429.4,442.96,
HC PR 99381 Initial Preventive Medicine New Patient <1year,PX-96910144,CDM,99381,CPT,983,RC,,inpatient,,,295,265.5,,0.95,,280.25,Percent of total billed charges,,,0.98,,289.1,Percent of total billed charges,,,0.95,,280.25,Percent of total billed charges,,,0.97,,286.15,Percent of total billed charges,,,0.97,,286.15,Percent of total billed charges,,,0.96,,283.2,Percent of total billed charges,,,0.95,,280.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,280.25,Percent of total billed charges,,280.25,289.1,
HC PR 99381 Initial Preventive Medicine New Patient <1year,PX-96910144,CDM,99381,CPT,983,RC,,outpatient,,,295,265.5,,0.95,,280.25,Percent of total billed charges,,,0.98,,289.1,Percent of total billed charges,,,0.95,,280.25,Percent of total billed charges,,,0.95,,280.25,Percent of total billed charges,,,0.97,,286.15,Percent of total billed charges,,,0.96,,283.2,Percent of total billed charges,,,0.95,,280.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,280.25,Percent of total billed charges,,280.25,289.1,
HC PR 99382 Init Pm E/M New Pat 1-4 Yrs,PX-96910147,CDM,99382,CPT,983,RC,,inpatient,,,308,277.2,,0.95,,292.6,Percent of total billed charges,,,0.98,,301.84,Percent of total billed charges,,,0.95,,292.6,Percent of total billed charges,,,0.97,,298.76,Percent of total billed charges,,,0.97,,298.76,Percent of total billed charges,,,0.96,,295.68,Percent of total billed charges,,,0.95,,292.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,292.6,Percent of total billed charges,,292.6,301.84,
HC PR 99382 Init Pm E/M New Pat 1-4 Yrs,PX-96910147,CDM,99382,CPT,983,RC,,outpatient,,,308,277.2,,0.95,,292.6,Percent of total billed charges,,,0.98,,301.84,Percent of total billed charges,,,0.95,,292.6,Percent of total billed charges,,,0.95,,292.6,Percent of total billed charges,,,0.97,,298.76,Percent of total billed charges,,,0.96,,295.68,Percent of total billed charges,,,0.95,,292.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,292.6,Percent of total billed charges,,292.6,301.84,
HC PR 99383 Prev Visit New Age 5-11,PX-96910149,CDM,99383,CPT,983,RC,,inpatient,,,320,288,,0.95,,304,Percent of total billed charges,,,0.98,,313.6,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,0.97,,310.4,Percent of total billed charges,,,0.97,,310.4,Percent of total billed charges,,,0.96,,307.2,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,304,Percent of total billed charges,,304,313.6,
HC PR 99383 Prev Visit New Age 5-11,PX-96910149,CDM,99383,CPT,983,RC,,outpatient,,,320,288,,0.95,,304,Percent of total billed charges,,,0.98,,313.6,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,0.97,,310.4,Percent of total billed charges,,,0.96,,307.2,Percent of total billed charges,,,0.95,,304,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,304,Percent of total billed charges,,304,313.6,
HC PR 99384 Prev Visit New Age 12-17,PX-96910152,CDM,99384,CPT,983,RC,,inpatient,,,362,325.8,,0.95,,343.9,Percent of total billed charges,,,0.98,,354.76,Percent of total billed charges,,,0.95,,343.9,Percent of total billed charges,,,0.97,,351.14,Percent of total billed charges,,,0.97,,351.14,Percent of total billed charges,,,0.96,,347.52,Percent of total billed charges,,,0.95,,343.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,343.9,Percent of total billed charges,,343.9,354.76,
HC PR 99384 Prev Visit New Age 12-17,PX-96910152,CDM,99384,CPT,983,RC,,outpatient,,,362,325.8,,0.95,,343.9,Percent of total billed charges,,,0.98,,354.76,Percent of total billed charges,,,0.95,,343.9,Percent of total billed charges,,,0.95,,343.9,Percent of total billed charges,,,0.97,,351.14,Percent of total billed charges,,,0.96,,347.52,Percent of total billed charges,,,0.95,,343.9,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,343.9,Percent of total billed charges,,343.9,354.76,
HC PR 99385 Prev Visit New Age 18-39,PX-96910154,CDM,99385,CPT,983,RC,,inpatient,,,353,317.7,,0.95,,335.35,Percent of total billed charges,,,0.98,,345.94,Percent of total billed charges,,,0.95,,335.35,Percent of total billed charges,,,0.97,,342.41,Percent of total billed charges,,,0.97,,342.41,Percent of total billed charges,,,0.96,,338.88,Percent of total billed charges,,,0.95,,335.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,335.35,Percent of total billed charges,,335.35,345.94,
HC PR 99385 Prev Visit New Age 18-39,PX-96910154,CDM,99385,CPT,983,RC,,outpatient,,,353,317.7,,0.95,,335.35,Percent of total billed charges,,,0.98,,345.94,Percent of total billed charges,,,0.95,,335.35,Percent of total billed charges,,,0.95,,335.35,Percent of total billed charges,,,0.97,,342.41,Percent of total billed charges,,,0.96,,338.88,Percent of total billed charges,,,0.95,,335.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,335.35,Percent of total billed charges,,335.35,345.94,
HC PR 99386 Prev Visit New Age 40-64,PX-96910156,CDM,99386,CPT,983,RC,,inpatient,,,406,365.4,,0.95,,385.7,Percent of total billed charges,,,0.98,,397.88,Percent of total billed charges,,,0.95,,385.7,Percent of total billed charges,,,0.97,,393.82,Percent of total billed charges,,,0.97,,393.82,Percent of total billed charges,,,0.96,,389.76,Percent of total billed charges,,,0.95,,385.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,385.7,Percent of total billed charges,,385.7,397.88,
HC PR 99386 Prev Visit New Age 40-64,PX-96910156,CDM,99386,CPT,983,RC,,outpatient,,,406,365.4,,0.95,,385.7,Percent of total billed charges,,,0.98,,397.88,Percent of total billed charges,,,0.95,,385.7,Percent of total billed charges,,,0.95,,385.7,Percent of total billed charges,,,0.97,,393.82,Percent of total billed charges,,,0.96,,389.76,Percent of total billed charges,,,0.95,,385.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,385.7,Percent of total billed charges,,385.7,397.88,
HC PR 99387 Init Pm E/M New Pat 65+ Yrs,PX-96910158,CDM,99387,CPT,983,RC,,inpatient,,,420,378,,0.95,,399,Percent of total billed charges,,,0.98,,411.6,Percent of total billed charges,,,0.95,,399,Percent of total billed charges,,,0.97,,407.4,Percent of total billed charges,,,0.97,,407.4,Percent of total billed charges,,,0.96,,403.2,Percent of total billed charges,,,0.95,,399,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,399,Percent of total billed charges,,399,411.6,
HC PR 99387 Init Pm E/M New Pat 65+ Yrs,PX-96910158,CDM,99387,CPT,983,RC,,outpatient,,,420,378,,0.95,,399,Percent of total billed charges,,,0.98,,411.6,Percent of total billed charges,,,0.95,,399,Percent of total billed charges,,,0.95,,399,Percent of total billed charges,,,0.97,,407.4,Percent of total billed charges,,,0.96,,403.2,Percent of total billed charges,,,0.95,,399,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,399,Percent of total billed charges,,399,411.6,
HC PR 99391 per Pm Reeval Est Pat Inf,PX-96910161,CDM,99391,CPT,983,RC,,inpatient,,,265,238.5,,0.95,,251.75,Percent of total billed charges,,,0.98,,259.7,Percent of total billed charges,,,0.95,,251.75,Percent of total billed charges,,,0.97,,257.05,Percent of total billed charges,,,0.97,,257.05,Percent of total billed charges,,,0.96,,254.4,Percent of total billed charges,,,0.95,,251.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,251.75,Percent of total billed charges,,251.75,259.7,
HC PR 99391 per Pm Reeval Est Pat Inf,PX-96910161,CDM,99391,CPT,983,RC,,outpatient,,,265,238.5,,0.95,,251.75,Percent of total billed charges,,,0.98,,259.7,Percent of total billed charges,,,0.95,,251.75,Percent of total billed charges,,,0.95,,251.75,Percent of total billed charges,,,0.97,,257.05,Percent of total billed charges,,,0.96,,254.4,Percent of total billed charges,,,0.95,,251.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,251.75,Percent of total billed charges,,251.75,259.7,
HC PR 99392 Prev Visit Est Age 1-4,PX-96910163,CDM,99392,CPT,983,RC,,inpatient,,,283,254.7,,0.95,,268.85,Percent of total billed charges,,,0.98,,277.34,Percent of total billed charges,,,0.95,,268.85,Percent of total billed charges,,,0.97,,274.51,Percent of total billed charges,,,0.97,,274.51,Percent of total billed charges,,,0.96,,271.68,Percent of total billed charges,,,0.95,,268.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,268.85,Percent of total billed charges,,268.85,277.34,
HC PR 99392 Prev Visit Est Age 1-4,PX-96910163,CDM,99392,CPT,983,RC,,outpatient,,,283,254.7,,0.95,,268.85,Percent of total billed charges,,,0.98,,277.34,Percent of total billed charges,,,0.95,,268.85,Percent of total billed charges,,,0.95,,268.85,Percent of total billed charges,,,0.97,,274.51,Percent of total billed charges,,,0.96,,271.68,Percent of total billed charges,,,0.95,,268.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,268.85,Percent of total billed charges,,268.85,277.34,
HC PR 99393 Prev Visit Est Age 5-11,PX-96910165,CDM,99393,CPT,983,RC,,inpatient,,,283,254.7,,0.95,,268.85,Percent of total billed charges,,,0.98,,277.34,Percent of total billed charges,,,0.95,,268.85,Percent of total billed charges,,,0.97,,274.51,Percent of total billed charges,,,0.97,,274.51,Percent of total billed charges,,,0.96,,271.68,Percent of total billed charges,,,0.95,,268.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,268.85,Percent of total billed charges,,268.85,277.34,
HC PR 99393 Prev Visit Est Age 5-11,PX-96910165,CDM,99393,CPT,983,RC,,outpatient,,,283,254.7,,0.95,,268.85,Percent of total billed charges,,,0.98,,277.34,Percent of total billed charges,,,0.95,,268.85,Percent of total billed charges,,,0.95,,268.85,Percent of total billed charges,,,0.97,,274.51,Percent of total billed charges,,,0.96,,271.68,Percent of total billed charges,,,0.95,,268.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,268.85,Percent of total billed charges,,268.85,277.34,
HC PR 99394 Prev Visit Est Age 12-17,PX-96910167,CDM,99394,CPT,983,RC,,inpatient,,,308,277.2,,0.95,,292.6,Percent of total billed charges,,,0.98,,301.84,Percent of total billed charges,,,0.95,,292.6,Percent of total billed charges,,,0.97,,298.76,Percent of total billed charges,,,0.97,,298.76,Percent of total billed charges,,,0.96,,295.68,Percent of total billed charges,,,0.95,,292.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,292.6,Percent of total billed charges,,292.6,301.84,
HC PR 99394 Prev Visit Est Age 12-17,PX-96910167,CDM,99394,CPT,983,RC,,outpatient,,,308,277.2,,0.95,,292.6,Percent of total billed charges,,,0.98,,301.84,Percent of total billed charges,,,0.95,,292.6,Percent of total billed charges,,,0.95,,292.6,Percent of total billed charges,,,0.97,,298.76,Percent of total billed charges,,,0.96,,295.68,Percent of total billed charges,,,0.95,,292.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,292.6,Percent of total billed charges,,292.6,301.84,
HC PR 99395 Prev Visit Est Age 18-39,PX-96910170,CDM,99395,CPT,983,RC,,inpatient,,,317,285.3,,0.95,,301.15,Percent of total billed charges,,,0.98,,310.66,Percent of total billed charges,,,0.95,,301.15,Percent of total billed charges,,,0.97,,307.49,Percent of total billed charges,,,0.97,,307.49,Percent of total billed charges,,,0.96,,304.32,Percent of total billed charges,,,0.95,,301.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,301.15,Percent of total billed charges,,301.15,310.66,
HC PR 99395 Prev Visit Est Age 18-39,PX-96910170,CDM,99395,CPT,983,RC,,outpatient,,,317,285.3,,0.95,,301.15,Percent of total billed charges,,,0.98,,310.66,Percent of total billed charges,,,0.95,,301.15,Percent of total billed charges,,,0.95,,301.15,Percent of total billed charges,,,0.97,,307.49,Percent of total billed charges,,,0.96,,304.32,Percent of total billed charges,,,0.95,,301.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,301.15,Percent of total billed charges,,301.15,310.66,
HC PR 99396 Prev Visit Est Age 40-64,PX-96910172,CDM,99396,CPT,983,RC,,inpatient,,,338,304.2,,0.95,,321.1,Percent of total billed charges,,,0.98,,331.24,Percent of total billed charges,,,0.95,,321.1,Percent of total billed charges,,,0.97,,327.86,Percent of total billed charges,,,0.97,,327.86,Percent of total billed charges,,,0.96,,324.48,Percent of total billed charges,,,0.95,,321.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,321.1,Percent of total billed charges,,321.1,331.24,
HC PR 99396 Prev Visit Est Age 40-64,PX-96910172,CDM,99396,CPT,983,RC,,outpatient,,,338,304.2,,0.95,,321.1,Percent of total billed charges,,,0.98,,331.24,Percent of total billed charges,,,0.95,,321.1,Percent of total billed charges,,,0.95,,321.1,Percent of total billed charges,,,0.97,,327.86,Percent of total billed charges,,,0.96,,324.48,Percent of total billed charges,,,0.95,,321.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,321.1,Percent of total billed charges,,321.1,331.24,
HC PR 99397 per Pm Reeval Est Pat 65+ Yr,PX-96910174,CDM,99397,CPT,983,RC,,inpatient,,,363,326.7,,0.95,,344.85,Percent of total billed charges,,,0.98,,355.74,Percent of total billed charges,,,0.95,,344.85,Percent of total billed charges,,,0.97,,352.11,Percent of total billed charges,,,0.97,,352.11,Percent of total billed charges,,,0.96,,348.48,Percent of total billed charges,,,0.95,,344.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,344.85,Percent of total billed charges,,344.85,355.74,
HC PR 99397 per Pm Reeval Est Pat 65+ Yr,PX-96910174,CDM,99397,CPT,983,RC,,outpatient,,,363,326.7,,0.95,,344.85,Percent of total billed charges,,,0.98,,355.74,Percent of total billed charges,,,0.95,,344.85,Percent of total billed charges,,,0.95,,344.85,Percent of total billed charges,,,0.97,,352.11,Percent of total billed charges,,,0.96,,348.48,Percent of total billed charges,,,0.95,,344.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,344.85,Percent of total billed charges,,344.85,355.74,
HC PR 99401 Preventive Counseling Indiv 15 Min,PX-96910176,CDM,99401,CPT,983,RC,,inpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
HC PR 99401 Preventive Counseling Indiv 15 Min,PX-96910176,CDM,99401,CPT,983,RC,,outpatient,,,95,85.5,,0.95,,90.25,Percent of total billed charges,,,0.98,,93.1,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,0.97,,92.15,Percent of total billed charges,,,0.96,,91.2,Percent of total billed charges,,,0.95,,90.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,90.25,Percent of total billed charges,,90.25,93.1,
HC PR 99441 Phone E/M by Phys 5-10 Min,PX-96910185,CDM,99441,CPT,983,RC,,inpatient,,,139,125.1,,0.95,,132.05,Percent of total billed charges,,,0.98,,136.22,Percent of total billed charges,,,0.95,,132.05,Percent of total billed charges,,,0.97,,134.83,Percent of total billed charges,,,0.97,,134.83,Percent of total billed charges,,,0.96,,133.44,Percent of total billed charges,,,0.95,,132.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,132.05,Percent of total billed charges,,132.05,136.22,
HC PR 99441 Phone E/M by Phys 5-10 Min,PX-96910185,CDM,99441,CPT,983,RC,,outpatient,,,139,125.1,,0.95,,132.05,Percent of total billed charges,,,0.98,,136.22,Percent of total billed charges,,,0.95,,132.05,Percent of total billed charges,,,0.95,,132.05,Percent of total billed charges,,,0.97,,134.83,Percent of total billed charges,,,0.96,,133.44,Percent of total billed charges,,,0.95,,132.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,132.05,Percent of total billed charges,,132.05,136.22,
HC PR 99442 Phone E/M by Phys 11-20 Min,PX-96910188,CDM,99442,CPT,983,RC,,inpatient,,,223,200.7,,0.95,,211.85,Percent of total billed charges,,,0.98,,218.54,Percent of total billed charges,,,0.95,,211.85,Percent of total billed charges,,,0.97,,216.31,Percent of total billed charges,,,0.97,,216.31,Percent of total billed charges,,,0.96,,214.08,Percent of total billed charges,,,0.95,,211.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,211.85,Percent of total billed charges,,211.85,218.54,
HC PR 99442 Phone E/M by Phys 11-20 Min,PX-96910188,CDM,99442,CPT,983,RC,,outpatient,,,223,200.7,,0.95,,211.85,Percent of total billed charges,,,0.98,,218.54,Percent of total billed charges,,,0.95,,211.85,Percent of total billed charges,,,0.95,,211.85,Percent of total billed charges,,,0.97,,216.31,Percent of total billed charges,,,0.96,,214.08,Percent of total billed charges,,,0.95,,211.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,211.85,Percent of total billed charges,,211.85,218.54,
HC PR G0402 Initial Preventive Exam MC,PX-96910316,CDM,G0402,HCPCS,983,RC,,inpatient,,,220,198,,0.95,,209,Percent of total billed charges,,,0.98,,215.6,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,0.97,,213.4,Percent of total billed charges,,,0.97,,213.4,Percent of total billed charges,,,0.96,,211.2,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,209,Percent of total billed charges,,209,215.6,
HC PR G0402 Initial Preventive Exam MC,PX-96910316,CDM,G0402,HCPCS,983,RC,,outpatient,,,220,198,,0.95,,209,Percent of total billed charges,,,0.98,,215.6,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,0.97,,213.4,Percent of total billed charges,,,0.96,,211.2,Percent of total billed charges,,,0.95,,209,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,209,Percent of total billed charges,,209,215.6,
HC PR ED 99408 Alcohol/Drug Screen 15-30 Min Cdm,PX-98110003,CDM,99408,CPT,981,RC,,inpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
HC PR ED 99408 Alcohol/Drug Screen 15-30 Min Cdm,PX-98110003,CDM,99408,CPT,981,RC,,outpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
HC PR ED 99409 Alcohol/Drug Screen > 30 Min Cdm,PX-98110005,CDM,99409,CPT,981,RC,,inpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
HC PR ED 99409 Alcohol/Drug Screen > 30 Min Cdm,PX-98110005,CDM,99409,CPT,981,RC,,outpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
New Pt Visit - Level 2,PX-98310002,CDM,99202,CPT,983,RC,,inpatient,,,197,177.3,,0.95,,187.15,Percent of total billed charges,,,0.98,,193.06,Percent of total billed charges,,,0.95,,187.15,Percent of total billed charges,,,0.97,,191.09,Percent of total billed charges,,,0.97,,191.09,Percent of total billed charges,,,0.96,,189.12,Percent of total billed charges,,,0.95,,187.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,187.15,Percent of total billed charges,,187.15,193.06,
New Pt Visit - Level 2,PX-98310002,CDM,99202,CPT,983,RC,,outpatient,,,197,177.3,,0.95,,187.15,Percent of total billed charges,,,0.98,,193.06,Percent of total billed charges,,,0.95,,187.15,Percent of total billed charges,,,0.95,,187.15,Percent of total billed charges,,,0.97,,191.09,Percent of total billed charges,,,0.96,,189.12,Percent of total billed charges,,,0.95,,187.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,187.15,Percent of total billed charges,,187.15,193.06,
HC PR 99203 New Pt Visit - Level 3,PX-98310003,CDM,99203,CPT,983,RC,,inpatient,,,289,260.1,,0.95,,274.55,Percent of total billed charges,,,0.98,,283.22,Percent of total billed charges,,,0.95,,274.55,Percent of total billed charges,,,0.97,,280.33,Percent of total billed charges,,,0.97,,280.33,Percent of total billed charges,,,0.96,,277.44,Percent of total billed charges,,,0.95,,274.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,274.55,Percent of total billed charges,,274.55,283.22,
HC PR 99203 New Pt Visit - Level 3,PX-98310003,CDM,99203,CPT,983,RC,,outpatient,,,289,260.1,,0.95,,274.55,Percent of total billed charges,,,0.98,,283.22,Percent of total billed charges,,,0.95,,274.55,Percent of total billed charges,,,0.95,,274.55,Percent of total billed charges,,,0.97,,280.33,Percent of total billed charges,,,0.96,,277.44,Percent of total billed charges,,,0.95,,274.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,274.55,Percent of total billed charges,,274.55,283.22,
HC PR New Pt Visit /or Gen Emplymnt Phys - Level 4,PX-98310004,CDM,99204,CPT,983,RC,,inpatient,,,437,393.3,,0.95,,415.15,Percent of total billed charges,,,0.98,,428.26,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,0.97,,423.89,Percent of total billed charges,,,0.97,,423.89,Percent of total billed charges,,,0.96,,419.52,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,415.15,Percent of total billed charges,,415.15,428.26,
HC PR New Pt Visit /or Gen Emplymnt Phys - Level 4,PX-98310004,CDM,99204,CPT,983,RC,,outpatient,,,437,393.3,,0.95,,415.15,Percent of total billed charges,,,0.98,,428.26,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,0.97,,423.89,Percent of total billed charges,,,0.96,,419.52,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,415.15,Percent of total billed charges,,415.15,428.26,
New Pt Visit - Level 5,PX-98310005,CDM,99205,CPT,983,RC,,inpatient,,,549,494.1,,0.95,,521.55,Percent of total billed charges,,,0.98,,538.02,Percent of total billed charges,,,0.95,,521.55,Percent of total billed charges,,,0.97,,532.53,Percent of total billed charges,,,0.97,,532.53,Percent of total billed charges,,,0.96,,527.04,Percent of total billed charges,,,0.95,,521.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,521.55,Percent of total billed charges,,521.55,538.02,
New Pt Visit - Level 5,PX-98310005,CDM,99205,CPT,983,RC,,outpatient,,,549,494.1,,0.95,,521.55,Percent of total billed charges,,,0.98,,538.02,Percent of total billed charges,,,0.95,,521.55,Percent of total billed charges,,,0.95,,521.55,Percent of total billed charges,,,0.97,,532.53,Percent of total billed charges,,,0.96,,527.04,Percent of total billed charges,,,0.95,,521.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,521.55,Percent of total billed charges,,521.55,538.02,
Estab Pt Visit - Level 1,PX-98310006,CDM,99211,CPT,983,RC,,inpatient,,,58,52.2,,0.95,,55.1,Percent of total billed charges,,,0.98,,56.84,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,0.97,,56.26,Percent of total billed charges,,,0.97,,56.26,Percent of total billed charges,,,0.96,,55.68,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,55.1,Percent of total billed charges,,55.1,56.84,
Estab Pt Visit - Level 1,PX-98310006,CDM,99211,CPT,983,RC,,outpatient,,,58,52.2,,0.95,,55.1,Percent of total billed charges,,,0.98,,56.84,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,0.97,,56.26,Percent of total billed charges,,,0.96,,55.68,Percent of total billed charges,,,0.95,,55.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,55.1,Percent of total billed charges,,55.1,56.84,
Estab Pt Visit - Level 2,PX-98310007,CDM,99212,CPT,983,RC,,inpatient,,,117,105.3,,0.95,,111.15,Percent of total billed charges,,,0.98,,114.66,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.96,,112.32,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,111.15,Percent of total billed charges,,111.15,114.66,
Estab Pt Visit - Level 2,PX-98310007,CDM,99212,CPT,983,RC,,outpatient,,,117,105.3,,0.95,,111.15,Percent of total billed charges,,,0.98,,114.66,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,0.97,,113.49,Percent of total billed charges,,,0.96,,112.32,Percent of total billed charges,,,0.95,,111.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,111.15,Percent of total billed charges,,111.15,114.66,
Estab Pt Visit - Level 3,PX-98310008,CDM,99213,CPT,983,RC,,inpatient,,,193,173.7,,0.95,,183.35,Percent of total billed charges,,,0.98,,189.14,Percent of total billed charges,,,0.95,,183.35,Percent of total billed charges,,,0.97,,187.21,Percent of total billed charges,,,0.97,,187.21,Percent of total billed charges,,,0.96,,185.28,Percent of total billed charges,,,0.95,,183.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,183.35,Percent of total billed charges,,183.35,189.14,
Estab Pt Visit - Level 3,PX-98310008,CDM,99213,CPT,983,RC,,outpatient,,,193,173.7,,0.95,,183.35,Percent of total billed charges,,,0.98,,189.14,Percent of total billed charges,,,0.95,,183.35,Percent of total billed charges,,,0.95,,183.35,Percent of total billed charges,,,0.97,,187.21,Percent of total billed charges,,,0.96,,185.28,Percent of total billed charges,,,0.95,,183.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,183.35,Percent of total billed charges,,183.35,189.14,
HC PR 99214 Estab Pt Visit - Level 4,PX-98310009,CDM,99214,CPT,983,RC,,inpatient,,,286,257.4,,0.95,,271.7,Percent of total billed charges,,,0.98,,280.28,Percent of total billed charges,,,0.95,,271.7,Percent of total billed charges,,,0.97,,277.42,Percent of total billed charges,,,0.97,,277.42,Percent of total billed charges,,,0.96,,274.56,Percent of total billed charges,,,0.95,,271.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,271.7,Percent of total billed charges,,271.7,280.28,
HC PR 99214 Estab Pt Visit - Level 4,PX-98310009,CDM,99214,CPT,983,RC,,outpatient,,,286,257.4,,0.95,,271.7,Percent of total billed charges,,,0.98,,280.28,Percent of total billed charges,,,0.95,,271.7,Percent of total billed charges,,,0.95,,271.7,Percent of total billed charges,,,0.97,,277.42,Percent of total billed charges,,,0.96,,274.56,Percent of total billed charges,,,0.95,,271.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,271.7,Percent of total billed charges,,271.7,280.28,
Estab Pt Visit - Level 5,PX-98310010,CDM,99215,CPT,983,RC,,inpatient,,,386,347.4,,0.95,,366.7,Percent of total billed charges,,,0.98,,378.28,Percent of total billed charges,,,0.95,,366.7,Percent of total billed charges,,,0.97,,374.42,Percent of total billed charges,,,0.97,,374.42,Percent of total billed charges,,,0.96,,370.56,Percent of total billed charges,,,0.95,,366.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,366.7,Percent of total billed charges,,366.7,378.28,
Estab Pt Visit - Level 5,PX-98310010,CDM,99215,CPT,983,RC,,outpatient,,,386,347.4,,0.95,,366.7,Percent of total billed charges,,,0.98,,378.28,Percent of total billed charges,,,0.95,,366.7,Percent of total billed charges,,,0.95,,366.7,Percent of total billed charges,,,0.97,,374.42,Percent of total billed charges,,,0.96,,370.56,Percent of total billed charges,,,0.95,,366.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,366.7,Percent of total billed charges,,366.7,378.28,
"HC PR 99499 Exam, Dot Cntr",PX-98310017,CDM,99499,CPT,983,RC,,inpatient,,,157,141.3,,0.95,,149.15,Percent of total billed charges,,,0.98,,153.86,Percent of total billed charges,,,0.95,,149.15,Percent of total billed charges,,,0.97,,152.29,Percent of total billed charges,,,0.97,,152.29,Percent of total billed charges,,,0.96,,150.72,Percent of total billed charges,,,0.95,,149.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,149.15,Percent of total billed charges,,149.15,153.86,
"HC PR 99499 Exam, Dot Cntr",PX-98310017,CDM,99499,CPT,983,RC,,outpatient,,,157,141.3,,0.95,,149.15,Percent of total billed charges,,,0.98,,153.86,Percent of total billed charges,,,0.95,,149.15,Percent of total billed charges,,,0.95,,149.15,Percent of total billed charges,,,0.97,,152.29,Percent of total billed charges,,,0.96,,150.72,Percent of total billed charges,,,0.95,,149.15,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,149.15,Percent of total billed charges,,149.15,153.86,
"HC PR G0438 Ppps, Initial Visit",PX-98310030,CDM,G0438,HCPCS,983,RC,,inpatient,,,407,366.3,,0.95,,386.65,Percent of total billed charges,,,0.98,,398.86,Percent of total billed charges,,,0.95,,386.65,Percent of total billed charges,,,0.97,,394.79,Percent of total billed charges,,,0.97,,394.79,Percent of total billed charges,,,0.96,,390.72,Percent of total billed charges,,,0.95,,386.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,386.65,Percent of total billed charges,,386.65,398.86,
"HC PR G0438 Ppps, Initial Visit",PX-98310030,CDM,G0438,HCPCS,983,RC,,outpatient,,,407,366.3,,0.95,,386.65,Percent of total billed charges,,,0.98,,398.86,Percent of total billed charges,,,0.95,,386.65,Percent of total billed charges,,,0.95,,386.65,Percent of total billed charges,,,0.97,,394.79,Percent of total billed charges,,,0.96,,390.72,Percent of total billed charges,,,0.95,,386.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,386.65,Percent of total billed charges,,386.65,398.86,
"HC PR Ppps, Subseq Visit",PX-98310031,CDM,G0439,HCPCS,983,RC,,inpatient,,,346,311.4,,0.95,,328.7,Percent of total billed charges,,,0.98,,339.08,Percent of total billed charges,,,0.95,,328.7,Percent of total billed charges,,,0.97,,335.62,Percent of total billed charges,,,0.97,,335.62,Percent of total billed charges,,,0.96,,332.16,Percent of total billed charges,,,0.95,,328.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,328.7,Percent of total billed charges,,328.7,339.08,
"HC PR Ppps, Subseq Visit",PX-98310031,CDM,G0439,HCPCS,983,RC,,outpatient,,,346,311.4,,0.95,,328.7,Percent of total billed charges,,,0.98,,339.08,Percent of total billed charges,,,0.95,,328.7,Percent of total billed charges,,,0.95,,328.7,Percent of total billed charges,,,0.97,,335.62,Percent of total billed charges,,,0.96,,332.16,Percent of total billed charges,,,0.95,,328.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,328.7,Percent of total billed charges,,328.7,339.08,
HC PR 99221 1st Hospital IP/Obs Care Sf/Low Mdm 40 Minutes Cdm,PX-98710005,CDM,99221,CPT,987,RC,,inpatient,,,271,243.9,,0.95,,257.45,Percent of total billed charges,,,0.98,,265.58,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,0.97,,262.87,Percent of total billed charges,,,0.97,,262.87,Percent of total billed charges,,,0.96,,260.16,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,257.45,Percent of total billed charges,,257.45,265.58,
HC PR 99221 1st Hospital IP/Obs Care Sf/Low Mdm 40 Minutes Cdm,PX-98710005,CDM,99221,CPT,987,RC,,outpatient,,,271,243.9,,0.95,,257.45,Percent of total billed charges,,,0.98,,265.58,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,0.97,,262.87,Percent of total billed charges,,,0.96,,260.16,Percent of total billed charges,,,0.95,,257.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,257.45,Percent of total billed charges,,257.45,265.58,
HC PR 99222 1st Hospital IP/Obs Care Moderate Mdm 55 Minutes Cdm,PX-98710006,CDM,99222,CPT,987,RC,,inpatient,,,366,329.4,,0.95,,347.7,Percent of total billed charges,,,0.98,,358.68,Percent of total billed charges,,,0.95,,347.7,Percent of total billed charges,,,0.97,,355.02,Percent of total billed charges,,,0.97,,355.02,Percent of total billed charges,,,0.96,,351.36,Percent of total billed charges,,,0.95,,347.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,347.7,Percent of total billed charges,,347.7,358.68,
HC PR 99222 1st Hospital IP/Obs Care Moderate Mdm 55 Minutes Cdm,PX-98710006,CDM,99222,CPT,987,RC,,outpatient,,,366,329.4,,0.95,,347.7,Percent of total billed charges,,,0.98,,358.68,Percent of total billed charges,,,0.95,,347.7,Percent of total billed charges,,,0.95,,347.7,Percent of total billed charges,,,0.97,,355.02,Percent of total billed charges,,,0.96,,351.36,Percent of total billed charges,,,0.95,,347.7,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,347.7,Percent of total billed charges,,347.7,358.68,
HC PR 99223 1st Hospital IP/Obs Care High Mdm 75 Minutes Cdm,PX-98710007,CDM,99223,CPT,987,RC,,inpatient,,,540,486,,0.95,,513,Percent of total billed charges,,,0.98,,529.2,Percent of total billed charges,,,0.95,,513,Percent of total billed charges,,,0.97,,523.8,Percent of total billed charges,,,0.97,,523.8,Percent of total billed charges,,,0.96,,518.4,Percent of total billed charges,,,0.95,,513,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,513,Percent of total billed charges,,513,529.2,
HC PR 99223 1st Hospital IP/Obs Care High Mdm 75 Minutes Cdm,PX-98710007,CDM,99223,CPT,987,RC,,outpatient,,,540,486,,0.95,,513,Percent of total billed charges,,,0.98,,529.2,Percent of total billed charges,,,0.95,,513,Percent of total billed charges,,,0.95,,513,Percent of total billed charges,,,0.97,,523.8,Percent of total billed charges,,,0.96,,518.4,Percent of total billed charges,,,0.95,,513,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,513,Percent of total billed charges,,513,529.2,
HC PR 99231 Sbsq Hospital IP/Obs Care Sf/Low Mdm 25 Minutes Cdm,PX-98710011,CDM,99231,CPT,987,RC,,inpatient,,,121,108.9,,0.95,,114.95,Percent of total billed charges,,,0.98,,118.58,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.96,,116.16,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114.95,Percent of total billed charges,,114.95,118.58,
HC PR 99231 Sbsq Hospital IP/Obs Care Sf/Low Mdm 25 Minutes Cdm,PX-98710011,CDM,99231,CPT,987,RC,,outpatient,,,121,108.9,,0.95,,114.95,Percent of total billed charges,,,0.98,,118.58,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,0.97,,117.37,Percent of total billed charges,,,0.96,,116.16,Percent of total billed charges,,,0.95,,114.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114.95,Percent of total billed charges,,114.95,118.58,
HC PR 99232 Sbsq Hospital IP/Obs Care Mod Mdm 35 Minutes Cdm,PX-98710012,CDM,99232,CPT,987,RC,,inpatient,,,193,173.7,,0.95,,183.35,Percent of total billed charges,,,0.98,,189.14,Percent of total billed charges,,,0.95,,183.35,Percent of total billed charges,,,0.97,,187.21,Percent of total billed charges,,,0.97,,187.21,Percent of total billed charges,,,0.96,,185.28,Percent of total billed charges,,,0.95,,183.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,183.35,Percent of total billed charges,,183.35,189.14,
HC PR 99232 Sbsq Hospital IP/Obs Care Mod Mdm 35 Minutes Cdm,PX-98710012,CDM,99232,CPT,987,RC,,outpatient,,,193,173.7,,0.95,,183.35,Percent of total billed charges,,,0.98,,189.14,Percent of total billed charges,,,0.95,,183.35,Percent of total billed charges,,,0.95,,183.35,Percent of total billed charges,,,0.97,,187.21,Percent of total billed charges,,,0.96,,185.28,Percent of total billed charges,,,0.95,,183.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,183.35,Percent of total billed charges,,183.35,189.14,
HC PR 99233 Sbsq Hospital IP/Obs Care High Mdm 50 Minutes Cdm,PX-98710013,CDM,99233,CPT,987,RC,,inpatient,,,289,260.1,,0.95,,274.55,Percent of total billed charges,,,0.98,,283.22,Percent of total billed charges,,,0.95,,274.55,Percent of total billed charges,,,0.97,,280.33,Percent of total billed charges,,,0.97,,280.33,Percent of total billed charges,,,0.96,,277.44,Percent of total billed charges,,,0.95,,274.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,274.55,Percent of total billed charges,,274.55,283.22,
HC PR 99233 Sbsq Hospital IP/Obs Care High Mdm 50 Minutes Cdm,PX-98710013,CDM,99233,CPT,987,RC,,outpatient,,,289,260.1,,0.95,,274.55,Percent of total billed charges,,,0.98,,283.22,Percent of total billed charges,,,0.95,,274.55,Percent of total billed charges,,,0.95,,274.55,Percent of total billed charges,,,0.97,,280.33,Percent of total billed charges,,,0.96,,277.44,Percent of total billed charges,,,0.95,,274.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,274.55,Percent of total billed charges,,274.55,283.22,
HC PR 99238 Hospital IP/Obs Discharge Day Mgmt 30 Min/< Cdm,PX-98710017,CDM,99238,CPT,987,RC,,inpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
HC PR 99238 Hospital IP/Obs Discharge Day Mgmt 30 Min/< Cdm,PX-98710017,CDM,99238,CPT,987,RC,,outpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
HC PR 99239 Hospital IP/Obs Discharge Day Mgmt > 30 Min Cdm,PX-98710018,CDM,99239,CPT,987,RC,,inpatient,,,372,334.8,,0.95,,353.4,Percent of total billed charges,,,0.98,,364.56,Percent of total billed charges,,,0.95,,353.4,Percent of total billed charges,,,0.97,,360.84,Percent of total billed charges,,,0.97,,360.84,Percent of total billed charges,,,0.96,,357.12,Percent of total billed charges,,,0.95,,353.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,353.4,Percent of total billed charges,,353.4,364.56,
HC PR 99239 Hospital IP/Obs Discharge Day Mgmt > 30 Min Cdm,PX-98710018,CDM,99239,CPT,987,RC,,outpatient,,,372,334.8,,0.95,,353.4,Percent of total billed charges,,,0.98,,364.56,Percent of total billed charges,,,0.95,,353.4,Percent of total billed charges,,,0.95,,353.4,Percent of total billed charges,,,0.97,,360.84,Percent of total billed charges,,,0.96,,357.12,Percent of total billed charges,,,0.95,,353.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,353.4,Percent of total billed charges,,353.4,364.56,
HC PR 99243 Office/OP Consltj New/Est Pt Low Mdm 30 Minutes Cdm,PX-98810003,CDM,99243,CPT,988,RC,,inpatient,,,281,252.9,,0.95,,266.95,Percent of total billed charges,,,0.98,,275.38,Percent of total billed charges,,,0.95,,266.95,Percent of total billed charges,,,0.97,,272.57,Percent of total billed charges,,,0.97,,272.57,Percent of total billed charges,,,0.96,,269.76,Percent of total billed charges,,,0.95,,266.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,266.95,Percent of total billed charges,,266.95,275.38,
HC PR 99243 Office/OP Consltj New/Est Pt Low Mdm 30 Minutes Cdm,PX-98810003,CDM,99243,CPT,988,RC,,outpatient,,,281,252.9,,0.95,,266.95,Percent of total billed charges,,,0.98,,275.38,Percent of total billed charges,,,0.95,,266.95,Percent of total billed charges,,,0.95,,266.95,Percent of total billed charges,,,0.97,,272.57,Percent of total billed charges,,,0.96,,269.76,Percent of total billed charges,,,0.95,,266.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,266.95,Percent of total billed charges,,266.95,275.38,
HC PR 99252 IP/Obs Consltj New/Est Pt Sf Mdm 35 Minutes Cdm,PX-98810007,CDM,99252,CPT,988,RC,,inpatient,,,174,156.6,,0.95,,165.3,Percent of total billed charges,,,0.98,,170.52,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,0.97,,168.78,Percent of total billed charges,,,0.97,,168.78,Percent of total billed charges,,,0.96,,167.04,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,165.3,Percent of total billed charges,,165.3,170.52,
HC PR 99252 IP/Obs Consltj New/Est Pt Sf Mdm 35 Minutes Cdm,PX-98810007,CDM,99252,CPT,988,RC,,outpatient,,,174,156.6,,0.95,,165.3,Percent of total billed charges,,,0.98,,170.52,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,0.97,,168.78,Percent of total billed charges,,,0.96,,167.04,Percent of total billed charges,,,0.95,,165.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,165.3,Percent of total billed charges,,165.3,170.52,
HC PR 99253 IP/Obs Consltj New/Est Pt Low Mdm 45 Minutes Cdm,PX-98810008,CDM,99253,CPT,988,RC,,inpatient,,,293,263.7,,0.95,,278.35,Percent of total billed charges,,,0.98,,287.14,Percent of total billed charges,,,0.95,,278.35,Percent of total billed charges,,,0.97,,284.21,Percent of total billed charges,,,0.97,,284.21,Percent of total billed charges,,,0.96,,281.28,Percent of total billed charges,,,0.95,,278.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,278.35,Percent of total billed charges,,278.35,287.14,
HC PR 99253 IP/Obs Consltj New/Est Pt Low Mdm 45 Minutes Cdm,PX-98810008,CDM,99253,CPT,988,RC,,outpatient,,,293,263.7,,0.95,,278.35,Percent of total billed charges,,,0.98,,287.14,Percent of total billed charges,,,0.95,,278.35,Percent of total billed charges,,,0.95,,278.35,Percent of total billed charges,,,0.97,,284.21,Percent of total billed charges,,,0.96,,281.28,Percent of total billed charges,,,0.95,,278.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,278.35,Percent of total billed charges,,278.35,287.14,
"Application/modality to 1 or more areas; traction, mechanical",PX-42010110,CDM,97012,CPT,420,RC,,inpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
"Application/modality to 1 or more areas; traction, mechanical",PX-42010110,CDM,97012,CPT,420,RC,,outpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
Electric Stimulation Therapy,PX-42010113,CDM,97014,CPT,420,RC,,inpatient,,,133,119.7,,0.95,,126.35,Percent of total billed charges,,,0.98,,130.34,Percent of total billed charges,,,0.95,,126.35,Percent of total billed charges,,,0.97,,129.01,Percent of total billed charges,,,0.97,,129.01,Percent of total billed charges,,,0.96,,127.68,Percent of total billed charges,,,0.95,,126.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,126.35,Percent of total billed charges,,126.35,130.34,
Electric Stimulation Therapy,PX-42010113,CDM,97014,CPT,420,RC,,outpatient,,,133,119.7,,0.95,,126.35,Percent of total billed charges,,,0.98,,130.34,Percent of total billed charges,,,0.95,,126.35,Percent of total billed charges,,,0.95,,126.35,Percent of total billed charges,,,0.97,,129.01,Percent of total billed charges,,,0.96,,127.68,Percent of total billed charges,,,0.95,,126.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,126.35,Percent of total billed charges,,126.35,130.34,
Application of a modality to 1 or more areas; whirlpool,PX-42010117,CDM,97022,CPT,420,RC,,inpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
Application of a modality to 1 or more areas; whirlpool,PX-42010117,CDM,97022,CPT,420,RC,,outpatient,,,80,72,,0.95,,76,Percent of total billed charges,,,0.98,,78.4,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,0.97,,77.6,Percent of total billed charges,,,0.96,,76.8,Percent of total billed charges,,,0.95,,76,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76,Percent of total billed charges,,76,78.4,
Electrical stimulation therapy (manual),PX-42010124,CDM,97032,CPT,420,RC,,inpatient,,,127,114.3,,0.95,,120.65,Percent of total billed charges,,,0.98,,124.46,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,0.97,,123.19,Percent of total billed charges,,,0.97,,123.19,Percent of total billed charges,,,0.96,,121.92,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,120.65,Percent of total billed charges,,120.65,124.46,
Electrical stimulation therapy (manual),PX-42010124,CDM,97032,CPT,420,RC,,outpatient,,,127,114.3,,0.95,,120.65,Percent of total billed charges,,,0.98,,124.46,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,0.97,,123.19,Percent of total billed charges,,,0.96,,121.92,Percent of total billed charges,,,0.95,,120.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,120.65,Percent of total billed charges,,120.65,124.46,
"Iontophoresis, each 15 minutes",PX-42010125,CDM,97033,CPT,420,RC,,inpatient,,,107,96.3,,0.95,,101.65,Percent of total billed charges,,,0.98,,104.86,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.96,,102.72,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,101.65,Percent of total billed charges,,101.65,104.86,
"Iontophoresis, each 15 minutes",PX-42010125,CDM,97033,CPT,420,RC,,outpatient,,,107,96.3,,0.95,,101.65,Percent of total billed charges,,,0.98,,104.86,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,0.97,,103.79,Percent of total billed charges,,,0.96,,102.72,Percent of total billed charges,,,0.95,,101.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,101.65,Percent of total billed charges,,101.65,104.86,
Ultrasound Therapy,PX-42010127,CDM,97035,CPT,420,RC,,inpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Ultrasound Therapy,PX-42010127,CDM,97035,CPT,420,RC,,outpatient,,,83,74.7,,0.95,,78.85,Percent of total billed charges,,,0.98,,81.34,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,0.97,,80.51,Percent of total billed charges,,,0.96,,79.68,Percent of total billed charges,,,0.95,,78.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,78.85,Percent of total billed charges,,78.85,81.34,
Therapeutic exercises,PX-42010131,CDM,97110,CPT,420,RC,,inpatient,,,132,118.8,,0.95,,125.4,Percent of total billed charges,,,0.98,,129.36,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.96,,126.72,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,125.4,Percent of total billed charges,,125.4,129.36,
Therapeutic exercises,PX-42010131,CDM,97110,CPT,420,RC,,outpatient,,,132,118.8,,0.95,,125.4,Percent of total billed charges,,,0.98,,129.36,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,0.97,,128.04,Percent of total billed charges,,,0.96,,126.72,Percent of total billed charges,,,0.95,,125.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,125.4,Percent of total billed charges,,125.4,129.36,
Neuromuscular reeducation of movement,PX-42010139,CDM,97112,CPT,420,RC,,inpatient,,,136,122.4,,0.95,,129.2,Percent of total billed charges,,,0.98,,133.28,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,0.97,,131.92,Percent of total billed charges,,,0.97,,131.92,Percent of total billed charges,,,0.96,,130.56,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,129.2,Percent of total billed charges,,129.2,133.28,
Neuromuscular reeducation of movement,PX-42010139,CDM,97112,CPT,420,RC,,outpatient,,,136,122.4,,0.95,,129.2,Percent of total billed charges,,,0.98,,133.28,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,0.97,,131.92,Percent of total billed charges,,,0.96,,130.56,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,129.2,Percent of total billed charges,,129.2,133.28,
"Therapy using water pool to exercises, each 15 m",PX-42010141,CDM,97113,CPT,420,RC,,inpatient,,,147,132.3,,0.95,,139.65,Percent of total billed charges,,,0.98,,144.06,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,0.97,,142.59,Percent of total billed charges,,,0.97,,142.59,Percent of total billed charges,,,0.96,,141.12,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,139.65,Percent of total billed charges,,139.65,144.06,
"Therapy using water pool to exercises, each 15 m",PX-42010141,CDM,97113,CPT,420,RC,,outpatient,,,147,132.3,,0.95,,139.65,Percent of total billed charges,,,0.98,,144.06,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,0.97,,142.59,Percent of total billed charges,,,0.96,,141.12,Percent of total billed charges,,,0.95,,139.65,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,139.65,Percent of total billed charges,,139.65,144.06,
Therapeutic procedure; gait training,PX-42010142,CDM,97116,CPT,420,RC,,inpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
Therapeutic procedure; gait training,PX-42010142,CDM,97116,CPT,420,RC,,outpatient,,,129,116.1,,0.95,,122.55,Percent of total billed charges,,,0.98,,126.42,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,0.97,,125.13,Percent of total billed charges,,,0.96,,123.84,Percent of total billed charges,,,0.95,,122.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,122.55,Percent of total billed charges,,122.55,126.42,
Manual therapy techniques,PX-42010150,CDM,97140,CPT,420,RC,,inpatient,,,131,117.9,,0.95,,124.45,Percent of total billed charges,,,0.98,,128.38,Percent of total billed charges,,,0.95,,124.45,Percent of total billed charges,,,0.97,,127.07,Percent of total billed charges,,,0.97,,127.07,Percent of total billed charges,,,0.96,,125.76,Percent of total billed charges,,,0.95,,124.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,124.45,Percent of total billed charges,,124.45,128.38,
Manual therapy techniques,PX-42010150,CDM,97140,CPT,420,RC,,outpatient,,,131,117.9,,0.95,,124.45,Percent of total billed charges,,,0.98,,128.38,Percent of total billed charges,,,0.95,,124.45,Percent of total billed charges,,,0.95,,124.45,Percent of total billed charges,,,0.97,,127.07,Percent of total billed charges,,,0.96,,125.76,Percent of total billed charges,,,0.95,,124.45,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,124.45,Percent of total billed charges,,124.45,128.38,
Therapy procedure in a group setting,PX-42010153,CDM,97150,CPT,420,RC,,inpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
Therapy procedure in a group setting,PX-42010153,CDM,97150,CPT,420,RC,,outpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
"Therapeutic activities, ea 15 mins",PX-42010160,CDM,97530,CPT,420,RC,,inpatient,,,123,110.7,,0.95,,116.85,Percent of total billed charges,,,0.98,,120.54,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.96,,118.08,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,116.85,Percent of total billed charges,,116.85,120.54,
"Therapeutic activities, ea 15 mins",PX-42010160,CDM,97530,CPT,420,RC,,outpatient,,,123,110.7,,0.95,,116.85,Percent of total billed charges,,,0.98,,120.54,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,0.97,,119.31,Percent of total billed charges,,,0.96,,118.08,Percent of total billed charges,,,0.95,,116.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,116.85,Percent of total billed charges,,116.85,120.54,
"Evaluation for wheelchair, each 15 minutes",PX-42010165,CDM,97542,CPT,420,RC,,inpatient,,,165,148.5,,0.95,,156.75,Percent of total billed charges,,,0.98,,161.7,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.96,,158.4,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,156.75,Percent of total billed charges,,156.75,161.7,
"Evaluation for wheelchair, each 15 minutes",PX-42010165,CDM,97542,CPT,420,RC,,outpatient,,,165,148.5,,0.95,,156.75,Percent of total billed charges,,,0.98,,161.7,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,0.97,,160.05,Percent of total billed charges,,,0.96,,158.4,Percent of total billed charges,,,0.95,,156.75,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,156.75,Percent of total billed charges,,156.75,161.7,
HC Debridement Open Wound 20 Sq Cm/<,PX-42010166,CDM,97597,CPT,420,RC,,inpatient,,,176,158.4,,0.95,,167.2,Percent of total billed charges,,,0.98,,172.48,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,0.97,,170.72,Percent of total billed charges,,,0.97,,170.72,Percent of total billed charges,,,0.96,,168.96,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,167.2,Percent of total billed charges,,167.2,172.48,
HC Debridement Open Wound 20 Sq Cm/<,PX-42010166,CDM,97597,CPT,420,RC,,outpatient,,,176,158.4,,0.95,,167.2,Percent of total billed charges,,,0.98,,172.48,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,0.97,,170.72,Percent of total billed charges,,,0.96,,168.96,Percent of total billed charges,,,0.95,,167.2,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,167.2,Percent of total billed charges,,167.2,172.48,
"Measure functional capacity, each 15m",PX-42010248,CDM,97750,CPT,420,RC,,inpatient,,,108,97.2,,0.95,,102.6,Percent of total billed charges,,,0.98,,105.84,Percent of total billed charges,,,0.95,,102.6,Percent of total billed charges,,,0.97,,104.76,Percent of total billed charges,,,0.97,,104.76,Percent of total billed charges,,,0.96,,103.68,Percent of total billed charges,,,0.95,,102.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,102.6,Percent of total billed charges,,102.6,105.84,
"Measure functional capacity, each 15m",PX-42010248,CDM,97750,CPT,420,RC,,outpatient,,,108,97.2,,0.95,,102.6,Percent of total billed charges,,,0.98,,105.84,Percent of total billed charges,,,0.95,,102.6,Percent of total billed charges,,,0.95,,102.6,Percent of total billed charges,,,0.97,,104.76,Percent of total billed charges,,,0.96,,103.68,Percent of total billed charges,,,0.95,,102.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,102.6,Percent of total billed charges,,102.6,105.84,
Orthotic(s) management and training,PX-42010264,CDM,97760,CPT,420,RC,,inpatient,,,120,108,,0.95,,114,Percent of total billed charges,,,0.98,,117.6,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.96,,115.2,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114,Percent of total billed charges,,114,117.6,
Orthotic(s) management and training,PX-42010264,CDM,97760,CPT,420,RC,,outpatient,,,120,108,,0.95,,114,Percent of total billed charges,,,0.98,,117.6,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.96,,115.2,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,114,Percent of total billed charges,,114,117.6,
Prosthetic(s) training,PX-42010265,CDM,97761,CPT,420,RC,,inpatient,,,112,100.8,,0.95,,106.4,Percent of total billed charges,,,0.98,,109.76,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.96,,107.52,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,106.4,Percent of total billed charges,,106.4,109.76,
Prosthetic(s) training,PX-42010265,CDM,97761,CPT,420,RC,,outpatient,,,112,100.8,,0.95,,106.4,Percent of total billed charges,,,0.98,,109.76,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.96,,107.52,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,106.4,Percent of total billed charges,,106.4,109.76,
HC Elec Stim Unattended to 1 or More Areas Other Than Wound Care,PX-42010270,CDM,G0283,HCPCS,420,RC,,inpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
HC Elec Stim Unattended to 1 or More Areas Other Than Wound Care,PX-42010270,CDM,G0283,HCPCS,420,RC,,outpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,133,Percent of total billed charges,,133,137.2,
Psychiatric diagnostic evaluation,PX-91410110,CDM,90791,CPT,914,RC,,inpatient,,,363,326.7,,0.95,,344.85,Percent of total billed charges,,,0.98,,355.74,Percent of total billed charges,,,0.95,,344.85,Percent of total billed charges,,,0.97,,352.11,Percent of total billed charges,,,0.97,,352.11,Percent of total billed charges,,,0.96,,348.48,Percent of total billed charges,,,0.95,,344.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,344.85,Percent of total billed charges,,344.85,355.74,
Psychiatric diagnostic evaluation,PX-91410110,CDM,90791,CPT,914,RC,,outpatient,,,363,326.7,,0.95,,344.85,Percent of total billed charges,,,0.98,,355.74,Percent of total billed charges,,,0.95,,344.85,Percent of total billed charges,,,0.95,,344.85,Percent of total billed charges,,,0.97,,352.11,Percent of total billed charges,,,0.96,,348.48,Percent of total billed charges,,,0.95,,344.85,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,344.85,Percent of total billed charges,,344.85,355.74,
"Psychotherapy, 1 hour",PX-91410111,CDM,90837,CPT,914,RC,,inpatient,,,328,295.2,,0.95,,311.6,Percent of total billed charges,,,0.98,,321.44,Percent of total billed charges,,,0.95,,311.6,Percent of total billed charges,,,0.97,,318.16,Percent of total billed charges,,,0.97,,318.16,Percent of total billed charges,,,0.96,,314.88,Percent of total billed charges,,,0.95,,311.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,311.6,Percent of total billed charges,,311.6,321.44,
"Psychotherapy, 1 hour",PX-91410111,CDM,90837,CPT,914,RC,,outpatient,,,328,295.2,,0.95,,311.6,Percent of total billed charges,,,0.98,,321.44,Percent of total billed charges,,,0.95,,311.6,Percent of total billed charges,,,0.95,,311.6,Percent of total billed charges,,,0.97,,318.16,Percent of total billed charges,,,0.96,,314.88,Percent of total billed charges,,,0.95,,311.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,311.6,Percent of total billed charges,,311.6,321.44,
"Psychotherapy, 30 minutes",PX-91410113,CDM,90832,CPT,914,RC,,inpatient,,,168,151.2,,0.95,,159.6,Percent of total billed charges,,,0.98,,164.64,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,0.97,,162.96,Percent of total billed charges,,,0.97,,162.96,Percent of total billed charges,,,0.96,,161.28,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,159.6,Percent of total billed charges,,159.6,164.64,
"Psychotherapy, 30 minutes",PX-91410113,CDM,90832,CPT,914,RC,,outpatient,,,168,151.2,,0.95,,159.6,Percent of total billed charges,,,0.98,,164.64,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,0.97,,162.96,Percent of total billed charges,,,0.96,,161.28,Percent of total billed charges,,,0.95,,159.6,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,159.6,Percent of total billed charges,,159.6,164.64,
Application of hot wax bath,PX-43010004,CDM,97018,CPT,430,RC,,inpatient,,,70,63,,0.95,,66.5,Percent of total billed charges,,,0.98,,68.6,Percent of total billed charges,,,0.95,,66.5,Percent of total billed charges,,,0.97,,67.9,Percent of total billed charges,,,0.97,,67.9,Percent of total billed charges,,,0.96,,67.2,Percent of total billed charges,,,0.95,,66.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,66.5,Percent of total billed charges,,66.5,68.6,
Application of hot wax bath,PX-43010004,CDM,97018,CPT,430,RC,,outpatient,,,70,63,,0.95,,66.5,Percent of total billed charges,,,0.98,,68.6,Percent of total billed charges,,,0.95,,66.5,Percent of total billed charges,,,0.95,,66.5,Percent of total billed charges,,,0.97,,67.9,Percent of total billed charges,,,0.96,,67.2,Percent of total billed charges,,,0.95,,66.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,66.5,Percent of total billed charges,,66.5,68.6,
HC Speedgraft / Allograft,PX-3254092WWM,CDM,C1713,HCPCS,278,RC,,inpatient,,,4810,4329,,0.95,,4569.5,Percent of total billed charges,,,0.98,,4713.8,Percent of total billed charges,,,0.95,,4569.5,Percent of total billed charges,,,0.97,,4665.7,Percent of total billed charges,,,0.97,,4665.7,Percent of total billed charges,,,0.96,,4617.6,Percent of total billed charges,,,0.95,,4569.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4569.5,Percent of total billed charges,,4569.5,4713.8,
HC Speedgraft / Allograft,PX-3254092WWM,CDM,C1713,HCPCS,278,RC,,outpatient,,,4810,4329,,0.95,,4569.5,Percent of total billed charges,,,0.98,,4713.8,Percent of total billed charges,,,0.95,,4569.5,Percent of total billed charges,,,0.95,,4569.5,Percent of total billed charges,,,0.97,,4665.7,Percent of total billed charges,,,0.96,,4617.6,Percent of total billed charges,,,0.95,,4569.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,4569.5,Percent of total billed charges,,4569.5,4713.8,
Sensory integrative techniques,PX-43010007,CDM,97533,CPT,430,RC,,inpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
Sensory integrative techniques,PX-43010007,CDM,97533,CPT,430,RC,,outpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
Self-care/home management training,PX-43010008,CDM,97535,CPT,430,RC,,inpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
Self-care/home management training,PX-43010008,CDM,97535,CPT,430,RC,,outpatient,,,118,106.2,,0.95,,112.1,Percent of total billed charges,,,0.98,,115.64,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,0.97,,114.46,Percent of total billed charges,,,0.96,,113.28,Percent of total billed charges,,,0.95,,112.1,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,112.1,Percent of total billed charges,,112.1,115.64,
HC Drill Cannulated 10.5,PX-3254094WWM,CDM,3254094WWM,LOCAL,272,RC,,inpatient,,,514,462.6,,0.95,,488.3,Percent of total billed charges,,,0.98,,503.72,Percent of total billed charges,,,0.95,,488.3,Percent of total billed charges,,,0.97,,498.58,Percent of total billed charges,,,0.97,,498.58,Percent of total billed charges,,,0.96,,493.44,Percent of total billed charges,,,0.95,,488.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,488.3,Percent of total billed charges,,488.3,503.72,
HC Drill Cannulated 10.5,PX-3254094WWM,CDM,3254094WWM,LOCAL,272,RC,,outpatient,,,514,462.6,,0.95,,488.3,Percent of total billed charges,,,0.98,,503.72,Percent of total billed charges,,,0.95,,488.3,Percent of total billed charges,,,0.95,,488.3,Percent of total billed charges,,,0.97,,498.58,Percent of total billed charges,,,0.96,,493.44,Percent of total billed charges,,,0.95,,488.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,488.3,Percent of total billed charges,,488.3,503.72,
HC Drill Cannulated 10,PX-3254093WWM,CDM,3254093WWM,LOCAL,272,RC,,inpatient,,,514,462.6,,0.95,,488.3,Percent of total billed charges,,,0.98,,503.72,Percent of total billed charges,,,0.95,,488.3,Percent of total billed charges,,,0.97,,498.58,Percent of total billed charges,,,0.97,,498.58,Percent of total billed charges,,,0.96,,493.44,Percent of total billed charges,,,0.95,,488.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,488.3,Percent of total billed charges,,488.3,503.72,
HC Drill Cannulated 10,PX-3254093WWM,CDM,3254093WWM,LOCAL,272,RC,,outpatient,,,514,462.6,,0.95,,488.3,Percent of total billed charges,,,0.98,,503.72,Percent of total billed charges,,,0.95,,488.3,Percent of total billed charges,,,0.95,,488.3,Percent of total billed charges,,,0.97,,498.58,Percent of total billed charges,,,0.96,,493.44,Percent of total billed charges,,,0.95,,488.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,488.3,Percent of total billed charges,,488.3,503.72,
"Treat speech, language, voice, communication, hearing",PX-44010016,CDM,92507,CPT,440,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"Treat speech, language, voice, communication, hearing",PX-44010016,CDM,92507,CPT,440,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"Treat speech, language, voice, communication, hearing",PX-44010024,CDM,92508,CPT,440,RC,,inpatient,,,81,72.9,,0.95,,76.95,Percent of total billed charges,,,0.98,,79.38,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.96,,77.76,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76.95,Percent of total billed charges,,76.95,79.38,
"Treat speech, language, voice, communication, hearing",PX-44010024,CDM,92508,CPT,440,RC,,outpatient,,,81,72.9,,0.95,,76.95,Percent of total billed charges,,,0.98,,79.38,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.96,,77.76,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,76.95,Percent of total billed charges,,76.95,79.38,
Treatment of swallowing and feeding disorder,PX-44010042,CDM,92526,CPT,440,RC,,inpatient,,,349,314.1,,0.95,,331.55,Percent of total billed charges,,,0.98,,342.02,Percent of total billed charges,,,0.95,,331.55,Percent of total billed charges,,,0.97,,338.53,Percent of total billed charges,,,0.97,,338.53,Percent of total billed charges,,,0.96,,335.04,Percent of total billed charges,,,0.95,,331.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,331.55,Percent of total billed charges,,331.55,342.02,
Treatment of swallowing and feeding disorder,PX-44010042,CDM,92526,CPT,440,RC,,outpatient,,,349,314.1,,0.95,,331.55,Percent of total billed charges,,,0.98,,342.02,Percent of total billed charges,,,0.95,,331.55,Percent of total billed charges,,,0.95,,331.55,Percent of total billed charges,,,0.97,,338.53,Percent of total billed charges,,,0.96,,335.04,Percent of total billed charges,,,0.95,,331.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,331.55,Percent of total billed charges,,331.55,342.02,
Therapy service for speech-generating device w/ programming,PX-44010062,CDM,92609,CPT,440,RC,,inpatient,,,414,372.6,,0.95,,393.3,Percent of total billed charges,,,0.98,,405.72,Percent of total billed charges,,,0.95,,393.3,Percent of total billed charges,,,0.97,,401.58,Percent of total billed charges,,,0.97,,401.58,Percent of total billed charges,,,0.96,,397.44,Percent of total billed charges,,,0.95,,393.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,393.3,Percent of total billed charges,,393.3,405.72,
Therapy service for speech-generating device w/ programming,PX-44010062,CDM,92609,CPT,440,RC,,outpatient,,,414,372.6,,0.95,,393.3,Percent of total billed charges,,,0.98,,405.72,Percent of total billed charges,,,0.95,,393.3,Percent of total billed charges,,,0.95,,393.3,Percent of total billed charges,,,0.97,,401.58,Percent of total billed charges,,,0.96,,397.44,Percent of total billed charges,,,0.95,,393.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,393.3,Percent of total billed charges,,393.3,405.72,
"Assess loss of ability to speak, write, understand language",PX-44010074,CDM,96105,CPT,444,RC,,inpatient,,,334,300.6,,0.95,,317.3,Percent of total billed charges,,,0.98,,327.32,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,0.97,,323.98,Percent of total billed charges,,,0.97,,323.98,Percent of total billed charges,,,0.96,,320.64,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,317.3,Percent of total billed charges,,317.3,327.32,
"Assess loss of ability to speak, write, understand language",PX-44010074,CDM,96105,CPT,444,RC,,outpatient,,,334,300.6,,0.95,,317.3,Percent of total billed charges,,,0.98,,327.32,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,0.97,,323.98,Percent of total billed charges,,,0.96,,320.64,Percent of total billed charges,,,0.95,,317.3,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,317.3,Percent of total billed charges,,317.3,327.32,
Assess the ability to complete specific functional tasks,PX-44010083,CDM,96125,CPT,444,RC,,inpatient,,,401,360.9,,0.95,,380.95,Percent of total billed charges,,,0.98,,392.98,Percent of total billed charges,,,0.95,,380.95,Percent of total billed charges,,,0.97,,388.97,Percent of total billed charges,,,0.97,,388.97,Percent of total billed charges,,,0.96,,384.96,Percent of total billed charges,,,0.95,,380.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,380.95,Percent of total billed charges,,380.95,392.98,
Assess the ability to complete specific functional tasks,PX-44010083,CDM,96125,CPT,444,RC,,outpatient,,,401,360.9,,0.95,,380.95,Percent of total billed charges,,,0.98,,392.98,Percent of total billed charges,,,0.95,,380.95,Percent of total billed charges,,,0.95,,380.95,Percent of total billed charges,,,0.97,,388.97,Percent of total billed charges,,,0.96,,384.96,Percent of total billed charges,,,0.95,,380.95,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,380.95,Percent of total billed charges,,380.95,392.98,
Evaluation of swallowing function,PX-44410026,CDM,92610,CPT,444,RC,,inpatient,,,272,244.8,,0.95,,258.4,Percent of total billed charges,,,0.98,,266.56,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,0.97,,263.84,Percent of total billed charges,,,0.97,,263.84,Percent of total billed charges,,,0.96,,261.12,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,258.4,Percent of total billed charges,,258.4,266.56,
Evaluation of swallowing function,PX-44410026,CDM,92610,CPT,444,RC,,outpatient,,,272,244.8,,0.95,,258.4,Percent of total billed charges,,,0.98,,266.56,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,0.97,,263.84,Percent of total billed charges,,,0.96,,261.12,Percent of total billed charges,,,0.95,,258.4,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,258.4,Percent of total billed charges,,258.4,266.56,
Evaluation and recording of swallowing using an endoscope,PX-44410054,CDM,92612,CPT,444,RC,,inpatient,,,423,380.7,,0.95,,401.85,Percent of total billed charges,,,0.98,,414.54,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,0.97,,410.31,Percent of total billed charges,,,0.97,,410.31,Percent of total billed charges,,,0.96,,406.08,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,,,,,,,0.95,,401.85,Percent of total billed charges,,401.85,414.54,
Evaluation and recording of swallowing using an endoscope,PX-44410054,CDM,92612,CPT,444,RC,,outpatient,,,423,380.7,,0.95,,401.85,Percent of total billed charges,,,0.98,,414.54,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,0.97,,410.31,Percent of total billed charges,,,0.96,,406.08,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,,,,,,,0.95,,401.85,Percent of total billed charges,,401.85,414.54,
Developmental Test Lim,PX-96910005,CDM,96110,CPT,983,RC,,inpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
Developmental Test Lim,PX-96910005,CDM,96110,CPT,983,RC,,outpatient,,,29,26.1,,0.95,,27.55,Percent of total billed charges,,,0.98,,28.42,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,0.97,,28.13,Percent of total billed charges,,,0.96,,27.84,Percent of total billed charges,,,0.95,,27.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,27.55,Percent of total billed charges,,27.55,28.42,
Neg Press Wound Treatment </= 50 Sq Cm,PX-96910007,CDM,97605,CPT,983,RC,,inpatient,,,539,485.1,,0.95,,512.05,Percent of total billed charges,,,0.98,,528.22,Percent of total billed charges,,,0.95,,512.05,Percent of total billed charges,,,0.97,,522.83,Percent of total billed charges,,,0.97,,522.83,Percent of total billed charges,,,0.96,,517.44,Percent of total billed charges,,,0.95,,512.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,512.05,Percent of total billed charges,,512.05,528.22,
Neg Press Wound Treatment </= 50 Sq Cm,PX-96910007,CDM,97605,CPT,983,RC,,outpatient,,,539,485.1,,0.95,,512.05,Percent of total billed charges,,,0.98,,528.22,Percent of total billed charges,,,0.95,,512.05,Percent of total billed charges,,,0.95,,512.05,Percent of total billed charges,,,0.97,,522.83,Percent of total billed charges,,,0.96,,517.44,Percent of total billed charges,,,0.95,,512.05,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,512.05,Percent of total billed charges,,512.05,528.22,
HC PR 97597 Debridement Open Wound 20 Sq Cm/<,PX-97510016,CDM,97597,CPT,975,RC,,inpatient,,,249,224.1,,0.95,,236.55,Percent of total billed charges,,,0.98,,244.02,Percent of total billed charges,,,0.95,,236.55,Percent of total billed charges,,,0.97,,241.53,Percent of total billed charges,,,0.97,,241.53,Percent of total billed charges,,,0.96,,239.04,Percent of total billed charges,,,0.95,,236.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,236.55,Percent of total billed charges,,236.55,244.02,
HC PR 97597 Debridement Open Wound 20 Sq Cm/<,PX-97510016,CDM,97597,CPT,975,RC,,outpatient,,,249,224.1,,0.95,,236.55,Percent of total billed charges,,,0.98,,244.02,Percent of total billed charges,,,0.95,,236.55,Percent of total billed charges,,,0.95,,236.55,Percent of total billed charges,,,0.97,,241.53,Percent of total billed charges,,,0.96,,239.04,Percent of total billed charges,,,0.95,,236.55,Percent of total billed charges,,,,,,,Included in ER Case rate,,0.95,,236.55,Percent of total billed charges,,236.55,244.02,
ACETAMINOPHEN 160 MG/5ML PO SOLN,RX-100,CDM,J3490,HCPCS,637,RC,,inpatient,10.2,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
ACETAMINOPHEN 160 MG/5ML PO SOLN,RX-100,CDM,J3490,HCPCS,637,RC,,outpatient,10.2,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
FAMOTIDINE 20 MG PO TABS,RX-10011,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.06,5.45,,0.95,,5.76,Percent of total billed charges,,,0.98,,5.94,Percent of total billed charges,,,0.95,,5.76,Percent of total billed charges,,,0.97,,5.88,Percent of total billed charges,,,0.97,,5.88,Percent of total billed charges,,,0.96,,5.82,Percent of total billed charges,,,0.95,,5.76,Percent of total billed charges,,,,,,,,,0.95,,5.76,Percent of total billed charges,,5.76,5.94,
FAMOTIDINE 20 MG PO TABS,RX-10011,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.06,5.45,,0.95,,5.76,Percent of total billed charges,,,0.98,,5.94,Percent of total billed charges,,,0.95,,5.76,Percent of total billed charges,,,0.95,,5.76,Percent of total billed charges,,,0.97,,5.88,Percent of total billed charges,,,0.96,,5.82,Percent of total billed charges,,,0.95,,5.76,Percent of total billed charges,,,,,,,,,0.95,,5.76,Percent of total billed charges,,5.76,5.94,
LEVONORGESTREL 1.5 MG PO TABS,RX-100354,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,117.84,106.06,,0.95,,111.95,Percent of total billed charges,,,0.98,,115.48,Percent of total billed charges,,,0.95,,111.95,Percent of total billed charges,,,0.97,,114.3,Percent of total billed charges,,,0.97,,114.3,Percent of total billed charges,,,0.96,,113.13,Percent of total billed charges,,,0.95,,111.95,Percent of total billed charges,,,,,,,,,0.95,,111.95,Percent of total billed charges,,111.95,115.48,
LEVONORGESTREL 1.5 MG PO TABS,RX-100354,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,117.84,106.06,,0.95,,111.95,Percent of total billed charges,,,0.98,,115.48,Percent of total billed charges,,,0.95,,111.95,Percent of total billed charges,,,0.95,,111.95,Percent of total billed charges,,,0.97,,114.3,Percent of total billed charges,,,0.96,,113.13,Percent of total billed charges,,,0.95,,111.95,Percent of total billed charges,,,,,,,,,0.95,,111.95,Percent of total billed charges,,111.95,115.48,
FINASTERIDE 5 MG PO TABS,RX-10037,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.2,7.38,,0.95,,7.79,Percent of total billed charges,,,0.98,,8.04,Percent of total billed charges,,,0.95,,7.79,Percent of total billed charges,,,0.97,,7.95,Percent of total billed charges,,,0.97,,7.95,Percent of total billed charges,,,0.96,,7.87,Percent of total billed charges,,,0.95,,7.79,Percent of total billed charges,,,,,,,,,0.95,,7.79,Percent of total billed charges,,7.79,8.04,
FINASTERIDE 5 MG PO TABS,RX-10037,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.2,7.38,,0.95,,7.79,Percent of total billed charges,,,0.98,,8.04,Percent of total billed charges,,,0.95,,7.79,Percent of total billed charges,,,0.95,,7.79,Percent of total billed charges,,,0.97,,7.95,Percent of total billed charges,,,0.96,,7.87,Percent of total billed charges,,,0.95,,7.79,Percent of total billed charges,,,,,,,,,0.95,,7.79,Percent of total billed charges,,7.79,8.04,
FLECAINIDE ACETATE 50 MG PO TABS,RX-10043,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.63,7.77,,0.95,,8.2,Percent of total billed charges,,,0.98,,8.46,Percent of total billed charges,,,0.95,,8.2,Percent of total billed charges,,,0.97,,8.37,Percent of total billed charges,,,0.97,,8.37,Percent of total billed charges,,,0.96,,8.28,Percent of total billed charges,,,0.95,,8.2,Percent of total billed charges,,,,,,,,,0.95,,8.2,Percent of total billed charges,,8.2,8.46,
FLECAINIDE ACETATE 50 MG PO TABS,RX-10043,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.63,7.77,,0.95,,8.2,Percent of total billed charges,,,0.98,,8.46,Percent of total billed charges,,,0.95,,8.2,Percent of total billed charges,,,0.95,,8.2,Percent of total billed charges,,,0.97,,8.37,Percent of total billed charges,,,0.96,,8.28,Percent of total billed charges,,,0.95,,8.2,Percent of total billed charges,,,,,,,,,0.95,,8.2,Percent of total billed charges,,8.2,8.46,
FLUCONAZOLE 100 MG PO TABS,RX-10044,CDM,J3490,HCPCS,637,RC,,inpatient,0.5,UN,5.99,5.39,,0.95,,5.69,Percent of total billed charges,,,0.98,,5.87,Percent of total billed charges,,,0.95,,5.69,Percent of total billed charges,,,0.97,,5.81,Percent of total billed charges,,,0.97,,5.81,Percent of total billed charges,,,0.96,,5.75,Percent of total billed charges,,,0.95,,5.69,Percent of total billed charges,,,,,,,,,0.95,,5.69,Percent of total billed charges,,5.69,5.87,
FLUCONAZOLE 100 MG PO TABS,RX-10044,CDM,J3490,HCPCS,637,RC,,outpatient,0.5,UN,5.99,5.39,,0.95,,5.69,Percent of total billed charges,,,0.98,,5.87,Percent of total billed charges,,,0.95,,5.69,Percent of total billed charges,,,0.95,,5.69,Percent of total billed charges,,,0.97,,5.81,Percent of total billed charges,,,0.96,,5.75,Percent of total billed charges,,,0.95,,5.69,Percent of total billed charges,,,,,,,,,0.95,,5.69,Percent of total billed charges,,5.69,5.87,
FLUCONAZOLE IN SODIUM CHLORIDE 200-0.9 MG/100ML-% IV SOLN,RX-10049,CDM,J1450,HCPCS,636,RC,,inpatient,100,ML,47.75,42.98,,0.95,,45.36,Percent of total billed charges,,,0.98,,46.8,Percent of total billed charges,,,0.95,,45.36,Percent of total billed charges,,,0.97,,46.32,Percent of total billed charges,,,0.97,,46.32,Percent of total billed charges,,,0.96,,45.84,Percent of total billed charges,,,0.95,,45.36,Percent of total billed charges,,,,,,,,,0.95,,45.36,Percent of total billed charges,,45.36,46.8,
FLUCONAZOLE IN SODIUM CHLORIDE 200-0.9 MG/100ML-% IV SOLN,RX-10049,CDM,J1450,HCPCS,636,RC,,outpatient,100,ML,47.75,42.98,,0.95,,45.36,Percent of total billed charges,,,0.98,,46.8,Percent of total billed charges,,,0.95,,45.36,Percent of total billed charges,,,0.95,,45.36,Percent of total billed charges,,,0.97,,46.32,Percent of total billed charges,,,0.96,,45.84,Percent of total billed charges,,,0.95,,45.36,Percent of total billed charges,,,,,,,,,0.95,,45.36,Percent of total billed charges,,45.36,46.8,
OXALIPLATIN 100 MG/20ML IV SOLN,RX-100527,CDM,J9263,HCPCS,636,RC,,inpatient,20,ML,721,648.9,,0.95,,684.95,Percent of total billed charges,,,0.98,,706.58,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,0.97,,699.37,Percent of total billed charges,,,0.97,,699.37,Percent of total billed charges,,,0.96,,692.16,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,,,,,,,0.95,,684.95,Percent of total billed charges,,684.95,706.58,
OXALIPLATIN 100 MG/20ML IV SOLN,RX-100527,CDM,J9263,HCPCS,636,RC,,outpatient,20,ML,721,648.9,,0.95,,684.95,Percent of total billed charges,,,0.98,,706.58,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,0.97,,699.37,Percent of total billed charges,,,0.96,,692.16,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,,,,,,,0.95,,684.95,Percent of total billed charges,,684.95,706.58,
FLUDROCORTISONE ACETATE 0.1 MG PO TABS,RX-10054,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,9.95,8.96,,0.95,,9.45,Percent of total billed charges,,,0.98,,9.75,Percent of total billed charges,,,0.95,,9.45,Percent of total billed charges,,,0.97,,9.65,Percent of total billed charges,,,0.97,,9.65,Percent of total billed charges,,,0.96,,9.55,Percent of total billed charges,,,0.95,,9.45,Percent of total billed charges,,,,,,,,,0.95,,9.45,Percent of total billed charges,,9.45,9.75,
FLUDROCORTISONE ACETATE 0.1 MG PO TABS,RX-10054,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,9.95,8.96,,0.95,,9.45,Percent of total billed charges,,,0.98,,9.75,Percent of total billed charges,,,0.95,,9.45,Percent of total billed charges,,,0.95,,9.45,Percent of total billed charges,,,0.97,,9.65,Percent of total billed charges,,,0.96,,9.55,Percent of total billed charges,,,0.95,,9.45,Percent of total billed charges,,,,,,,,,0.95,,9.45,Percent of total billed charges,,9.45,9.75,
FLUOXETINE HCL 20 MG PO CAPS,RX-10070,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.17,5.55,,0.95,,5.86,Percent of total billed charges,,,0.98,,6.05,Percent of total billed charges,,,0.95,,5.86,Percent of total billed charges,,,0.97,,5.98,Percent of total billed charges,,,0.97,,5.98,Percent of total billed charges,,,0.96,,5.92,Percent of total billed charges,,,0.95,,5.86,Percent of total billed charges,,,,,,,,,0.95,,5.86,Percent of total billed charges,,5.86,6.05,
FLUOXETINE HCL 20 MG PO CAPS,RX-10070,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.17,5.55,,0.95,,5.86,Percent of total billed charges,,,0.98,,6.05,Percent of total billed charges,,,0.95,,5.86,Percent of total billed charges,,,0.95,,5.86,Percent of total billed charges,,,0.97,,5.98,Percent of total billed charges,,,0.96,,5.92,Percent of total billed charges,,,0.95,,5.86,Percent of total billed charges,,,,,,,,,0.95,,5.86,Percent of total billed charges,,5.86,6.05,
GLIPIZIDE 5 MG PO TABS,RX-10117,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.04,6.34,,0.95,,6.69,Percent of total billed charges,,,0.98,,6.9,Percent of total billed charges,,,0.95,,6.69,Percent of total billed charges,,,0.97,,6.83,Percent of total billed charges,,,0.97,,6.83,Percent of total billed charges,,,0.96,,6.76,Percent of total billed charges,,,0.95,,6.69,Percent of total billed charges,,,,,,,,,0.95,,6.69,Percent of total billed charges,,6.69,6.9,
GLIPIZIDE 5 MG PO TABS,RX-10117,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.04,6.34,,0.95,,6.69,Percent of total billed charges,,,0.98,,6.9,Percent of total billed charges,,,0.95,,6.69,Percent of total billed charges,,,0.95,,6.69,Percent of total billed charges,,,0.97,,6.83,Percent of total billed charges,,,0.96,,6.76,Percent of total billed charges,,,0.95,,6.69,Percent of total billed charges,,,,,,,,,0.95,,6.69,Percent of total billed charges,,6.69,6.9,
VITAMIN D (ERGOCALCIFEROL) 1.25 MG (50000 UT) PO CAPS,RX-101414,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.75,9.68,,0.95,,10.21,Percent of total billed charges,,,0.98,,10.54,Percent of total billed charges,,,0.95,,10.21,Percent of total billed charges,,,0.97,,10.43,Percent of total billed charges,,,0.97,,10.43,Percent of total billed charges,,,0.96,,10.32,Percent of total billed charges,,,0.95,,10.21,Percent of total billed charges,,,,,,,,,0.95,,10.21,Percent of total billed charges,,10.21,10.54,
VITAMIN D (ERGOCALCIFEROL) 1.25 MG (50000 UT) PO CAPS,RX-101414,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.75,9.68,,0.95,,10.21,Percent of total billed charges,,,0.98,,10.54,Percent of total billed charges,,,0.95,,10.21,Percent of total billed charges,,,0.95,,10.21,Percent of total billed charges,,,0.97,,10.43,Percent of total billed charges,,,0.96,,10.32,Percent of total billed charges,,,0.95,,10.21,Percent of total billed charges,,,,,,,,,0.95,,10.21,Percent of total billed charges,,10.21,10.54,
TAMSULOSIN HCL 0.4 MG PO CAPS,RX-101440,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.15,6.44,,0.95,,6.79,Percent of total billed charges,,,0.98,,7.01,Percent of total billed charges,,,0.95,,6.79,Percent of total billed charges,,,0.97,,6.94,Percent of total billed charges,,,0.97,,6.94,Percent of total billed charges,,,0.96,,6.86,Percent of total billed charges,,,0.95,,6.79,Percent of total billed charges,,,,,,,,,0.95,,6.79,Percent of total billed charges,,6.79,7.01,
TAMSULOSIN HCL 0.4 MG PO CAPS,RX-101440,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.15,6.44,,0.95,,6.79,Percent of total billed charges,,,0.98,,7.01,Percent of total billed charges,,,0.95,,6.79,Percent of total billed charges,,,0.95,,6.79,Percent of total billed charges,,,0.97,,6.94,Percent of total billed charges,,,0.96,,6.86,Percent of total billed charges,,,0.95,,6.79,Percent of total billed charges,,,,,,,,,0.95,,6.79,Percent of total billed charges,,6.79,7.01,
HEPARIN SODIUM (PORCINE) 1000 UNIT/ML INJECTION SOLN,RX-10176,CDM,J1644,HCPCS,636,RC,,inpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
HEPARIN SODIUM (PORCINE) 1000 UNIT/ML INJECTION SOLN,RX-10176,CDM,J1644,HCPCS,636,RC,,outpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
SOTALOL HCL 150 MG/10ML IV SOLN,RX-102032,CDM,C9482,HCPCS,636,RC,,inpatient,10,ML,4717.18,4245.46,,0.95,,4481.32,Percent of total billed charges,,,0.98,,4622.84,Percent of total billed charges,,,0.95,,4481.32,Percent of total billed charges,,,0.97,,4575.66,Percent of total billed charges,,,0.97,,4575.66,Percent of total billed charges,,,0.96,,4528.49,Percent of total billed charges,,,0.95,,4481.32,Percent of total billed charges,,,,,,,,,0.95,,4481.32,Percent of total billed charges,,4481.32,4622.84,
SOTALOL HCL 150 MG/10ML IV SOLN,RX-102032,CDM,C9482,HCPCS,636,RC,,outpatient,10,ML,4717.18,4245.46,,0.95,,4481.32,Percent of total billed charges,,,0.98,,4622.84,Percent of total billed charges,,,0.95,,4481.32,Percent of total billed charges,,,0.95,,4481.32,Percent of total billed charges,,,0.97,,4575.66,Percent of total billed charges,,,0.96,,4528.49,Percent of total billed charges,,,0.95,,4481.32,Percent of total billed charges,,,,,,,,,0.95,,4481.32,Percent of total billed charges,,4481.32,4622.84,
HYDROCORTISONE 5 MG PO TABS,RX-10209,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.75,6.08,,0.95,,6.41,Percent of total billed charges,,,0.98,,6.62,Percent of total billed charges,,,0.95,,6.41,Percent of total billed charges,,,0.97,,6.55,Percent of total billed charges,,,0.97,,6.55,Percent of total billed charges,,,0.96,,6.48,Percent of total billed charges,,,0.95,,6.41,Percent of total billed charges,,,,,,,,,0.95,,6.41,Percent of total billed charges,,6.41,6.62,
HYDROCORTISONE 5 MG PO TABS,RX-10209,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.75,6.08,,0.95,,6.41,Percent of total billed charges,,,0.98,,6.62,Percent of total billed charges,,,0.95,,6.41,Percent of total billed charges,,,0.95,,6.41,Percent of total billed charges,,,0.97,,6.55,Percent of total billed charges,,,0.96,,6.48,Percent of total billed charges,,,0.95,,6.41,Percent of total billed charges,,,,,,,,,0.95,,6.41,Percent of total billed charges,,6.41,6.62,
HYDROCORTISONE 100 MG/60ML RECTAL ENEM,RX-10210,CDM,J3490,HCPCS,637,RC,,inpatient,60,ML,165.26,148.73,,0.95,,157,Percent of total billed charges,,,0.98,,161.95,Percent of total billed charges,,,0.95,,157,Percent of total billed charges,,,0.97,,160.3,Percent of total billed charges,,,0.97,,160.3,Percent of total billed charges,,,0.96,,158.65,Percent of total billed charges,,,0.95,,157,Percent of total billed charges,,,,,,,,,0.95,,157,Percent of total billed charges,,157,161.95,
HYDROCORTISONE 100 MG/60ML RECTAL ENEM,RX-10210,CDM,J3490,HCPCS,637,RC,,outpatient,60,ML,165.26,148.73,,0.95,,157,Percent of total billed charges,,,0.98,,161.95,Percent of total billed charges,,,0.95,,157,Percent of total billed charges,,,0.95,,157,Percent of total billed charges,,,0.97,,160.3,Percent of total billed charges,,,0.96,,158.65,Percent of total billed charges,,,0.95,,157,Percent of total billed charges,,,,,,,,,0.95,,157,Percent of total billed charges,,157,161.95,
LIDOCAINE HCL (PF) 1 % INJECTION SOLN,RX-102339,CDM,J7999,HCPCS,250,RC,,inpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
LIDOCAINE HCL (PF) 1 % INJECTION SOLN,RX-102339,CDM,J7999,HCPCS,250,RC,,outpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
LIDOCAINE HCL (PF) 2 % INJECTION SOLN,RX-102340,CDM,J3490,HCPCS,250,RC,,inpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
LIDOCAINE HCL (PF) 2 % INJECTION SOLN,RX-102340,CDM,J3490,HCPCS,250,RC,,outpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
KCL IN DEXTROSE-NACL 20-5-0.9 MEQ/L-%-% IV SOLN,RX-102376,CDM,J3490,HCPCS,250,RC,,inpatient,1000,ML,93.99,84.59,,0.95,,89.29,Percent of total billed charges,,,0.98,,92.11,Percent of total billed charges,,,0.95,,89.29,Percent of total billed charges,,,0.97,,91.17,Percent of total billed charges,,,0.97,,91.17,Percent of total billed charges,,,0.96,,90.23,Percent of total billed charges,,,0.95,,89.29,Percent of total billed charges,,,,,,,,,0.95,,89.29,Percent of total billed charges,,89.29,92.11,
KCL IN DEXTROSE-NACL 20-5-0.9 MEQ/L-%-% IV SOLN,RX-102376,CDM,J3490,HCPCS,250,RC,,outpatient,1000,ML,93.99,84.59,,0.95,,89.29,Percent of total billed charges,,,0.98,,92.11,Percent of total billed charges,,,0.95,,89.29,Percent of total billed charges,,,0.95,,89.29,Percent of total billed charges,,,0.97,,91.17,Percent of total billed charges,,,0.96,,90.23,Percent of total billed charges,,,0.95,,89.29,Percent of total billed charges,,,,,,,,,0.95,,89.29,Percent of total billed charges,,89.29,92.11,
KCL IN DEXTROSE-NACL 10-5-0.45 MEQ/L-%-% IV SOLN,RX-102380,CDM,J3490,HCPCS,258,RC,,inpatient,1000,ML,101.72,91.55,,0.95,,96.63,Percent of total billed charges,,,0.98,,99.69,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,0.97,,98.67,Percent of total billed charges,,,0.97,,98.67,Percent of total billed charges,,,0.96,,97.65,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,,,,,,,0.95,,96.63,Percent of total billed charges,,96.63,99.69,
KCL IN DEXTROSE-NACL 10-5-0.45 MEQ/L-%-% IV SOLN,RX-102380,CDM,J3490,HCPCS,258,RC,,outpatient,1000,ML,101.72,91.55,,0.95,,96.63,Percent of total billed charges,,,0.98,,99.69,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,0.97,,98.67,Percent of total billed charges,,,0.96,,97.65,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,,,,,,,0.95,,96.63,Percent of total billed charges,,96.63,99.69,
KCL IN DEXTROSE-NACL 20-5-0.45 MEQ/L-%-% IV SOLN,RX-102383,CDM,J3490,HCPCS,250,RC,,inpatient,1000,ML,93.99,84.59,,0.95,,89.29,Percent of total billed charges,,,0.98,,92.11,Percent of total billed charges,,,0.95,,89.29,Percent of total billed charges,,,0.97,,91.17,Percent of total billed charges,,,0.97,,91.17,Percent of total billed charges,,,0.96,,90.23,Percent of total billed charges,,,0.95,,89.29,Percent of total billed charges,,,,,,,,,0.95,,89.29,Percent of total billed charges,,89.29,92.11,
KCL IN DEXTROSE-NACL 20-5-0.45 MEQ/L-%-% IV SOLN,RX-102383,CDM,J3490,HCPCS,250,RC,,outpatient,1000,ML,93.99,84.59,,0.95,,89.29,Percent of total billed charges,,,0.98,,92.11,Percent of total billed charges,,,0.95,,89.29,Percent of total billed charges,,,0.95,,89.29,Percent of total billed charges,,,0.97,,91.17,Percent of total billed charges,,,0.96,,90.23,Percent of total billed charges,,,0.95,,89.29,Percent of total billed charges,,,,,,,,,0.95,,89.29,Percent of total billed charges,,89.29,92.11,
KCL IN DEXTROSE-NACL 40-5-0.45 MEQ/L-%-% IV SOLN,RX-102388,CDM,J3490,HCPCS,250,RC,,inpatient,1000,ML,101.72,91.55,,0.95,,96.63,Percent of total billed charges,,,0.98,,99.69,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,0.97,,98.67,Percent of total billed charges,,,0.97,,98.67,Percent of total billed charges,,,0.96,,97.65,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,,,,,,,0.95,,96.63,Percent of total billed charges,,96.63,99.69,
KCL IN DEXTROSE-NACL 40-5-0.45 MEQ/L-%-% IV SOLN,RX-102388,CDM,J3490,HCPCS,250,RC,,outpatient,1000,ML,101.72,91.55,,0.95,,96.63,Percent of total billed charges,,,0.98,,99.69,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,0.97,,98.67,Percent of total billed charges,,,0.96,,97.65,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,,,,,,,0.95,,96.63,Percent of total billed charges,,96.63,99.69,
IBUPROFEN 100 MG/5ML PO SUSP,RX-10246,CDM,J3490,HCPCS,637,RC,,inpatient,10,ML,8.84,7.96,,0.95,,8.4,Percent of total billed charges,,,0.98,,8.66,Percent of total billed charges,,,0.95,,8.4,Percent of total billed charges,,,0.97,,8.57,Percent of total billed charges,,,0.97,,8.57,Percent of total billed charges,,,0.96,,8.49,Percent of total billed charges,,,0.95,,8.4,Percent of total billed charges,,,,,,,,,0.95,,8.4,Percent of total billed charges,,8.4,8.66,
IBUPROFEN 100 MG/5ML PO SUSP,RX-10246,CDM,J3490,HCPCS,637,RC,,outpatient,10,ML,8.84,7.96,,0.95,,8.4,Percent of total billed charges,,,0.98,,8.66,Percent of total billed charges,,,0.95,,8.4,Percent of total billed charges,,,0.95,,8.4,Percent of total billed charges,,,0.97,,8.57,Percent of total billed charges,,,0.96,,8.49,Percent of total billed charges,,,0.95,,8.4,Percent of total billed charges,,,,,,,,,0.95,,8.4,Percent of total billed charges,,8.4,8.66,
INSULIN NPH ISOPHANE & REGULAR (70-30) 100 UNIT/ML SUBQ SUSP,RX-10286,CDM,J1815,HCPCS,637,RC,,inpatient,10,ML,71.34,64.21,,0.95,,67.77,Percent of total billed charges,,,0.98,,69.91,Percent of total billed charges,,,0.95,,67.77,Percent of total billed charges,,,0.97,,69.2,Percent of total billed charges,,,0.97,,69.2,Percent of total billed charges,,,0.96,,68.49,Percent of total billed charges,,,0.95,,67.77,Percent of total billed charges,,,,,,,,,0.95,,67.77,Percent of total billed charges,,67.77,69.91,
INSULIN NPH ISOPHANE & REGULAR (70-30) 100 UNIT/ML SUBQ SUSP,RX-10286,CDM,J1815,HCPCS,637,RC,,outpatient,10,ML,71.34,64.21,,0.95,,67.77,Percent of total billed charges,,,0.98,,69.91,Percent of total billed charges,,,0.95,,67.77,Percent of total billed charges,,,0.95,,67.77,Percent of total billed charges,,,0.97,,69.2,Percent of total billed charges,,,0.96,,68.49,Percent of total billed charges,,,0.95,,67.77,Percent of total billed charges,,,,,,,,,0.95,,67.77,Percent of total billed charges,,67.77,69.91,
INSULIN REGULAR HUMAN 100 UNIT/ML INJECTION SOLN,RX-10289,CDM,J1815,HCPCS,637,RC,,inpatient,3,ML,24.38,21.94,,0.95,,23.16,Percent of total billed charges,,,0.98,,23.89,Percent of total billed charges,,,0.95,,23.16,Percent of total billed charges,,,0.97,,23.65,Percent of total billed charges,,,0.97,,23.65,Percent of total billed charges,,,0.96,,23.4,Percent of total billed charges,,,0.95,,23.16,Percent of total billed charges,,,,,,,,,0.95,,23.16,Percent of total billed charges,,23.16,23.89,
INSULIN REGULAR HUMAN 100 UNIT/ML INJECTION SOLN,RX-10289,CDM,J1815,HCPCS,637,RC,,outpatient,3,ML,24.38,21.94,,0.95,,23.16,Percent of total billed charges,,,0.98,,23.89,Percent of total billed charges,,,0.95,,23.16,Percent of total billed charges,,,0.95,,23.16,Percent of total billed charges,,,0.97,,23.65,Percent of total billed charges,,,0.96,,23.4,Percent of total billed charges,,,0.95,,23.16,Percent of total billed charges,,,,,,,,,0.95,,23.16,Percent of total billed charges,,23.16,23.89,
ACETAMINOPHEN 120 MG RECTAL SUPP,RX-103,CDM,J3490,HCPCS,637,RC,,inpatient,3,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
ACETAMINOPHEN 120 MG RECTAL SUPP,RX-103,CDM,J3490,HCPCS,637,RC,,outpatient,3,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
BETAMETHASONE VALERATE 0.1 % EX CREA,RX-1031,CDM,J3490,HCPCS,637,RC,,inpatient,15,GR,58.89,53,,0.95,,55.95,Percent of total billed charges,,,0.98,,57.71,Percent of total billed charges,,,0.95,,55.95,Percent of total billed charges,,,0.97,,57.12,Percent of total billed charges,,,0.97,,57.12,Percent of total billed charges,,,0.96,,56.53,Percent of total billed charges,,,0.95,,55.95,Percent of total billed charges,,,,,,,,,0.95,,55.95,Percent of total billed charges,,55.95,57.71,
BETAMETHASONE VALERATE 0.1 % EX CREA,RX-1031,CDM,J3490,HCPCS,637,RC,,outpatient,15,GR,58.89,53,,0.95,,55.95,Percent of total billed charges,,,0.98,,57.71,Percent of total billed charges,,,0.95,,55.95,Percent of total billed charges,,,0.95,,55.95,Percent of total billed charges,,,0.97,,57.12,Percent of total billed charges,,,0.96,,56.53,Percent of total billed charges,,,0.95,,55.95,Percent of total billed charges,,,,,,,,,0.95,,55.95,Percent of total billed charges,,55.95,57.71,
BETAMETHASONE VALERATE 0.1 % EX OINT,RX-1033,CDM,J3490,HCPCS,637,RC,,inpatient,15,GR,38.66,34.79,,0.95,,36.73,Percent of total billed charges,,,0.98,,37.89,Percent of total billed charges,,,0.95,,36.73,Percent of total billed charges,,,0.97,,37.5,Percent of total billed charges,,,0.97,,37.5,Percent of total billed charges,,,0.96,,37.11,Percent of total billed charges,,,0.95,,36.73,Percent of total billed charges,,,,,,,,,0.95,,36.73,Percent of total billed charges,,36.73,37.89,
BETAMETHASONE VALERATE 0.1 % EX OINT,RX-1033,CDM,J3490,HCPCS,637,RC,,outpatient,15,GR,38.66,34.79,,0.95,,36.73,Percent of total billed charges,,,0.98,,37.89,Percent of total billed charges,,,0.95,,36.73,Percent of total billed charges,,,0.95,,36.73,Percent of total billed charges,,,0.97,,37.5,Percent of total billed charges,,,0.96,,37.11,Percent of total billed charges,,,0.95,,36.73,Percent of total billed charges,,,,,,,,,0.95,,36.73,Percent of total billed charges,,36.73,37.89,
ISOSULFAN BLUE 1 % SUBQ SOLN,RX-10358,CDM,Q9968,HCPCS,636,RC,,inpatient,1.5,ML,892.61,803.35,,0.95,,847.98,Percent of total billed charges,,,0.98,,874.76,Percent of total billed charges,,,0.95,,847.98,Percent of total billed charges,,,0.97,,865.83,Percent of total billed charges,,,0.97,,865.83,Percent of total billed charges,,,0.96,,856.91,Percent of total billed charges,,,0.95,,847.98,Percent of total billed charges,,,,,,,,,0.95,,847.98,Percent of total billed charges,,847.98,874.76,
ISOSULFAN BLUE 1 % SUBQ SOLN,RX-10358,CDM,Q9968,HCPCS,636,RC,,outpatient,1.5,ML,892.61,803.35,,0.95,,847.98,Percent of total billed charges,,,0.98,,874.76,Percent of total billed charges,,,0.95,,847.98,Percent of total billed charges,,,0.95,,847.98,Percent of total billed charges,,,0.97,,865.83,Percent of total billed charges,,,0.96,,856.91,Percent of total billed charges,,,0.95,,847.98,Percent of total billed charges,,,,,,,,,0.95,,847.98,Percent of total billed charges,,847.98,874.76,
KETOCONAZOLE 2 % EX CREA,RX-10368,CDM,J3490,HCPCS,637,RC,,inpatient,15,GR,86.9,78.21,,0.95,,82.56,Percent of total billed charges,,,0.98,,85.16,Percent of total billed charges,,,0.95,,82.56,Percent of total billed charges,,,0.97,,84.29,Percent of total billed charges,,,0.97,,84.29,Percent of total billed charges,,,0.96,,83.42,Percent of total billed charges,,,0.95,,82.56,Percent of total billed charges,,,,,,,,,0.95,,82.56,Percent of total billed charges,,82.56,85.16,
KETOCONAZOLE 2 % EX CREA,RX-10368,CDM,J3490,HCPCS,637,RC,,outpatient,15,GR,86.9,78.21,,0.95,,82.56,Percent of total billed charges,,,0.98,,85.16,Percent of total billed charges,,,0.95,,82.56,Percent of total billed charges,,,0.95,,82.56,Percent of total billed charges,,,0.97,,84.29,Percent of total billed charges,,,0.96,,83.42,Percent of total billed charges,,,0.95,,82.56,Percent of total billed charges,,,,,,,,,0.95,,82.56,Percent of total billed charges,,82.56,85.16,
KETOCONAZOLE 200 MG PO TABS,RX-10369,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.73,9.66,,0.95,,10.19,Percent of total billed charges,,,0.98,,10.52,Percent of total billed charges,,,0.95,,10.19,Percent of total billed charges,,,0.97,,10.41,Percent of total billed charges,,,0.97,,10.41,Percent of total billed charges,,,0.96,,10.3,Percent of total billed charges,,,0.95,,10.19,Percent of total billed charges,,,,,,,,,0.95,,10.19,Percent of total billed charges,,10.19,10.52,
KETOCONAZOLE 200 MG PO TABS,RX-10369,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.73,9.66,,0.95,,10.19,Percent of total billed charges,,,0.98,,10.52,Percent of total billed charges,,,0.95,,10.19,Percent of total billed charges,,,0.95,,10.19,Percent of total billed charges,,,0.97,,10.41,Percent of total billed charges,,,0.96,,10.3,Percent of total billed charges,,,0.95,,10.19,Percent of total billed charges,,,,,,,,,0.95,,10.19,Percent of total billed charges,,10.19,10.52,
KETOROLAC TROMETHAMINE 10 MG PO TABS,RX-10371,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,22.06,19.85,,0.95,,20.96,Percent of total billed charges,,,0.98,,21.62,Percent of total billed charges,,,0.95,,20.96,Percent of total billed charges,,,0.97,,21.4,Percent of total billed charges,,,0.97,,21.4,Percent of total billed charges,,,0.96,,21.18,Percent of total billed charges,,,0.95,,20.96,Percent of total billed charges,,,,,,,,,0.95,,20.96,Percent of total billed charges,,20.96,21.62,
KETOROLAC TROMETHAMINE 10 MG PO TABS,RX-10371,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,22.06,19.85,,0.95,,20.96,Percent of total billed charges,,,0.98,,21.62,Percent of total billed charges,,,0.95,,20.96,Percent of total billed charges,,,0.95,,20.96,Percent of total billed charges,,,0.97,,21.4,Percent of total billed charges,,,0.96,,21.18,Percent of total billed charges,,,0.95,,20.96,Percent of total billed charges,,,,,,,,,0.95,,20.96,Percent of total billed charges,,20.96,21.62,
LABETALOL HCL 100 MG PO TABS,RX-10373,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.42,6.68,,0.95,,7.05,Percent of total billed charges,,,0.98,,7.27,Percent of total billed charges,,,0.95,,7.05,Percent of total billed charges,,,0.97,,7.2,Percent of total billed charges,,,0.97,,7.2,Percent of total billed charges,,,0.96,,7.12,Percent of total billed charges,,,0.95,,7.05,Percent of total billed charges,,,,,,,,,0.95,,7.05,Percent of total billed charges,,7.05,7.27,
LABETALOL HCL 100 MG PO TABS,RX-10373,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.42,6.68,,0.95,,7.05,Percent of total billed charges,,,0.98,,7.27,Percent of total billed charges,,,0.95,,7.05,Percent of total billed charges,,,0.95,,7.05,Percent of total billed charges,,,0.97,,7.2,Percent of total billed charges,,,0.96,,7.12,Percent of total billed charges,,,0.95,,7.05,Percent of total billed charges,,,,,,,,,0.95,,7.05,Percent of total billed charges,,7.05,7.27,
LEUPROLIDE ACETATE 7.5 MG IM KIT,RX-10392,CDM,J9217,HCPCS,636,RC,,inpatient,7.5,ME,517.56,465.8,,0.95,,491.68,Percent of total billed charges,,,0.98,,507.21,Percent of total billed charges,,,0.95,,491.68,Percent of total billed charges,,,0.97,,502.03,Percent of total billed charges,,,0.97,,502.03,Percent of total billed charges,,,0.96,,496.86,Percent of total billed charges,,,0.95,,491.68,Percent of total billed charges,,,,,,,,,0.95,,491.68,Percent of total billed charges,,491.68,507.21,
LEUPROLIDE ACETATE 7.5 MG IM KIT,RX-10392,CDM,J9217,HCPCS,636,RC,,outpatient,7.5,ME,517.56,465.8,,0.95,,491.68,Percent of total billed charges,,,0.98,,507.21,Percent of total billed charges,,,0.95,,491.68,Percent of total billed charges,,,0.95,,491.68,Percent of total billed charges,,,0.97,,502.03,Percent of total billed charges,,,0.96,,496.86,Percent of total billed charges,,,0.95,,491.68,Percent of total billed charges,,,,,,,,,0.95,,491.68,Percent of total billed charges,,491.68,507.21,
ACETAMINOPHEN 325 MG RECTAL SUPP,RX-104,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
ACETAMINOPHEN 325 MG RECTAL SUPP,RX-104,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
LEVOTHYROXINE SODIUM 88 MCG PO TABS,RX-10403,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.97,7.17,,0.95,,7.57,Percent of total billed charges,,,0.98,,7.81,Percent of total billed charges,,,0.95,,7.57,Percent of total billed charges,,,0.97,,7.73,Percent of total billed charges,,,0.97,,7.73,Percent of total billed charges,,,0.96,,7.65,Percent of total billed charges,,,0.95,,7.57,Percent of total billed charges,,,,,,,,,0.95,,7.57,Percent of total billed charges,,7.57,7.81,
LEVOTHYROXINE SODIUM 88 MCG PO TABS,RX-10403,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.97,7.17,,0.95,,7.57,Percent of total billed charges,,,0.98,,7.81,Percent of total billed charges,,,0.95,,7.57,Percent of total billed charges,,,0.95,,7.57,Percent of total billed charges,,,0.97,,7.73,Percent of total billed charges,,,0.96,,7.65,Percent of total billed charges,,,0.95,,7.57,Percent of total billed charges,,,,,,,,,0.95,,7.57,Percent of total billed charges,,7.57,7.81,
LEVOTHYROXINE SODIUM 112 MCG PO TABS,RX-10404,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.38,7.54,,0.95,,7.96,Percent of total billed charges,,,0.98,,8.21,Percent of total billed charges,,,0.95,,7.96,Percent of total billed charges,,,0.97,,8.13,Percent of total billed charges,,,0.97,,8.13,Percent of total billed charges,,,0.96,,8.04,Percent of total billed charges,,,0.95,,7.96,Percent of total billed charges,,,,,,,,,0.95,,7.96,Percent of total billed charges,,7.96,8.21,
LEVOTHYROXINE SODIUM 112 MCG PO TABS,RX-10404,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.38,7.54,,0.95,,7.96,Percent of total billed charges,,,0.98,,8.21,Percent of total billed charges,,,0.95,,7.96,Percent of total billed charges,,,0.95,,7.96,Percent of total billed charges,,,0.97,,8.13,Percent of total billed charges,,,0.96,,8.04,Percent of total billed charges,,,0.95,,7.96,Percent of total billed charges,,,,,,,,,0.95,,7.96,Percent of total billed charges,,7.96,8.21,
LEVOTHYROXINE SODIUM 137 MCG PO TABS,RX-10405,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.96,8.06,,0.95,,8.51,Percent of total billed charges,,,0.98,,8.78,Percent of total billed charges,,,0.95,,8.51,Percent of total billed charges,,,0.97,,8.69,Percent of total billed charges,,,0.97,,8.69,Percent of total billed charges,,,0.96,,8.6,Percent of total billed charges,,,0.95,,8.51,Percent of total billed charges,,,,,,,,,0.95,,8.51,Percent of total billed charges,,8.51,8.78,
LEVOTHYROXINE SODIUM 137 MCG PO TABS,RX-10405,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.96,8.06,,0.95,,8.51,Percent of total billed charges,,,0.98,,8.78,Percent of total billed charges,,,0.95,,8.51,Percent of total billed charges,,,0.95,,8.51,Percent of total billed charges,,,0.97,,8.69,Percent of total billed charges,,,0.96,,8.6,Percent of total billed charges,,,0.95,,8.51,Percent of total billed charges,,,,,,,,,0.95,,8.51,Percent of total billed charges,,8.51,8.78,
LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200000 INJECTION SOLN,RX-10428,CDM,J2004,HCPCS,250,RC,,inpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200000 INJECTION SOLN,RX-10428,CDM,J2004,HCPCS,250,RC,,outpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
LIDOCAINE-EPINEPHRINE 2 %-1:100000 INJECTION SOLN,RX-10430,CDM,J2004,HCPCS,636,RC,,inpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
LIDOCAINE-EPINEPHRINE 2 %-1:100000 INJECTION SOLN,RX-10430,CDM,J2004,HCPCS,636,RC,,outpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
LIDOCAINE-PRILOCAINE 2.5-2.5 % EX CREA,RX-10434,CDM,J3490,HCPCS,637,RC,,inpatient,5,GR,35.12,31.61,,0.95,,33.36,Percent of total billed charges,,,0.98,,34.42,Percent of total billed charges,,,0.95,,33.36,Percent of total billed charges,,,0.97,,34.07,Percent of total billed charges,,,0.97,,34.07,Percent of total billed charges,,,0.96,,33.72,Percent of total billed charges,,,0.95,,33.36,Percent of total billed charges,,,,,,,,,0.95,,33.36,Percent of total billed charges,,33.36,34.42,
LIDOCAINE-PRILOCAINE 2.5-2.5 % EX CREA,RX-10434,CDM,J3490,HCPCS,637,RC,,outpatient,5,GR,35.12,31.61,,0.95,,33.36,Percent of total billed charges,,,0.98,,34.42,Percent of total billed charges,,,0.95,,33.36,Percent of total billed charges,,,0.95,,33.36,Percent of total billed charges,,,0.97,,34.07,Percent of total billed charges,,,0.96,,33.72,Percent of total billed charges,,,0.95,,33.36,Percent of total billed charges,,,,,,,,,0.95,,33.36,Percent of total billed charges,,33.36,34.42,
LISINOPRIL 10 MG PO TABS,RX-10449,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,5.94,5.35,,0.95,,5.64,Percent of total billed charges,,,0.98,,5.82,Percent of total billed charges,,,0.95,,5.64,Percent of total billed charges,,,0.97,,5.76,Percent of total billed charges,,,0.97,,5.76,Percent of total billed charges,,,0.96,,5.7,Percent of total billed charges,,,0.95,,5.64,Percent of total billed charges,,,,,,,,,0.95,,5.64,Percent of total billed charges,,5.64,5.82,
LISINOPRIL 10 MG PO TABS,RX-10449,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,5.94,5.35,,0.95,,5.64,Percent of total billed charges,,,0.98,,5.82,Percent of total billed charges,,,0.95,,5.64,Percent of total billed charges,,,0.95,,5.64,Percent of total billed charges,,,0.97,,5.76,Percent of total billed charges,,,0.96,,5.7,Percent of total billed charges,,,0.95,,5.64,Percent of total billed charges,,,,,,,,,0.95,,5.64,Percent of total billed charges,,5.64,5.82,
LISINOPRIL 5 MG PO TABS,RX-10451,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.01,5.41,,0.95,,5.71,Percent of total billed charges,,,0.98,,5.89,Percent of total billed charges,,,0.95,,5.71,Percent of total billed charges,,,0.97,,5.83,Percent of total billed charges,,,0.97,,5.83,Percent of total billed charges,,,0.96,,5.77,Percent of total billed charges,,,0.95,,5.71,Percent of total billed charges,,,,,,,,,0.95,,5.71,Percent of total billed charges,,5.71,5.89,
LISINOPRIL 5 MG PO TABS,RX-10451,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.01,5.41,,0.95,,5.71,Percent of total billed charges,,,0.98,,5.89,Percent of total billed charges,,,0.95,,5.71,Percent of total billed charges,,,0.95,,5.71,Percent of total billed charges,,,0.97,,5.83,Percent of total billed charges,,,0.96,,5.77,Percent of total billed charges,,,0.95,,5.71,Percent of total billed charges,,,,,,,,,0.95,,5.71,Percent of total billed charges,,5.71,5.89,
LITHIUM CARBONATE ER 450 MG PO TBCR,RX-10455,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.7,6.93,,0.95,,7.32,Percent of total billed charges,,,0.98,,7.55,Percent of total billed charges,,,0.95,,7.32,Percent of total billed charges,,,0.97,,7.47,Percent of total billed charges,,,0.97,,7.47,Percent of total billed charges,,,0.96,,7.39,Percent of total billed charges,,,0.95,,7.32,Percent of total billed charges,,,,,,,,,0.95,,7.32,Percent of total billed charges,,7.32,7.55,
LITHIUM CARBONATE ER 450 MG PO TBCR,RX-10455,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.7,6.93,,0.95,,7.32,Percent of total billed charges,,,0.98,,7.55,Percent of total billed charges,,,0.95,,7.32,Percent of total billed charges,,,0.95,,7.32,Percent of total billed charges,,,0.97,,7.47,Percent of total billed charges,,,0.96,,7.39,Percent of total billed charges,,,0.95,,7.32,Percent of total billed charges,,,,,,,,,0.95,,7.32,Percent of total billed charges,,7.32,7.55,
LORAZEPAM 2 MG/ML INJECTION SOLN,RX-10467,CDM,J2060,HCPCS,636,RC,,inpatient,0.25,ML,46.35,41.72,,0.95,,44.03,Percent of total billed charges,,,0.98,,45.42,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,0.97,,44.96,Percent of total billed charges,,,0.97,,44.96,Percent of total billed charges,,,0.96,,44.5,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,,,,,,,0.95,,44.03,Percent of total billed charges,,44.03,45.42,
LORAZEPAM 2 MG/ML INJECTION SOLN,RX-10467,CDM,J2060,HCPCS,636,RC,,outpatient,0.25,ML,46.35,41.72,,0.95,,44.03,Percent of total billed charges,,,0.98,,45.42,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,0.97,,44.96,Percent of total billed charges,,,0.96,,44.5,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,,,,,,,0.95,,44.03,Percent of total billed charges,,44.03,45.42,
LOVASTATIN 20 MG PO TABS,RX-10470,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,5.94,5.35,,0.95,,5.64,Percent of total billed charges,,,0.98,,5.82,Percent of total billed charges,,,0.95,,5.64,Percent of total billed charges,,,0.97,,5.76,Percent of total billed charges,,,0.97,,5.76,Percent of total billed charges,,,0.96,,5.7,Percent of total billed charges,,,0.95,,5.64,Percent of total billed charges,,,,,,,,,0.95,,5.64,Percent of total billed charges,,5.64,5.82,
LOVASTATIN 20 MG PO TABS,RX-10470,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,5.94,5.35,,0.95,,5.64,Percent of total billed charges,,,0.98,,5.82,Percent of total billed charges,,,0.95,,5.64,Percent of total billed charges,,,0.95,,5.64,Percent of total billed charges,,,0.97,,5.76,Percent of total billed charges,,,0.96,,5.7,Percent of total billed charges,,,0.95,,5.64,Percent of total billed charges,,,,,,,,,0.95,,5.64,Percent of total billed charges,,5.64,5.82,
ACETAMINOPHEN 650 MG RECTAL SUPP,RX-105,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
ACETAMINOPHEN 650 MG RECTAL SUPP,RX-105,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
METHIMAZOLE 5 MG PO TABS,RX-10553,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.53,7.68,,0.95,,8.1,Percent of total billed charges,,,0.98,,8.36,Percent of total billed charges,,,0.95,,8.1,Percent of total billed charges,,,0.97,,8.27,Percent of total billed charges,,,0.97,,8.27,Percent of total billed charges,,,0.96,,8.19,Percent of total billed charges,,,0.95,,8.1,Percent of total billed charges,,,,,,,,,0.95,,8.1,Percent of total billed charges,,8.1,8.36,
METHIMAZOLE 5 MG PO TABS,RX-10553,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.53,7.68,,0.95,,8.1,Percent of total billed charges,,,0.98,,8.36,Percent of total billed charges,,,0.95,,8.1,Percent of total billed charges,,,0.95,,8.1,Percent of total billed charges,,,0.97,,8.27,Percent of total billed charges,,,0.96,,8.19,Percent of total billed charges,,,0.95,,8.1,Percent of total billed charges,,,,,,,,,0.95,,8.1,Percent of total billed charges,,8.1,8.36,
METHYLERGONOVINE MALEATE 0.2 MG/ML INJECTION SOLN,RX-10571,CDM,J2210,HCPCS,636,RC,,inpatient,1,ML,187.08,168.37,,0.95,,177.73,Percent of total billed charges,,,0.98,,183.34,Percent of total billed charges,,,0.95,,177.73,Percent of total billed charges,,,0.97,,181.47,Percent of total billed charges,,,0.97,,181.47,Percent of total billed charges,,,0.96,,179.6,Percent of total billed charges,,,0.95,,177.73,Percent of total billed charges,,,,,,,,,0.95,,177.73,Percent of total billed charges,,177.73,183.34,
METHYLERGONOVINE MALEATE 0.2 MG/ML INJECTION SOLN,RX-10571,CDM,J2210,HCPCS,636,RC,,outpatient,1,ML,187.08,168.37,,0.95,,177.73,Percent of total billed charges,,,0.98,,183.34,Percent of total billed charges,,,0.95,,177.73,Percent of total billed charges,,,0.95,,177.73,Percent of total billed charges,,,0.97,,181.47,Percent of total billed charges,,,0.96,,179.6,Percent of total billed charges,,,0.95,,177.73,Percent of total billed charges,,,,,,,,,0.95,,177.73,Percent of total billed charges,,177.73,183.34,
METHYLERGONOVINE MALEATE 0.2 MG PO TABS,RX-10572,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,59.28,53.35,,0.95,,56.32,Percent of total billed charges,,,0.98,,58.09,Percent of total billed charges,,,0.95,,56.32,Percent of total billed charges,,,0.97,,57.5,Percent of total billed charges,,,0.97,,57.5,Percent of total billed charges,,,0.96,,56.91,Percent of total billed charges,,,0.95,,56.32,Percent of total billed charges,,,,,,,,,0.95,,56.32,Percent of total billed charges,,56.32,58.09,
METHYLERGONOVINE MALEATE 0.2 MG PO TABS,RX-10572,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,59.28,53.35,,0.95,,56.32,Percent of total billed charges,,,0.98,,58.09,Percent of total billed charges,,,0.95,,56.32,Percent of total billed charges,,,0.95,,56.32,Percent of total billed charges,,,0.97,,57.5,Percent of total billed charges,,,0.96,,56.91,Percent of total billed charges,,,0.95,,56.32,Percent of total billed charges,,,,,,,,,0.95,,56.32,Percent of total billed charges,,56.32,58.09,
METHYLPREDNISOLONE SODIUM SUCC 1000 MG INJECTION SOLR,RX-10577,CDM,J2919,HCPCS,636,RC,,inpatient,16,ML,145.21,130.69,,0.95,,137.95,Percent of total billed charges,,,0.98,,142.31,Percent of total billed charges,,,0.95,,137.95,Percent of total billed charges,,,0.97,,140.85,Percent of total billed charges,,,0.97,,140.85,Percent of total billed charges,,,0.96,,139.4,Percent of total billed charges,,,0.95,,137.95,Percent of total billed charges,,,,,,,,,0.95,,137.95,Percent of total billed charges,,137.95,142.31,
METHYLPREDNISOLONE SODIUM SUCC 1000 MG INJECTION SOLR,RX-10577,CDM,J2919,HCPCS,636,RC,,outpatient,16,ML,145.21,130.69,,0.95,,137.95,Percent of total billed charges,,,0.98,,142.31,Percent of total billed charges,,,0.95,,137.95,Percent of total billed charges,,,0.95,,137.95,Percent of total billed charges,,,0.97,,140.85,Percent of total billed charges,,,0.96,,139.4,Percent of total billed charges,,,0.95,,137.95,Percent of total billed charges,,,,,,,,,0.95,,137.95,Percent of total billed charges,,137.95,142.31,
METHYLPREDNISOLONE SODIUM SUCC 500 MG INJECTION SOLR,RX-10581,CDM,J2919,HCPCS,636,RC,,inpatient,8,ML,91.51,82.36,,0.95,,86.93,Percent of total billed charges,,,0.98,,89.68,Percent of total billed charges,,,0.95,,86.93,Percent of total billed charges,,,0.97,,88.76,Percent of total billed charges,,,0.97,,88.76,Percent of total billed charges,,,0.96,,87.85,Percent of total billed charges,,,0.95,,86.93,Percent of total billed charges,,,,,,,,,0.95,,86.93,Percent of total billed charges,,86.93,89.68,
METHYLPREDNISOLONE SODIUM SUCC 500 MG INJECTION SOLR,RX-10581,CDM,J2919,HCPCS,636,RC,,outpatient,8,ML,91.51,82.36,,0.95,,86.93,Percent of total billed charges,,,0.98,,89.68,Percent of total billed charges,,,0.95,,86.93,Percent of total billed charges,,,0.95,,86.93,Percent of total billed charges,,,0.97,,88.76,Percent of total billed charges,,,0.96,,87.85,Percent of total billed charges,,,0.95,,86.93,Percent of total billed charges,,,,,,,,,0.95,,86.93,Percent of total billed charges,,86.93,89.68,
PENICILLIN G BENZATHINE 1200000 UNIT/2ML IM SUSY,RX-105829,CDM,J0561,HCPCS,636,RC,,inpatient,1,ML,467.97,421.17,,0.95,,444.57,Percent of total billed charges,,,0.98,,458.61,Percent of total billed charges,,,0.95,,444.57,Percent of total billed charges,,,0.97,,453.93,Percent of total billed charges,,,0.97,,453.93,Percent of total billed charges,,,0.96,,449.25,Percent of total billed charges,,,0.95,,444.57,Percent of total billed charges,,,,,,,,,0.95,,444.57,Percent of total billed charges,,444.57,458.61,
PENICILLIN G BENZATHINE 1200000 UNIT/2ML IM SUSY,RX-105829,CDM,J0561,HCPCS,636,RC,,outpatient,1,ML,467.97,421.17,,0.95,,444.57,Percent of total billed charges,,,0.98,,458.61,Percent of total billed charges,,,0.95,,444.57,Percent of total billed charges,,,0.95,,444.57,Percent of total billed charges,,,0.97,,453.93,Percent of total billed charges,,,0.96,,449.25,Percent of total billed charges,,,0.95,,444.57,Percent of total billed charges,,,,,,,,,0.95,,444.57,Percent of total billed charges,,444.57,458.61,
PENICILLIN G BENZATHINE & PROC 1200000 UNIT/2ML IM SUSP,RX-105831,CDM,J0558,HCPCS,636,RC,,inpatient,2,ML,425.74,383.17,,0.95,,404.45,Percent of total billed charges,,,0.98,,417.23,Percent of total billed charges,,,0.95,,404.45,Percent of total billed charges,,,0.97,,412.97,Percent of total billed charges,,,0.97,,412.97,Percent of total billed charges,,,0.96,,408.71,Percent of total billed charges,,,0.95,,404.45,Percent of total billed charges,,,,,,,,,0.95,,404.45,Percent of total billed charges,,404.45,417.23,
PENICILLIN G BENZATHINE & PROC 1200000 UNIT/2ML IM SUSP,RX-105831,CDM,J0558,HCPCS,636,RC,,outpatient,2,ML,425.74,383.17,,0.95,,404.45,Percent of total billed charges,,,0.98,,417.23,Percent of total billed charges,,,0.95,,404.45,Percent of total billed charges,,,0.95,,404.45,Percent of total billed charges,,,0.97,,412.97,Percent of total billed charges,,,0.96,,408.71,Percent of total billed charges,,,0.95,,404.45,Percent of total billed charges,,,,,,,,,0.95,,404.45,Percent of total billed charges,,404.45,417.23,
TOCILIZUMAB 80 MG/4ML IV SOLN,RX-105841,CDM,J3262,HCPCS,636,RC,,inpatient,4,ML,927.93,835.14,,0.95,,881.53,Percent of total billed charges,,,0.98,,909.37,Percent of total billed charges,,,0.95,,881.53,Percent of total billed charges,,,0.97,,900.09,Percent of total billed charges,,,0.97,,900.09,Percent of total billed charges,,,0.96,,890.81,Percent of total billed charges,,,0.95,,881.53,Percent of total billed charges,,,,,,,,,0.95,,881.53,Percent of total billed charges,,881.53,909.37,
TOCILIZUMAB 80 MG/4ML IV SOLN,RX-105841,CDM,J3262,HCPCS,636,RC,,outpatient,4,ML,927.93,835.14,,0.95,,881.53,Percent of total billed charges,,,0.98,,909.37,Percent of total billed charges,,,0.95,,881.53,Percent of total billed charges,,,0.95,,881.53,Percent of total billed charges,,,0.97,,900.09,Percent of total billed charges,,,0.96,,890.81,Percent of total billed charges,,,0.95,,881.53,Percent of total billed charges,,,,,,,,,0.95,,881.53,Percent of total billed charges,,881.53,909.37,
TOCILIZUMAB 200 MG/10ML IV SOLN,RX-105842,CDM,J3262,HCPCS,636,RC,,inpatient,10,ML,2319.82,2087.84,,0.95,,2203.83,Percent of total billed charges,,,0.98,,2273.42,Percent of total billed charges,,,0.95,,2203.83,Percent of total billed charges,,,0.97,,2250.23,Percent of total billed charges,,,0.97,,2250.23,Percent of total billed charges,,,0.96,,2227.03,Percent of total billed charges,,,0.95,,2203.83,Percent of total billed charges,,,,,,,,,0.95,,2203.83,Percent of total billed charges,,2203.83,2273.42,
TOCILIZUMAB 200 MG/10ML IV SOLN,RX-105842,CDM,J3262,HCPCS,636,RC,,outpatient,10,ML,2319.82,2087.84,,0.95,,2203.83,Percent of total billed charges,,,0.98,,2273.42,Percent of total billed charges,,,0.95,,2203.83,Percent of total billed charges,,,0.95,,2203.83,Percent of total billed charges,,,0.97,,2250.23,Percent of total billed charges,,,0.96,,2227.03,Percent of total billed charges,,,0.95,,2203.83,Percent of total billed charges,,,,,,,,,0.95,,2203.83,Percent of total billed charges,,2203.83,2273.42,
TOCILIZUMAB 400 MG/20ML IV SOLN,RX-105843,CDM,J3262,HCPCS,636,RC,,inpatient,20,ML,4639.63,4175.67,,0.95,,4407.65,Percent of total billed charges,,,0.98,,4546.84,Percent of total billed charges,,,0.95,,4407.65,Percent of total billed charges,,,0.97,,4500.44,Percent of total billed charges,,,0.97,,4500.44,Percent of total billed charges,,,0.96,,4454.04,Percent of total billed charges,,,0.95,,4407.65,Percent of total billed charges,,,,,,,,,0.95,,4407.65,Percent of total billed charges,,4407.65,4546.84,
TOCILIZUMAB 400 MG/20ML IV SOLN,RX-105843,CDM,J3262,HCPCS,636,RC,,outpatient,20,ML,4639.63,4175.67,,0.95,,4407.65,Percent of total billed charges,,,0.98,,4546.84,Percent of total billed charges,,,0.95,,4407.65,Percent of total billed charges,,,0.95,,4407.65,Percent of total billed charges,,,0.97,,4500.44,Percent of total billed charges,,,0.96,,4454.04,Percent of total billed charges,,,0.95,,4407.65,Percent of total billed charges,,,,,,,,,0.95,,4407.65,Percent of total billed charges,,4407.65,4546.84,
BEVACIZUMAB 100 MG/4ML IV SOLN,RX-105845,CDM,J9035,HCPCS,636,RC,,inpatient,4,ML,1736.5,1562.85,,0.95,,1649.68,Percent of total billed charges,,,0.98,,1701.77,Percent of total billed charges,,,0.95,,1649.68,Percent of total billed charges,,,0.97,,1684.41,Percent of total billed charges,,,0.97,,1684.41,Percent of total billed charges,,,0.96,,1667.04,Percent of total billed charges,,,0.95,,1649.68,Percent of total billed charges,,,,,,,,,0.95,,1649.68,Percent of total billed charges,,1649.68,1701.77,
BEVACIZUMAB 100 MG/4ML IV SOLN,RX-105845,CDM,J9035,HCPCS,636,RC,,outpatient,4,ML,1736.5,1562.85,,0.95,,1649.68,Percent of total billed charges,,,0.98,,1701.77,Percent of total billed charges,,,0.95,,1649.68,Percent of total billed charges,,,0.95,,1649.68,Percent of total billed charges,,,0.97,,1684.41,Percent of total billed charges,,,0.96,,1667.04,Percent of total billed charges,,,0.95,,1649.68,Percent of total billed charges,,,,,,,,,0.95,,1649.68,Percent of total billed charges,,1649.68,1701.77,
BEVACIZUMAB 400 MG/16ML IV SOLN,RX-105846,CDM,J9035,HCPCS,636,RC,,inpatient,16,ML,6636.96,5973.26,,0.95,,6305.11,Percent of total billed charges,,,0.98,,6504.22,Percent of total billed charges,,,0.95,,6305.11,Percent of total billed charges,,,0.97,,6437.85,Percent of total billed charges,,,0.97,,6437.85,Percent of total billed charges,,,0.96,,6371.48,Percent of total billed charges,,,0.95,,6305.11,Percent of total billed charges,,,,,,,,,0.95,,6305.11,Percent of total billed charges,,6305.11,6504.22,
BEVACIZUMAB 400 MG/16ML IV SOLN,RX-105846,CDM,J9035,HCPCS,636,RC,,outpatient,16,ML,6636.96,5973.26,,0.95,,6305.11,Percent of total billed charges,,,0.98,,6504.22,Percent of total billed charges,,,0.95,,6305.11,Percent of total billed charges,,,0.95,,6305.11,Percent of total billed charges,,,0.97,,6437.85,Percent of total billed charges,,,0.96,,6371.48,Percent of total billed charges,,,0.95,,6305.11,Percent of total billed charges,,,,,,,,,0.95,,6305.11,Percent of total billed charges,,6305.11,6504.22,
CETUXIMAB 200 MG/100ML IV SOLN,RX-105852,CDM,J9055,HCPCS,636,RC,,inpatient,100,ML,3140.27,2826.24,,0.95,,2983.26,Percent of total billed charges,,,0.98,,3077.46,Percent of total billed charges,,,0.95,,2983.26,Percent of total billed charges,,,0.97,,3046.06,Percent of total billed charges,,,0.97,,3046.06,Percent of total billed charges,,,0.96,,3014.66,Percent of total billed charges,,,0.95,,2983.26,Percent of total billed charges,,,,,,,,,0.95,,2983.26,Percent of total billed charges,,2983.26,3077.46,
CETUXIMAB 200 MG/100ML IV SOLN,RX-105852,CDM,J9055,HCPCS,636,RC,,outpatient,100,ML,3140.27,2826.24,,0.95,,2983.26,Percent of total billed charges,,,0.98,,3077.46,Percent of total billed charges,,,0.95,,2983.26,Percent of total billed charges,,,0.95,,2983.26,Percent of total billed charges,,,0.97,,3046.06,Percent of total billed charges,,,0.96,,3014.66,Percent of total billed charges,,,0.95,,2983.26,Percent of total billed charges,,,,,,,,,0.95,,2983.26,Percent of total billed charges,,2983.26,3077.46,
FILGRASTIM 300 MCG/0.5ML INJECTION SOSY,RX-105855,CDM,J1442,HCPCS,636,RC,,inpatient,0.5,ML,1034.39,930.95,,0.95,,982.67,Percent of total billed charges,,,0.98,,1013.7,Percent of total billed charges,,,0.95,,982.67,Percent of total billed charges,,,0.97,,1003.36,Percent of total billed charges,,,0.97,,1003.36,Percent of total billed charges,,,0.96,,993.01,Percent of total billed charges,,,0.95,,982.67,Percent of total billed charges,,,,,,,,,0.95,,982.67,Percent of total billed charges,,982.67,1013.7,
FILGRASTIM 300 MCG/0.5ML INJECTION SOSY,RX-105855,CDM,J1442,HCPCS,636,RC,,outpatient,0.5,ML,1034.39,930.95,,0.95,,982.67,Percent of total billed charges,,,0.98,,1013.7,Percent of total billed charges,,,0.95,,982.67,Percent of total billed charges,,,0.95,,982.67,Percent of total billed charges,,,0.97,,1003.36,Percent of total billed charges,,,0.96,,993.01,Percent of total billed charges,,,0.95,,982.67,Percent of total billed charges,,,,,,,,,0.95,,982.67,Percent of total billed charges,,982.67,1013.7,
FILGRASTIM 480 MCG/0.8ML INJECTION SOSY,RX-105856,CDM,J1442,HCPCS,636,RC,,inpatient,0.8,ML,927.47,834.72,,0.95,,881.1,Percent of total billed charges,,,0.98,,908.92,Percent of total billed charges,,,0.95,,881.1,Percent of total billed charges,,,0.97,,899.65,Percent of total billed charges,,,0.97,,899.65,Percent of total billed charges,,,0.96,,890.37,Percent of total billed charges,,,0.95,,881.1,Percent of total billed charges,,,,,,,,,0.95,,881.1,Percent of total billed charges,,881.1,908.92,
FILGRASTIM 480 MCG/0.8ML INJECTION SOSY,RX-105856,CDM,J1442,HCPCS,636,RC,,outpatient,0.8,ML,927.47,834.72,,0.95,,881.1,Percent of total billed charges,,,0.98,,908.92,Percent of total billed charges,,,0.95,,881.1,Percent of total billed charges,,,0.95,,881.1,Percent of total billed charges,,,0.97,,899.65,Percent of total billed charges,,,0.96,,890.37,Percent of total billed charges,,,0.95,,881.1,Percent of total billed charges,,,,,,,,,0.95,,881.1,Percent of total billed charges,,881.1,908.92,
FULVESTRANT 250 MG/5ML IM SOSY,RX-105876,CDM,J9395,HCPCS,636,RC,,inpatient,5,ML,500.19,450.17,,0.95,,475.18,Percent of total billed charges,,,0.98,,490.19,Percent of total billed charges,,,0.95,,475.18,Percent of total billed charges,,,0.97,,485.18,Percent of total billed charges,,,0.97,,485.18,Percent of total billed charges,,,0.96,,480.18,Percent of total billed charges,,,0.95,,475.18,Percent of total billed charges,,,,,,,,,0.95,,475.18,Percent of total billed charges,,475.18,490.19,
FULVESTRANT 250 MG/5ML IM SOSY,RX-105876,CDM,J9395,HCPCS,636,RC,,outpatient,5,ML,500.19,450.17,,0.95,,475.18,Percent of total billed charges,,,0.98,,490.19,Percent of total billed charges,,,0.95,,475.18,Percent of total billed charges,,,0.95,,475.18,Percent of total billed charges,,,0.97,,485.18,Percent of total billed charges,,,0.96,,480.18,Percent of total billed charges,,,0.95,,475.18,Percent of total billed charges,,,,,,,,,0.95,,475.18,Percent of total billed charges,,475.18,490.19,
METOLAZONE 5 MG PO TABS,RX-10588,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,9.18,8.26,,0.95,,8.72,Percent of total billed charges,,,0.98,,9,Percent of total billed charges,,,0.95,,8.72,Percent of total billed charges,,,0.97,,8.9,Percent of total billed charges,,,0.97,,8.9,Percent of total billed charges,,,0.96,,8.81,Percent of total billed charges,,,0.95,,8.72,Percent of total billed charges,,,,,,,,,0.95,,8.72,Percent of total billed charges,,8.72,9,
METOLAZONE 5 MG PO TABS,RX-10588,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,9.18,8.26,,0.95,,8.72,Percent of total billed charges,,,0.98,,9,Percent of total billed charges,,,0.95,,8.72,Percent of total billed charges,,,0.95,,8.72,Percent of total billed charges,,,0.97,,8.9,Percent of total billed charges,,,0.96,,8.81,Percent of total billed charges,,,0.95,,8.72,Percent of total billed charges,,,,,,,,,0.95,,8.72,Percent of total billed charges,,8.72,9,
LEVOFLOXACIN IN D5W 250 MG/50ML IV SOLN,RX-105898,CDM,J1956,HCPCS,636,RC,,inpatient,50,ML,89.67,80.7,,0.95,,85.19,Percent of total billed charges,,,0.98,,87.88,Percent of total billed charges,,,0.95,,85.19,Percent of total billed charges,,,0.97,,86.98,Percent of total billed charges,,,0.97,,86.98,Percent of total billed charges,,,0.96,,86.08,Percent of total billed charges,,,0.95,,85.19,Percent of total billed charges,,,,,,,,,0.95,,85.19,Percent of total billed charges,,85.19,87.88,
LEVOFLOXACIN IN D5W 250 MG/50ML IV SOLN,RX-105898,CDM,J1956,HCPCS,636,RC,,outpatient,50,ML,89.67,80.7,,0.95,,85.19,Percent of total billed charges,,,0.98,,87.88,Percent of total billed charges,,,0.95,,85.19,Percent of total billed charges,,,0.95,,85.19,Percent of total billed charges,,,0.97,,86.98,Percent of total billed charges,,,0.96,,86.08,Percent of total billed charges,,,0.95,,85.19,Percent of total billed charges,,,,,,,,,0.95,,85.19,Percent of total billed charges,,85.19,87.88,
LEVOFLOXACIN IN D5W 500 MG/100ML IV SOLN,RX-105899,CDM,J1956,HCPCS,636,RC,,inpatient,100,ML,91.06,81.95,,0.95,,86.51,Percent of total billed charges,,,0.98,,89.24,Percent of total billed charges,,,0.95,,86.51,Percent of total billed charges,,,0.97,,88.33,Percent of total billed charges,,,0.97,,88.33,Percent of total billed charges,,,0.96,,87.42,Percent of total billed charges,,,0.95,,86.51,Percent of total billed charges,,,,,,,,,0.95,,86.51,Percent of total billed charges,,86.51,89.24,
LEVOFLOXACIN IN D5W 500 MG/100ML IV SOLN,RX-105899,CDM,J1956,HCPCS,636,RC,,outpatient,100,ML,91.06,81.95,,0.95,,86.51,Percent of total billed charges,,,0.98,,89.24,Percent of total billed charges,,,0.95,,86.51,Percent of total billed charges,,,0.95,,86.51,Percent of total billed charges,,,0.97,,88.33,Percent of total billed charges,,,0.96,,87.42,Percent of total billed charges,,,0.95,,86.51,Percent of total billed charges,,,,,,,,,0.95,,86.51,Percent of total billed charges,,86.51,89.24,
LEVOFLOXACIN IN D5W 750 MG/150ML IV SOLN,RX-105900,CDM,J1956,HCPCS,636,RC,,inpatient,150,ML,185.65,167.09,,0.95,,176.37,Percent of total billed charges,,,0.98,,181.94,Percent of total billed charges,,,0.95,,176.37,Percent of total billed charges,,,0.97,,180.08,Percent of total billed charges,,,0.97,,180.08,Percent of total billed charges,,,0.96,,178.22,Percent of total billed charges,,,0.95,,176.37,Percent of total billed charges,,,,,,,,,0.95,,176.37,Percent of total billed charges,,176.37,181.94,
LEVOFLOXACIN IN D5W 750 MG/150ML IV SOLN,RX-105900,CDM,J1956,HCPCS,636,RC,,outpatient,150,ML,185.65,167.09,,0.95,,176.37,Percent of total billed charges,,,0.98,,181.94,Percent of total billed charges,,,0.95,,176.37,Percent of total billed charges,,,0.95,,176.37,Percent of total billed charges,,,0.97,,180.08,Percent of total billed charges,,,0.96,,178.22,Percent of total billed charges,,,0.95,,176.37,Percent of total billed charges,,,,,,,,,0.95,,176.37,Percent of total billed charges,,176.37,181.94,
DOCETAXEL 80 MG/4ML IV CONC,RX-105902,CDM,J9171,HCPCS,636,RC,,inpatient,4,ML,721,648.9,,0.95,,684.95,Percent of total billed charges,,,0.98,,706.58,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,0.97,,699.37,Percent of total billed charges,,,0.97,,699.37,Percent of total billed charges,,,0.96,,692.16,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,,,,,,,0.95,,684.95,Percent of total billed charges,,684.95,706.58,
DOCETAXEL 80 MG/4ML IV CONC,RX-105902,CDM,J9171,HCPCS,636,RC,,outpatient,4,ML,721,648.9,,0.95,,684.95,Percent of total billed charges,,,0.98,,706.58,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,0.97,,699.37,Percent of total billed charges,,,0.96,,692.16,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,,,,,,,0.95,,684.95,Percent of total billed charges,,684.95,706.58,
CIPROFLOXACIN IN D5W 200 MG/100ML IV SOLN,RX-105908,CDM,J0744,HCPCS,636,RC,,inpatient,100,ML,39.14,35.23,,0.95,,37.18,Percent of total billed charges,,,0.98,,38.36,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,0.97,,37.97,Percent of total billed charges,,,0.97,,37.97,Percent of total billed charges,,,0.96,,37.57,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,,,,,,,0.95,,37.18,Percent of total billed charges,,37.18,38.36,
CIPROFLOXACIN IN D5W 200 MG/100ML IV SOLN,RX-105908,CDM,J0744,HCPCS,636,RC,,outpatient,100,ML,39.14,35.23,,0.95,,37.18,Percent of total billed charges,,,0.98,,38.36,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,0.97,,37.97,Percent of total billed charges,,,0.96,,37.57,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,,,,,,,0.95,,37.18,Percent of total billed charges,,37.18,38.36,
IMMUNE GLOBULIN (HUMAN) 30 GM/300ML IV SOLN,RX-106015,CDM,J1568,HCPCS,636,RC,,inpatient,300,ML,5164.86,4648.37,,0.95,,4906.62,Percent of total billed charges,,,0.98,,5061.56,Percent of total billed charges,,,0.95,,4906.62,Percent of total billed charges,,,0.97,,5009.91,Percent of total billed charges,,,0.97,,5009.91,Percent of total billed charges,,,0.96,,4958.27,Percent of total billed charges,,,0.95,,4906.62,Percent of total billed charges,,,,,,,,,0.95,,4906.62,Percent of total billed charges,,4906.62,5061.56,
IMMUNE GLOBULIN (HUMAN) 30 GM/300ML IV SOLN,RX-106015,CDM,J1568,HCPCS,636,RC,,outpatient,300,ML,5164.86,4648.37,,0.95,,4906.62,Percent of total billed charges,,,0.98,,5061.56,Percent of total billed charges,,,0.95,,4906.62,Percent of total billed charges,,,0.95,,4906.62,Percent of total billed charges,,,0.97,,5009.91,Percent of total billed charges,,,0.96,,4958.27,Percent of total billed charges,,,0.95,,4906.62,Percent of total billed charges,,,,,,,,,0.95,,4906.62,Percent of total billed charges,,4906.62,5061.56,
MIDODRINE HCL 5 MG PO TABS,RX-10610,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,9.54,8.59,,0.95,,9.06,Percent of total billed charges,,,0.98,,9.35,Percent of total billed charges,,,0.95,,9.06,Percent of total billed charges,,,0.97,,9.25,Percent of total billed charges,,,0.97,,9.25,Percent of total billed charges,,,0.96,,9.16,Percent of total billed charges,,,0.95,,9.06,Percent of total billed charges,,,,,,,,,0.95,,9.06,Percent of total billed charges,,9.06,9.35,
MIDODRINE HCL 5 MG PO TABS,RX-10610,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,9.54,8.59,,0.95,,9.06,Percent of total billed charges,,,0.98,,9.35,Percent of total billed charges,,,0.95,,9.06,Percent of total billed charges,,,0.95,,9.06,Percent of total billed charges,,,0.97,,9.25,Percent of total billed charges,,,0.96,,9.16,Percent of total billed charges,,,0.95,,9.06,Percent of total billed charges,,,,,,,,,0.95,,9.06,Percent of total billed charges,,9.06,9.35,
DOCETAXEL 160 MG/16ML IV SOLN,RX-106195,CDM,J9171,HCPCS,636,RC,,inpatient,16,ML,721,648.9,,0.95,,684.95,Percent of total billed charges,,,0.98,,706.58,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,0.97,,699.37,Percent of total billed charges,,,0.97,,699.37,Percent of total billed charges,,,0.96,,692.16,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,,,,,,,0.95,,684.95,Percent of total billed charges,,684.95,706.58,
DOCETAXEL 160 MG/16ML IV SOLN,RX-106195,CDM,J9171,HCPCS,636,RC,,outpatient,16,ML,721,648.9,,0.95,,684.95,Percent of total billed charges,,,0.98,,706.58,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,0.97,,699.37,Percent of total billed charges,,,0.96,,692.16,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,,,,,,,0.95,,684.95,Percent of total billed charges,,684.95,706.58,
IPILIMUMAB 50 MG/10ML IV SOLN,RX-106242,CDM,J9228,HCPCS,636,RC,,inpatient,10,ML,16500.91,14850.82,,0.95,,15675.86,Percent of total billed charges,,,0.98,,16170.89,Percent of total billed charges,,,0.95,,15675.86,Percent of total billed charges,,,0.97,,16005.88,Percent of total billed charges,,,0.97,,16005.88,Percent of total billed charges,,,0.96,,15840.87,Percent of total billed charges,,,0.95,,15675.86,Percent of total billed charges,,,,,,,,,0.95,,15675.86,Percent of total billed charges,,15675.86,16170.89,
IPILIMUMAB 50 MG/10ML IV SOLN,RX-106242,CDM,J9228,HCPCS,636,RC,,outpatient,10,ML,16500.91,14850.82,,0.95,,15675.86,Percent of total billed charges,,,0.98,,16170.89,Percent of total billed charges,,,0.95,,15675.86,Percent of total billed charges,,,0.95,,15675.86,Percent of total billed charges,,,0.97,,16005.88,Percent of total billed charges,,,0.96,,15840.87,Percent of total billed charges,,,0.95,,15675.86,Percent of total billed charges,,,,,,,,,0.95,,15675.86,Percent of total billed charges,,15675.86,16170.89,
MISOPROSTOL 100 MCG PO TABS,RX-10628,CDM,J3490,HCPCS,637,RC,,inpatient,0.25,UN,5.67,5.1,,0.95,,5.39,Percent of total billed charges,,,0.98,,5.56,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,0.97,,5.5,Percent of total billed charges,,,0.97,,5.5,Percent of total billed charges,,,0.96,,5.44,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,,,,,,,0.95,,5.39,Percent of total billed charges,,5.39,5.56,
MISOPROSTOL 100 MCG PO TABS,RX-10628,CDM,J3490,HCPCS,637,RC,,outpatient,0.25,UN,5.67,5.1,,0.95,,5.39,Percent of total billed charges,,,0.98,,5.56,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,0.97,,5.5,Percent of total billed charges,,,0.96,,5.44,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,,,,,,,0.95,,5.39,Percent of total billed charges,,5.39,5.56,
CHLORHEXIDINE GLUCONATE 4 % EX SOLN,RX-106327,CDM,J3490,HCPCS,637,RC,,inpatient,946,ML,30.7,27.63,,0.95,,29.17,Percent of total billed charges,,,0.98,,30.09,Percent of total billed charges,,,0.95,,29.17,Percent of total billed charges,,,0.97,,29.78,Percent of total billed charges,,,0.97,,29.78,Percent of total billed charges,,,0.96,,29.47,Percent of total billed charges,,,0.95,,29.17,Percent of total billed charges,,,,,,,,,0.95,,29.17,Percent of total billed charges,,29.17,30.09,
CHLORHEXIDINE GLUCONATE 4 % EX SOLN,RX-106327,CDM,J3490,HCPCS,637,RC,,outpatient,946,ML,30.7,27.63,,0.95,,29.17,Percent of total billed charges,,,0.98,,30.09,Percent of total billed charges,,,0.95,,29.17,Percent of total billed charges,,,0.95,,29.17,Percent of total billed charges,,,0.97,,29.78,Percent of total billed charges,,,0.96,,29.47,Percent of total billed charges,,,0.95,,29.17,Percent of total billed charges,,,,,,,,,0.95,,29.17,Percent of total billed charges,,29.17,30.09,
MUPIROCIN 2 % EX OINT,RX-10674,CDM,J3490,HCPCS,637,RC,,inpatient,22,GR,39.67,35.7,,0.95,,37.69,Percent of total billed charges,,,0.98,,38.88,Percent of total billed charges,,,0.95,,37.69,Percent of total billed charges,,,0.97,,38.48,Percent of total billed charges,,,0.97,,38.48,Percent of total billed charges,,,0.96,,38.08,Percent of total billed charges,,,0.95,,37.69,Percent of total billed charges,,,,,,,,,0.95,,37.69,Percent of total billed charges,,37.69,38.88,
MUPIROCIN 2 % EX OINT,RX-10674,CDM,J3490,HCPCS,637,RC,,outpatient,22,GR,39.67,35.7,,0.95,,37.69,Percent of total billed charges,,,0.98,,38.88,Percent of total billed charges,,,0.95,,37.69,Percent of total billed charges,,,0.95,,37.69,Percent of total billed charges,,,0.97,,38.48,Percent of total billed charges,,,0.96,,38.08,Percent of total billed charges,,,0.95,,37.69,Percent of total billed charges,,,,,,,,,0.95,,37.69,Percent of total billed charges,,37.69,38.88,
RIVAROXABAN 10 MG PO TABS,RX-107075,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,5.73,5.16,,0.95,,5.44,Percent of total billed charges,,,0.98,,5.62,Percent of total billed charges,,,0.95,,5.44,Percent of total billed charges,,,0.97,,5.56,Percent of total billed charges,,,0.97,,5.56,Percent of total billed charges,,,0.96,,5.5,Percent of total billed charges,,,0.95,,5.44,Percent of total billed charges,,,,,,,,,0.95,,5.44,Percent of total billed charges,,5.44,5.62,
RIVAROXABAN 10 MG PO TABS,RX-107075,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,5.73,5.16,,0.95,,5.44,Percent of total billed charges,,,0.98,,5.62,Percent of total billed charges,,,0.95,,5.44,Percent of total billed charges,,,0.95,,5.44,Percent of total billed charges,,,0.97,,5.56,Percent of total billed charges,,,0.96,,5.5,Percent of total billed charges,,,0.95,,5.44,Percent of total billed charges,,,,,,,,,0.95,,5.44,Percent of total billed charges,,5.44,5.62,
NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,RX-10734,CDM,J3490,HCPCS,250,RC,,inpatient,4,ML,18.66,16.79,,0.95,,17.73,Percent of total billed charges,,,0.98,,18.29,Percent of total billed charges,,,0.95,,17.73,Percent of total billed charges,,,0.97,,18.1,Percent of total billed charges,,,0.97,,18.1,Percent of total billed charges,,,0.96,,17.91,Percent of total billed charges,,,0.95,,17.73,Percent of total billed charges,,,,,,,,,0.95,,17.73,Percent of total billed charges,,17.73,18.29,
NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,RX-10734,CDM,J3490,HCPCS,250,RC,,outpatient,4,ML,18.66,16.79,,0.95,,17.73,Percent of total billed charges,,,0.98,,18.29,Percent of total billed charges,,,0.95,,17.73,Percent of total billed charges,,,0.95,,17.73,Percent of total billed charges,,,0.97,,18.1,Percent of total billed charges,,,0.96,,17.91,Percent of total billed charges,,,0.95,,17.73,Percent of total billed charges,,,,,,,,,0.95,,17.73,Percent of total billed charges,,17.73,18.29,
FIDAXOMICIN 200 MG PO TABS,RX-107468,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,288.09,259.28,,0.95,,273.69,Percent of total billed charges,,,0.98,,282.33,Percent of total billed charges,,,0.95,,273.69,Percent of total billed charges,,,0.97,,279.45,Percent of total billed charges,,,0.97,,279.45,Percent of total billed charges,,,0.96,,276.57,Percent of total billed charges,,,0.95,,273.69,Percent of total billed charges,,,,,,,,,0.95,,273.69,Percent of total billed charges,,273.69,282.33,
FIDAXOMICIN 200 MG PO TABS,RX-107468,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,288.09,259.28,,0.95,,273.69,Percent of total billed charges,,,0.98,,282.33,Percent of total billed charges,,,0.95,,273.69,Percent of total billed charges,,,0.95,,273.69,Percent of total billed charges,,,0.97,,279.45,Percent of total billed charges,,,0.96,,276.57,Percent of total billed charges,,,0.95,,273.69,Percent of total billed charges,,,,,,,,,0.95,,273.69,Percent of total billed charges,,273.69,282.33,
BISACODYL 5 MG PO TBEC,RX-1079,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,5.82,5.24,,0.95,,5.53,Percent of total billed charges,,,0.98,,5.7,Percent of total billed charges,,,0.95,,5.53,Percent of total billed charges,,,0.97,,5.65,Percent of total billed charges,,,0.97,,5.65,Percent of total billed charges,,,0.96,,5.59,Percent of total billed charges,,,0.95,,5.53,Percent of total billed charges,,,,,,,,,0.95,,5.53,Percent of total billed charges,,5.53,5.7,
BISACODYL 5 MG PO TBEC,RX-1079,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,5.82,5.24,,0.95,,5.53,Percent of total billed charges,,,0.98,,5.7,Percent of total billed charges,,,0.95,,5.53,Percent of total billed charges,,,0.95,,5.53,Percent of total billed charges,,,0.97,,5.65,Percent of total billed charges,,,0.96,,5.59,Percent of total billed charges,,,0.95,,5.53,Percent of total billed charges,,,,,,,,,0.95,,5.53,Percent of total billed charges,,5.53,5.7,
BISACODYL 10 MG RECTAL SUPP,RX-1080,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
BISACODYL 10 MG RECTAL SUPP,RX-1080,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
OXYCODONE HCL 100 MG/5ML PO CONC,RX-10812,CDM,J3490,HCPCS,637,RC,,inpatient,0.25,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
OXYCODONE HCL 100 MG/5ML PO CONC,RX-10812,CDM,J3490,HCPCS,637,RC,,outpatient,0.25,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
OXYCODONE HCL 5 MG/5ML PO SOLN,RX-10813,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,16.76,15.08,,0.95,,15.92,Percent of total billed charges,,,0.98,,16.42,Percent of total billed charges,,,0.95,,15.92,Percent of total billed charges,,,0.97,,16.26,Percent of total billed charges,,,0.97,,16.26,Percent of total billed charges,,,0.96,,16.09,Percent of total billed charges,,,0.95,,15.92,Percent of total billed charges,,,,,,,,,0.95,,15.92,Percent of total billed charges,,15.92,16.42,
OXYCODONE HCL 5 MG/5ML PO SOLN,RX-10813,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,16.76,15.08,,0.95,,15.92,Percent of total billed charges,,,0.98,,16.42,Percent of total billed charges,,,0.95,,15.92,Percent of total billed charges,,,0.95,,15.92,Percent of total billed charges,,,0.97,,16.26,Percent of total billed charges,,,0.96,,16.09,Percent of total billed charges,,,0.95,,15.92,Percent of total billed charges,,,,,,,,,0.95,,15.92,Percent of total billed charges,,15.92,16.42,
OXYCODONE HCL 5 MG PO TABS,RX-10814,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.21,7.39,,0.95,,7.8,Percent of total billed charges,,,0.98,,8.05,Percent of total billed charges,,,0.95,,7.8,Percent of total billed charges,,,0.97,,7.96,Percent of total billed charges,,,0.97,,7.96,Percent of total billed charges,,,0.96,,7.88,Percent of total billed charges,,,0.95,,7.8,Percent of total billed charges,,,,,,,,,0.95,,7.8,Percent of total billed charges,,7.8,8.05,
OXYCODONE HCL 5 MG PO TABS,RX-10814,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.21,7.39,,0.95,,7.8,Percent of total billed charges,,,0.98,,8.05,Percent of total billed charges,,,0.95,,7.8,Percent of total billed charges,,,0.95,,7.8,Percent of total billed charges,,,0.97,,7.96,Percent of total billed charges,,,0.96,,7.88,Percent of total billed charges,,,0.95,,7.8,Percent of total billed charges,,,,,,,,,0.95,,7.8,Percent of total billed charges,,7.8,8.05,
ENOXAPARIN SODIUM 30 MG/0.3ML INJECTION SOSY,RX-108383,CDM,J1650,HCPCS,636,RC,,inpatient,0.3,ML,124.51,112.06,,0.95,,118.28,Percent of total billed charges,,,0.98,,122.02,Percent of total billed charges,,,0.95,,118.28,Percent of total billed charges,,,0.97,,120.77,Percent of total billed charges,,,0.97,,120.77,Percent of total billed charges,,,0.96,,119.53,Percent of total billed charges,,,0.95,,118.28,Percent of total billed charges,,,,,,,,,0.95,,118.28,Percent of total billed charges,,118.28,122.02,
ENOXAPARIN SODIUM 30 MG/0.3ML INJECTION SOSY,RX-108383,CDM,J1650,HCPCS,636,RC,,outpatient,0.3,ML,124.51,112.06,,0.95,,118.28,Percent of total billed charges,,,0.98,,122.02,Percent of total billed charges,,,0.95,,118.28,Percent of total billed charges,,,0.95,,118.28,Percent of total billed charges,,,0.97,,120.77,Percent of total billed charges,,,0.96,,119.53,Percent of total billed charges,,,0.95,,118.28,Percent of total billed charges,,,,,,,,,0.95,,118.28,Percent of total billed charges,,118.28,122.02,
ENOXAPARIN SODIUM 40 MG/0.4ML INJECTION SOSY,RX-108384,CDM,J1650,HCPCS,636,RC,,inpatient,0.4,ML,131.63,118.47,,0.95,,125.05,Percent of total billed charges,,,0.98,,129,Percent of total billed charges,,,0.95,,125.05,Percent of total billed charges,,,0.97,,127.68,Percent of total billed charges,,,0.97,,127.68,Percent of total billed charges,,,0.96,,126.36,Percent of total billed charges,,,0.95,,125.05,Percent of total billed charges,,,,,,,,,0.95,,125.05,Percent of total billed charges,,125.05,129,
ENOXAPARIN SODIUM 40 MG/0.4ML INJECTION SOSY,RX-108384,CDM,J1650,HCPCS,636,RC,,outpatient,0.4,ML,131.63,118.47,,0.95,,125.05,Percent of total billed charges,,,0.98,,129,Percent of total billed charges,,,0.95,,125.05,Percent of total billed charges,,,0.95,,125.05,Percent of total billed charges,,,0.97,,127.68,Percent of total billed charges,,,0.96,,126.36,Percent of total billed charges,,,0.95,,125.05,Percent of total billed charges,,,,,,,,,0.95,,125.05,Percent of total billed charges,,125.05,129,
ENOXAPARIN SODIUM 60 MG/0.6ML INJECTION SOSY,RX-108385,CDM,J1650,HCPCS,636,RC,,inpatient,0.5,ML,144.05,129.65,,0.95,,136.85,Percent of total billed charges,,,0.98,,141.17,Percent of total billed charges,,,0.95,,136.85,Percent of total billed charges,,,0.97,,139.73,Percent of total billed charges,,,0.97,,139.73,Percent of total billed charges,,,0.96,,138.29,Percent of total billed charges,,,0.95,,136.85,Percent of total billed charges,,,,,,,,,0.95,,136.85,Percent of total billed charges,,136.85,141.17,
ENOXAPARIN SODIUM 60 MG/0.6ML INJECTION SOSY,RX-108385,CDM,J1650,HCPCS,636,RC,,outpatient,0.5,ML,144.05,129.65,,0.95,,136.85,Percent of total billed charges,,,0.98,,141.17,Percent of total billed charges,,,0.95,,136.85,Percent of total billed charges,,,0.95,,136.85,Percent of total billed charges,,,0.97,,139.73,Percent of total billed charges,,,0.96,,138.29,Percent of total billed charges,,,0.95,,136.85,Percent of total billed charges,,,,,,,,,0.95,,136.85,Percent of total billed charges,,136.85,141.17,
ENOXAPARIN SODIUM 80 MG/0.8ML INJECTION SOSY,RX-108386,CDM,J1650,HCPCS,636,RC,,inpatient,0.7,ML,153.15,137.84,,0.95,,145.49,Percent of total billed charges,,,0.98,,150.09,Percent of total billed charges,,,0.95,,145.49,Percent of total billed charges,,,0.97,,148.56,Percent of total billed charges,,,0.97,,148.56,Percent of total billed charges,,,0.96,,147.02,Percent of total billed charges,,,0.95,,145.49,Percent of total billed charges,,,,,,,,,0.95,,145.49,Percent of total billed charges,,145.49,150.09,
ENOXAPARIN SODIUM 80 MG/0.8ML INJECTION SOSY,RX-108386,CDM,J1650,HCPCS,636,RC,,outpatient,0.7,ML,153.15,137.84,,0.95,,145.49,Percent of total billed charges,,,0.98,,150.09,Percent of total billed charges,,,0.95,,145.49,Percent of total billed charges,,,0.95,,145.49,Percent of total billed charges,,,0.97,,148.56,Percent of total billed charges,,,0.96,,147.02,Percent of total billed charges,,,0.95,,145.49,Percent of total billed charges,,,,,,,,,0.95,,145.49,Percent of total billed charges,,145.49,150.09,
ENOXAPARIN SODIUM 100 MG/ML INJECTION SOSY,RX-108387,CDM,J1650,HCPCS,636,RC,,inpatient,0.9,ML,167.49,150.74,,0.95,,159.12,Percent of total billed charges,,,0.98,,164.14,Percent of total billed charges,,,0.95,,159.12,Percent of total billed charges,,,0.97,,162.47,Percent of total billed charges,,,0.97,,162.47,Percent of total billed charges,,,0.96,,160.79,Percent of total billed charges,,,0.95,,159.12,Percent of total billed charges,,,,,,,,,0.95,,159.12,Percent of total billed charges,,159.12,164.14,
ENOXAPARIN SODIUM 100 MG/ML INJECTION SOSY,RX-108387,CDM,J1650,HCPCS,636,RC,,outpatient,0.9,ML,167.49,150.74,,0.95,,159.12,Percent of total billed charges,,,0.98,,164.14,Percent of total billed charges,,,0.95,,159.12,Percent of total billed charges,,,0.95,,159.12,Percent of total billed charges,,,0.97,,162.47,Percent of total billed charges,,,0.96,,160.79,Percent of total billed charges,,,0.95,,159.12,Percent of total billed charges,,,,,,,,,0.95,,159.12,Percent of total billed charges,,159.12,164.14,
PEG 3350-KCL-NABCB-NACL-NASULF 236 G PO SOLR,RX-10839,CDM,J3490,HCPCS,637,RC,,inpatient,4000,ML,92.7,83.43,,0.95,,88.07,Percent of total billed charges,,,0.98,,90.85,Percent of total billed charges,,,0.95,,88.07,Percent of total billed charges,,,0.97,,89.92,Percent of total billed charges,,,0.97,,89.92,Percent of total billed charges,,,0.96,,88.99,Percent of total billed charges,,,0.95,,88.07,Percent of total billed charges,,,,,,,,,0.95,,88.07,Percent of total billed charges,,88.07,90.85,
PEG 3350-KCL-NABCB-NACL-NASULF 236 G PO SOLR,RX-10839,CDM,J3490,HCPCS,637,RC,,outpatient,4000,ML,92.7,83.43,,0.95,,88.07,Percent of total billed charges,,,0.98,,90.85,Percent of total billed charges,,,0.95,,88.07,Percent of total billed charges,,,0.95,,88.07,Percent of total billed charges,,,0.97,,89.92,Percent of total billed charges,,,0.96,,88.99,Percent of total billed charges,,,0.95,,88.07,Percent of total billed charges,,,,,,,,,0.95,,88.07,Percent of total billed charges,,88.07,90.85,
PAROXETINE HCL 20 MG PO TABS,RX-10855,CDM,J3490,HCPCS,637,RC,,inpatient,0.5,UN,5.67,5.1,,0.95,,5.39,Percent of total billed charges,,,0.98,,5.56,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,0.97,,5.5,Percent of total billed charges,,,0.97,,5.5,Percent of total billed charges,,,0.96,,5.44,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,,,,,,,0.95,,5.39,Percent of total billed charges,,5.39,5.56,
PAROXETINE HCL 20 MG PO TABS,RX-10855,CDM,J3490,HCPCS,637,RC,,outpatient,0.5,UN,5.67,5.1,,0.95,,5.39,Percent of total billed charges,,,0.98,,5.56,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,0.97,,5.5,Percent of total billed charges,,,0.96,,5.44,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,,,,,,,0.95,,5.39,Percent of total billed charges,,5.39,5.56,
PERMETHRIN 5 % EX CREA,RX-10917,CDM,J3490,HCPCS,637,RC,,inpatient,60,GR,308.31,277.48,,0.95,,292.89,Percent of total billed charges,,,0.98,,302.14,Percent of total billed charges,,,0.95,,292.89,Percent of total billed charges,,,0.97,,299.06,Percent of total billed charges,,,0.97,,299.06,Percent of total billed charges,,,0.96,,295.98,Percent of total billed charges,,,0.95,,292.89,Percent of total billed charges,,,,,,,,,0.95,,292.89,Percent of total billed charges,,292.89,302.14,
PERMETHRIN 5 % EX CREA,RX-10917,CDM,J3490,HCPCS,637,RC,,outpatient,60,GR,308.31,277.48,,0.95,,292.89,Percent of total billed charges,,,0.98,,302.14,Percent of total billed charges,,,0.95,,292.89,Percent of total billed charges,,,0.95,,292.89,Percent of total billed charges,,,0.97,,299.06,Percent of total billed charges,,,0.96,,295.98,Percent of total billed charges,,,0.95,,292.89,Percent of total billed charges,,,,,,,,,0.95,,292.89,Percent of total billed charges,,292.89,302.14,
BUPIVACAINE-EPINEPHRINE (PF) 0.5% -1:200000 INJECTION SOLN,RX-109182,CDM,J3490,HCPCS,250,RC,,inpatient,5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
BUPIVACAINE-EPINEPHRINE (PF) 0.5% -1:200000 INJECTION SOLN,RX-109182,CDM,J3490,HCPCS,250,RC,,outpatient,5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
BUPIVACAINE HCL (PF) 0.25 % INJECTION SOLN,RX-109186,CDM,J0665,HCPCS,636,RC,,inpatient,5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
BUPIVACAINE HCL (PF) 0.25 % INJECTION SOLN,RX-109186,CDM,J0665,HCPCS,636,RC,,outpatient,5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
BUPIVACAINE HCL (PF) 0.5 % INJECTION SOLN,RX-109187,CDM,J0665,HCPCS,636,RC,,inpatient,5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
BUPIVACAINE HCL (PF) 0.5 % INJECTION SOLN,RX-109187,CDM,J0665,HCPCS,636,RC,,outpatient,5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
NEOMYCIN-POLYMYXIN-DEXAMETH 3.5-10000-0.1 OP OINT,RX-109290,CDM,J3490,HCPCS,637,RC,,inpatient,4,GR,137.95,124.16,,0.95,,131.05,Percent of total billed charges,,,0.98,,135.19,Percent of total billed charges,,,0.95,,131.05,Percent of total billed charges,,,0.97,,133.81,Percent of total billed charges,,,0.97,,133.81,Percent of total billed charges,,,0.96,,132.43,Percent of total billed charges,,,0.95,,131.05,Percent of total billed charges,,,,,,,,,0.95,,131.05,Percent of total billed charges,,131.05,135.19,
NEOMYCIN-POLYMYXIN-DEXAMETH 3.5-10000-0.1 OP OINT,RX-109290,CDM,J3490,HCPCS,637,RC,,outpatient,4,GR,137.95,124.16,,0.95,,131.05,Percent of total billed charges,,,0.98,,135.19,Percent of total billed charges,,,0.95,,131.05,Percent of total billed charges,,,0.95,,131.05,Percent of total billed charges,,,0.97,,133.81,Percent of total billed charges,,,0.96,,132.43,Percent of total billed charges,,,0.95,,131.05,Percent of total billed charges,,,,,,,,,0.95,,131.05,Percent of total billed charges,,131.05,135.19,
PHENTOLAMINE MESYLATE 5 MG INJECTION SOLR,RX-10947,CDM,J2760,HCPCS,636,RC,,inpatient,1,ML,813.15,731.84,,0.95,,772.49,Percent of total billed charges,,,0.98,,796.89,Percent of total billed charges,,,0.95,,772.49,Percent of total billed charges,,,0.97,,788.76,Percent of total billed charges,,,0.97,,788.76,Percent of total billed charges,,,0.96,,780.62,Percent of total billed charges,,,0.95,,772.49,Percent of total billed charges,,,,,,,,,0.95,,772.49,Percent of total billed charges,,772.49,796.89,
PHENTOLAMINE MESYLATE 5 MG INJECTION SOLR,RX-10947,CDM,J2760,HCPCS,636,RC,,outpatient,1,ML,813.15,731.84,,0.95,,772.49,Percent of total billed charges,,,0.98,,796.89,Percent of total billed charges,,,0.95,,772.49,Percent of total billed charges,,,0.95,,772.49,Percent of total billed charges,,,0.97,,788.76,Percent of total billed charges,,,0.96,,780.62,Percent of total billed charges,,,0.95,,772.49,Percent of total billed charges,,,,,,,,,0.95,,772.49,Percent of total billed charges,,772.49,796.89,
PHYTONADIONE 10 MG/ML INJECTION SOLN,RX-11023,CDM,J3430,HCPCS,636,RC,,inpatient,0.2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
PHYTONADIONE 10 MG/ML INJECTION SOLN,RX-11023,CDM,J3430,HCPCS,636,RC,,outpatient,0.2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
FOSAPREPITANT DIMEGLUMINE 150 MG IV SOLR,RX-110233,CDM,J1453,HCPCS,636,RC,,inpatient,5,ML,80.7,72.63,,0.95,,76.67,Percent of total billed charges,,,0.98,,79.09,Percent of total billed charges,,,0.95,,76.67,Percent of total billed charges,,,0.97,,78.28,Percent of total billed charges,,,0.97,,78.28,Percent of total billed charges,,,0.96,,77.47,Percent of total billed charges,,,0.95,,76.67,Percent of total billed charges,,,,,,,,,0.95,,76.67,Percent of total billed charges,,76.67,79.09,
FOSAPREPITANT DIMEGLUMINE 150 MG IV SOLR,RX-110233,CDM,J1453,HCPCS,636,RC,,outpatient,5,ML,80.7,72.63,,0.95,,76.67,Percent of total billed charges,,,0.98,,79.09,Percent of total billed charges,,,0.95,,76.67,Percent of total billed charges,,,0.95,,76.67,Percent of total billed charges,,,0.97,,78.28,Percent of total billed charges,,,0.96,,77.47,Percent of total billed charges,,,0.95,,76.67,Percent of total billed charges,,,,,,,,,0.95,,76.67,Percent of total billed charges,,76.67,79.09,
PHYTONADIONE 5 MG PO TABS,RX-11024,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,175.66,158.09,,0.95,,166.88,Percent of total billed charges,,,0.98,,172.15,Percent of total billed charges,,,0.95,,166.88,Percent of total billed charges,,,0.97,,170.39,Percent of total billed charges,,,0.97,,170.39,Percent of total billed charges,,,0.96,,168.63,Percent of total billed charges,,,0.95,,166.88,Percent of total billed charges,,,,,,,,,0.95,,166.88,Percent of total billed charges,,166.88,172.15,
PHYTONADIONE 5 MG PO TABS,RX-11024,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,175.66,158.09,,0.95,,166.88,Percent of total billed charges,,,0.98,,172.15,Percent of total billed charges,,,0.95,,166.88,Percent of total billed charges,,,0.95,,166.88,Percent of total billed charges,,,0.97,,170.39,Percent of total billed charges,,,0.96,,168.63,Percent of total billed charges,,,0.95,,166.88,Percent of total billed charges,,,,,,,,,0.95,,166.88,Percent of total billed charges,,166.88,172.15,
DENOSUMAB 120 MG/1.7ML SUBQ SOLN,RX-110254,CDM,J0897,HCPCS,636,RC,,inpatient,1.7,ML,5739.03,5165.13,,0.95,,5452.08,Percent of total billed charges,,,0.98,,5624.25,Percent of total billed charges,,,0.95,,5452.08,Percent of total billed charges,,,0.97,,5566.86,Percent of total billed charges,,,0.97,,5566.86,Percent of total billed charges,,,0.96,,5509.47,Percent of total billed charges,,,0.95,,5452.08,Percent of total billed charges,,,,,,,,,0.95,,5452.08,Percent of total billed charges,,5452.08,5624.25,
DENOSUMAB 120 MG/1.7ML SUBQ SOLN,RX-110254,CDM,J0897,HCPCS,636,RC,,outpatient,1.7,ML,5739.03,5165.13,,0.95,,5452.08,Percent of total billed charges,,,0.98,,5624.25,Percent of total billed charges,,,0.95,,5452.08,Percent of total billed charges,,,0.95,,5452.08,Percent of total billed charges,,,0.97,,5566.86,Percent of total billed charges,,,0.96,,5509.47,Percent of total billed charges,,,0.95,,5452.08,Percent of total billed charges,,,,,,,,,0.95,,5452.08,Percent of total billed charges,,5452.08,5624.25,
PNEUMOCOCCAL VAC POLYVALENT 25 MCG/0.5ML INJECTION SOSY,RX-11037,CDM,90732,HCPCS,636,RC,,inpatient,0.5,ML,359.31,323.38,,0.95,,341.34,Percent of total billed charges,,,0.98,,352.12,Percent of total billed charges,,,0.95,,341.34,Percent of total billed charges,,,0.97,,348.53,Percent of total billed charges,,,0.97,,348.53,Percent of total billed charges,,,0.96,,344.94,Percent of total billed charges,,,0.95,,341.34,Percent of total billed charges,,,,,,,,,0.95,,341.34,Percent of total billed charges,,341.34,352.12,
PNEUMOCOCCAL VAC POLYVALENT 25 MCG/0.5ML INJECTION SOSY,RX-11037,CDM,90732,HCPCS,636,RC,,outpatient,0.5,ML,359.31,323.38,,0.95,,341.34,Percent of total billed charges,,,0.98,,352.12,Percent of total billed charges,,,0.95,,341.34,Percent of total billed charges,,,0.95,,341.34,Percent of total billed charges,,,0.97,,348.53,Percent of total billed charges,,,0.96,,344.94,Percent of total billed charges,,,0.95,,341.34,Percent of total billed charges,,,,,,,,,0.95,,341.34,Percent of total billed charges,,341.34,352.12,
CALCIUM POLYCARBOPHIL 625 MG PO TABS,RX-11046,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.05,7.25,,0.95,,7.65,Percent of total billed charges,,,0.98,,7.89,Percent of total billed charges,,,0.95,,7.65,Percent of total billed charges,,,0.97,,7.81,Percent of total billed charges,,,0.97,,7.81,Percent of total billed charges,,,0.96,,7.73,Percent of total billed charges,,,0.95,,7.65,Percent of total billed charges,,,,,,,,,0.95,,7.65,Percent of total billed charges,,7.65,7.89,
CALCIUM POLYCARBOPHIL 625 MG PO TABS,RX-11046,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.05,7.25,,0.95,,7.65,Percent of total billed charges,,,0.98,,7.89,Percent of total billed charges,,,0.95,,7.65,Percent of total billed charges,,,0.95,,7.65,Percent of total billed charges,,,0.97,,7.81,Percent of total billed charges,,,0.96,,7.73,Percent of total billed charges,,,0.95,,7.65,Percent of total billed charges,,,,,,,,,0.95,,7.65,Percent of total billed charges,,7.65,7.89,
OSELTAMIVIR PHOSPHATE 6 MG/ML PO SUSR,RX-110469,CDM,J3490,HCPCS,637,RC,,inpatient,12.5,ML,24.41,21.97,,0.95,,23.19,Percent of total billed charges,,,0.98,,23.92,Percent of total billed charges,,,0.95,,23.19,Percent of total billed charges,,,0.97,,23.68,Percent of total billed charges,,,0.97,,23.68,Percent of total billed charges,,,0.96,,23.43,Percent of total billed charges,,,0.95,,23.19,Percent of total billed charges,,,,,,,,,0.95,,23.19,Percent of total billed charges,,23.19,23.92,
OSELTAMIVIR PHOSPHATE 6 MG/ML PO SUSR,RX-110469,CDM,J3490,HCPCS,637,RC,,outpatient,12.5,ML,24.41,21.97,,0.95,,23.19,Percent of total billed charges,,,0.98,,23.92,Percent of total billed charges,,,0.95,,23.19,Percent of total billed charges,,,0.95,,23.19,Percent of total billed charges,,,0.97,,23.68,Percent of total billed charges,,,0.96,,23.43,Percent of total billed charges,,,0.95,,23.19,Percent of total billed charges,,,,,,,,,0.95,,23.19,Percent of total billed charges,,23.19,23.92,
CEFTAROLINE FOSAMIL 600 MG IV SOLR,RX-110521,CDM,J0712,HCPCS,636,RC,,inpatient,20,ML,594.49,535.04,,0.95,,564.77,Percent of total billed charges,,,0.98,,582.6,Percent of total billed charges,,,0.95,,564.77,Percent of total billed charges,,,0.97,,576.66,Percent of total billed charges,,,0.97,,576.66,Percent of total billed charges,,,0.96,,570.71,Percent of total billed charges,,,0.95,,564.77,Percent of total billed charges,,,,,,,,,0.95,,564.77,Percent of total billed charges,,564.77,582.6,
CEFTAROLINE FOSAMIL 600 MG IV SOLR,RX-110521,CDM,J0712,HCPCS,636,RC,,outpatient,20,ML,594.49,535.04,,0.95,,564.77,Percent of total billed charges,,,0.98,,582.6,Percent of total billed charges,,,0.95,,564.77,Percent of total billed charges,,,0.95,,564.77,Percent of total billed charges,,,0.97,,576.66,Percent of total billed charges,,,0.96,,570.71,Percent of total billed charges,,,0.95,,564.77,Percent of total billed charges,,,,,,,,,0.95,,564.77,Percent of total billed charges,,564.77,582.6,
POTASSIUM PHOSPHATE MONOBASIC 500 MG PO TABS,RX-11087,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
POTASSIUM PHOSPHATE MONOBASIC 500 MG PO TABS,RX-11087,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
ACETAMINOPHEN 10 MG/ML IV SOLN,RX-110882,CDM,J0134,HCPCS,636,RC,,inpatient,65,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
ACETAMINOPHEN 10 MG/ML IV SOLN,RX-110882,CDM,J0134,HCPCS,636,RC,,outpatient,65,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
PRAVASTATIN SODIUM 20 MG PO TABS,RX-11111,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.28,7.45,,0.95,,7.87,Percent of total billed charges,,,0.98,,8.11,Percent of total billed charges,,,0.95,,7.87,Percent of total billed charges,,,0.97,,8.03,Percent of total billed charges,,,0.97,,8.03,Percent of total billed charges,,,0.96,,7.95,Percent of total billed charges,,,0.95,,7.87,Percent of total billed charges,,,,,,,,,0.95,,7.87,Percent of total billed charges,,7.87,8.11,
PRAVASTATIN SODIUM 20 MG PO TABS,RX-11111,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.28,7.45,,0.95,,7.87,Percent of total billed charges,,,0.98,,8.11,Percent of total billed charges,,,0.95,,7.87,Percent of total billed charges,,,0.95,,7.87,Percent of total billed charges,,,0.97,,8.03,Percent of total billed charges,,,0.96,,7.95,Percent of total billed charges,,,0.95,,7.87,Percent of total billed charges,,,,,,,,,0.95,,7.87,Percent of total billed charges,,7.87,8.11,
PRAZIQUANTEL 600 MG PO TABS,RX-11113,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,196.04,176.44,,0.95,,186.24,Percent of total billed charges,,,0.98,,192.12,Percent of total billed charges,,,0.95,,186.24,Percent of total billed charges,,,0.97,,190.16,Percent of total billed charges,,,0.97,,190.16,Percent of total billed charges,,,0.96,,188.2,Percent of total billed charges,,,0.95,,186.24,Percent of total billed charges,,,,,,,,,0.95,,186.24,Percent of total billed charges,,186.24,192.12,
PRAZIQUANTEL 600 MG PO TABS,RX-11113,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,196.04,176.44,,0.95,,186.24,Percent of total billed charges,,,0.98,,192.12,Percent of total billed charges,,,0.95,,186.24,Percent of total billed charges,,,0.95,,186.24,Percent of total billed charges,,,0.97,,190.16,Percent of total billed charges,,,0.96,,188.2,Percent of total billed charges,,,0.95,,186.24,Percent of total billed charges,,,,,,,,,0.95,,186.24,Percent of total billed charges,,186.24,192.12,
PRIMIDONE 50 MG PO TABS,RX-11129,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
PRIMIDONE 50 MG PO TABS,RX-11129,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
PROCHLORPERAZINE 25 MG RECTAL SUPP,RX-11138,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,28.8,25.92,,0.95,,27.36,Percent of total billed charges,,,0.98,,28.22,Percent of total billed charges,,,0.95,,27.36,Percent of total billed charges,,,0.97,,27.94,Percent of total billed charges,,,0.97,,27.94,Percent of total billed charges,,,0.96,,27.65,Percent of total billed charges,,,0.95,,27.36,Percent of total billed charges,,,,,,,,,0.95,,27.36,Percent of total billed charges,,27.36,28.22,
PROCHLORPERAZINE 25 MG RECTAL SUPP,RX-11138,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,28.8,25.92,,0.95,,27.36,Percent of total billed charges,,,0.98,,28.22,Percent of total billed charges,,,0.95,,27.36,Percent of total billed charges,,,0.95,,27.36,Percent of total billed charges,,,0.97,,27.94,Percent of total billed charges,,,0.96,,27.65,Percent of total billed charges,,,0.95,,27.36,Percent of total billed charges,,,,,,,,,0.95,,27.36,Percent of total billed charges,,27.36,28.22,
PROMETHAZINE HCL 12.5 MG RECTAL SUPP,RX-11143,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,32.68,29.41,,0.95,,31.05,Percent of total billed charges,,,0.98,,32.03,Percent of total billed charges,,,0.95,,31.05,Percent of total billed charges,,,0.97,,31.7,Percent of total billed charges,,,0.97,,31.7,Percent of total billed charges,,,0.96,,31.37,Percent of total billed charges,,,0.95,,31.05,Percent of total billed charges,,,,,,,,,0.95,,31.05,Percent of total billed charges,,31.05,32.03,
PROMETHAZINE HCL 12.5 MG RECTAL SUPP,RX-11143,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,32.68,29.41,,0.95,,31.05,Percent of total billed charges,,,0.98,,32.03,Percent of total billed charges,,,0.95,,31.05,Percent of total billed charges,,,0.95,,31.05,Percent of total billed charges,,,0.97,,31.7,Percent of total billed charges,,,0.96,,31.37,Percent of total billed charges,,,0.95,,31.05,Percent of total billed charges,,,,,,,,,0.95,,31.05,Percent of total billed charges,,31.05,32.03,
PROMETHAZINE HCL 25 MG RECTAL SUPP,RX-11144,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,32.68,29.41,,0.95,,31.05,Percent of total billed charges,,,0.98,,32.03,Percent of total billed charges,,,0.95,,31.05,Percent of total billed charges,,,0.97,,31.7,Percent of total billed charges,,,0.97,,31.7,Percent of total billed charges,,,0.96,,31.37,Percent of total billed charges,,,0.95,,31.05,Percent of total billed charges,,,,,,,,,0.95,,31.05,Percent of total billed charges,,31.05,32.03,
PROMETHAZINE HCL 25 MG RECTAL SUPP,RX-11144,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,32.68,29.41,,0.95,,31.05,Percent of total billed charges,,,0.98,,32.03,Percent of total billed charges,,,0.95,,31.05,Percent of total billed charges,,,0.95,,31.05,Percent of total billed charges,,,0.97,,31.7,Percent of total billed charges,,,0.96,,31.37,Percent of total billed charges,,,0.95,,31.05,Percent of total billed charges,,,,,,,,,0.95,,31.05,Percent of total billed charges,,31.05,32.03,
HYDROMORPHONE 1 MG/ML PCA,RX-112365,CDM,J7999,HCPCS,636,RC,,inpatient,30,ML,68.46,61.61,,0.95,,65.04,Percent of total billed charges,,,0.98,,67.09,Percent of total billed charges,,,0.95,,65.04,Percent of total billed charges,,,0.97,,66.41,Percent of total billed charges,,,0.97,,66.41,Percent of total billed charges,,,0.96,,65.72,Percent of total billed charges,,,0.95,,65.04,Percent of total billed charges,,,,,,,,,0.95,,65.04,Percent of total billed charges,,65.04,67.09,
HYDROMORPHONE 1 MG/ML PCA,RX-112365,CDM,J7999,HCPCS,636,RC,,outpatient,30,ML,68.46,61.61,,0.95,,65.04,Percent of total billed charges,,,0.98,,67.09,Percent of total billed charges,,,0.95,,65.04,Percent of total billed charges,,,0.95,,65.04,Percent of total billed charges,,,0.97,,66.41,Percent of total billed charges,,,0.96,,65.72,Percent of total billed charges,,,0.95,,65.04,Percent of total billed charges,,,,,,,,,0.95,,65.04,Percent of total billed charges,,65.04,67.09,
IBANDRONATE SODIUM 3 MG/3ML IV SOLN,RX-112429,CDM,J1740,HCPCS,636,RC,,inpatient,3,ML,161.07,144.96,,0.95,,153.02,Percent of total billed charges,,,0.98,,157.85,Percent of total billed charges,,,0.95,,153.02,Percent of total billed charges,,,0.97,,156.24,Percent of total billed charges,,,0.97,,156.24,Percent of total billed charges,,,0.96,,154.63,Percent of total billed charges,,,0.95,,153.02,Percent of total billed charges,,,,,,,,,0.95,,153.02,Percent of total billed charges,,153.02,157.85,
IBANDRONATE SODIUM 3 MG/3ML IV SOLN,RX-112429,CDM,J1740,HCPCS,636,RC,,outpatient,3,ML,161.07,144.96,,0.95,,153.02,Percent of total billed charges,,,0.98,,157.85,Percent of total billed charges,,,0.95,,153.02,Percent of total billed charges,,,0.95,,153.02,Percent of total billed charges,,,0.97,,156.24,Percent of total billed charges,,,0.96,,154.63,Percent of total billed charges,,,0.95,,153.02,Percent of total billed charges,,,,,,,,,0.95,,153.02,Percent of total billed charges,,153.02,157.85,
CALCIUM CARB-CHOLECALCIFEROL 500-5 MG-MCG PO TABS,RX-112441,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,5.92,5.33,,0.95,,5.62,Percent of total billed charges,,,0.98,,5.8,Percent of total billed charges,,,0.95,,5.62,Percent of total billed charges,,,0.97,,5.74,Percent of total billed charges,,,0.97,,5.74,Percent of total billed charges,,,0.96,,5.68,Percent of total billed charges,,,0.95,,5.62,Percent of total billed charges,,,,,,,,,0.95,,5.62,Percent of total billed charges,,5.62,5.8,
CALCIUM CARB-CHOLECALCIFEROL 500-5 MG-MCG PO TABS,RX-112441,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,5.92,5.33,,0.95,,5.62,Percent of total billed charges,,,0.98,,5.8,Percent of total billed charges,,,0.95,,5.62,Percent of total billed charges,,,0.95,,5.62,Percent of total billed charges,,,0.97,,5.74,Percent of total billed charges,,,0.96,,5.68,Percent of total billed charges,,,0.95,,5.62,Percent of total billed charges,,,,,,,,,0.95,,5.62,Percent of total billed charges,,5.62,5.8,
BRENTUXIMAB VEDOTIN 50 MG IV SOLR,RX-112636,CDM,J9042,HCPCS,636,RC,,inpatient,10,ML,15095.59,13586.03,,0.95,,14340.81,Percent of total billed charges,,,0.98,,14793.68,Percent of total billed charges,,,0.95,,14340.81,Percent of total billed charges,,,0.97,,14642.72,Percent of total billed charges,,,0.97,,14642.72,Percent of total billed charges,,,0.96,,14491.77,Percent of total billed charges,,,0.95,,14340.81,Percent of total billed charges,,,,,,,,,0.95,,14340.81,Percent of total billed charges,,14340.81,14793.68,
BRENTUXIMAB VEDOTIN 50 MG IV SOLR,RX-112636,CDM,J9042,HCPCS,636,RC,,outpatient,10,ML,15095.59,13586.03,,0.95,,14340.81,Percent of total billed charges,,,0.98,,14793.68,Percent of total billed charges,,,0.95,,14340.81,Percent of total billed charges,,,0.95,,14340.81,Percent of total billed charges,,,0.97,,14642.72,Percent of total billed charges,,,0.96,,14491.77,Percent of total billed charges,,,0.95,,14340.81,Percent of total billed charges,,,,,,,,,0.95,,14340.81,Percent of total billed charges,,14340.81,14793.68,
GAMMAGARD 2.5 GM/25ML INJECTION SOLN,RX-112708,CDM,J1569,HCPCS,636,RC,,inpatient,25,ML,599.63,539.67,,0.95,,569.65,Percent of total billed charges,,,0.98,,587.64,Percent of total billed charges,,,0.95,,569.65,Percent of total billed charges,,,0.97,,581.64,Percent of total billed charges,,,0.97,,581.64,Percent of total billed charges,,,0.96,,575.64,Percent of total billed charges,,,0.95,,569.65,Percent of total billed charges,,,,,,,,,0.95,,569.65,Percent of total billed charges,,569.65,587.64,
GAMMAGARD 2.5 GM/25ML INJECTION SOLN,RX-112708,CDM,J1569,HCPCS,636,RC,,outpatient,25,ML,599.63,539.67,,0.95,,569.65,Percent of total billed charges,,,0.98,,587.64,Percent of total billed charges,,,0.95,,569.65,Percent of total billed charges,,,0.95,,569.65,Percent of total billed charges,,,0.97,,581.64,Percent of total billed charges,,,0.96,,575.64,Percent of total billed charges,,,0.95,,569.65,Percent of total billed charges,,,,,,,,,0.95,,569.65,Percent of total billed charges,,569.65,587.64,
GAMMAGARD 10 GM/100ML INJECTION SOLN,RX-112710,CDM,J1569,HCPCS,636,RC,,inpatient,100,ML,1365.3,1228.77,,0.95,,1297.04,Percent of total billed charges,,,0.98,,1337.99,Percent of total billed charges,,,0.95,,1297.04,Percent of total billed charges,,,0.97,,1324.34,Percent of total billed charges,,,0.97,,1324.34,Percent of total billed charges,,,0.96,,1310.69,Percent of total billed charges,,,0.95,,1297.04,Percent of total billed charges,,,,,,,,,0.95,,1297.04,Percent of total billed charges,,1297.04,1337.99,
GAMMAGARD 10 GM/100ML INJECTION SOLN,RX-112710,CDM,J1569,HCPCS,636,RC,,outpatient,100,ML,1365.3,1228.77,,0.95,,1297.04,Percent of total billed charges,,,0.98,,1337.99,Percent of total billed charges,,,0.95,,1297.04,Percent of total billed charges,,,0.95,,1297.04,Percent of total billed charges,,,0.97,,1324.34,Percent of total billed charges,,,0.96,,1310.69,Percent of total billed charges,,,0.95,,1297.04,Percent of total billed charges,,,,,,,,,0.95,,1297.04,Percent of total billed charges,,1297.04,1337.99,
GAMMAGARD 20 GM/200ML INJECTION SOLN,RX-112711,CDM,J1569,HCPCS,636,RC,,inpatient,200,ML,2730.59,2457.53,,0.95,,2594.06,Percent of total billed charges,,,0.98,,2675.98,Percent of total billed charges,,,0.95,,2594.06,Percent of total billed charges,,,0.97,,2648.67,Percent of total billed charges,,,0.97,,2648.67,Percent of total billed charges,,,0.96,,2621.37,Percent of total billed charges,,,0.95,,2594.06,Percent of total billed charges,,,,,,,,,0.95,,2594.06,Percent of total billed charges,,2594.06,2675.98,
GAMMAGARD 20 GM/200ML INJECTION SOLN,RX-112711,CDM,J1569,HCPCS,636,RC,,outpatient,200,ML,2730.59,2457.53,,0.95,,2594.06,Percent of total billed charges,,,0.98,,2675.98,Percent of total billed charges,,,0.95,,2594.06,Percent of total billed charges,,,0.95,,2594.06,Percent of total billed charges,,,0.97,,2648.67,Percent of total billed charges,,,0.96,,2621.37,Percent of total billed charges,,,0.95,,2594.06,Percent of total billed charges,,,,,,,,,0.95,,2594.06,Percent of total billed charges,,2594.06,2675.98,
GAMMAGARD 30 GM/300ML INJECTION SOLN,RX-112712,CDM,J1569,HCPCS,636,RC,,inpatient,300,ML,4095.88,3686.29,,0.95,,3891.09,Percent of total billed charges,,,0.98,,4013.96,Percent of total billed charges,,,0.95,,3891.09,Percent of total billed charges,,,0.97,,3973,Percent of total billed charges,,,0.97,,3973,Percent of total billed charges,,,0.96,,3932.04,Percent of total billed charges,,,0.95,,3891.09,Percent of total billed charges,,,,,,,,,0.95,,3891.09,Percent of total billed charges,,3891.09,4013.96,
GAMMAGARD 30 GM/300ML INJECTION SOLN,RX-112712,CDM,J1569,HCPCS,636,RC,,outpatient,300,ML,4095.88,3686.29,,0.95,,3891.09,Percent of total billed charges,,,0.98,,4013.96,Percent of total billed charges,,,0.95,,3891.09,Percent of total billed charges,,,0.95,,3891.09,Percent of total billed charges,,,0.97,,3973,Percent of total billed charges,,,0.96,,3932.04,Percent of total billed charges,,,0.95,,3891.09,Percent of total billed charges,,,,,,,,,0.95,,3891.09,Percent of total billed charges,,3891.09,4013.96,
ZOLEDRONIC ACID 4 MG/100ML IV SOLN,RX-112752,CDM,J3489,HCPCS,636,RC,,inpatient,100,ML,121.13,109.02,,0.95,,115.07,Percent of total billed charges,,,0.98,,118.71,Percent of total billed charges,,,0.95,,115.07,Percent of total billed charges,,,0.97,,117.5,Percent of total billed charges,,,0.97,,117.5,Percent of total billed charges,,,0.96,,116.28,Percent of total billed charges,,,0.95,,115.07,Percent of total billed charges,,,,,,,,,0.95,,115.07,Percent of total billed charges,,115.07,118.71,
ZOLEDRONIC ACID 4 MG/100ML IV SOLN,RX-112752,CDM,J3489,HCPCS,636,RC,,outpatient,100,ML,121.13,109.02,,0.95,,115.07,Percent of total billed charges,,,0.98,,118.71,Percent of total billed charges,,,0.95,,115.07,Percent of total billed charges,,,0.95,,115.07,Percent of total billed charges,,,0.97,,117.5,Percent of total billed charges,,,0.96,,116.28,Percent of total billed charges,,,0.95,,115.07,Percent of total billed charges,,,,,,,,,0.95,,115.07,Percent of total billed charges,,115.07,118.71,
RIFAMPIN 300 MG PO CAPS,RX-11293,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,15.33,13.8,,0.95,,14.56,Percent of total billed charges,,,0.98,,15.02,Percent of total billed charges,,,0.95,,14.56,Percent of total billed charges,,,0.97,,14.87,Percent of total billed charges,,,0.97,,14.87,Percent of total billed charges,,,0.96,,14.72,Percent of total billed charges,,,0.95,,14.56,Percent of total billed charges,,,,,,,,,0.95,,14.56,Percent of total billed charges,,14.56,15.02,
RIFAMPIN 300 MG PO CAPS,RX-11293,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,15.33,13.8,,0.95,,14.56,Percent of total billed charges,,,0.98,,15.02,Percent of total billed charges,,,0.95,,14.56,Percent of total billed charges,,,0.95,,14.56,Percent of total billed charges,,,0.97,,14.87,Percent of total billed charges,,,0.96,,14.72,Percent of total billed charges,,,0.95,,14.56,Percent of total billed charges,,,,,,,,,0.95,,14.56,Percent of total billed charges,,14.56,15.02,
ACETAZOLAMIDE 250 MG PO TABS,RX-113,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,15.78,14.2,,0.95,,14.99,Percent of total billed charges,,,0.98,,15.46,Percent of total billed charges,,,0.95,,14.99,Percent of total billed charges,,,0.97,,15.31,Percent of total billed charges,,,0.97,,15.31,Percent of total billed charges,,,0.96,,15.15,Percent of total billed charges,,,0.95,,14.99,Percent of total billed charges,,,,,,,,,0.95,,14.99,Percent of total billed charges,,14.99,15.46,
ACETAZOLAMIDE 250 MG PO TABS,RX-113,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,15.78,14.2,,0.95,,14.99,Percent of total billed charges,,,0.98,,15.46,Percent of total billed charges,,,0.95,,14.99,Percent of total billed charges,,,0.95,,14.99,Percent of total billed charges,,,0.97,,15.31,Percent of total billed charges,,,0.96,,15.15,Percent of total billed charges,,,0.95,,14.99,Percent of total billed charges,,,,,,,,,0.95,,14.99,Percent of total billed charges,,14.99,15.46,
SENNOSIDES 8.6 MG PO TABS,RX-11349,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,5.87,5.28,,0.95,,5.58,Percent of total billed charges,,,0.98,,5.75,Percent of total billed charges,,,0.95,,5.58,Percent of total billed charges,,,0.97,,5.69,Percent of total billed charges,,,0.97,,5.69,Percent of total billed charges,,,0.96,,5.64,Percent of total billed charges,,,0.95,,5.58,Percent of total billed charges,,,,,,,,,0.95,,5.58,Percent of total billed charges,,5.58,5.75,
SENNOSIDES 8.6 MG PO TABS,RX-11349,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,5.87,5.28,,0.95,,5.58,Percent of total billed charges,,,0.98,,5.75,Percent of total billed charges,,,0.95,,5.58,Percent of total billed charges,,,0.95,,5.58,Percent of total billed charges,,,0.97,,5.69,Percent of total billed charges,,,0.96,,5.64,Percent of total billed charges,,,0.95,,5.58,Percent of total billed charges,,,,,,,,,0.95,,5.58,Percent of total billed charges,,5.58,5.75,
SERTRALINE HCL 100 MG PO TABS,RX-11350,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.13,5.52,,0.95,,5.82,Percent of total billed charges,,,0.98,,6.01,Percent of total billed charges,,,0.95,,5.82,Percent of total billed charges,,,0.97,,5.95,Percent of total billed charges,,,0.97,,5.95,Percent of total billed charges,,,0.96,,5.88,Percent of total billed charges,,,0.95,,5.82,Percent of total billed charges,,,,,,,,,0.95,,5.82,Percent of total billed charges,,5.82,6.01,
SERTRALINE HCL 100 MG PO TABS,RX-11350,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.13,5.52,,0.95,,5.82,Percent of total billed charges,,,0.98,,6.01,Percent of total billed charges,,,0.95,,5.82,Percent of total billed charges,,,0.95,,5.82,Percent of total billed charges,,,0.97,,5.95,Percent of total billed charges,,,0.96,,5.88,Percent of total billed charges,,,0.95,,5.82,Percent of total billed charges,,,,,,,,,0.95,,5.82,Percent of total billed charges,,5.82,6.01,
SERTRALINE HCL 50 MG PO TABS,RX-11351,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.27,6.54,,0.95,,6.91,Percent of total billed charges,,,0.98,,7.12,Percent of total billed charges,,,0.95,,6.91,Percent of total billed charges,,,0.97,,7.05,Percent of total billed charges,,,0.97,,7.05,Percent of total billed charges,,,0.96,,6.98,Percent of total billed charges,,,0.95,,6.91,Percent of total billed charges,,,,,,,,,0.95,,6.91,Percent of total billed charges,,6.91,7.12,
SERTRALINE HCL 50 MG PO TABS,RX-11351,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.27,6.54,,0.95,,6.91,Percent of total billed charges,,,0.98,,7.12,Percent of total billed charges,,,0.95,,6.91,Percent of total billed charges,,,0.95,,6.91,Percent of total billed charges,,,0.97,,7.05,Percent of total billed charges,,,0.96,,6.98,Percent of total billed charges,,,0.95,,6.91,Percent of total billed charges,,,,,,,,,0.95,,6.91,Percent of total billed charges,,6.91,7.12,
SILVER NITRATE-POT NITRATE 75-25 % EX MISC,RX-11359,CDM,J3490,HCPCS,250,RC,,inpatient,1,UN,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
SILVER NITRATE-POT NITRATE 75-25 % EX MISC,RX-11359,CDM,J3490,HCPCS,250,RC,,outpatient,1,UN,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
SIMVASTATIN 10 MG PO TABS,RX-11364,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.28,5.65,,0.95,,5.97,Percent of total billed charges,,,0.98,,6.15,Percent of total billed charges,,,0.95,,5.97,Percent of total billed charges,,,0.97,,6.09,Percent of total billed charges,,,0.97,,6.09,Percent of total billed charges,,,0.96,,6.03,Percent of total billed charges,,,0.95,,5.97,Percent of total billed charges,,,,,,,,,0.95,,5.97,Percent of total billed charges,,5.97,6.15,
SIMVASTATIN 10 MG PO TABS,RX-11364,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.28,5.65,,0.95,,5.97,Percent of total billed charges,,,0.98,,6.15,Percent of total billed charges,,,0.95,,5.97,Percent of total billed charges,,,0.95,,5.97,Percent of total billed charges,,,0.97,,6.09,Percent of total billed charges,,,0.96,,6.03,Percent of total billed charges,,,0.95,,5.97,Percent of total billed charges,,,,,,,,,0.95,,5.97,Percent of total billed charges,,5.97,6.15,
SIMVASTATIN 20 MG PO TABS,RX-11365,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.36,5.72,,0.95,,6.04,Percent of total billed charges,,,0.98,,6.23,Percent of total billed charges,,,0.95,,6.04,Percent of total billed charges,,,0.97,,6.17,Percent of total billed charges,,,0.97,,6.17,Percent of total billed charges,,,0.96,,6.11,Percent of total billed charges,,,0.95,,6.04,Percent of total billed charges,,,,,,,,,0.95,,6.04,Percent of total billed charges,,6.04,6.23,
SIMVASTATIN 20 MG PO TABS,RX-11365,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.36,5.72,,0.95,,6.04,Percent of total billed charges,,,0.98,,6.23,Percent of total billed charges,,,0.95,,6.04,Percent of total billed charges,,,0.95,,6.04,Percent of total billed charges,,,0.97,,6.17,Percent of total billed charges,,,0.96,,6.11,Percent of total billed charges,,,0.95,,6.04,Percent of total billed charges,,,,,,,,,0.95,,6.04,Percent of total billed charges,,6.04,6.23,
BUPIVACAINE LIPOSOME 1.3 % INJECTION SUSP,RX-113701,CDM,C9290,HCPCS,636,RC,,inpatient,1,ML,87.17,78.45,,0.95,,82.81,Percent of total billed charges,,,0.98,,85.43,Percent of total billed charges,,,0.95,,82.81,Percent of total billed charges,,,0.97,,84.55,Percent of total billed charges,,,0.97,,84.55,Percent of total billed charges,,,0.96,,83.68,Percent of total billed charges,,,0.95,,82.81,Percent of total billed charges,,,,,,,,,0.95,,82.81,Percent of total billed charges,,82.81,85.43,
BUPIVACAINE LIPOSOME 1.3 % INJECTION SUSP,RX-113701,CDM,C9290,HCPCS,636,RC,,outpatient,1,ML,87.17,78.45,,0.95,,82.81,Percent of total billed charges,,,0.98,,85.43,Percent of total billed charges,,,0.95,,82.81,Percent of total billed charges,,,0.95,,82.81,Percent of total billed charges,,,0.97,,84.55,Percent of total billed charges,,,0.96,,83.68,Percent of total billed charges,,,0.95,,82.81,Percent of total billed charges,,,,,,,,,0.95,,82.81,Percent of total billed charges,,82.81,85.43,
GEMCITABINE HCL 200 MG/5.26ML IV SOLN,RX-113706,CDM,J9201,HCPCS,636,RC,,inpatient,5.26,ML,136.31,122.68,,0.95,,129.49,Percent of total billed charges,,,0.98,,133.58,Percent of total billed charges,,,0.95,,129.49,Percent of total billed charges,,,0.97,,132.22,Percent of total billed charges,,,0.97,,132.22,Percent of total billed charges,,,0.96,,130.86,Percent of total billed charges,,,0.95,,129.49,Percent of total billed charges,,,,,,,,,0.95,,129.49,Percent of total billed charges,,129.49,133.58,
GEMCITABINE HCL 200 MG/5.26ML IV SOLN,RX-113706,CDM,J9201,HCPCS,636,RC,,outpatient,5.26,ML,136.31,122.68,,0.95,,129.49,Percent of total billed charges,,,0.98,,133.58,Percent of total billed charges,,,0.95,,129.49,Percent of total billed charges,,,0.95,,129.49,Percent of total billed charges,,,0.97,,132.22,Percent of total billed charges,,,0.96,,130.86,Percent of total billed charges,,,0.95,,129.49,Percent of total billed charges,,,,,,,,,0.95,,129.49,Percent of total billed charges,,129.49,133.58,
GEMCITABINE HCL 1 GM/26.3ML IV SOLN,RX-113707,CDM,J9201,HCPCS,636,RC,,inpatient,26.3,ML,168.89,152,,0.95,,160.45,Percent of total billed charges,,,0.98,,165.51,Percent of total billed charges,,,0.95,,160.45,Percent of total billed charges,,,0.97,,163.82,Percent of total billed charges,,,0.97,,163.82,Percent of total billed charges,,,0.96,,162.13,Percent of total billed charges,,,0.95,,160.45,Percent of total billed charges,,,,,,,,,0.95,,160.45,Percent of total billed charges,,160.45,165.51,
GEMCITABINE HCL 1 GM/26.3ML IV SOLN,RX-113707,CDM,J9201,HCPCS,636,RC,,outpatient,26.3,ML,168.89,152,,0.95,,160.45,Percent of total billed charges,,,0.98,,165.51,Percent of total billed charges,,,0.95,,160.45,Percent of total billed charges,,,0.95,,160.45,Percent of total billed charges,,,0.97,,163.82,Percent of total billed charges,,,0.96,,162.13,Percent of total billed charges,,,0.95,,160.45,Percent of total billed charges,,,,,,,,,0.95,,160.45,Percent of total billed charges,,160.45,165.51,
GEMCITABINE HCL 2 GM/52.6ML IV SOLN,RX-113708,CDM,J9201,HCPCS,636,RC,,inpatient,52.6,ML,215.38,193.84,,0.95,,204.61,Percent of total billed charges,,,0.98,,211.07,Percent of total billed charges,,,0.95,,204.61,Percent of total billed charges,,,0.97,,208.92,Percent of total billed charges,,,0.97,,208.92,Percent of total billed charges,,,0.96,,206.76,Percent of total billed charges,,,0.95,,204.61,Percent of total billed charges,,,,,,,,,0.95,,204.61,Percent of total billed charges,,204.61,211.07,
GEMCITABINE HCL 2 GM/52.6ML IV SOLN,RX-113708,CDM,J9201,HCPCS,636,RC,,outpatient,52.6,ML,215.38,193.84,,0.95,,204.61,Percent of total billed charges,,,0.98,,211.07,Percent of total billed charges,,,0.95,,204.61,Percent of total billed charges,,,0.95,,204.61,Percent of total billed charges,,,0.97,,208.92,Percent of total billed charges,,,0.96,,206.76,Percent of total billed charges,,,0.95,,204.61,Percent of total billed charges,,,,,,,,,0.95,,204.61,Percent of total billed charges,,204.61,211.07,
LEVOTHYROXINE SODIUM 100 MCG IV SOLR,RX-113913,CDM,J0650,HCPCS,250,RC,,inpatient,5,ML,221.46,199.31,,0.95,,210.39,Percent of total billed charges,,,0.98,,217.03,Percent of total billed charges,,,0.95,,210.39,Percent of total billed charges,,,0.97,,214.82,Percent of total billed charges,,,0.97,,214.82,Percent of total billed charges,,,0.96,,212.6,Percent of total billed charges,,,0.95,,210.39,Percent of total billed charges,,,,,,,,,0.95,,210.39,Percent of total billed charges,,210.39,217.03,
LEVOTHYROXINE SODIUM 100 MCG IV SOLR,RX-113913,CDM,J0650,HCPCS,250,RC,,outpatient,5,ML,221.46,199.31,,0.95,,210.39,Percent of total billed charges,,,0.98,,217.03,Percent of total billed charges,,,0.95,,210.39,Percent of total billed charges,,,0.95,,210.39,Percent of total billed charges,,,0.97,,214.82,Percent of total billed charges,,,0.96,,212.6,Percent of total billed charges,,,0.95,,210.39,Percent of total billed charges,,,,,,,,,0.95,,210.39,Percent of total billed charges,,210.39,217.03,
SOD CITRATE-CITRIC ACID 500-334 MG/5ML PO SOLN,RX-11394,CDM,J3490,HCPCS,637,RC,,inpatient,10,ML,9.01,8.11,,0.95,,8.56,Percent of total billed charges,,,0.98,,8.83,Percent of total billed charges,,,0.95,,8.56,Percent of total billed charges,,,0.97,,8.74,Percent of total billed charges,,,0.97,,8.74,Percent of total billed charges,,,0.96,,8.65,Percent of total billed charges,,,0.95,,8.56,Percent of total billed charges,,,,,,,,,0.95,,8.56,Percent of total billed charges,,8.56,8.83,
SOD CITRATE-CITRIC ACID 500-334 MG/5ML PO SOLN,RX-11394,CDM,J3490,HCPCS,637,RC,,outpatient,10,ML,9.01,8.11,,0.95,,8.56,Percent of total billed charges,,,0.98,,8.83,Percent of total billed charges,,,0.95,,8.56,Percent of total billed charges,,,0.95,,8.56,Percent of total billed charges,,,0.97,,8.74,Percent of total billed charges,,,0.96,,8.65,Percent of total billed charges,,,0.95,,8.56,Percent of total billed charges,,,,,,,,,0.95,,8.56,Percent of total billed charges,,8.56,8.83,
ACETAZOLAMIDE SODIUM 500 MG INJECTION SOLR,RX-114,CDM,J1120,HCPCS,636,RC,,inpatient,2.5,ML,84.96,76.46,,0.95,,80.71,Percent of total billed charges,,,0.98,,83.26,Percent of total billed charges,,,0.95,,80.71,Percent of total billed charges,,,0.97,,82.41,Percent of total billed charges,,,0.97,,82.41,Percent of total billed charges,,,0.96,,81.56,Percent of total billed charges,,,0.95,,80.71,Percent of total billed charges,,,,,,,,,0.95,,80.71,Percent of total billed charges,,80.71,83.26,
ACETAZOLAMIDE SODIUM 500 MG INJECTION SOLR,RX-114,CDM,J1120,HCPCS,636,RC,,outpatient,2.5,ML,84.96,76.46,,0.95,,80.71,Percent of total billed charges,,,0.98,,83.26,Percent of total billed charges,,,0.95,,80.71,Percent of total billed charges,,,0.95,,80.71,Percent of total billed charges,,,0.97,,82.41,Percent of total billed charges,,,0.96,,81.56,Percent of total billed charges,,,0.95,,80.71,Percent of total billed charges,,,,,,,,,0.95,,80.71,Percent of total billed charges,,80.71,83.26,
SODIUM CHLORIDE 0.9 % IRRIG SOLN,RX-11403,CDM,J3490,HCPCS,250,RC,,inpatient,1000,ML,97.85,88.07,,0.95,,92.96,Percent of total billed charges,,,0.98,,95.89,Percent of total billed charges,,,0.95,,92.96,Percent of total billed charges,,,0.97,,94.91,Percent of total billed charges,,,0.97,,94.91,Percent of total billed charges,,,0.96,,93.94,Percent of total billed charges,,,0.95,,92.96,Percent of total billed charges,,,,,,,,,0.95,,92.96,Percent of total billed charges,,92.96,95.89,
SODIUM CHLORIDE 0.9 % IRRIG SOLN,RX-11403,CDM,J3490,HCPCS,250,RC,,outpatient,1000,ML,97.85,88.07,,0.95,,92.96,Percent of total billed charges,,,0.98,,95.89,Percent of total billed charges,,,0.95,,92.96,Percent of total billed charges,,,0.95,,92.96,Percent of total billed charges,,,0.97,,94.91,Percent of total billed charges,,,0.96,,93.94,Percent of total billed charges,,,0.95,,92.96,Percent of total billed charges,,,,,,,,,0.95,,92.96,Percent of total billed charges,,92.96,95.89,
SOTALOL HCL 80 MG PO TABS,RX-11421,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,11.44,10.3,,0.95,,10.87,Percent of total billed charges,,,0.98,,11.21,Percent of total billed charges,,,0.95,,10.87,Percent of total billed charges,,,0.97,,11.1,Percent of total billed charges,,,0.97,,11.1,Percent of total billed charges,,,0.96,,10.98,Percent of total billed charges,,,0.95,,10.87,Percent of total billed charges,,,,,,,,,0.95,,10.87,Percent of total billed charges,,10.87,11.21,
SOTALOL HCL 80 MG PO TABS,RX-11421,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,11.44,10.3,,0.95,,10.87,Percent of total billed charges,,,0.98,,11.21,Percent of total billed charges,,,0.95,,10.87,Percent of total billed charges,,,0.95,,10.87,Percent of total billed charges,,,0.97,,11.1,Percent of total billed charges,,,0.96,,10.98,Percent of total billed charges,,,0.95,,10.87,Percent of total billed charges,,,,,,,,,0.95,,10.87,Percent of total billed charges,,10.87,11.21,
OXYTOCIN-SODIUM CHLORIDE 30-0.9 UT/500ML-% IV SOLN,RX-114210,CDM,J7999,HCPCS,250,RC,,inpatient,500,ML,108.15,97.34,,0.95,,102.74,Percent of total billed charges,,,0.98,,105.99,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,0.97,,104.91,Percent of total billed charges,,,0.97,,104.91,Percent of total billed charges,,,0.96,,103.82,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,,,,,,,0.95,,102.74,Percent of total billed charges,,102.74,105.99,
OXYTOCIN-SODIUM CHLORIDE 30-0.9 UT/500ML-% IV SOLN,RX-114210,CDM,J7999,HCPCS,250,RC,,outpatient,500,ML,108.15,97.34,,0.95,,102.74,Percent of total billed charges,,,0.98,,105.99,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,0.97,,104.91,Percent of total billed charges,,,0.96,,103.82,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,,,,,,,0.95,,102.74,Percent of total billed charges,,102.74,105.99,
SPIRONOLACTONE 100 MG PO TABS,RX-11425,CDM,J3490,HCPCS,637,RC,,inpatient,0.5,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
SPIRONOLACTONE 100 MG PO TABS,RX-11425,CDM,J3490,HCPCS,637,RC,,outpatient,0.5,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
ACETAMINOPHEN-CODEINE 300-30 MG (ED HOMEPACK) PO TABS,RX-114399,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,24.61,22.15,,0.95,,23.38,Percent of total billed charges,,,0.98,,24.12,Percent of total billed charges,,,0.95,,23.38,Percent of total billed charges,,,0.97,,23.87,Percent of total billed charges,,,0.97,,23.87,Percent of total billed charges,,,0.96,,23.63,Percent of total billed charges,,,0.95,,23.38,Percent of total billed charges,,,,,,,,,0.95,,23.38,Percent of total billed charges,,23.38,24.12,
ACETAMINOPHEN-CODEINE 300-30 MG (ED HOMEPACK) PO TABS,RX-114399,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,24.61,22.15,,0.95,,23.38,Percent of total billed charges,,,0.98,,24.12,Percent of total billed charges,,,0.95,,23.38,Percent of total billed charges,,,0.95,,23.38,Percent of total billed charges,,,0.97,,23.87,Percent of total billed charges,,,0.96,,23.63,Percent of total billed charges,,,0.95,,23.38,Percent of total billed charges,,,,,,,,,0.95,,23.38,Percent of total billed charges,,23.38,24.12,
RACEPINEPHRINE HCL 2.25 % INHAL NEBU,RX-114401,CDM,J3490,HCPCS,637,RC,,inpatient,0.25,ML,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
RACEPINEPHRINE HCL 2.25 % INHAL NEBU,RX-114401,CDM,J3490,HCPCS,637,RC,,outpatient,0.25,ML,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
SUCRALFATE 1 GM/10ML PO SUSP,RX-11441,CDM,J3490,HCPCS,637,RC,,inpatient,10,ML,32.17,28.95,,0.95,,30.56,Percent of total billed charges,,,0.98,,31.53,Percent of total billed charges,,,0.95,,30.56,Percent of total billed charges,,,0.97,,31.2,Percent of total billed charges,,,0.97,,31.2,Percent of total billed charges,,,0.96,,30.88,Percent of total billed charges,,,0.95,,30.56,Percent of total billed charges,,,,,,,,,0.95,,30.56,Percent of total billed charges,,30.56,31.53,
SUCRALFATE 1 GM/10ML PO SUSP,RX-11441,CDM,J3490,HCPCS,637,RC,,outpatient,10,ML,32.17,28.95,,0.95,,30.56,Percent of total billed charges,,,0.98,,31.53,Percent of total billed charges,,,0.95,,30.56,Percent of total billed charges,,,0.95,,30.56,Percent of total billed charges,,,0.97,,31.2,Percent of total billed charges,,,0.96,,30.88,Percent of total billed charges,,,0.95,,30.56,Percent of total billed charges,,,,,,,,,0.95,,30.56,Percent of total billed charges,,30.56,31.53,
PROMETHAZINE HCL 25 MG/ML (IM ONLY) INJECTION SOLN,RX-114463,CDM,J2550,HCPCS,636,RC,,inpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
PROMETHAZINE HCL 25 MG/ML (IM ONLY) INJECTION SOLN,RX-114463,CDM,J2550,HCPCS,636,RC,,outpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
DEXAMETHASONE SOD PHOSPHATE PF 10 MG/ML INJECTION SOLN,RX-114597,CDM,J1100,HCPCS,636,RC,,inpatient,0.2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
DEXAMETHASONE SOD PHOSPHATE PF 10 MG/ML INJECTION SOLN,RX-114597,CDM,J1100,HCPCS,636,RC,,outpatient,0.2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
LEVOFLOXACIN 500 MG (ED HOMEPACK) PO TABS,RX-114639,CDM,J3490,HCPCS,637,RC,,inpatient,2,UN,14.66,13.19,,0.95,,13.93,Percent of total billed charges,,,0.98,,14.37,Percent of total billed charges,,,0.95,,13.93,Percent of total billed charges,,,0.97,,14.22,Percent of total billed charges,,,0.97,,14.22,Percent of total billed charges,,,0.96,,14.07,Percent of total billed charges,,,0.95,,13.93,Percent of total billed charges,,,,,,,,,0.95,,13.93,Percent of total billed charges,,13.93,14.37,
LEVOFLOXACIN 500 MG (ED HOMEPACK) PO TABS,RX-114639,CDM,J3490,HCPCS,637,RC,,outpatient,2,UN,14.66,13.19,,0.95,,13.93,Percent of total billed charges,,,0.98,,14.37,Percent of total billed charges,,,0.95,,13.93,Percent of total billed charges,,,0.95,,13.93,Percent of total billed charges,,,0.97,,14.22,Percent of total billed charges,,,0.96,,14.07,Percent of total billed charges,,,0.95,,13.93,Percent of total billed charges,,,,,,,,,0.95,,13.93,Percent of total billed charges,,13.93,14.37,
TERBUTALINE SULFATE 1 MG/ML INJECTION SOLN,RX-11507,CDM,J3105,HCPCS,636,RC,,inpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
TERBUTALINE SULFATE 1 MG/ML INJECTION SOLN,RX-11507,CDM,J3105,HCPCS,636,RC,,outpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
TERBUTALINE SULFATE 2.5 MG PO TABS,RX-11508,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.87,9.78,,0.95,,10.33,Percent of total billed charges,,,0.98,,10.65,Percent of total billed charges,,,0.95,,10.33,Percent of total billed charges,,,0.97,,10.54,Percent of total billed charges,,,0.97,,10.54,Percent of total billed charges,,,0.96,,10.44,Percent of total billed charges,,,0.95,,10.33,Percent of total billed charges,,,,,,,,,0.95,,10.33,Percent of total billed charges,,10.33,10.65,
TERBUTALINE SULFATE 2.5 MG PO TABS,RX-11508,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.87,9.78,,0.95,,10.33,Percent of total billed charges,,,0.98,,10.65,Percent of total billed charges,,,0.95,,10.33,Percent of total billed charges,,,0.95,,10.33,Percent of total billed charges,,,0.97,,10.54,Percent of total billed charges,,,0.96,,10.44,Percent of total billed charges,,,0.95,,10.33,Percent of total billed charges,,,,,,,,,0.95,,10.33,Percent of total billed charges,,10.33,10.65,
TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LFU IM INJ,RX-11515,CDM,90714,HCPCS,636,RC,,inpatient,0.5,ML,116.16,104.54,,0.95,,110.35,Percent of total billed charges,,,0.98,,113.84,Percent of total billed charges,,,0.95,,110.35,Percent of total billed charges,,,0.97,,112.68,Percent of total billed charges,,,0.97,,112.68,Percent of total billed charges,,,0.96,,111.51,Percent of total billed charges,,,0.95,,110.35,Percent of total billed charges,,,,,,,,,0.95,,110.35,Percent of total billed charges,,110.35,113.84,
TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LFU IM INJ,RX-11515,CDM,90714,HCPCS,636,RC,,outpatient,0.5,ML,116.16,104.54,,0.95,,110.35,Percent of total billed charges,,,0.98,,113.84,Percent of total billed charges,,,0.95,,110.35,Percent of total billed charges,,,0.95,,110.35,Percent of total billed charges,,,0.97,,112.68,Percent of total billed charges,,,0.96,,111.51,Percent of total billed charges,,,0.95,,110.35,Percent of total billed charges,,,,,,,,,0.95,,110.35,Percent of total billed charges,,110.35,113.84,
METHYLNALTREXONE BROMIDE 8 MG/0.4ML SUBQ SOLN,RX-115573,CDM,J2212,HCPCS,637,RC,,inpatient,0.4,ML,518.77,466.89,,0.95,,492.83,Percent of total billed charges,,,0.98,,508.39,Percent of total billed charges,,,0.95,,492.83,Percent of total billed charges,,,0.97,,503.21,Percent of total billed charges,,,0.97,,503.21,Percent of total billed charges,,,0.96,,498.02,Percent of total billed charges,,,0.95,,492.83,Percent of total billed charges,,,,,,,,,0.95,,492.83,Percent of total billed charges,,492.83,508.39,
METHYLNALTREXONE BROMIDE 8 MG/0.4ML SUBQ SOLN,RX-115573,CDM,J2212,HCPCS,637,RC,,outpatient,0.4,ML,518.77,466.89,,0.95,,492.83,Percent of total billed charges,,,0.98,,508.39,Percent of total billed charges,,,0.95,,492.83,Percent of total billed charges,,,0.95,,492.83,Percent of total billed charges,,,0.97,,503.21,Percent of total billed charges,,,0.96,,498.02,Percent of total billed charges,,,0.95,,492.83,Percent of total billed charges,,,,,,,,,0.95,,492.83,Percent of total billed charges,,492.83,508.39,
TIMOLOL MALEATE 0.25 % OP SOLN,RX-11561,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,23.68,21.31,,0.95,,22.5,Percent of total billed charges,,,0.98,,23.21,Percent of total billed charges,,,0.95,,22.5,Percent of total billed charges,,,0.97,,22.97,Percent of total billed charges,,,0.97,,22.97,Percent of total billed charges,,,0.96,,22.73,Percent of total billed charges,,,0.95,,22.5,Percent of total billed charges,,,,,,,,,0.95,,22.5,Percent of total billed charges,,22.5,23.21,
TIMOLOL MALEATE 0.25 % OP SOLN,RX-11561,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,23.68,21.31,,0.95,,22.5,Percent of total billed charges,,,0.98,,23.21,Percent of total billed charges,,,0.95,,22.5,Percent of total billed charges,,,0.95,,22.5,Percent of total billed charges,,,0.97,,22.97,Percent of total billed charges,,,0.96,,22.73,Percent of total billed charges,,,0.95,,22.5,Percent of total billed charges,,,,,,,,,0.95,,22.5,Percent of total billed charges,,22.5,23.21,
TIMOLOL MALEATE 0.5 % OP SOLN,RX-11562,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,41.81,37.63,,0.95,,39.72,Percent of total billed charges,,,0.98,,40.97,Percent of total billed charges,,,0.95,,39.72,Percent of total billed charges,,,0.97,,40.56,Percent of total billed charges,,,0.97,,40.56,Percent of total billed charges,,,0.96,,40.14,Percent of total billed charges,,,0.95,,39.72,Percent of total billed charges,,,,,,,,,0.95,,39.72,Percent of total billed charges,,39.72,40.97,
TIMOLOL MALEATE 0.5 % OP SOLN,RX-11562,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,41.81,37.63,,0.95,,39.72,Percent of total billed charges,,,0.98,,40.97,Percent of total billed charges,,,0.95,,39.72,Percent of total billed charges,,,0.95,,39.72,Percent of total billed charges,,,0.97,,40.56,Percent of total billed charges,,,0.96,,40.14,Percent of total billed charges,,,0.95,,39.72,Percent of total billed charges,,,,,,,,,0.95,,39.72,Percent of total billed charges,,39.72,40.97,
CEFAZOLIN SODIUM-DEXTROSE 2-3 GM-%(50ML) IV SOLR,RX-115785,CDM,J0690,HCPCS,636,RC,,inpatient,50,ML,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
CEFAZOLIN SODIUM-DEXTROSE 2-3 GM-%(50ML) IV SOLR,RX-115785,CDM,J0690,HCPCS,636,RC,,outpatient,50,ML,79,71.1,,0.95,,75.05,Percent of total billed charges,,,0.98,,77.42,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,0.97,,76.63,Percent of total billed charges,,,0.96,,75.84,Percent of total billed charges,,,0.95,,75.05,Percent of total billed charges,,,,,,,,,0.95,,75.05,Percent of total billed charges,,75.05,77.42,
TRIAMCINOLONE ACETONIDE 10 MG/ML INJECTION SUSP,RX-11584,CDM,J3301,HCPCS,636,RC,,inpatient,0.25,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
TRIAMCINOLONE ACETONIDE 10 MG/ML INJECTION SUSP,RX-11584,CDM,J3301,HCPCS,636,RC,,outpatient,0.25,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
WITCH HAZEL-GLYCERIN EX PADS,RX-11678,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
WITCH HAZEL-GLYCERIN EX PADS,RX-11678,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
PERTUZUMAB 420 MG/14ML IV SOLN,RX-118659,CDM,J9306,HCPCS,636,RC,,inpatient,14,ML,12374.61,11137.15,,0.95,,11755.88,Percent of total billed charges,,,0.98,,12127.12,Percent of total billed charges,,,0.95,,11755.88,Percent of total billed charges,,,0.97,,12003.37,Percent of total billed charges,,,0.97,,12003.37,Percent of total billed charges,,,0.96,,11879.63,Percent of total billed charges,,,0.95,,11755.88,Percent of total billed charges,,,,,,,,,0.95,,11755.88,Percent of total billed charges,,11755.88,12127.12,
PERTUZUMAB 420 MG/14ML IV SOLN,RX-118659,CDM,J9306,HCPCS,636,RC,,outpatient,14,ML,12374.61,11137.15,,0.95,,11755.88,Percent of total billed charges,,,0.98,,12127.12,Percent of total billed charges,,,0.95,,11755.88,Percent of total billed charges,,,0.95,,11755.88,Percent of total billed charges,,,0.97,,12003.37,Percent of total billed charges,,,0.96,,11879.63,Percent of total billed charges,,,0.95,,11755.88,Percent of total billed charges,,,,,,,,,0.95,,11755.88,Percent of total billed charges,,11755.88,12127.12,
IPRATROPIUM-ALBUTEROL 20-100 MCG/ACT INHAL AERS,RX-118768,CDM,J3490,HCPCS,637,RC,,inpatient,4,GR,1246.48,1121.83,,0.95,,1184.16,Percent of total billed charges,,,0.98,,1221.55,Percent of total billed charges,,,0.95,,1184.16,Percent of total billed charges,,,0.97,,1209.09,Percent of total billed charges,,,0.97,,1209.09,Percent of total billed charges,,,0.96,,1196.62,Percent of total billed charges,,,0.95,,1184.16,Percent of total billed charges,,,,,,,,,0.95,,1184.16,Percent of total billed charges,,1184.16,1221.55,
IPRATROPIUM-ALBUTEROL 20-100 MCG/ACT INHAL AERS,RX-118768,CDM,J3490,HCPCS,637,RC,,outpatient,4,GR,1246.48,1121.83,,0.95,,1184.16,Percent of total billed charges,,,0.98,,1221.55,Percent of total billed charges,,,0.95,,1184.16,Percent of total billed charges,,,0.95,,1184.16,Percent of total billed charges,,,0.97,,1209.09,Percent of total billed charges,,,0.96,,1196.62,Percent of total billed charges,,,0.95,,1184.16,Percent of total billed charges,,,,,,,,,0.95,,1184.16,Percent of total billed charges,,1184.16,1221.55,
CULTURELLE PO CAPS,RX-118827,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,13.08,11.77,,0.95,,12.43,Percent of total billed charges,,,0.98,,12.82,Percent of total billed charges,,,0.95,,12.43,Percent of total billed charges,,,0.97,,12.69,Percent of total billed charges,,,0.97,,12.69,Percent of total billed charges,,,0.96,,12.56,Percent of total billed charges,,,0.95,,12.43,Percent of total billed charges,,,,,,,,,0.95,,12.43,Percent of total billed charges,,12.43,12.82,
CULTURELLE PO CAPS,RX-118827,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,13.08,11.77,,0.95,,12.43,Percent of total billed charges,,,0.98,,12.82,Percent of total billed charges,,,0.95,,12.43,Percent of total billed charges,,,0.95,,12.43,Percent of total billed charges,,,0.97,,12.69,Percent of total billed charges,,,0.96,,12.56,Percent of total billed charges,,,0.95,,12.43,Percent of total billed charges,,,,,,,,,0.95,,12.43,Percent of total billed charges,,12.43,12.82,
METHOTREXATE SODIUM (PF) 50 MG/2ML INJECTION SOLN,RX-119365,CDM,J9260,HCPCS,636,RC,,inpatient,2,ML,145.84,131.26,,0.95,,138.55,Percent of total billed charges,,,0.98,,142.92,Percent of total billed charges,,,0.95,,138.55,Percent of total billed charges,,,0.97,,141.46,Percent of total billed charges,,,0.97,,141.46,Percent of total billed charges,,,0.96,,140.01,Percent of total billed charges,,,0.95,,138.55,Percent of total billed charges,,,,,,,,,0.95,,138.55,Percent of total billed charges,,138.55,142.92,
METHOTREXATE SODIUM (PF) 50 MG/2ML INJECTION SOLN,RX-119365,CDM,J9260,HCPCS,636,RC,,outpatient,2,ML,145.84,131.26,,0.95,,138.55,Percent of total billed charges,,,0.98,,142.92,Percent of total billed charges,,,0.95,,138.55,Percent of total billed charges,,,0.95,,138.55,Percent of total billed charges,,,0.97,,141.46,Percent of total billed charges,,,0.96,,140.01,Percent of total billed charges,,,0.95,,138.55,Percent of total billed charges,,,,,,,,,0.95,,138.55,Percent of total billed charges,,138.55,142.92,
MORPHINE SULFATE (CONCENTRATE) 100 MG/5ML PO SOLN,RX-119792,CDM,J3490,HCPCS,637,RC,,inpatient,0.25,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
MORPHINE SULFATE (CONCENTRATE) 100 MG/5ML PO SOLN,RX-119792,CDM,J3490,HCPCS,637,RC,,outpatient,0.25,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
MORPHINE SULFATE (PF) 4 MG/ML IV SOLN,RX-120156,CDM,J2270,HCPCS,636,RC,,inpatient,0.75,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
MORPHINE SULFATE (PF) 4 MG/ML IV SOLN,RX-120156,CDM,J2270,HCPCS,636,RC,,outpatient,0.75,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
MECLIZINE HCL 12.5 MG PO TABS,RX-12024,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.83,7.05,,0.95,,7.44,Percent of total billed charges,,,0.98,,7.67,Percent of total billed charges,,,0.95,,7.44,Percent of total billed charges,,,0.97,,7.6,Percent of total billed charges,,,0.97,,7.6,Percent of total billed charges,,,0.96,,7.52,Percent of total billed charges,,,0.95,,7.44,Percent of total billed charges,,,,,,,,,0.95,,7.44,Percent of total billed charges,,7.44,7.67,
MECLIZINE HCL 12.5 MG PO TABS,RX-12024,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.83,7.05,,0.95,,7.44,Percent of total billed charges,,,0.98,,7.67,Percent of total billed charges,,,0.95,,7.44,Percent of total billed charges,,,0.95,,7.44,Percent of total billed charges,,,0.97,,7.6,Percent of total billed charges,,,0.96,,7.52,Percent of total billed charges,,,0.95,,7.44,Percent of total billed charges,,,,,,,,,0.95,,7.44,Percent of total billed charges,,7.44,7.67,
MAGNESIUM OXIDE -MG SUPPLEMENT 400 (240 MG) MG PO TABS,RX-120355,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.03,5.43,,0.95,,5.73,Percent of total billed charges,,,0.98,,5.91,Percent of total billed charges,,,0.95,,5.73,Percent of total billed charges,,,0.97,,5.85,Percent of total billed charges,,,0.97,,5.85,Percent of total billed charges,,,0.96,,5.79,Percent of total billed charges,,,0.95,,5.73,Percent of total billed charges,,,,,,,,,0.95,,5.73,Percent of total billed charges,,5.73,5.91,
MAGNESIUM OXIDE -MG SUPPLEMENT 400 (240 MG) MG PO TABS,RX-120355,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.03,5.43,,0.95,,5.73,Percent of total billed charges,,,0.98,,5.91,Percent of total billed charges,,,0.95,,5.73,Percent of total billed charges,,,0.95,,5.73,Percent of total billed charges,,,0.97,,5.85,Percent of total billed charges,,,0.96,,5.79,Percent of total billed charges,,,0.95,,5.73,Percent of total billed charges,,,,,,,,,0.95,,5.73,Percent of total billed charges,,5.73,5.91,
INFUVITE ADULT IV SOLN,RX-121894,CDM,J3490,HCPCS,250,RC,,inpatient,5,ML,22.78,20.5,,0.95,,21.64,Percent of total billed charges,,,0.98,,22.32,Percent of total billed charges,,,0.95,,21.64,Percent of total billed charges,,,0.97,,22.1,Percent of total billed charges,,,0.97,,22.1,Percent of total billed charges,,,0.96,,21.87,Percent of total billed charges,,,0.95,,21.64,Percent of total billed charges,,,,,,,,,0.95,,21.64,Percent of total billed charges,,21.64,22.32,
INFUVITE ADULT IV SOLN,RX-121894,CDM,J3490,HCPCS,250,RC,,outpatient,5,ML,22.78,20.5,,0.95,,21.64,Percent of total billed charges,,,0.98,,22.32,Percent of total billed charges,,,0.95,,21.64,Percent of total billed charges,,,0.95,,21.64,Percent of total billed charges,,,0.97,,22.1,Percent of total billed charges,,,0.96,,21.87,Percent of total billed charges,,,0.95,,21.64,Percent of total billed charges,,,,,,,,,0.95,,21.64,Percent of total billed charges,,21.64,22.32,
APIXABAN 5 MG PO TABS,RX-121935,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,13.46,12.11,,0.95,,12.79,Percent of total billed charges,,,0.98,,13.19,Percent of total billed charges,,,0.95,,12.79,Percent of total billed charges,,,0.97,,13.06,Percent of total billed charges,,,0.97,,13.06,Percent of total billed charges,,,0.96,,12.92,Percent of total billed charges,,,0.95,,12.79,Percent of total billed charges,,,,,,,,,0.95,,12.79,Percent of total billed charges,,12.79,13.19,
APIXABAN 5 MG PO TABS,RX-121935,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,13.46,12.11,,0.95,,12.79,Percent of total billed charges,,,0.98,,13.19,Percent of total billed charges,,,0.95,,12.79,Percent of total billed charges,,,0.95,,12.79,Percent of total billed charges,,,0.97,,13.06,Percent of total billed charges,,,0.96,,12.92,Percent of total billed charges,,,0.95,,12.79,Percent of total billed charges,,,,,,,,,0.95,,12.79,Percent of total billed charges,,12.79,13.19,
VENLAFAXINE HCL 37.5 MG PO TABS,RX-12207,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.17,7.35,,0.95,,7.76,Percent of total billed charges,,,0.98,,8.01,Percent of total billed charges,,,0.95,,7.76,Percent of total billed charges,,,0.97,,7.92,Percent of total billed charges,,,0.97,,7.92,Percent of total billed charges,,,0.96,,7.84,Percent of total billed charges,,,0.95,,7.76,Percent of total billed charges,,,,,,,,,0.95,,7.76,Percent of total billed charges,,7.76,8.01,
VENLAFAXINE HCL 37.5 MG PO TABS,RX-12207,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.17,7.35,,0.95,,7.76,Percent of total billed charges,,,0.98,,8.01,Percent of total billed charges,,,0.95,,7.76,Percent of total billed charges,,,0.95,,7.76,Percent of total billed charges,,,0.97,,7.92,Percent of total billed charges,,,0.96,,7.84,Percent of total billed charges,,,0.95,,7.76,Percent of total billed charges,,,,,,,,,0.95,,7.76,Percent of total billed charges,,7.76,8.01,
BUPIVACAINE HCL 0.5 % INJECTION SOLN,RX-1223,CDM,J0665,HCPCS,636,RC,,inpatient,5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
BUPIVACAINE HCL 0.5 % INJECTION SOLN,RX-1223,CDM,J0665,HCPCS,636,RC,,outpatient,5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
MORPHINE SULFATE ER 30 MG PO TBCR,RX-122843,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,12.26,11.03,,0.95,,11.65,Percent of total billed charges,,,0.98,,12.01,Percent of total billed charges,,,0.95,,11.65,Percent of total billed charges,,,0.97,,11.89,Percent of total billed charges,,,0.97,,11.89,Percent of total billed charges,,,0.96,,11.77,Percent of total billed charges,,,0.95,,11.65,Percent of total billed charges,,,,,,,,,0.95,,11.65,Percent of total billed charges,,11.65,12.01,
MORPHINE SULFATE ER 30 MG PO TBCR,RX-122843,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,12.26,11.03,,0.95,,11.65,Percent of total billed charges,,,0.98,,12.01,Percent of total billed charges,,,0.95,,11.65,Percent of total billed charges,,,0.95,,11.65,Percent of total billed charges,,,0.97,,11.89,Percent of total billed charges,,,0.96,,11.77,Percent of total billed charges,,,0.95,,11.65,Percent of total billed charges,,,,,,,,,0.95,,11.65,Percent of total billed charges,,11.65,12.01,
ATRACURIUM BESYLATE 100 MG/10ML IV SOLN,RX-122856,CDM,J3490,HCPCS,250,RC,,inpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
ATRACURIUM BESYLATE 100 MG/10ML IV SOLN,RX-122856,CDM,J3490,HCPCS,250,RC,,outpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
MORPHINE SULFATE (PF) 2 MG/ML IV SOLN,RX-122857,CDM,J2270,HCPCS,636,RC,,inpatient,0.5,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
MORPHINE SULFATE (PF) 2 MG/ML IV SOLN,RX-122857,CDM,J2270,HCPCS,636,RC,,outpatient,0.5,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
MORPHINE SULFATE ER 15 MG PO TBCR,RX-122865,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,9.13,8.22,,0.95,,8.67,Percent of total billed charges,,,0.98,,8.95,Percent of total billed charges,,,0.95,,8.67,Percent of total billed charges,,,0.97,,8.86,Percent of total billed charges,,,0.97,,8.86,Percent of total billed charges,,,0.96,,8.76,Percent of total billed charges,,,0.95,,8.67,Percent of total billed charges,,,,,,,,,0.95,,8.67,Percent of total billed charges,,8.67,8.95,
MORPHINE SULFATE ER 15 MG PO TBCR,RX-122865,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,9.13,8.22,,0.95,,8.67,Percent of total billed charges,,,0.98,,8.95,Percent of total billed charges,,,0.95,,8.67,Percent of total billed charges,,,0.95,,8.67,Percent of total billed charges,,,0.97,,8.86,Percent of total billed charges,,,0.96,,8.76,Percent of total billed charges,,,0.95,,8.67,Percent of total billed charges,,,,,,,,,0.95,,8.67,Percent of total billed charges,,8.67,8.95,
ACETYLCYSTEINE 20 % INHAL SOLN,RX-123,CDM,J7608,HCPCS,636,RC,,inpatient,1,ML,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
ACETYLCYSTEINE 20 % INHAL SOLN,RX-123,CDM,J7608,HCPCS,636,RC,,outpatient,1,ML,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
PROTHROMBIN COMPLEX CONC HUMAN 500 UNITS IV KIT,RX-124009,CDM,J7168,HCPCS,636,RC,,inpatient,1,UN,1758.64,1582.78,,0.95,,1670.71,Percent of total billed charges,,,0.98,,1723.47,Percent of total billed charges,,,0.95,,1670.71,Percent of total billed charges,,,0.97,,1705.88,Percent of total billed charges,,,0.97,,1705.88,Percent of total billed charges,,,0.96,,1688.29,Percent of total billed charges,,,0.95,,1670.71,Percent of total billed charges,,,,,,,,,0.95,,1670.71,Percent of total billed charges,,1670.71,1723.47,
PROTHROMBIN COMPLEX CONC HUMAN 500 UNITS IV KIT,RX-124009,CDM,J7168,HCPCS,636,RC,,outpatient,1,UN,1758.64,1582.78,,0.95,,1670.71,Percent of total billed charges,,,0.98,,1723.47,Percent of total billed charges,,,0.95,,1670.71,Percent of total billed charges,,,0.95,,1670.71,Percent of total billed charges,,,0.97,,1705.88,Percent of total billed charges,,,0.96,,1688.29,Percent of total billed charges,,,0.95,,1670.71,Percent of total billed charges,,,,,,,,,0.95,,1670.71,Percent of total billed charges,,1670.71,1723.47,
NEOSTIGMINE METHYLSULFATE 5 MG/10ML IV SOLN,RX-124510,CDM,J2710,HCPCS,636,RC,,inpatient,10,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
NEOSTIGMINE METHYLSULFATE 5 MG/10ML IV SOLN,RX-124510,CDM,J2710,HCPCS,636,RC,,outpatient,10,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
DIPHENHYDRAMINE HCL 12.5 MG/5ML PO LIQD,RX-12556,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,9.32,8.39,,0.95,,8.85,Percent of total billed charges,,,0.98,,9.13,Percent of total billed charges,,,0.95,,8.85,Percent of total billed charges,,,0.97,,9.04,Percent of total billed charges,,,0.97,,9.04,Percent of total billed charges,,,0.96,,8.95,Percent of total billed charges,,,0.95,,8.85,Percent of total billed charges,,,,,,,,,0.95,,8.85,Percent of total billed charges,,8.85,9.13,
DIPHENHYDRAMINE HCL 12.5 MG/5ML PO LIQD,RX-12556,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,9.32,8.39,,0.95,,8.85,Percent of total billed charges,,,0.98,,9.13,Percent of total billed charges,,,0.95,,8.85,Percent of total billed charges,,,0.95,,8.85,Percent of total billed charges,,,0.97,,9.04,Percent of total billed charges,,,0.96,,8.95,Percent of total billed charges,,,0.95,,8.85,Percent of total billed charges,,,,,,,,,0.95,,8.85,Percent of total billed charges,,8.85,9.13,
IPRATROPIUM BROMIDE 0.02 % INHAL SOLN,RX-12580,CDM,J7644,HCPCS,636,RC,,inpatient,2.5,ML,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
IPRATROPIUM BROMIDE 0.02 % INHAL SOLN,RX-12580,CDM,J7644,HCPCS,636,RC,,outpatient,2.5,ML,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
TERBINAFINE HCL 250 MG PO TABS,RX-12724,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.29,5.66,,0.95,,5.98,Percent of total billed charges,,,0.98,,6.16,Percent of total billed charges,,,0.95,,5.98,Percent of total billed charges,,,0.97,,6.1,Percent of total billed charges,,,0.97,,6.1,Percent of total billed charges,,,0.96,,6.04,Percent of total billed charges,,,0.95,,5.98,Percent of total billed charges,,,,,,,,,0.95,,5.98,Percent of total billed charges,,5.98,6.16,
TERBINAFINE HCL 250 MG PO TABS,RX-12724,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.29,5.66,,0.95,,5.98,Percent of total billed charges,,,0.98,,6.16,Percent of total billed charges,,,0.95,,5.98,Percent of total billed charges,,,0.95,,5.98,Percent of total billed charges,,,0.97,,6.1,Percent of total billed charges,,,0.96,,6.04,Percent of total billed charges,,,0.95,,5.98,Percent of total billed charges,,,,,,,,,0.95,,5.98,Percent of total billed charges,,5.98,6.16,
CALCIUM CHLORIDE 10 % IV SOLN,RX-1306,CDM,J3490,HCPCS,250,RC,,inpatient,10,ML,50.39,45.35,,0.95,,47.87,Percent of total billed charges,,,0.98,,49.38,Percent of total billed charges,,,0.95,,47.87,Percent of total billed charges,,,0.97,,48.88,Percent of total billed charges,,,0.97,,48.88,Percent of total billed charges,,,0.96,,48.37,Percent of total billed charges,,,0.95,,47.87,Percent of total billed charges,,,,,,,,,0.95,,47.87,Percent of total billed charges,,47.87,49.38,
CALCIUM CHLORIDE 10 % IV SOLN,RX-1306,CDM,J3490,HCPCS,250,RC,,outpatient,10,ML,50.39,45.35,,0.95,,47.87,Percent of total billed charges,,,0.98,,49.38,Percent of total billed charges,,,0.95,,47.87,Percent of total billed charges,,,0.95,,47.87,Percent of total billed charges,,,0.97,,48.88,Percent of total billed charges,,,0.96,,48.37,Percent of total billed charges,,,0.95,,47.87,Percent of total billed charges,,,,,,,,,0.95,,47.87,Percent of total billed charges,,47.87,49.38,
VERAPAMIL HCL ER 240 MG PO TBCR,RX-13073,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.92,6.23,,0.95,,6.57,Percent of total billed charges,,,0.98,,6.78,Percent of total billed charges,,,0.95,,6.57,Percent of total billed charges,,,0.97,,6.71,Percent of total billed charges,,,0.97,,6.71,Percent of total billed charges,,,0.96,,6.64,Percent of total billed charges,,,0.95,,6.57,Percent of total billed charges,,,,,,,,,0.95,,6.57,Percent of total billed charges,,6.57,6.78,
VERAPAMIL HCL ER 240 MG PO TBCR,RX-13073,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.92,6.23,,0.95,,6.57,Percent of total billed charges,,,0.98,,6.78,Percent of total billed charges,,,0.95,,6.57,Percent of total billed charges,,,0.95,,6.57,Percent of total billed charges,,,0.97,,6.71,Percent of total billed charges,,,0.96,,6.64,Percent of total billed charges,,,0.95,,6.57,Percent of total billed charges,,,,,,,,,0.95,,6.57,Percent of total billed charges,,6.57,6.78,
CALCIUM CITRATE 950 (200 CA) MG PO TABS,RX-1308,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,5.86,5.27,,0.95,,5.57,Percent of total billed charges,,,0.98,,5.74,Percent of total billed charges,,,0.95,,5.57,Percent of total billed charges,,,0.97,,5.68,Percent of total billed charges,,,0.97,,5.68,Percent of total billed charges,,,0.96,,5.63,Percent of total billed charges,,,0.95,,5.57,Percent of total billed charges,,,,,,,,,0.95,,5.57,Percent of total billed charges,,5.57,5.74,
CALCIUM CITRATE 950 (200 CA) MG PO TABS,RX-1308,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,5.86,5.27,,0.95,,5.57,Percent of total billed charges,,,0.98,,5.74,Percent of total billed charges,,,0.95,,5.57,Percent of total billed charges,,,0.95,,5.57,Percent of total billed charges,,,0.97,,5.68,Percent of total billed charges,,,0.96,,5.63,Percent of total billed charges,,,0.95,,5.57,Percent of total billed charges,,,,,,,,,0.95,,5.57,Percent of total billed charges,,5.57,5.74,
CALCIUM GLUCONATE 10 % IV SOLN,RX-1312,CDM,J0612,HCPCS,636,RC,,inpatient,5,ML,21.56,19.4,,0.95,,20.48,Percent of total billed charges,,,0.98,,21.13,Percent of total billed charges,,,0.95,,20.48,Percent of total billed charges,,,0.97,,20.91,Percent of total billed charges,,,0.97,,20.91,Percent of total billed charges,,,0.96,,20.7,Percent of total billed charges,,,0.95,,20.48,Percent of total billed charges,,,,,,,,,0.95,,20.48,Percent of total billed charges,,20.48,21.13,
CALCIUM GLUCONATE 10 % IV SOLN,RX-1312,CDM,J0612,HCPCS,636,RC,,outpatient,5,ML,21.56,19.4,,0.95,,20.48,Percent of total billed charges,,,0.98,,21.13,Percent of total billed charges,,,0.95,,20.48,Percent of total billed charges,,,0.95,,20.48,Percent of total billed charges,,,0.97,,20.91,Percent of total billed charges,,,0.96,,20.7,Percent of total billed charges,,,0.95,,20.48,Percent of total billed charges,,,,,,,,,0.95,,20.48,Percent of total billed charges,,20.48,21.13,
VALACYCLOVIR HCL 500 MG PO TABS,RX-13133,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,12.01,10.81,,0.95,,11.41,Percent of total billed charges,,,0.98,,11.77,Percent of total billed charges,,,0.95,,11.41,Percent of total billed charges,,,0.97,,11.65,Percent of total billed charges,,,0.97,,11.65,Percent of total billed charges,,,0.96,,11.53,Percent of total billed charges,,,0.95,,11.41,Percent of total billed charges,,,,,,,,,0.95,,11.41,Percent of total billed charges,,11.41,11.77,
VALACYCLOVIR HCL 500 MG PO TABS,RX-13133,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,12.01,10.81,,0.95,,11.41,Percent of total billed charges,,,0.98,,11.77,Percent of total billed charges,,,0.95,,11.41,Percent of total billed charges,,,0.95,,11.41,Percent of total billed charges,,,0.97,,11.65,Percent of total billed charges,,,0.96,,11.53,Percent of total billed charges,,,0.95,,11.41,Percent of total billed charges,,,,,,,,,0.95,,11.41,Percent of total billed charges,,11.41,11.77,
CARBAMAZEPINE 100 MG/5ML PO SUSP,RX-1356,CDM,J3490,HCPCS,637,RC,,inpatient,10,ML,6.86,6.17,,0.95,,6.52,Percent of total billed charges,,,0.98,,6.72,Percent of total billed charges,,,0.95,,6.52,Percent of total billed charges,,,0.97,,6.65,Percent of total billed charges,,,0.97,,6.65,Percent of total billed charges,,,0.96,,6.59,Percent of total billed charges,,,0.95,,6.52,Percent of total billed charges,,,,,,,,,0.95,,6.52,Percent of total billed charges,,6.52,6.72,
CARBAMAZEPINE 100 MG/5ML PO SUSP,RX-1356,CDM,J3490,HCPCS,637,RC,,outpatient,10,ML,6.86,6.17,,0.95,,6.52,Percent of total billed charges,,,0.98,,6.72,Percent of total billed charges,,,0.95,,6.52,Percent of total billed charges,,,0.95,,6.52,Percent of total billed charges,,,0.97,,6.65,Percent of total billed charges,,,0.96,,6.59,Percent of total billed charges,,,0.95,,6.52,Percent of total billed charges,,,,,,,,,0.95,,6.52,Percent of total billed charges,,6.52,6.72,
FLUCONAZOLE 150 MG PO TABS,RX-13577,CDM,J3490,HCPCS,637,RC,,inpatient,0.5,UN,8.3,7.47,,0.95,,7.89,Percent of total billed charges,,,0.98,,8.13,Percent of total billed charges,,,0.95,,7.89,Percent of total billed charges,,,0.97,,8.05,Percent of total billed charges,,,0.97,,8.05,Percent of total billed charges,,,0.96,,7.97,Percent of total billed charges,,,0.95,,7.89,Percent of total billed charges,,,,,,,,,0.95,,7.89,Percent of total billed charges,,7.89,8.13,
FLUCONAZOLE 150 MG PO TABS,RX-13577,CDM,J3490,HCPCS,637,RC,,outpatient,0.5,UN,8.3,7.47,,0.95,,7.89,Percent of total billed charges,,,0.98,,8.13,Percent of total billed charges,,,0.95,,7.89,Percent of total billed charges,,,0.95,,7.89,Percent of total billed charges,,,0.97,,8.05,Percent of total billed charges,,,0.96,,7.97,Percent of total billed charges,,,0.95,,7.89,Percent of total billed charges,,,,,,,,,0.95,,7.89,Percent of total billed charges,,7.89,8.13,
BACITRACIN ZINC 500 UNIT/GM EX OINT,RX-13818,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
BACITRACIN ZINC 500 UNIT/GM EX OINT,RX-13818,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
LAMOTRIGINE 25 MG PO TABS,RX-13981,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,25.74,23.17,,0.95,,24.45,Percent of total billed charges,,,0.98,,25.23,Percent of total billed charges,,,0.95,,24.45,Percent of total billed charges,,,0.97,,24.97,Percent of total billed charges,,,0.97,,24.97,Percent of total billed charges,,,0.96,,24.71,Percent of total billed charges,,,0.95,,24.45,Percent of total billed charges,,,,,,,,,0.95,,24.45,Percent of total billed charges,,24.45,25.23,
LAMOTRIGINE 25 MG PO TABS,RX-13981,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,25.74,23.17,,0.95,,24.45,Percent of total billed charges,,,0.98,,25.23,Percent of total billed charges,,,0.95,,24.45,Percent of total billed charges,,,0.95,,24.45,Percent of total billed charges,,,0.97,,24.97,Percent of total billed charges,,,0.96,,24.71,Percent of total billed charges,,,0.95,,24.45,Percent of total billed charges,,,,,,,,,0.95,,24.45,Percent of total billed charges,,24.45,25.23,
LAMOTRIGINE 100 MG PO TABS,RX-13982,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.28,5.65,,0.95,,5.97,Percent of total billed charges,,,0.98,,6.15,Percent of total billed charges,,,0.95,,5.97,Percent of total billed charges,,,0.97,,6.09,Percent of total billed charges,,,0.97,,6.09,Percent of total billed charges,,,0.96,,6.03,Percent of total billed charges,,,0.95,,5.97,Percent of total billed charges,,,,,,,,,0.95,,5.97,Percent of total billed charges,,5.97,6.15,
LAMOTRIGINE 100 MG PO TABS,RX-13982,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.28,5.65,,0.95,,5.97,Percent of total billed charges,,,0.98,,6.15,Percent of total billed charges,,,0.95,,5.97,Percent of total billed charges,,,0.95,,5.97,Percent of total billed charges,,,0.97,,6.09,Percent of total billed charges,,,0.96,,6.03,Percent of total billed charges,,,0.95,,5.97,Percent of total billed charges,,,,,,,,,0.95,,5.97,Percent of total billed charges,,5.97,6.15,
DILTIAZEM HCL ER 90 MG PO CP12,RX-14101,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,22.09,19.88,,0.95,,20.99,Percent of total billed charges,,,0.98,,21.65,Percent of total billed charges,,,0.95,,20.99,Percent of total billed charges,,,0.97,,21.43,Percent of total billed charges,,,0.97,,21.43,Percent of total billed charges,,,0.96,,21.21,Percent of total billed charges,,,0.95,,20.99,Percent of total billed charges,,,,,,,,,0.95,,20.99,Percent of total billed charges,,20.99,21.65,
DILTIAZEM HCL ER 90 MG PO CP12,RX-14101,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,22.09,19.88,,0.95,,20.99,Percent of total billed charges,,,0.98,,21.65,Percent of total billed charges,,,0.95,,20.99,Percent of total billed charges,,,0.95,,20.99,Percent of total billed charges,,,0.97,,21.43,Percent of total billed charges,,,0.96,,21.21,Percent of total billed charges,,,0.95,,20.99,Percent of total billed charges,,,,,,,,,0.95,,20.99,Percent of total billed charges,,20.99,21.65,
KETOCONAZOLE 2 % EX SHAM,RX-14132,CDM,J3490,HCPCS,637,RC,,inpatient,120,ML,84.55,76.1,,0.95,,80.32,Percent of total billed charges,,,0.98,,82.86,Percent of total billed charges,,,0.95,,80.32,Percent of total billed charges,,,0.97,,82.01,Percent of total billed charges,,,0.97,,82.01,Percent of total billed charges,,,0.96,,81.17,Percent of total billed charges,,,0.95,,80.32,Percent of total billed charges,,,,,,,,,0.95,,80.32,Percent of total billed charges,,80.32,82.86,
KETOCONAZOLE 2 % EX SHAM,RX-14132,CDM,J3490,HCPCS,637,RC,,outpatient,120,ML,84.55,76.1,,0.95,,80.32,Percent of total billed charges,,,0.98,,82.86,Percent of total billed charges,,,0.95,,80.32,Percent of total billed charges,,,0.95,,80.32,Percent of total billed charges,,,0.97,,82.01,Percent of total billed charges,,,0.96,,81.17,Percent of total billed charges,,,0.95,,80.32,Percent of total billed charges,,,,,,,,,0.95,,80.32,Percent of total billed charges,,80.32,82.86,
FERRIC CARBOXYMALTOSE 750 MG/15ML IV SOLN,RX-143120,CDM,J1439,HCPCS,636,RC,,inpatient,15,ML,1783.61,1605.25,,0.95,,1694.43,Percent of total billed charges,,,0.98,,1747.94,Percent of total billed charges,,,0.95,,1694.43,Percent of total billed charges,,,0.97,,1730.1,Percent of total billed charges,,,0.97,,1730.1,Percent of total billed charges,,,0.96,,1712.27,Percent of total billed charges,,,0.95,,1694.43,Percent of total billed charges,,,,,,,,,0.95,,1694.43,Percent of total billed charges,,1694.43,1747.94,
FERRIC CARBOXYMALTOSE 750 MG/15ML IV SOLN,RX-143120,CDM,J1439,HCPCS,636,RC,,outpatient,15,ML,1783.61,1605.25,,0.95,,1694.43,Percent of total billed charges,,,0.98,,1747.94,Percent of total billed charges,,,0.95,,1694.43,Percent of total billed charges,,,0.95,,1694.43,Percent of total billed charges,,,0.97,,1730.1,Percent of total billed charges,,,0.96,,1712.27,Percent of total billed charges,,,0.95,,1694.43,Percent of total billed charges,,,,,,,,,0.95,,1694.43,Percent of total billed charges,,1694.43,1747.94,
ROTAVIRUS VAC LIVE PENTAVALENT PO SOLN,RX-144424,CDM,90680,HCPCS,636,RC,,inpatient,2,ML,253.81,228.43,,0.95,,241.12,Percent of total billed charges,,,0.98,,248.73,Percent of total billed charges,,,0.95,,241.12,Percent of total billed charges,,,0.97,,246.2,Percent of total billed charges,,,0.97,,246.2,Percent of total billed charges,,,0.96,,243.66,Percent of total billed charges,,,0.95,,241.12,Percent of total billed charges,,,,,,,,,0.95,,241.12,Percent of total billed charges,,241.12,248.73,
ROTAVIRUS VAC LIVE PENTAVALENT PO SOLN,RX-144424,CDM,90680,HCPCS,636,RC,,outpatient,2,ML,253.81,228.43,,0.95,,241.12,Percent of total billed charges,,,0.98,,248.73,Percent of total billed charges,,,0.95,,241.12,Percent of total billed charges,,,0.95,,241.12,Percent of total billed charges,,,0.97,,246.2,Percent of total billed charges,,,0.96,,243.66,Percent of total billed charges,,,0.95,,241.12,Percent of total billed charges,,,,,,,,,0.95,,241.12,Percent of total billed charges,,241.12,248.73,
MILRINONE LACTATE 10 MG/10ML IV SOLN,RX-144430,CDM,J2260,HCPCS,636,RC,,inpatient,10,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
MILRINONE LACTATE 10 MG/10ML IV SOLN,RX-144430,CDM,J2260,HCPCS,636,RC,,outpatient,10,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
OXYCODONE HCL ER 10 MG PO T12A,RX-144442,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,20.14,18.13,,0.95,,19.13,Percent of total billed charges,,,0.98,,19.74,Percent of total billed charges,,,0.95,,19.13,Percent of total billed charges,,,0.97,,19.54,Percent of total billed charges,,,0.97,,19.54,Percent of total billed charges,,,0.96,,19.33,Percent of total billed charges,,,0.95,,19.13,Percent of total billed charges,,,,,,,,,0.95,,19.13,Percent of total billed charges,,19.13,19.74,
OXYCODONE HCL ER 10 MG PO T12A,RX-144442,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,20.14,18.13,,0.95,,19.13,Percent of total billed charges,,,0.98,,19.74,Percent of total billed charges,,,0.95,,19.13,Percent of total billed charges,,,0.95,,19.13,Percent of total billed charges,,,0.97,,19.54,Percent of total billed charges,,,0.96,,19.33,Percent of total billed charges,,,0.95,,19.13,Percent of total billed charges,,,,,,,,,0.95,,19.13,Percent of total billed charges,,19.13,19.74,
CEFAZOLIN SODIUM 1 G INJECTION SOLR,RX-1445,CDM,J0690,HCPCS,636,RC,,inpatient,0.5,GR,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
CEFAZOLIN SODIUM 1 G INJECTION SOLR,RX-1445,CDM,J0690,HCPCS,636,RC,,outpatient,0.5,GR,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
CEFAZOLIN SODIUM 10 G INJECTION SOLR,RX-1446,CDM,J0690,HCPCS,636,RC,,inpatient,10,GR,27.35,24.62,,0.95,,25.98,Percent of total billed charges,,,0.98,,26.8,Percent of total billed charges,,,0.95,,25.98,Percent of total billed charges,,,0.97,,26.53,Percent of total billed charges,,,0.97,,26.53,Percent of total billed charges,,,0.96,,26.26,Percent of total billed charges,,,0.95,,25.98,Percent of total billed charges,,,,,,,,,0.95,,25.98,Percent of total billed charges,,25.98,26.8,
CEFAZOLIN SODIUM 10 G INJECTION SOLR,RX-1446,CDM,J0690,HCPCS,636,RC,,outpatient,10,GR,27.35,24.62,,0.95,,25.98,Percent of total billed charges,,,0.98,,26.8,Percent of total billed charges,,,0.95,,25.98,Percent of total billed charges,,,0.95,,25.98,Percent of total billed charges,,,0.97,,26.53,Percent of total billed charges,,,0.96,,26.26,Percent of total billed charges,,,0.95,,25.98,Percent of total billed charges,,,,,,,,,0.95,,25.98,Percent of total billed charges,,25.98,26.8,
DEXMEDETOMIDINE HCL 200 MCG/2ML IV SOLN,RX-144626,CDM,J7999,HCPCS,250,RC,,inpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
DEXMEDETOMIDINE HCL 200 MCG/2ML IV SOLN,RX-144626,CDM,J7999,HCPCS,250,RC,,outpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
BORTEZOMIB 3.5 MG INJECTION SOLR,RX-144647,CDM,J9041,HCPCS,636,RC,,inpatient,3.5,ML,3388.68,3049.81,,0.95,,3219.25,Percent of total billed charges,,,0.98,,3320.91,Percent of total billed charges,,,0.95,,3219.25,Percent of total billed charges,,,0.97,,3287.02,Percent of total billed charges,,,0.97,,3287.02,Percent of total billed charges,,,0.96,,3253.13,Percent of total billed charges,,,0.95,,3219.25,Percent of total billed charges,,,,,,,,,0.95,,3219.25,Percent of total billed charges,,3219.25,3320.91,
BORTEZOMIB 3.5 MG INJECTION SOLR,RX-144647,CDM,J9041,HCPCS,636,RC,,outpatient,3.5,ML,3388.68,3049.81,,0.95,,3219.25,Percent of total billed charges,,,0.98,,3320.91,Percent of total billed charges,,,0.95,,3219.25,Percent of total billed charges,,,0.95,,3219.25,Percent of total billed charges,,,0.97,,3287.02,Percent of total billed charges,,,0.96,,3253.13,Percent of total billed charges,,,0.95,,3219.25,Percent of total billed charges,,,,,,,,,0.95,,3219.25,Percent of total billed charges,,3219.25,3320.91,
ACETAMINOPHEN-CODEINE 120-12 MG/5ML PO SOLN,RX-14468,CDM,J3490,HCPCS,637,RC,,inpatient,12.5,ML,13.6,12.24,,0.95,,12.92,Percent of total billed charges,,,0.98,,13.33,Percent of total billed charges,,,0.95,,12.92,Percent of total billed charges,,,0.97,,13.19,Percent of total billed charges,,,0.97,,13.19,Percent of total billed charges,,,0.96,,13.06,Percent of total billed charges,,,0.95,,12.92,Percent of total billed charges,,,,,,,,,0.95,,12.92,Percent of total billed charges,,12.92,13.33,
ACETAMINOPHEN-CODEINE 120-12 MG/5ML PO SOLN,RX-14468,CDM,J3490,HCPCS,637,RC,,outpatient,12.5,ML,13.6,12.24,,0.95,,12.92,Percent of total billed charges,,,0.98,,13.33,Percent of total billed charges,,,0.95,,12.92,Percent of total billed charges,,,0.95,,12.92,Percent of total billed charges,,,0.97,,13.19,Percent of total billed charges,,,0.96,,13.06,Percent of total billed charges,,,0.95,,12.92,Percent of total billed charges,,,,,,,,,0.95,,12.92,Percent of total billed charges,,12.92,13.33,
TERAZOSIN HCL 1 MG PO CAPS,RX-14550,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.81,7.93,,0.95,,8.37,Percent of total billed charges,,,0.98,,8.63,Percent of total billed charges,,,0.95,,8.37,Percent of total billed charges,,,0.97,,8.55,Percent of total billed charges,,,0.97,,8.55,Percent of total billed charges,,,0.96,,8.46,Percent of total billed charges,,,0.95,,8.37,Percent of total billed charges,,,,,,,,,0.95,,8.37,Percent of total billed charges,,8.37,8.63,
TERAZOSIN HCL 1 MG PO CAPS,RX-14550,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.81,7.93,,0.95,,8.37,Percent of total billed charges,,,0.98,,8.63,Percent of total billed charges,,,0.95,,8.37,Percent of total billed charges,,,0.95,,8.37,Percent of total billed charges,,,0.97,,8.55,Percent of total billed charges,,,0.96,,8.46,Percent of total billed charges,,,0.95,,8.37,Percent of total billed charges,,,,,,,,,0.95,,8.37,Percent of total billed charges,,8.37,8.63,
OBINUTUZUMAB 1000 MG/40ML IV SOLN,RX-146304,CDM,J9301,HCPCS,636,RC,,inpatient,40,ML,16996.32,15296.69,,0.95,,16146.5,Percent of total billed charges,,,0.98,,16656.39,Percent of total billed charges,,,0.95,,16146.5,Percent of total billed charges,,,0.97,,16486.43,Percent of total billed charges,,,0.97,,16486.43,Percent of total billed charges,,,0.96,,16316.47,Percent of total billed charges,,,0.95,,16146.5,Percent of total billed charges,,,,,,,,,0.95,,16146.5,Percent of total billed charges,,16146.5,16656.39,
OBINUTUZUMAB 1000 MG/40ML IV SOLN,RX-146304,CDM,J9301,HCPCS,636,RC,,outpatient,40,ML,16996.32,15296.69,,0.95,,16146.5,Percent of total billed charges,,,0.98,,16656.39,Percent of total billed charges,,,0.95,,16146.5,Percent of total billed charges,,,0.95,,16146.5,Percent of total billed charges,,,0.97,,16486.43,Percent of total billed charges,,,0.96,,16316.47,Percent of total billed charges,,,0.95,,16146.5,Percent of total billed charges,,,,,,,,,0.95,,16146.5,Percent of total billed charges,,16146.5,16656.39,
MENINGOCOCCAL B RECOMB OMV ADJ IM SUSY,RX-146314,CDM,90620,HCPCS,636,RC,,inpatient,0.5,ML,652.67,587.4,,0.95,,620.04,Percent of total billed charges,,,0.98,,639.62,Percent of total billed charges,,,0.95,,620.04,Percent of total billed charges,,,0.97,,633.09,Percent of total billed charges,,,0.97,,633.09,Percent of total billed charges,,,0.96,,626.56,Percent of total billed charges,,,0.95,,620.04,Percent of total billed charges,,,,,,,,,0.95,,620.04,Percent of total billed charges,,620.04,639.62,
MENINGOCOCCAL B RECOMB OMV ADJ IM SUSY,RX-146314,CDM,90620,HCPCS,636,RC,,outpatient,0.5,ML,652.67,587.4,,0.95,,620.04,Percent of total billed charges,,,0.98,,639.62,Percent of total billed charges,,,0.95,,620.04,Percent of total billed charges,,,0.95,,620.04,Percent of total billed charges,,,0.97,,633.09,Percent of total billed charges,,,0.96,,626.56,Percent of total billed charges,,,0.95,,620.04,Percent of total billed charges,,,,,,,,,0.95,,620.04,Percent of total billed charges,,620.04,639.62,
NALOXEGOL OXALATE 12.5 MG PO TABS,RX-146319,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,49.06,44.15,,0.95,,46.61,Percent of total billed charges,,,0.98,,48.08,Percent of total billed charges,,,0.95,,46.61,Percent of total billed charges,,,0.97,,47.59,Percent of total billed charges,,,0.97,,47.59,Percent of total billed charges,,,0.96,,47.1,Percent of total billed charges,,,0.95,,46.61,Percent of total billed charges,,,,,,,,,0.95,,46.61,Percent of total billed charges,,46.61,48.08,
NALOXEGOL OXALATE 12.5 MG PO TABS,RX-146319,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,49.06,44.15,,0.95,,46.61,Percent of total billed charges,,,0.98,,48.08,Percent of total billed charges,,,0.95,,46.61,Percent of total billed charges,,,0.95,,46.61,Percent of total billed charges,,,0.97,,47.59,Percent of total billed charges,,,0.96,,47.1,Percent of total billed charges,,,0.95,,46.61,Percent of total billed charges,,,,,,,,,0.95,,46.61,Percent of total billed charges,,46.61,48.08,
TBO-FILGRASTIM 300 MCG/0.5ML SUBQ SOSY,RX-146349,CDM,J1447,HCPCS,636,RC,,inpatient,0.5,ML,809.14,728.23,,0.95,,768.68,Percent of total billed charges,,,0.98,,792.96,Percent of total billed charges,,,0.95,,768.68,Percent of total billed charges,,,0.97,,784.87,Percent of total billed charges,,,0.97,,784.87,Percent of total billed charges,,,0.96,,776.77,Percent of total billed charges,,,0.95,,768.68,Percent of total billed charges,,,,,,,,,0.95,,768.68,Percent of total billed charges,,768.68,792.96,
TBO-FILGRASTIM 300 MCG/0.5ML SUBQ SOSY,RX-146349,CDM,J1447,HCPCS,636,RC,,outpatient,0.5,ML,809.14,728.23,,0.95,,768.68,Percent of total billed charges,,,0.98,,792.96,Percent of total billed charges,,,0.95,,768.68,Percent of total billed charges,,,0.95,,768.68,Percent of total billed charges,,,0.97,,784.87,Percent of total billed charges,,,0.96,,776.77,Percent of total billed charges,,,0.95,,768.68,Percent of total billed charges,,,,,,,,,0.95,,768.68,Percent of total billed charges,,768.68,792.96,
TBO-FILGRASTIM 480 MCG/0.8ML SUBQ SOSY,RX-146350,CDM,J1447,HCPCS,636,RC,,inpatient,0.8,ML,674.99,607.49,,0.95,,641.24,Percent of total billed charges,,,0.98,,661.49,Percent of total billed charges,,,0.95,,641.24,Percent of total billed charges,,,0.97,,654.74,Percent of total billed charges,,,0.97,,654.74,Percent of total billed charges,,,0.96,,647.99,Percent of total billed charges,,,0.95,,641.24,Percent of total billed charges,,,,,,,,,0.95,,641.24,Percent of total billed charges,,641.24,661.49,
TBO-FILGRASTIM 480 MCG/0.8ML SUBQ SOSY,RX-146350,CDM,J1447,HCPCS,636,RC,,outpatient,0.8,ML,674.99,607.49,,0.95,,641.24,Percent of total billed charges,,,0.98,,661.49,Percent of total billed charges,,,0.95,,641.24,Percent of total billed charges,,,0.95,,641.24,Percent of total billed charges,,,0.97,,654.74,Percent of total billed charges,,,0.96,,647.99,Percent of total billed charges,,,0.95,,641.24,Percent of total billed charges,,,,,,,,,0.95,,641.24,Percent of total billed charges,,641.24,661.49,
EPOETIN ALFA 20000 UNIT/ML INJECTION SOLN,RX-14643,CDM,J0885,HCPCS,636,RC,,inpatient,1,ML,1067.45,960.71,,0.95,,1014.08,Percent of total billed charges,,,0.98,,1046.1,Percent of total billed charges,,,0.95,,1014.08,Percent of total billed charges,,,0.97,,1035.43,Percent of total billed charges,,,0.97,,1035.43,Percent of total billed charges,,,0.96,,1024.75,Percent of total billed charges,,,0.95,,1014.08,Percent of total billed charges,,,,,,,,,0.95,,1014.08,Percent of total billed charges,,1014.08,1046.1,
EPOETIN ALFA 20000 UNIT/ML INJECTION SOLN,RX-14643,CDM,J0885,HCPCS,636,RC,,outpatient,1,ML,1067.45,960.71,,0.95,,1014.08,Percent of total billed charges,,,0.98,,1046.1,Percent of total billed charges,,,0.95,,1014.08,Percent of total billed charges,,,0.95,,1014.08,Percent of total billed charges,,,0.97,,1035.43,Percent of total billed charges,,,0.96,,1024.75,Percent of total billed charges,,,0.95,,1014.08,Percent of total billed charges,,,,,,,,,0.95,,1014.08,Percent of total billed charges,,1014.08,1046.1,
METFORMIN HCL 850 MG PO TABS,RX-14719,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.62,5.96,,0.95,,6.29,Percent of total billed charges,,,0.98,,6.49,Percent of total billed charges,,,0.95,,6.29,Percent of total billed charges,,,0.97,,6.42,Percent of total billed charges,,,0.97,,6.42,Percent of total billed charges,,,0.96,,6.36,Percent of total billed charges,,,0.95,,6.29,Percent of total billed charges,,,,,,,,,0.95,,6.29,Percent of total billed charges,,6.29,6.49,
METFORMIN HCL 850 MG PO TABS,RX-14719,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.62,5.96,,0.95,,6.29,Percent of total billed charges,,,0.98,,6.49,Percent of total billed charges,,,0.95,,6.29,Percent of total billed charges,,,0.95,,6.29,Percent of total billed charges,,,0.97,,6.42,Percent of total billed charges,,,0.96,,6.36,Percent of total billed charges,,,0.95,,6.29,Percent of total billed charges,,,,,,,,,0.95,,6.29,Percent of total billed charges,,6.29,6.49,
TOBRAMYCIN 0.3 % OP SOLN,RX-147589,CDM,J3490,HCPCS,250,RC,,inpatient,5,ML,22.41,20.17,,0.95,,21.29,Percent of total billed charges,,,0.98,,21.96,Percent of total billed charges,,,0.95,,21.29,Percent of total billed charges,,,0.97,,21.74,Percent of total billed charges,,,0.97,,21.74,Percent of total billed charges,,,0.96,,21.51,Percent of total billed charges,,,0.95,,21.29,Percent of total billed charges,,,,,,,,,0.95,,21.29,Percent of total billed charges,,21.29,21.96,
TOBRAMYCIN 0.3 % OP SOLN,RX-147589,CDM,J3490,HCPCS,250,RC,,outpatient,5,ML,22.41,20.17,,0.95,,21.29,Percent of total billed charges,,,0.98,,21.96,Percent of total billed charges,,,0.95,,21.29,Percent of total billed charges,,,0.95,,21.29,Percent of total billed charges,,,0.97,,21.74,Percent of total billed charges,,,0.96,,21.51,Percent of total billed charges,,,0.95,,21.29,Percent of total billed charges,,,,,,,,,0.95,,21.29,Percent of total billed charges,,21.29,21.96,
ETOPOSIDE 100 MG/5ML IV SOLN,RX-147592,CDM,J9181,HCPCS,636,RC,,inpatient,5,ML,136.98,123.28,,0.95,,130.13,Percent of total billed charges,,,0.98,,134.24,Percent of total billed charges,,,0.95,,130.13,Percent of total billed charges,,,0.97,,132.87,Percent of total billed charges,,,0.97,,132.87,Percent of total billed charges,,,0.96,,131.5,Percent of total billed charges,,,0.95,,130.13,Percent of total billed charges,,,,,,,,,0.95,,130.13,Percent of total billed charges,,130.13,134.24,
ETOPOSIDE 100 MG/5ML IV SOLN,RX-147592,CDM,J9181,HCPCS,636,RC,,outpatient,5,ML,136.98,123.28,,0.95,,130.13,Percent of total billed charges,,,0.98,,134.24,Percent of total billed charges,,,0.95,,130.13,Percent of total billed charges,,,0.95,,130.13,Percent of total billed charges,,,0.97,,132.87,Percent of total billed charges,,,0.96,,131.5,Percent of total billed charges,,,0.95,,130.13,Percent of total billed charges,,,,,,,,,0.95,,130.13,Percent of total billed charges,,130.13,134.24,
FAMOTIDINE (PF) 20 MG/2ML IV SOLN,RX-147633,CDM,J7999,HCPCS,250,RC,,inpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
FAMOTIDINE (PF) 20 MG/2ML IV SOLN,RX-147633,CDM,J7999,HCPCS,250,RC,,outpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
EPINEPHRINE 0.15 MG/0.3ML INJECTION SOAJ,RX-147641,CDM,J0171,HCPCS,636,RC,,inpatient,0.3,ML,437.34,393.61,,0.95,,415.47,Percent of total billed charges,,,0.98,,428.59,Percent of total billed charges,,,0.95,,415.47,Percent of total billed charges,,,0.97,,424.22,Percent of total billed charges,,,0.97,,424.22,Percent of total billed charges,,,0.96,,419.85,Percent of total billed charges,,,0.95,,415.47,Percent of total billed charges,,,,,,,,,0.95,,415.47,Percent of total billed charges,,415.47,428.59,
EPINEPHRINE 0.15 MG/0.3ML INJECTION SOAJ,RX-147641,CDM,J0171,HCPCS,636,RC,,outpatient,0.3,ML,437.34,393.61,,0.95,,415.47,Percent of total billed charges,,,0.98,,428.59,Percent of total billed charges,,,0.95,,415.47,Percent of total billed charges,,,0.95,,415.47,Percent of total billed charges,,,0.97,,424.22,Percent of total billed charges,,,0.96,,419.85,Percent of total billed charges,,,0.95,,415.47,Percent of total billed charges,,,,,,,,,0.95,,415.47,Percent of total billed charges,,415.47,428.59,
EPINEPHRINE 0.3 MG/0.3ML INJECTION SOAJ,RX-147643,CDM,J0171,HCPCS,636,RC,,inpatient,0.3,ML,437.34,393.61,,0.95,,415.47,Percent of total billed charges,,,0.98,,428.59,Percent of total billed charges,,,0.95,,415.47,Percent of total billed charges,,,0.97,,424.22,Percent of total billed charges,,,0.97,,424.22,Percent of total billed charges,,,0.96,,419.85,Percent of total billed charges,,,0.95,,415.47,Percent of total billed charges,,,,,,,,,0.95,,415.47,Percent of total billed charges,,415.47,428.59,
EPINEPHRINE 0.3 MG/0.3ML INJECTION SOAJ,RX-147643,CDM,J0171,HCPCS,636,RC,,outpatient,0.3,ML,437.34,393.61,,0.95,,415.47,Percent of total billed charges,,,0.98,,428.59,Percent of total billed charges,,,0.95,,415.47,Percent of total billed charges,,,0.95,,415.47,Percent of total billed charges,,,0.97,,424.22,Percent of total billed charges,,,0.96,,419.85,Percent of total billed charges,,,0.95,,415.47,Percent of total billed charges,,,,,,,,,0.95,,415.47,Percent of total billed charges,,415.47,428.59,
TIZANIDINE HCL 2 MG PO TABS,RX-14792,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,9.07,8.16,,0.95,,8.62,Percent of total billed charges,,,0.98,,8.89,Percent of total billed charges,,,0.95,,8.62,Percent of total billed charges,,,0.97,,8.8,Percent of total billed charges,,,0.97,,8.8,Percent of total billed charges,,,0.96,,8.71,Percent of total billed charges,,,0.95,,8.62,Percent of total billed charges,,,,,,,,,0.95,,8.62,Percent of total billed charges,,8.62,8.89,
TIZANIDINE HCL 2 MG PO TABS,RX-14792,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,9.07,8.16,,0.95,,8.62,Percent of total billed charges,,,0.98,,8.89,Percent of total billed charges,,,0.95,,8.62,Percent of total billed charges,,,0.95,,8.62,Percent of total billed charges,,,0.97,,8.8,Percent of total billed charges,,,0.96,,8.71,Percent of total billed charges,,,0.95,,8.62,Percent of total billed charges,,,,,,,,,0.95,,8.62,Percent of total billed charges,,8.62,8.89,
TIZANIDINE HCL 4 MG PO TABS,RX-14793,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.88,7.09,,0.95,,7.49,Percent of total billed charges,,,0.98,,7.72,Percent of total billed charges,,,0.95,,7.49,Percent of total billed charges,,,0.97,,7.64,Percent of total billed charges,,,0.97,,7.64,Percent of total billed charges,,,0.96,,7.56,Percent of total billed charges,,,0.95,,7.49,Percent of total billed charges,,,,,,,,,0.95,,7.49,Percent of total billed charges,,7.49,7.72,
TIZANIDINE HCL 4 MG PO TABS,RX-14793,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.88,7.09,,0.95,,7.49,Percent of total billed charges,,,0.98,,7.72,Percent of total billed charges,,,0.95,,7.49,Percent of total billed charges,,,0.95,,7.49,Percent of total billed charges,,,0.97,,7.64,Percent of total billed charges,,,0.96,,7.56,Percent of total billed charges,,,0.95,,7.49,Percent of total billed charges,,,,,,,,,0.95,,7.49,Percent of total billed charges,,7.49,7.72,
SCOPOLAMINE 1 MG/3DAYS TD PT72,RX-148115,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,33.67,30.3,,0.95,,31.99,Percent of total billed charges,,,0.98,,33,Percent of total billed charges,,,0.95,,31.99,Percent of total billed charges,,,0.97,,32.66,Percent of total billed charges,,,0.97,,32.66,Percent of total billed charges,,,0.96,,32.32,Percent of total billed charges,,,0.95,,31.99,Percent of total billed charges,,,,,,,,,0.95,,31.99,Percent of total billed charges,,31.99,33,
SCOPOLAMINE 1 MG/3DAYS TD PT72,RX-148115,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,33.67,30.3,,0.95,,31.99,Percent of total billed charges,,,0.98,,33,Percent of total billed charges,,,0.95,,31.99,Percent of total billed charges,,,0.95,,31.99,Percent of total billed charges,,,0.97,,32.66,Percent of total billed charges,,,0.96,,32.32,Percent of total billed charges,,,0.95,,31.99,Percent of total billed charges,,,,,,,,,0.95,,31.99,Percent of total billed charges,,31.99,33,
LOSARTAN POTASSIUM 25 MG PO TABS,RX-14823,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
LOSARTAN POTASSIUM 25 MG PO TABS,RX-14823,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
FOSFOMYCIN TROMETHAMINE 3 G PO PACK,RX-14825,CDM,J3490,HCPCS,637,RC,,inpatient,3,GR,182.89,164.6,,0.95,,173.75,Percent of total billed charges,,,0.98,,179.23,Percent of total billed charges,,,0.95,,173.75,Percent of total billed charges,,,0.97,,177.4,Percent of total billed charges,,,0.97,,177.4,Percent of total billed charges,,,0.96,,175.57,Percent of total billed charges,,,0.95,,173.75,Percent of total billed charges,,,,,,,,,0.95,,173.75,Percent of total billed charges,,173.75,179.23,
FOSFOMYCIN TROMETHAMINE 3 G PO PACK,RX-14825,CDM,J3490,HCPCS,637,RC,,outpatient,3,GR,182.89,164.6,,0.95,,173.75,Percent of total billed charges,,,0.98,,179.23,Percent of total billed charges,,,0.95,,173.75,Percent of total billed charges,,,0.95,,173.75,Percent of total billed charges,,,0.97,,177.4,Percent of total billed charges,,,0.96,,175.57,Percent of total billed charges,,,0.95,,173.75,Percent of total billed charges,,,,,,,,,0.95,,173.75,Percent of total billed charges,,173.75,179.23,
DOPAMINE-DEXTROSE 1.6-5 MG/ML-% IV SOLN,RX-14845,CDM,J1265,HCPCS,636,RC,,inpatient,250,ML,108.15,97.34,,0.95,,102.74,Percent of total billed charges,,,0.98,,105.99,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,0.97,,104.91,Percent of total billed charges,,,0.97,,104.91,Percent of total billed charges,,,0.96,,103.82,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,,,,,,,0.95,,102.74,Percent of total billed charges,,102.74,105.99,
DOPAMINE-DEXTROSE 1.6-5 MG/ML-% IV SOLN,RX-14845,CDM,J1265,HCPCS,636,RC,,outpatient,250,ML,108.15,97.34,,0.95,,102.74,Percent of total billed charges,,,0.98,,105.99,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,0.97,,104.91,Percent of total billed charges,,,0.96,,103.82,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,,,,,,,0.95,,102.74,Percent of total billed charges,,102.74,105.99,
RAMUCIRUMAB 100 MG/10ML IV SOLN,RX-148493,CDM,J9308,HCPCS,636,RC,,inpatient,10,ML,3089,2780.1,,0.95,,2934.55,Percent of total billed charges,,,0.98,,3027.22,Percent of total billed charges,,,0.95,,2934.55,Percent of total billed charges,,,0.97,,2996.33,Percent of total billed charges,,,0.97,,2996.33,Percent of total billed charges,,,0.96,,2965.44,Percent of total billed charges,,,0.95,,2934.55,Percent of total billed charges,,,,,,,,,0.95,,2934.55,Percent of total billed charges,,2934.55,3027.22,
RAMUCIRUMAB 100 MG/10ML IV SOLN,RX-148493,CDM,J9308,HCPCS,636,RC,,outpatient,10,ML,3089,2780.1,,0.95,,2934.55,Percent of total billed charges,,,0.98,,3027.22,Percent of total billed charges,,,0.95,,2934.55,Percent of total billed charges,,,0.95,,2934.55,Percent of total billed charges,,,0.97,,2996.33,Percent of total billed charges,,,0.96,,2965.44,Percent of total billed charges,,,0.95,,2934.55,Percent of total billed charges,,,,,,,,,0.95,,2934.55,Percent of total billed charges,,2934.55,3027.22,
RAMUCIRUMAB 500 MG/50ML IV SOLN,RX-148494,CDM,J9308,HCPCS,636,RC,,inpatient,50,ML,15032.96,13529.66,,0.95,,14281.31,Percent of total billed charges,,,0.98,,14732.3,Percent of total billed charges,,,0.95,,14281.31,Percent of total billed charges,,,0.97,,14581.97,Percent of total billed charges,,,0.97,,14581.97,Percent of total billed charges,,,0.96,,14431.64,Percent of total billed charges,,,0.95,,14281.31,Percent of total billed charges,,,,,,,,,0.95,,14281.31,Percent of total billed charges,,14281.31,14732.3,
RAMUCIRUMAB 500 MG/50ML IV SOLN,RX-148494,CDM,J9308,HCPCS,636,RC,,outpatient,50,ML,15032.96,13529.66,,0.95,,14281.31,Percent of total billed charges,,,0.98,,14732.3,Percent of total billed charges,,,0.95,,14281.31,Percent of total billed charges,,,0.95,,14281.31,Percent of total billed charges,,,0.97,,14581.97,Percent of total billed charges,,,0.96,,14431.64,Percent of total billed charges,,,0.95,,14281.31,Percent of total billed charges,,,,,,,,,0.95,,14281.31,Percent of total billed charges,,14281.31,14732.3,
LIDOCAINE IN D5W 8-5 MG/ML-% IV SOLN,RX-14869,CDM,J2002,HCPCS,636,RC,,inpatient,250,ML,108.15,97.34,,0.95,,102.74,Percent of total billed charges,,,0.98,,105.99,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,0.97,,104.91,Percent of total billed charges,,,0.97,,104.91,Percent of total billed charges,,,0.96,,103.82,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,,,,,,,0.95,,102.74,Percent of total billed charges,,102.74,105.99,
LIDOCAINE IN D5W 8-5 MG/ML-% IV SOLN,RX-14869,CDM,J2002,HCPCS,636,RC,,outpatient,250,ML,108.15,97.34,,0.95,,102.74,Percent of total billed charges,,,0.98,,105.99,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,0.97,,104.91,Percent of total billed charges,,,0.96,,103.82,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,,,,,,,0.95,,102.74,Percent of total billed charges,,102.74,105.99,
VEDOLIZUMAB 300 MG IV SOLR,RX-148911,CDM,J3380,HCPCS,636,RC,,inpatient,5,ML,17866.9,16080.21,,0.95,,16973.56,Percent of total billed charges,,,0.98,,17509.56,Percent of total billed charges,,,0.95,,16973.56,Percent of total billed charges,,,0.97,,17330.89,Percent of total billed charges,,,0.97,,17330.89,Percent of total billed charges,,,0.96,,17152.22,Percent of total billed charges,,,0.95,,16973.56,Percent of total billed charges,,,,,,,,,0.95,,16973.56,Percent of total billed charges,,16973.56,17509.56,
VEDOLIZUMAB 300 MG IV SOLR,RX-148911,CDM,J3380,HCPCS,636,RC,,outpatient,5,ML,17866.9,16080.21,,0.95,,16973.56,Percent of total billed charges,,,0.98,,17509.56,Percent of total billed charges,,,0.95,,16973.56,Percent of total billed charges,,,0.95,,16973.56,Percent of total billed charges,,,0.97,,17330.89,Percent of total billed charges,,,0.96,,17152.22,Percent of total billed charges,,,0.95,,16973.56,Percent of total billed charges,,,,,,,,,0.95,,16973.56,Percent of total billed charges,,16973.56,17509.56,
SODIUM CHLORIDE BACTERIOSTATIC 0.9 % INJECTION SOLN,RX-14923,CDM,J3490,HCPCS,250,RC,,inpatient,30,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
SODIUM CHLORIDE BACTERIOSTATIC 0.9 % INJECTION SOLN,RX-14923,CDM,J3490,HCPCS,250,RC,,outpatient,30,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
POTASSIUM PHOSPHATES(66 MEQ K) 45 MMOLE/15ML IV SOLN,RX-149510,CDM,J3490,HCPCS,250,RC,,inpatient,15,ML,57.92,52.13,,0.95,,55.02,Percent of total billed charges,,,0.98,,56.76,Percent of total billed charges,,,0.95,,55.02,Percent of total billed charges,,,0.97,,56.18,Percent of total billed charges,,,0.97,,56.18,Percent of total billed charges,,,0.96,,55.6,Percent of total billed charges,,,0.95,,55.02,Percent of total billed charges,,,,,,,,,0.95,,55.02,Percent of total billed charges,,55.02,56.76,
POTASSIUM PHOSPHATES(66 MEQ K) 45 MMOLE/15ML IV SOLN,RX-149510,CDM,J3490,HCPCS,250,RC,,outpatient,15,ML,57.92,52.13,,0.95,,55.02,Percent of total billed charges,,,0.98,,56.76,Percent of total billed charges,,,0.95,,55.02,Percent of total billed charges,,,0.95,,55.02,Percent of total billed charges,,,0.97,,56.18,Percent of total billed charges,,,0.96,,55.6,Percent of total billed charges,,,0.95,,55.02,Percent of total billed charges,,,,,,,,,0.95,,55.02,Percent of total billed charges,,55.02,56.76,
RHO D IMMUNE GLOBULIN 1500 UNITS IM SOSY,RX-149518,CDM,J2790,HCPCS,636,RC,,inpatient,0.3,ME,259.17,233.25,,0.95,,246.21,Percent of total billed charges,,,0.98,,253.99,Percent of total billed charges,,,0.95,,246.21,Percent of total billed charges,,,0.97,,251.39,Percent of total billed charges,,,0.97,,251.39,Percent of total billed charges,,,0.96,,248.8,Percent of total billed charges,,,0.95,,246.21,Percent of total billed charges,,,,,,,,,0.95,,246.21,Percent of total billed charges,,246.21,253.99,
RHO D IMMUNE GLOBULIN 1500 UNITS IM SOSY,RX-149518,CDM,J2790,HCPCS,636,RC,,outpatient,0.3,ME,259.17,233.25,,0.95,,246.21,Percent of total billed charges,,,0.98,,253.99,Percent of total billed charges,,,0.95,,246.21,Percent of total billed charges,,,0.95,,246.21,Percent of total billed charges,,,0.97,,251.39,Percent of total billed charges,,,0.96,,248.8,Percent of total billed charges,,,0.95,,246.21,Percent of total billed charges,,,,,,,,,0.95,,246.21,Percent of total billed charges,,246.21,253.99,
DANTROLENE SODIUM 250 MG IV SUSR,RX-150538,CDM,J7999,HCPCS,250,RC,,inpatient,5,ML,2875.59,2588.03,,0.95,,2731.81,Percent of total billed charges,,,0.98,,2818.08,Percent of total billed charges,,,0.95,,2731.81,Percent of total billed charges,,,0.97,,2789.32,Percent of total billed charges,,,0.97,,2789.32,Percent of total billed charges,,,0.96,,2760.57,Percent of total billed charges,,,0.95,,2731.81,Percent of total billed charges,,,,,,,,,0.95,,2731.81,Percent of total billed charges,,2731.81,2818.08,
DANTROLENE SODIUM 250 MG IV SUSR,RX-150538,CDM,J7999,HCPCS,250,RC,,outpatient,5,ML,2875.59,2588.03,,0.95,,2731.81,Percent of total billed charges,,,0.98,,2818.08,Percent of total billed charges,,,0.95,,2731.81,Percent of total billed charges,,,0.95,,2731.81,Percent of total billed charges,,,0.97,,2789.32,Percent of total billed charges,,,0.96,,2760.57,Percent of total billed charges,,,0.95,,2731.81,Percent of total billed charges,,,,,,,,,0.95,,2731.81,Percent of total billed charges,,2731.81,2818.08,
NAPHAZOLINE-PHENIRAMINE 0.027-0.315 % OP SOLN,RX-15058,CDM,J3490,HCPCS,637,RC,,inpatient,15,ML,31.78,28.6,,0.95,,30.19,Percent of total billed charges,,,0.98,,31.14,Percent of total billed charges,,,0.95,,30.19,Percent of total billed charges,,,0.97,,30.83,Percent of total billed charges,,,0.97,,30.83,Percent of total billed charges,,,0.96,,30.51,Percent of total billed charges,,,0.95,,30.19,Percent of total billed charges,,,,,,,,,0.95,,30.19,Percent of total billed charges,,30.19,31.14,
NAPHAZOLINE-PHENIRAMINE 0.027-0.315 % OP SOLN,RX-15058,CDM,J3490,HCPCS,637,RC,,outpatient,15,ML,31.78,28.6,,0.95,,30.19,Percent of total billed charges,,,0.98,,31.14,Percent of total billed charges,,,0.95,,30.19,Percent of total billed charges,,,0.95,,30.19,Percent of total billed charges,,,0.97,,30.83,Percent of total billed charges,,,0.96,,30.51,Percent of total billed charges,,,0.95,,30.19,Percent of total billed charges,,,,,,,,,0.95,,30.19,Percent of total billed charges,,30.19,31.14,
EMPAGLIFLOZIN 10 MG PO TABS,RX-150723,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,47.61,42.85,,0.95,,45.23,Percent of total billed charges,,,0.98,,46.66,Percent of total billed charges,,,0.95,,45.23,Percent of total billed charges,,,0.97,,46.18,Percent of total billed charges,,,0.97,,46.18,Percent of total billed charges,,,0.96,,45.71,Percent of total billed charges,,,0.95,,45.23,Percent of total billed charges,,,,,,,,,0.95,,45.23,Percent of total billed charges,,45.23,46.66,
EMPAGLIFLOZIN 10 MG PO TABS,RX-150723,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,47.61,42.85,,0.95,,45.23,Percent of total billed charges,,,0.98,,46.66,Percent of total billed charges,,,0.95,,45.23,Percent of total billed charges,,,0.95,,45.23,Percent of total billed charges,,,0.97,,46.18,Percent of total billed charges,,,0.96,,45.71,Percent of total billed charges,,,0.95,,45.23,Percent of total billed charges,,,,,,,,,0.95,,45.23,Percent of total billed charges,,45.23,46.66,
HYALURONAN 30 MG/2ML INTRA-ARTICU SOSY,RX-151075,CDM,J7324,HCPCS,636,RC,,inpatient,2,ML,835.05,751.55,,0.95,,793.3,Percent of total billed charges,,,0.98,,818.35,Percent of total billed charges,,,0.95,,793.3,Percent of total billed charges,,,0.97,,810,Percent of total billed charges,,,0.97,,810,Percent of total billed charges,,,0.96,,801.65,Percent of total billed charges,,,0.95,,793.3,Percent of total billed charges,,,,,,,,,0.95,,793.3,Percent of total billed charges,,793.3,818.35,
HYALURONAN 30 MG/2ML INTRA-ARTICU SOSY,RX-151075,CDM,J7324,HCPCS,636,RC,,outpatient,2,ML,835.05,751.55,,0.95,,793.3,Percent of total billed charges,,,0.98,,818.35,Percent of total billed charges,,,0.95,,793.3,Percent of total billed charges,,,0.95,,793.3,Percent of total billed charges,,,0.97,,810,Percent of total billed charges,,,0.96,,801.65,Percent of total billed charges,,,0.95,,793.3,Percent of total billed charges,,,,,,,,,0.95,,793.3,Percent of total billed charges,,793.3,818.35,
SODIUM HYALURONATE (VISCOSUP) 20 MG/2ML INTRA-ARTICU SOSY,RX-151116,CDM,J7323,HCPCS,636,RC,,inpatient,2,ML,1106.77,996.09,,0.95,,1051.43,Percent of total billed charges,,,0.98,,1084.63,Percent of total billed charges,,,0.95,,1051.43,Percent of total billed charges,,,0.97,,1073.57,Percent of total billed charges,,,0.97,,1073.57,Percent of total billed charges,,,0.96,,1062.5,Percent of total billed charges,,,0.95,,1051.43,Percent of total billed charges,,,,,,,,,0.95,,1051.43,Percent of total billed charges,,1051.43,1084.63,
SODIUM HYALURONATE (VISCOSUP) 20 MG/2ML INTRA-ARTICU SOSY,RX-151116,CDM,J7323,HCPCS,636,RC,,outpatient,2,ML,1106.77,996.09,,0.95,,1051.43,Percent of total billed charges,,,0.98,,1084.63,Percent of total billed charges,,,0.95,,1051.43,Percent of total billed charges,,,0.95,,1051.43,Percent of total billed charges,,,0.97,,1073.57,Percent of total billed charges,,,0.96,,1062.5,Percent of total billed charges,,,0.95,,1051.43,Percent of total billed charges,,,,,,,,,0.95,,1051.43,Percent of total billed charges,,1051.43,1084.63,
OCTAGAM 10 GM/100ML IV SOLN,RX-151293,CDM,J1568,HCPCS,636,RC,,inpatient,100,ML,1887.99,1699.19,,0.95,,1793.59,Percent of total billed charges,,,0.98,,1850.23,Percent of total billed charges,,,0.95,,1793.59,Percent of total billed charges,,,0.97,,1831.35,Percent of total billed charges,,,0.97,,1831.35,Percent of total billed charges,,,0.96,,1812.47,Percent of total billed charges,,,0.95,,1793.59,Percent of total billed charges,,,,,,,,,0.95,,1793.59,Percent of total billed charges,,1793.59,1850.23,
OCTAGAM 10 GM/100ML IV SOLN,RX-151293,CDM,J1568,HCPCS,636,RC,,outpatient,100,ML,1887.99,1699.19,,0.95,,1793.59,Percent of total billed charges,,,0.98,,1850.23,Percent of total billed charges,,,0.95,,1793.59,Percent of total billed charges,,,0.95,,1793.59,Percent of total billed charges,,,0.97,,1831.35,Percent of total billed charges,,,0.96,,1812.47,Percent of total billed charges,,,0.95,,1793.59,Percent of total billed charges,,,,,,,,,0.95,,1793.59,Percent of total billed charges,,1793.59,1850.23,
OCTAGAM 20 GM/200ML IV SOLN,RX-151294,CDM,J1568,HCPCS,636,RC,,inpatient,200,ML,3443.24,3098.92,,0.95,,3271.08,Percent of total billed charges,,,0.98,,3374.38,Percent of total billed charges,,,0.95,,3271.08,Percent of total billed charges,,,0.97,,3339.94,Percent of total billed charges,,,0.97,,3339.94,Percent of total billed charges,,,0.96,,3305.51,Percent of total billed charges,,,0.95,,3271.08,Percent of total billed charges,,,,,,,,,0.95,,3271.08,Percent of total billed charges,,3271.08,3374.38,
OCTAGAM 20 GM/200ML IV SOLN,RX-151294,CDM,J1568,HCPCS,636,RC,,outpatient,200,ML,3443.24,3098.92,,0.95,,3271.08,Percent of total billed charges,,,0.98,,3374.38,Percent of total billed charges,,,0.95,,3271.08,Percent of total billed charges,,,0.95,,3271.08,Percent of total billed charges,,,0.97,,3339.94,Percent of total billed charges,,,0.96,,3305.51,Percent of total billed charges,,,0.95,,3271.08,Percent of total billed charges,,,,,,,,,0.95,,3271.08,Percent of total billed charges,,3271.08,3374.38,
SENNOSIDES 8.8 MG/5ML PO SYRP,RX-15168,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,11.79,10.61,,0.95,,11.2,Percent of total billed charges,,,0.98,,11.55,Percent of total billed charges,,,0.95,,11.2,Percent of total billed charges,,,0.97,,11.44,Percent of total billed charges,,,0.97,,11.44,Percent of total billed charges,,,0.96,,11.32,Percent of total billed charges,,,0.95,,11.2,Percent of total billed charges,,,,,,,,,0.95,,11.2,Percent of total billed charges,,11.2,11.55,
SENNOSIDES 8.8 MG/5ML PO SYRP,RX-15168,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,11.79,10.61,,0.95,,11.2,Percent of total billed charges,,,0.98,,11.55,Percent of total billed charges,,,0.95,,11.2,Percent of total billed charges,,,0.95,,11.2,Percent of total billed charges,,,0.97,,11.44,Percent of total billed charges,,,0.96,,11.32,Percent of total billed charges,,,0.95,,11.2,Percent of total billed charges,,,,,,,,,0.95,,11.2,Percent of total billed charges,,11.2,11.55,
PHENYLEPHRINE HCL (PRESSORS) 10 MG/ML IV SOLN,RX-151786,CDM,J2371,HCPCS,636,RC,,inpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
PHENYLEPHRINE HCL (PRESSORS) 10 MG/ML IV SOLN,RX-151786,CDM,J2371,HCPCS,636,RC,,outpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
DULAGLUTIDE 0.75 MG/0.5ML SUBQ SOAJ,RX-151812,CDM,J3590,HCPCS,637,RC,,inpatient,0.5,ML,749.93,674.94,,0.95,,712.43,Percent of total billed charges,,,0.98,,734.93,Percent of total billed charges,,,0.95,,712.43,Percent of total billed charges,,,0.97,,727.43,Percent of total billed charges,,,0.97,,727.43,Percent of total billed charges,,,0.96,,719.93,Percent of total billed charges,,,0.95,,712.43,Percent of total billed charges,,,,,,,,,0.95,,712.43,Percent of total billed charges,,712.43,734.93,
DULAGLUTIDE 0.75 MG/0.5ML SUBQ SOAJ,RX-151812,CDM,J3590,HCPCS,637,RC,,outpatient,0.5,ML,749.93,674.94,,0.95,,712.43,Percent of total billed charges,,,0.98,,734.93,Percent of total billed charges,,,0.95,,712.43,Percent of total billed charges,,,0.95,,712.43,Percent of total billed charges,,,0.97,,727.43,Percent of total billed charges,,,0.96,,719.93,Percent of total billed charges,,,0.95,,712.43,Percent of total billed charges,,,,,,,,,0.95,,712.43,Percent of total billed charges,,712.43,734.93,
MENTHOL-ZINC OXIDE 0.44-20.6 % EX OINT,RX-151858,CDM,J3490,HCPCS,637,RC,,inpatient,71,GR,24.32,21.89,,0.95,,23.1,Percent of total billed charges,,,0.98,,23.83,Percent of total billed charges,,,0.95,,23.1,Percent of total billed charges,,,0.97,,23.59,Percent of total billed charges,,,0.97,,23.59,Percent of total billed charges,,,0.96,,23.35,Percent of total billed charges,,,0.95,,23.1,Percent of total billed charges,,,,,,,,,0.95,,23.1,Percent of total billed charges,,23.1,23.83,
MENTHOL-ZINC OXIDE 0.44-20.6 % EX OINT,RX-151858,CDM,J3490,HCPCS,637,RC,,outpatient,71,GR,24.32,21.89,,0.95,,23.1,Percent of total billed charges,,,0.98,,23.83,Percent of total billed charges,,,0.95,,23.1,Percent of total billed charges,,,0.95,,23.1,Percent of total billed charges,,,0.97,,23.59,Percent of total billed charges,,,0.96,,23.35,Percent of total billed charges,,,0.95,,23.1,Percent of total billed charges,,,,,,,,,0.95,,23.1,Percent of total billed charges,,23.1,23.83,
GLUCAGON HCL (DIAGNOSTIC) 1 MG INJECTION SOLR,RX-152184,CDM,J1611,HCPCS,636,RC,,inpatient,1,ML,378.61,340.75,,0.95,,359.68,Percent of total billed charges,,,0.98,,371.04,Percent of total billed charges,,,0.95,,359.68,Percent of total billed charges,,,0.97,,367.25,Percent of total billed charges,,,0.97,,367.25,Percent of total billed charges,,,0.96,,363.47,Percent of total billed charges,,,0.95,,359.68,Percent of total billed charges,,,,,,,,,0.95,,359.68,Percent of total billed charges,,359.68,371.04,
GLUCAGON HCL (DIAGNOSTIC) 1 MG INJECTION SOLR,RX-152184,CDM,J1611,HCPCS,636,RC,,outpatient,1,ML,378.61,340.75,,0.95,,359.68,Percent of total billed charges,,,0.98,,371.04,Percent of total billed charges,,,0.95,,359.68,Percent of total billed charges,,,0.95,,359.68,Percent of total billed charges,,,0.97,,367.25,Percent of total billed charges,,,0.96,,363.47,Percent of total billed charges,,,0.95,,359.68,Percent of total billed charges,,,,,,,,,0.95,,359.68,Percent of total billed charges,,359.68,371.04,
VASOPRESSIN 20 UNIT/ML IV SOLN,RX-152286,CDM,J2598,HCPCS,636,RC,,inpatient,0.25,ML,24.11,21.7,,0.95,,22.9,Percent of total billed charges,,,0.98,,23.63,Percent of total billed charges,,,0.95,,22.9,Percent of total billed charges,,,0.97,,23.39,Percent of total billed charges,,,0.97,,23.39,Percent of total billed charges,,,0.96,,23.15,Percent of total billed charges,,,0.95,,22.9,Percent of total billed charges,,,,,,,,,0.95,,22.9,Percent of total billed charges,,22.9,23.63,
VASOPRESSIN 20 UNIT/ML IV SOLN,RX-152286,CDM,J2598,HCPCS,636,RC,,outpatient,0.25,ML,24.11,21.7,,0.95,,22.9,Percent of total billed charges,,,0.98,,23.63,Percent of total billed charges,,,0.95,,22.9,Percent of total billed charges,,,0.95,,22.9,Percent of total billed charges,,,0.97,,23.39,Percent of total billed charges,,,0.96,,23.15,Percent of total billed charges,,,0.95,,22.9,Percent of total billed charges,,,,,,,,,0.95,,22.9,Percent of total billed charges,,22.9,23.63,
HPV 9-VALENT RECOMB VACCINE IM SUSY,RX-152563,CDM,90651,HCPCS,636,RC,,inpatient,0.5,ML,882.64,794.38,,0.95,,838.51,Percent of total billed charges,,,0.98,,864.99,Percent of total billed charges,,,0.95,,838.51,Percent of total billed charges,,,0.97,,856.16,Percent of total billed charges,,,0.97,,856.16,Percent of total billed charges,,,0.96,,847.33,Percent of total billed charges,,,0.95,,838.51,Percent of total billed charges,,,,,,,,,0.95,,838.51,Percent of total billed charges,,838.51,864.99,
HPV 9-VALENT RECOMB VACCINE IM SUSY,RX-152563,CDM,90651,HCPCS,636,RC,,outpatient,0.5,ML,882.64,794.38,,0.95,,838.51,Percent of total billed charges,,,0.98,,864.99,Percent of total billed charges,,,0.95,,838.51,Percent of total billed charges,,,0.95,,838.51,Percent of total billed charges,,,0.97,,856.16,Percent of total billed charges,,,0.96,,847.33,Percent of total billed charges,,,0.95,,838.51,Percent of total billed charges,,,,,,,,,0.95,,838.51,Percent of total billed charges,,838.51,864.99,
NIVOLUMAB 100 MG/10ML IV SOLN,RX-152623,CDM,J9299,HCPCS,636,RC,,inpatient,10,ML,6623.28,5960.95,,0.95,,6292.12,Percent of total billed charges,,,0.98,,6490.81,Percent of total billed charges,,,0.95,,6292.12,Percent of total billed charges,,,0.97,,6424.58,Percent of total billed charges,,,0.97,,6424.58,Percent of total billed charges,,,0.96,,6358.35,Percent of total billed charges,,,0.95,,6292.12,Percent of total billed charges,,,,,,,,,0.95,,6292.12,Percent of total billed charges,,6292.12,6490.81,
NIVOLUMAB 100 MG/10ML IV SOLN,RX-152623,CDM,J9299,HCPCS,636,RC,,outpatient,10,ML,6623.28,5960.95,,0.95,,6292.12,Percent of total billed charges,,,0.98,,6490.81,Percent of total billed charges,,,0.95,,6292.12,Percent of total billed charges,,,0.95,,6292.12,Percent of total billed charges,,,0.97,,6424.58,Percent of total billed charges,,,0.96,,6358.35,Percent of total billed charges,,,0.95,,6292.12,Percent of total billed charges,,,,,,,,,0.95,,6292.12,Percent of total billed charges,,6292.12,6490.81,
SUMATRIPTAN SUCCINATE 50 MG PO TABS,RX-15328,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
SUMATRIPTAN SUCCINATE 50 MG PO TABS,RX-15328,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
SACUBITRIL-VALSARTAN 24-26 MG PO TABS,RX-154952,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,40.21,36.19,,0.95,,38.2,Percent of total billed charges,,,0.98,,39.41,Percent of total billed charges,,,0.95,,38.2,Percent of total billed charges,,,0.97,,39,Percent of total billed charges,,,0.97,,39,Percent of total billed charges,,,0.96,,38.6,Percent of total billed charges,,,0.95,,38.2,Percent of total billed charges,,,,,,,,,0.95,,38.2,Percent of total billed charges,,38.2,39.41,
SACUBITRIL-VALSARTAN 24-26 MG PO TABS,RX-154952,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,40.21,36.19,,0.95,,38.2,Percent of total billed charges,,,0.98,,39.41,Percent of total billed charges,,,0.95,,38.2,Percent of total billed charges,,,0.95,,38.2,Percent of total billed charges,,,0.97,,39,Percent of total billed charges,,,0.96,,38.6,Percent of total billed charges,,,0.95,,38.2,Percent of total billed charges,,,,,,,,,0.95,,38.2,Percent of total billed charges,,38.2,39.41,
SACUBITRIL-VALSARTAN 49-51 MG PO TABS,RX-154953,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,40.21,36.19,,0.95,,38.2,Percent of total billed charges,,,0.98,,39.41,Percent of total billed charges,,,0.95,,38.2,Percent of total billed charges,,,0.97,,39,Percent of total billed charges,,,0.97,,39,Percent of total billed charges,,,0.96,,38.6,Percent of total billed charges,,,0.95,,38.2,Percent of total billed charges,,,,,,,,,0.95,,38.2,Percent of total billed charges,,38.2,39.41,
SACUBITRIL-VALSARTAN 49-51 MG PO TABS,RX-154953,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,40.21,36.19,,0.95,,38.2,Percent of total billed charges,,,0.98,,39.41,Percent of total billed charges,,,0.95,,38.2,Percent of total billed charges,,,0.95,,38.2,Percent of total billed charges,,,0.97,,39,Percent of total billed charges,,,0.96,,38.6,Percent of total billed charges,,,0.95,,38.2,Percent of total billed charges,,,,,,,,,0.95,,38.2,Percent of total billed charges,,38.2,39.41,
FILGRASTIM-SNDZ 300 MCG/0.5ML INJECTION SOSY,RX-155754,CDM,Q5101,HCPCS,636,RC,,inpatient,0.5,ML,464.64,418.18,,0.95,,441.41,Percent of total billed charges,,,0.98,,455.35,Percent of total billed charges,,,0.95,,441.41,Percent of total billed charges,,,0.97,,450.7,Percent of total billed charges,,,0.97,,450.7,Percent of total billed charges,,,0.96,,446.05,Percent of total billed charges,,,0.95,,441.41,Percent of total billed charges,,,,,,,,,0.95,,441.41,Percent of total billed charges,,441.41,455.35,
FILGRASTIM-SNDZ 300 MCG/0.5ML INJECTION SOSY,RX-155754,CDM,Q5101,HCPCS,636,RC,,outpatient,0.5,ML,464.64,418.18,,0.95,,441.41,Percent of total billed charges,,,0.98,,455.35,Percent of total billed charges,,,0.95,,441.41,Percent of total billed charges,,,0.95,,441.41,Percent of total billed charges,,,0.97,,450.7,Percent of total billed charges,,,0.96,,446.05,Percent of total billed charges,,,0.95,,441.41,Percent of total billed charges,,,,,,,,,0.95,,441.41,Percent of total billed charges,,441.41,455.35,
RITUXIMAB 100 MG/10ML IV SOLN,RX-155756,CDM,J9312,HCPCS,636,RC,,inpatient,10,ML,2028.73,1825.86,,0.95,,1927.29,Percent of total billed charges,,,0.98,,1988.16,Percent of total billed charges,,,0.95,,1927.29,Percent of total billed charges,,,0.97,,1967.87,Percent of total billed charges,,,0.97,,1967.87,Percent of total billed charges,,,0.96,,1947.58,Percent of total billed charges,,,0.95,,1927.29,Percent of total billed charges,,,,,,,,,0.95,,1927.29,Percent of total billed charges,,1927.29,1988.16,
RITUXIMAB 100 MG/10ML IV SOLN,RX-155756,CDM,J9312,HCPCS,636,RC,,outpatient,10,ML,2028.73,1825.86,,0.95,,1927.29,Percent of total billed charges,,,0.98,,1988.16,Percent of total billed charges,,,0.95,,1927.29,Percent of total billed charges,,,0.95,,1927.29,Percent of total billed charges,,,0.97,,1967.87,Percent of total billed charges,,,0.96,,1947.58,Percent of total billed charges,,,0.95,,1927.29,Percent of total billed charges,,,,,,,,,0.95,,1927.29,Percent of total billed charges,,1927.29,1988.16,
RITUXIMAB 500 MG/50ML IV SOLN,RX-155757,CDM,J9312,HCPCS,636,RC,,inpatient,50,ML,9731.65,8758.49,,0.95,,9245.07,Percent of total billed charges,,,0.98,,9537.02,Percent of total billed charges,,,0.95,,9245.07,Percent of total billed charges,,,0.97,,9439.7,Percent of total billed charges,,,0.97,,9439.7,Percent of total billed charges,,,0.96,,9342.38,Percent of total billed charges,,,0.95,,9245.07,Percent of total billed charges,,,,,,,,,0.95,,9245.07,Percent of total billed charges,,9245.07,9537.02,
RITUXIMAB 500 MG/50ML IV SOLN,RX-155757,CDM,J9312,HCPCS,636,RC,,outpatient,50,ML,9731.65,8758.49,,0.95,,9245.07,Percent of total billed charges,,,0.98,,9537.02,Percent of total billed charges,,,0.95,,9245.07,Percent of total billed charges,,,0.95,,9245.07,Percent of total billed charges,,,0.97,,9439.7,Percent of total billed charges,,,0.96,,9342.38,Percent of total billed charges,,,0.95,,9245.07,Percent of total billed charges,,,,,,,,,0.95,,9245.07,Percent of total billed charges,,9245.07,9537.02,
MAGNESIUM SULFATE 20 GM/500ML IV SOLN,RX-155759,CDM,J3475,HCPCS,636,RC,,inpatient,500,ML,108.15,97.34,,0.95,,102.74,Percent of total billed charges,,,0.98,,105.99,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,0.97,,104.91,Percent of total billed charges,,,0.97,,104.91,Percent of total billed charges,,,0.96,,103.82,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,,,,,,,0.95,,102.74,Percent of total billed charges,,102.74,105.99,
MAGNESIUM SULFATE 20 GM/500ML IV SOLN,RX-155759,CDM,J3475,HCPCS,636,RC,,outpatient,500,ML,108.15,97.34,,0.95,,102.74,Percent of total billed charges,,,0.98,,105.99,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,0.97,,104.91,Percent of total billed charges,,,0.96,,103.82,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,,,,,,,0.95,,102.74,Percent of total billed charges,,102.74,105.99,
PEGFILGRASTIM 6 MG/0.6ML SUBQ SOSY,RX-155762,CDM,J2506,HCPCS,636,RC,,inpatient,0.6,ML,6699.84,6029.86,,0.95,,6364.85,Percent of total billed charges,,,0.98,,6565.84,Percent of total billed charges,,,0.95,,6364.85,Percent of total billed charges,,,0.97,,6498.84,Percent of total billed charges,,,0.97,,6498.84,Percent of total billed charges,,,0.96,,6431.85,Percent of total billed charges,,,0.95,,6364.85,Percent of total billed charges,,,,,,,,,0.95,,6364.85,Percent of total billed charges,,6364.85,6565.84,
PEGFILGRASTIM 6 MG/0.6ML SUBQ SOSY,RX-155762,CDM,J2506,HCPCS,636,RC,,outpatient,0.6,ML,6699.84,6029.86,,0.95,,6364.85,Percent of total billed charges,,,0.98,,6565.84,Percent of total billed charges,,,0.95,,6364.85,Percent of total billed charges,,,0.95,,6364.85,Percent of total billed charges,,,0.97,,6498.84,Percent of total billed charges,,,0.96,,6431.85,Percent of total billed charges,,,0.95,,6364.85,Percent of total billed charges,,,,,,,,,0.95,,6364.85,Percent of total billed charges,,6364.85,6565.84,
DARBEPOETIN ALFA 60 MCG/0.3ML INJECTION SOSY,RX-155781,CDM,J0881,HCPCS,636,RC,,inpatient,0.3,ML,1276.9,1149.21,,0.95,,1213.06,Percent of total billed charges,,,0.98,,1251.36,Percent of total billed charges,,,0.95,,1213.06,Percent of total billed charges,,,0.97,,1238.59,Percent of total billed charges,,,0.97,,1238.59,Percent of total billed charges,,,0.96,,1225.82,Percent of total billed charges,,,0.95,,1213.06,Percent of total billed charges,,,,,,,,,0.95,,1213.06,Percent of total billed charges,,1213.06,1251.36,
DARBEPOETIN ALFA 60 MCG/0.3ML INJECTION SOSY,RX-155781,CDM,J0881,HCPCS,636,RC,,outpatient,0.3,ML,1276.9,1149.21,,0.95,,1213.06,Percent of total billed charges,,,0.98,,1251.36,Percent of total billed charges,,,0.95,,1213.06,Percent of total billed charges,,,0.95,,1213.06,Percent of total billed charges,,,0.97,,1238.59,Percent of total billed charges,,,0.96,,1225.82,Percent of total billed charges,,,0.95,,1213.06,Percent of total billed charges,,,,,,,,,0.95,,1213.06,Percent of total billed charges,,1213.06,1251.36,
DARBEPOETIN ALFA 100 MCG/0.5ML INJECTION SOSY,RX-155783,CDM,J0881,HCPCS,636,RC,,inpatient,0.5,ML,1773.47,1596.12,,0.95,,1684.8,Percent of total billed charges,,,0.98,,1738,Percent of total billed charges,,,0.95,,1684.8,Percent of total billed charges,,,0.97,,1720.27,Percent of total billed charges,,,0.97,,1720.27,Percent of total billed charges,,,0.96,,1702.53,Percent of total billed charges,,,0.95,,1684.8,Percent of total billed charges,,,,,,,,,0.95,,1684.8,Percent of total billed charges,,1684.8,1738,
DARBEPOETIN ALFA 100 MCG/0.5ML INJECTION SOSY,RX-155783,CDM,J0881,HCPCS,636,RC,,outpatient,0.5,ML,1773.47,1596.12,,0.95,,1684.8,Percent of total billed charges,,,0.98,,1738,Percent of total billed charges,,,0.95,,1684.8,Percent of total billed charges,,,0.95,,1684.8,Percent of total billed charges,,,0.97,,1720.27,Percent of total billed charges,,,0.96,,1702.53,Percent of total billed charges,,,0.95,,1684.8,Percent of total billed charges,,,,,,,,,0.95,,1684.8,Percent of total billed charges,,1684.8,1738,
DARBEPOETIN ALFA 150 MCG/0.3ML INJECTION SOSY,RX-155785,CDM,J0881,HCPCS,636,RC,,inpatient,0.3,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
DARBEPOETIN ALFA 150 MCG/0.3ML INJECTION SOSY,RX-155785,CDM,J0881,HCPCS,636,RC,,outpatient,0.3,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
DARBEPOETIN ALFA 200 MCG/0.4ML INJECTION SOSY,RX-155786,CDM,J0881,HCPCS,636,RC,,inpatient,0.4,ML,3650.81,3285.73,,0.95,,3468.27,Percent of total billed charges,,,0.98,,3577.79,Percent of total billed charges,,,0.95,,3468.27,Percent of total billed charges,,,0.97,,3541.29,Percent of total billed charges,,,0.97,,3541.29,Percent of total billed charges,,,0.96,,3504.78,Percent of total billed charges,,,0.95,,3468.27,Percent of total billed charges,,,,,,,,,0.95,,3468.27,Percent of total billed charges,,3468.27,3577.79,
DARBEPOETIN ALFA 200 MCG/0.4ML INJECTION SOSY,RX-155786,CDM,J0881,HCPCS,636,RC,,outpatient,0.4,ML,3650.81,3285.73,,0.95,,3468.27,Percent of total billed charges,,,0.98,,3577.79,Percent of total billed charges,,,0.95,,3468.27,Percent of total billed charges,,,0.95,,3468.27,Percent of total billed charges,,,0.97,,3541.29,Percent of total billed charges,,,0.96,,3504.78,Percent of total billed charges,,,0.95,,3468.27,Percent of total billed charges,,,,,,,,,0.95,,3468.27,Percent of total billed charges,,3468.27,3577.79,
DARBEPOETIN ALFA 500 MCG/ML INJECTION SOSY,RX-155788,CDM,J0881,HCPCS,636,RC,,inpatient,1,ML,6023.83,5421.45,,0.95,,5722.64,Percent of total billed charges,,,0.98,,5903.35,Percent of total billed charges,,,0.95,,5722.64,Percent of total billed charges,,,0.97,,5843.12,Percent of total billed charges,,,0.97,,5843.12,Percent of total billed charges,,,0.96,,5782.88,Percent of total billed charges,,,0.95,,5722.64,Percent of total billed charges,,,,,,,,,0.95,,5722.64,Percent of total billed charges,,5722.64,5903.35,
DARBEPOETIN ALFA 500 MCG/ML INJECTION SOSY,RX-155788,CDM,J0881,HCPCS,636,RC,,outpatient,1,ML,6023.83,5421.45,,0.95,,5722.64,Percent of total billed charges,,,0.98,,5903.35,Percent of total billed charges,,,0.95,,5722.64,Percent of total billed charges,,,0.95,,5722.64,Percent of total billed charges,,,0.97,,5843.12,Percent of total billed charges,,,0.96,,5782.88,Percent of total billed charges,,,0.95,,5722.64,Percent of total billed charges,,,,,,,,,0.95,,5722.64,Percent of total billed charges,,5722.64,5903.35,
CHERRY PO SYRP,RX-1562,CDM,J3490,HCPCS,637,RC,,inpatient,473,ML,54.81,49.33,,0.95,,52.07,Percent of total billed charges,,,0.98,,53.71,Percent of total billed charges,,,0.95,,52.07,Percent of total billed charges,,,0.97,,53.17,Percent of total billed charges,,,0.97,,53.17,Percent of total billed charges,,,0.96,,52.62,Percent of total billed charges,,,0.95,,52.07,Percent of total billed charges,,,,,,,,,0.95,,52.07,Percent of total billed charges,,52.07,53.71,
CHERRY PO SYRP,RX-1562,CDM,J3490,HCPCS,637,RC,,outpatient,473,ML,54.81,49.33,,0.95,,52.07,Percent of total billed charges,,,0.98,,53.71,Percent of total billed charges,,,0.95,,52.07,Percent of total billed charges,,,0.95,,52.07,Percent of total billed charges,,,0.97,,53.17,Percent of total billed charges,,,0.96,,52.62,Percent of total billed charges,,,0.95,,52.07,Percent of total billed charges,,,,,,,,,0.95,,52.07,Percent of total billed charges,,52.07,53.71,
TRABECTEDIN 1 MG IV SOLR,RX-156360,CDM,J9352,HCPCS,636,RC,,inpatient,20,ML,6537.28,5883.55,,0.95,,6210.42,Percent of total billed charges,,,0.98,,6406.53,Percent of total billed charges,,,0.95,,6210.42,Percent of total billed charges,,,0.97,,6341.16,Percent of total billed charges,,,0.97,,6341.16,Percent of total billed charges,,,0.96,,6275.79,Percent of total billed charges,,,0.95,,6210.42,Percent of total billed charges,,,,,,,,,0.95,,6210.42,Percent of total billed charges,,6210.42,6406.53,
TRABECTEDIN 1 MG IV SOLR,RX-156360,CDM,J9352,HCPCS,636,RC,,outpatient,20,ML,6537.28,5883.55,,0.95,,6210.42,Percent of total billed charges,,,0.98,,6406.53,Percent of total billed charges,,,0.95,,6210.42,Percent of total billed charges,,,0.95,,6210.42,Percent of total billed charges,,,0.97,,6341.16,Percent of total billed charges,,,0.96,,6275.79,Percent of total billed charges,,,0.95,,6210.42,Percent of total billed charges,,,,,,,,,0.95,,6210.42,Percent of total billed charges,,6210.42,6406.53,
IDARUCIZUMAB 2.5 GM/50ML IV SOLN,RX-156450,CDM,J3590,HCPCS,636,RC,,inpatient,100,ML,9301.89,8371.7,,0.95,,8836.8,Percent of total billed charges,,,0.98,,9115.85,Percent of total billed charges,,,0.95,,8836.8,Percent of total billed charges,,,0.97,,9022.83,Percent of total billed charges,,,0.97,,9022.83,Percent of total billed charges,,,0.96,,8929.81,Percent of total billed charges,,,0.95,,8836.8,Percent of total billed charges,,,,,,,,,0.95,,8836.8,Percent of total billed charges,,8836.8,9115.85,
IDARUCIZUMAB 2.5 GM/50ML IV SOLN,RX-156450,CDM,J3590,HCPCS,636,RC,,outpatient,100,ML,9301.89,8371.7,,0.95,,8836.8,Percent of total billed charges,,,0.98,,9115.85,Percent of total billed charges,,,0.95,,8836.8,Percent of total billed charges,,,0.95,,8836.8,Percent of total billed charges,,,0.97,,9022.83,Percent of total billed charges,,,0.96,,8929.81,Percent of total billed charges,,,0.95,,8836.8,Percent of total billed charges,,,,,,,,,0.95,,8836.8,Percent of total billed charges,,8836.8,9115.85,
CALCIUM ACETATE (PHOS BINDER) 667 MG PO CAPS,RX-156463,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.39,9.35,,0.95,,9.87,Percent of total billed charges,,,0.98,,10.18,Percent of total billed charges,,,0.95,,9.87,Percent of total billed charges,,,0.97,,10.08,Percent of total billed charges,,,0.97,,10.08,Percent of total billed charges,,,0.96,,9.97,Percent of total billed charges,,,0.95,,9.87,Percent of total billed charges,,,,,,,,,0.95,,9.87,Percent of total billed charges,,9.87,10.18,
CALCIUM ACETATE (PHOS BINDER) 667 MG PO CAPS,RX-156463,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.39,9.35,,0.95,,9.87,Percent of total billed charges,,,0.98,,10.18,Percent of total billed charges,,,0.95,,9.87,Percent of total billed charges,,,0.95,,9.87,Percent of total billed charges,,,0.97,,10.08,Percent of total billed charges,,,0.96,,9.97,Percent of total billed charges,,,0.95,,9.87,Percent of total billed charges,,,,,,,,,0.95,,9.87,Percent of total billed charges,,9.87,10.18,
DARATUMUMAB 400 MG/20ML IV SOLN,RX-156697,CDM,J9145,HCPCS,636,RC,,inpatient,20,ML,5904.42,5313.98,,0.95,,5609.2,Percent of total billed charges,,,0.98,,5786.33,Percent of total billed charges,,,0.95,,5609.2,Percent of total billed charges,,,0.97,,5727.29,Percent of total billed charges,,,0.97,,5727.29,Percent of total billed charges,,,0.96,,5668.24,Percent of total billed charges,,,0.95,,5609.2,Percent of total billed charges,,,,,,,,,0.95,,5609.2,Percent of total billed charges,,5609.2,5786.33,
DARATUMUMAB 400 MG/20ML IV SOLN,RX-156697,CDM,J9145,HCPCS,636,RC,,outpatient,20,ML,5904.42,5313.98,,0.95,,5609.2,Percent of total billed charges,,,0.98,,5786.33,Percent of total billed charges,,,0.95,,5609.2,Percent of total billed charges,,,0.95,,5609.2,Percent of total billed charges,,,0.97,,5727.29,Percent of total billed charges,,,0.96,,5668.24,Percent of total billed charges,,,0.95,,5609.2,Percent of total billed charges,,,,,,,,,0.95,,5609.2,Percent of total billed charges,,5609.2,5786.33,
MULTIVITAMIN ADULT PO TABS,RX-156902,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,5.88,5.29,,0.95,,5.59,Percent of total billed charges,,,0.98,,5.76,Percent of total billed charges,,,0.95,,5.59,Percent of total billed charges,,,0.97,,5.7,Percent of total billed charges,,,0.97,,5.7,Percent of total billed charges,,,0.96,,5.64,Percent of total billed charges,,,0.95,,5.59,Percent of total billed charges,,,,,,,,,0.95,,5.59,Percent of total billed charges,,5.59,5.76,
MULTIVITAMIN ADULT PO TABS,RX-156902,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,5.88,5.29,,0.95,,5.59,Percent of total billed charges,,,0.98,,5.76,Percent of total billed charges,,,0.95,,5.59,Percent of total billed charges,,,0.95,,5.59,Percent of total billed charges,,,0.97,,5.7,Percent of total billed charges,,,0.96,,5.64,Percent of total billed charges,,,0.95,,5.59,Percent of total billed charges,,,,,,,,,0.95,,5.59,Percent of total billed charges,,5.59,5.76,
PATIROMER SORBITEX CALCIUM 8.4 G PO PACK,RX-156923,CDM,J3490,HCPCS,250,RC,,inpatient,1,UN,161.58,145.42,,0.95,,153.5,Percent of total billed charges,,,0.98,,158.35,Percent of total billed charges,,,0.95,,153.5,Percent of total billed charges,,,0.97,,156.73,Percent of total billed charges,,,0.97,,156.73,Percent of total billed charges,,,0.96,,155.12,Percent of total billed charges,,,0.95,,153.5,Percent of total billed charges,,,,,,,,,0.95,,153.5,Percent of total billed charges,,153.5,158.35,
PATIROMER SORBITEX CALCIUM 8.4 G PO PACK,RX-156923,CDM,J3490,HCPCS,250,RC,,outpatient,1,UN,161.58,145.42,,0.95,,153.5,Percent of total billed charges,,,0.98,,158.35,Percent of total billed charges,,,0.95,,153.5,Percent of total billed charges,,,0.95,,153.5,Percent of total billed charges,,,0.97,,156.73,Percent of total billed charges,,,0.96,,155.12,Percent of total billed charges,,,0.95,,153.5,Percent of total billed charges,,,,,,,,,0.95,,153.5,Percent of total billed charges,,153.5,158.35,
SUGAMMADEX SODIUM 200 MG/2ML IV SOLN,RX-157285,CDM,J3490,HCPCS,250,RC,,inpatient,2,ML,397.92,358.13,,0.95,,378.02,Percent of total billed charges,,,0.98,,389.96,Percent of total billed charges,,,0.95,,378.02,Percent of total billed charges,,,0.97,,385.98,Percent of total billed charges,,,0.97,,385.98,Percent of total billed charges,,,0.96,,382,Percent of total billed charges,,,0.95,,378.02,Percent of total billed charges,,,,,,,,,0.95,,378.02,Percent of total billed charges,,378.02,389.96,
SUGAMMADEX SODIUM 200 MG/2ML IV SOLN,RX-157285,CDM,J3490,HCPCS,250,RC,,outpatient,2,ML,397.92,358.13,,0.95,,378.02,Percent of total billed charges,,,0.98,,389.96,Percent of total billed charges,,,0.95,,378.02,Percent of total billed charges,,,0.95,,378.02,Percent of total billed charges,,,0.97,,385.98,Percent of total billed charges,,,0.96,,382,Percent of total billed charges,,,0.95,,378.02,Percent of total billed charges,,,,,,,,,0.95,,378.02,Percent of total billed charges,,378.02,389.96,
CALCITONIN (SALMON) 200 UNIT/ACT INTRANASAL SOLN,RX-15738,CDM,J3490,HCPCS,637,RC,,inpatient,3.7,ML,159.29,143.36,,0.95,,151.33,Percent of total billed charges,,,0.98,,156.1,Percent of total billed charges,,,0.95,,151.33,Percent of total billed charges,,,0.97,,154.51,Percent of total billed charges,,,0.97,,154.51,Percent of total billed charges,,,0.96,,152.92,Percent of total billed charges,,,0.95,,151.33,Percent of total billed charges,,,,,,,,,0.95,,151.33,Percent of total billed charges,,151.33,156.1,
CALCITONIN (SALMON) 200 UNIT/ACT INTRANASAL SOLN,RX-15738,CDM,J3490,HCPCS,637,RC,,outpatient,3.7,ML,159.29,143.36,,0.95,,151.33,Percent of total billed charges,,,0.98,,156.1,Percent of total billed charges,,,0.95,,151.33,Percent of total billed charges,,,0.95,,151.33,Percent of total billed charges,,,0.97,,154.51,Percent of total billed charges,,,0.96,,152.92,Percent of total billed charges,,,0.95,,151.33,Percent of total billed charges,,,,,,,,,0.95,,151.33,Percent of total billed charges,,151.33,156.1,
BICALUTAMIDE 50 MG PO TABS,RX-15746,CDM,J8999,HCPCS,636,RC,,inpatient,1,UN,6.37,5.73,,0.95,,6.05,Percent of total billed charges,,,0.98,,6.24,Percent of total billed charges,,,0.95,,6.05,Percent of total billed charges,,,0.97,,6.18,Percent of total billed charges,,,0.97,,6.18,Percent of total billed charges,,,0.96,,6.12,Percent of total billed charges,,,0.95,,6.05,Percent of total billed charges,,,,,,,,,0.95,,6.05,Percent of total billed charges,,6.05,6.24,
BICALUTAMIDE 50 MG PO TABS,RX-15746,CDM,J8999,HCPCS,636,RC,,outpatient,1,UN,6.37,5.73,,0.95,,6.05,Percent of total billed charges,,,0.98,,6.24,Percent of total billed charges,,,0.95,,6.05,Percent of total billed charges,,,0.95,,6.05,Percent of total billed charges,,,0.97,,6.18,Percent of total billed charges,,,0.96,,6.12,Percent of total billed charges,,,0.95,,6.05,Percent of total billed charges,,,,,,,,,0.95,,6.05,Percent of total billed charges,,6.05,6.24,
CARVEDILOL 6.25 MG PO TABS,RX-15747,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.3,5.67,,0.95,,5.99,Percent of total billed charges,,,0.98,,6.17,Percent of total billed charges,,,0.95,,5.99,Percent of total billed charges,,,0.97,,6.11,Percent of total billed charges,,,0.97,,6.11,Percent of total billed charges,,,0.96,,6.05,Percent of total billed charges,,,0.95,,5.99,Percent of total billed charges,,,,,,,,,0.95,,5.99,Percent of total billed charges,,5.99,6.17,
CARVEDILOL 6.25 MG PO TABS,RX-15747,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.3,5.67,,0.95,,5.99,Percent of total billed charges,,,0.98,,6.17,Percent of total billed charges,,,0.95,,5.99,Percent of total billed charges,,,0.95,,5.99,Percent of total billed charges,,,0.97,,6.11,Percent of total billed charges,,,0.96,,6.05,Percent of total billed charges,,,0.95,,5.99,Percent of total billed charges,,,,,,,,,0.95,,5.99,Percent of total billed charges,,5.99,6.17,
AZITHROMYCIN 100 MG/5ML PO SUSR,RX-15796,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,15.12,13.61,,0.95,,14.36,Percent of total billed charges,,,0.98,,14.82,Percent of total billed charges,,,0.95,,14.36,Percent of total billed charges,,,0.97,,14.67,Percent of total billed charges,,,0.97,,14.67,Percent of total billed charges,,,0.96,,14.52,Percent of total billed charges,,,0.95,,14.36,Percent of total billed charges,,,,,,,,,0.95,,14.36,Percent of total billed charges,,14.36,14.82,
AZITHROMYCIN 100 MG/5ML PO SUSR,RX-15796,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,15.12,13.61,,0.95,,14.36,Percent of total billed charges,,,0.98,,14.82,Percent of total billed charges,,,0.95,,14.36,Percent of total billed charges,,,0.95,,14.36,Percent of total billed charges,,,0.97,,14.67,Percent of total billed charges,,,0.96,,14.52,Percent of total billed charges,,,0.95,,14.36,Percent of total billed charges,,,,,,,,,0.95,,14.36,Percent of total billed charges,,14.36,14.82,
AZITHROMYCIN 200 MG/5ML PO SUSR,RX-15797,CDM,J3490,HCPCS,637,RC,,inpatient,6.3,ML,31.13,28.02,,0.95,,29.57,Percent of total billed charges,,,0.98,,30.51,Percent of total billed charges,,,0.95,,29.57,Percent of total billed charges,,,0.97,,30.2,Percent of total billed charges,,,0.97,,30.2,Percent of total billed charges,,,0.96,,29.88,Percent of total billed charges,,,0.95,,29.57,Percent of total billed charges,,,,,,,,,0.95,,29.57,Percent of total billed charges,,29.57,30.51,
AZITHROMYCIN 200 MG/5ML PO SUSR,RX-15797,CDM,J3490,HCPCS,637,RC,,outpatient,6.3,ML,31.13,28.02,,0.95,,29.57,Percent of total billed charges,,,0.98,,30.51,Percent of total billed charges,,,0.95,,29.57,Percent of total billed charges,,,0.95,,29.57,Percent of total billed charges,,,0.97,,30.2,Percent of total billed charges,,,0.96,,29.88,Percent of total billed charges,,,0.95,,29.57,Percent of total billed charges,,,,,,,,,0.95,,29.57,Percent of total billed charges,,29.57,30.51,
NITROGLYCERIN IN D5W 200-5 MCG/ML-% IV SOLN,RX-15859,CDM,J2305,HCPCS,636,RC,,inpatient,250,ML,108.99,98.09,,0.95,,103.54,Percent of total billed charges,,,0.98,,106.81,Percent of total billed charges,,,0.95,,103.54,Percent of total billed charges,,,0.97,,105.72,Percent of total billed charges,,,0.97,,105.72,Percent of total billed charges,,,0.96,,104.63,Percent of total billed charges,,,0.95,,103.54,Percent of total billed charges,,,,,,,,,0.95,,103.54,Percent of total billed charges,,103.54,106.81,
NITROGLYCERIN IN D5W 200-5 MCG/ML-% IV SOLN,RX-15859,CDM,J2305,HCPCS,636,RC,,outpatient,250,ML,108.99,98.09,,0.95,,103.54,Percent of total billed charges,,,0.98,,106.81,Percent of total billed charges,,,0.95,,103.54,Percent of total billed charges,,,0.95,,103.54,Percent of total billed charges,,,0.97,,105.72,Percent of total billed charges,,,0.96,,104.63,Percent of total billed charges,,,0.95,,103.54,Percent of total billed charges,,,,,,,,,0.95,,103.54,Percent of total billed charges,,103.54,106.81,
DEXTROSE-SODIUM CHLORIDE 5-0.45 % IV SOLN,RX-15861,CDM,J3490,HCPCS,258,RC,,inpatient,1000,ML,97.85,88.07,,0.95,,92.96,Percent of total billed charges,,,0.98,,95.89,Percent of total billed charges,,,0.95,,92.96,Percent of total billed charges,,,0.97,,94.91,Percent of total billed charges,,,0.97,,94.91,Percent of total billed charges,,,0.96,,93.94,Percent of total billed charges,,,0.95,,92.96,Percent of total billed charges,,,,,,,,,0.95,,92.96,Percent of total billed charges,,92.96,95.89,
DEXTROSE-SODIUM CHLORIDE 5-0.45 % IV SOLN,RX-15861,CDM,J3490,HCPCS,258,RC,,outpatient,1000,ML,97.85,88.07,,0.95,,92.96,Percent of total billed charges,,,0.98,,95.89,Percent of total billed charges,,,0.95,,92.96,Percent of total billed charges,,,0.95,,92.96,Percent of total billed charges,,,0.97,,94.91,Percent of total billed charges,,,0.96,,93.94,Percent of total billed charges,,,0.95,,92.96,Percent of total billed charges,,,,,,,,,0.95,,92.96,Percent of total billed charges,,92.96,95.89,
DEXTROSE-SODIUM CHLORIDE 5-0.9 % IV SOLN,RX-15882,CDM,J7042,HCPCS,636,RC,,inpatient,1000,ML,97.85,88.07,,0.95,,92.96,Percent of total billed charges,,,0.98,,95.89,Percent of total billed charges,,,0.95,,92.96,Percent of total billed charges,,,0.97,,94.91,Percent of total billed charges,,,0.97,,94.91,Percent of total billed charges,,,0.96,,93.94,Percent of total billed charges,,,0.95,,92.96,Percent of total billed charges,,,,,,,,,0.95,,92.96,Percent of total billed charges,,92.96,95.89,
DEXTROSE-SODIUM CHLORIDE 5-0.9 % IV SOLN,RX-15882,CDM,J7042,HCPCS,636,RC,,outpatient,1000,ML,97.85,88.07,,0.95,,92.96,Percent of total billed charges,,,0.98,,95.89,Percent of total billed charges,,,0.95,,92.96,Percent of total billed charges,,,0.95,,92.96,Percent of total billed charges,,,0.97,,94.91,Percent of total billed charges,,,0.96,,93.94,Percent of total billed charges,,,0.95,,92.96,Percent of total billed charges,,,,,,,,,0.95,,92.96,Percent of total billed charges,,92.96,95.89,
PENICILLIN G POT IN DEXTROSE 60000 UNIT/ML IV SOLN,RX-15960,CDM,J2540,HCPCS,636,RC,,inpatient,50,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
PENICILLIN G POT IN DEXTROSE 60000 UNIT/ML IV SOLN,RX-15960,CDM,J2540,HCPCS,636,RC,,outpatient,50,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
DOBUTAMINE-DEXTROSE 4-5 MG/ML-% IV SOLN,RX-15982,CDM,J1250,HCPCS,636,RC,,inpatient,250,ML,59.49,53.54,,0.95,,56.52,Percent of total billed charges,,,0.98,,58.3,Percent of total billed charges,,,0.95,,56.52,Percent of total billed charges,,,0.97,,57.71,Percent of total billed charges,,,0.97,,57.71,Percent of total billed charges,,,0.96,,57.11,Percent of total billed charges,,,0.95,,56.52,Percent of total billed charges,,,,,,,,,0.95,,56.52,Percent of total billed charges,,56.52,58.3,
DOBUTAMINE-DEXTROSE 4-5 MG/ML-% IV SOLN,RX-15982,CDM,J1250,HCPCS,636,RC,,outpatient,250,ML,59.49,53.54,,0.95,,56.52,Percent of total billed charges,,,0.98,,58.3,Percent of total billed charges,,,0.95,,56.52,Percent of total billed charges,,,0.95,,56.52,Percent of total billed charges,,,0.97,,57.71,Percent of total billed charges,,,0.96,,57.11,Percent of total billed charges,,,0.95,,56.52,Percent of total billed charges,,,,,,,,,0.95,,56.52,Percent of total billed charges,,56.52,58.3,
IPRATROPIUM BROMIDE 0.06 % INTRANASAL SOLN,RX-16071,CDM,J3490,HCPCS,637,RC,,inpatient,15,ML,148.26,133.43,,0.95,,140.85,Percent of total billed charges,,,0.98,,145.29,Percent of total billed charges,,,0.95,,140.85,Percent of total billed charges,,,0.97,,143.81,Percent of total billed charges,,,0.97,,143.81,Percent of total billed charges,,,0.96,,142.33,Percent of total billed charges,,,0.95,,140.85,Percent of total billed charges,,,,,,,,,0.95,,140.85,Percent of total billed charges,,140.85,145.29,
IPRATROPIUM BROMIDE 0.06 % INTRANASAL SOLN,RX-16071,CDM,J3490,HCPCS,637,RC,,outpatient,15,ML,148.26,133.43,,0.95,,140.85,Percent of total billed charges,,,0.98,,145.29,Percent of total billed charges,,,0.95,,140.85,Percent of total billed charges,,,0.95,,140.85,Percent of total billed charges,,,0.97,,143.81,Percent of total billed charges,,,0.96,,142.33,Percent of total billed charges,,,0.95,,140.85,Percent of total billed charges,,,,,,,,,0.95,,140.85,Percent of total billed charges,,140.85,145.29,
LINEZOLID 600 MG/300ML IV SOLN,RX-161908,CDM,J2020,HCPCS,636,RC,,inpatient,300,ML,67.88,61.09,,0.95,,64.49,Percent of total billed charges,,,0.98,,66.52,Percent of total billed charges,,,0.95,,64.49,Percent of total billed charges,,,0.97,,65.84,Percent of total billed charges,,,0.97,,65.84,Percent of total billed charges,,,0.96,,65.16,Percent of total billed charges,,,0.95,,64.49,Percent of total billed charges,,,,,,,,,0.95,,64.49,Percent of total billed charges,,64.49,66.52,
LINEZOLID 600 MG/300ML IV SOLN,RX-161908,CDM,J2020,HCPCS,636,RC,,outpatient,300,ML,67.88,61.09,,0.95,,64.49,Percent of total billed charges,,,0.98,,66.52,Percent of total billed charges,,,0.95,,64.49,Percent of total billed charges,,,0.95,,64.49,Percent of total billed charges,,,0.97,,65.84,Percent of total billed charges,,,0.96,,65.16,Percent of total billed charges,,,0.95,,64.49,Percent of total billed charges,,,,,,,,,0.95,,64.49,Percent of total billed charges,,64.49,66.52,
LIDOCAINE HCL (PF) 4 % INJECTION SOLN,RX-161923,CDM,J3490,HCPCS,250,RC,,inpatient,5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
LIDOCAINE HCL (PF) 4 % INJECTION SOLN,RX-161923,CDM,J3490,HCPCS,250,RC,,outpatient,5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
PROPOFOL 200 MG/20ML IV EMUL,RX-161929,CDM,J2704,HCPCS,636,RC,,inpatient,2,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
PROPOFOL 200 MG/20ML IV EMUL,RX-161929,CDM,J2704,HCPCS,636,RC,,outpatient,2,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
FENTANYL CITRATE (PF) 100 MCG/2ML INJECTION SOLN,RX-161932,CDM,J3010,HCPCS,636,RC,,inpatient,2,ML,46.35,41.72,,0.95,,44.03,Percent of total billed charges,,,0.98,,45.42,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,0.97,,44.96,Percent of total billed charges,,,0.97,,44.96,Percent of total billed charges,,,0.96,,44.5,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,,,,,,,0.95,,44.03,Percent of total billed charges,,44.03,45.42,
FENTANYL CITRATE (PF) 100 MCG/2ML INJECTION SOLN,RX-161932,CDM,J3010,HCPCS,636,RC,,outpatient,2,ML,46.35,41.72,,0.95,,44.03,Percent of total billed charges,,,0.98,,45.42,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,0.97,,44.96,Percent of total billed charges,,,0.96,,44.5,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,,,,,,,0.95,,44.03,Percent of total billed charges,,44.03,45.42,
FENTANYL CITRATE (PF) 250 MCG/5ML INJECTION SOLN,RX-161933,CDM,J3010,HCPCS,636,RC,,inpatient,0.5,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
FENTANYL CITRATE (PF) 250 MCG/5ML INJECTION SOLN,RX-161933,CDM,J3010,HCPCS,636,RC,,outpatient,0.5,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
CHLORDIAZEPOXIDE HCL 25 MG PO CAPS,RX-1623,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.76,7.88,,0.95,,8.32,Percent of total billed charges,,,0.98,,8.58,Percent of total billed charges,,,0.95,,8.32,Percent of total billed charges,,,0.97,,8.5,Percent of total billed charges,,,0.97,,8.5,Percent of total billed charges,,,0.96,,8.41,Percent of total billed charges,,,0.95,,8.32,Percent of total billed charges,,,,,,,,,0.95,,8.32,Percent of total billed charges,,8.32,8.58,
CHLORDIAZEPOXIDE HCL 25 MG PO CAPS,RX-1623,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.76,7.88,,0.95,,8.32,Percent of total billed charges,,,0.98,,8.58,Percent of total billed charges,,,0.95,,8.32,Percent of total billed charges,,,0.95,,8.32,Percent of total billed charges,,,0.97,,8.5,Percent of total billed charges,,,0.96,,8.41,Percent of total billed charges,,,0.95,,8.32,Percent of total billed charges,,,,,,,,,0.95,,8.32,Percent of total billed charges,,8.32,8.58,
CHLORDIAZEPOXIDE HCL 5 MG PO CAPS,RX-1624,CDM,J3490,HCPCS,637,RC,,inpatient,2,UN,14.29,12.86,,0.95,,13.58,Percent of total billed charges,,,0.98,,14,Percent of total billed charges,,,0.95,,13.58,Percent of total billed charges,,,0.97,,13.86,Percent of total billed charges,,,0.97,,13.86,Percent of total billed charges,,,0.96,,13.72,Percent of total billed charges,,,0.95,,13.58,Percent of total billed charges,,,,,,,,,0.95,,13.58,Percent of total billed charges,,13.58,14,
CHLORDIAZEPOXIDE HCL 5 MG PO CAPS,RX-1624,CDM,J3490,HCPCS,637,RC,,outpatient,2,UN,14.29,12.86,,0.95,,13.58,Percent of total billed charges,,,0.98,,14,Percent of total billed charges,,,0.95,,13.58,Percent of total billed charges,,,0.95,,13.58,Percent of total billed charges,,,0.97,,13.86,Percent of total billed charges,,,0.96,,13.72,Percent of total billed charges,,,0.95,,13.58,Percent of total billed charges,,,,,,,,,0.95,,13.58,Percent of total billed charges,,13.58,14,
ATEZOLIZUMAB 1200 MG/20ML IV SOLN,RX-163008,CDM,J9022,HCPCS,636,RC,,inpatient,20,ML,22494.13,20244.72,,0.95,,21369.42,Percent of total billed charges,,,0.98,,22044.25,Percent of total billed charges,,,0.95,,21369.42,Percent of total billed charges,,,0.97,,21819.31,Percent of total billed charges,,,0.97,,21819.31,Percent of total billed charges,,,0.96,,21594.36,Percent of total billed charges,,,0.95,,21369.42,Percent of total billed charges,,,,,,,,,0.95,,21369.42,Percent of total billed charges,,21369.42,22044.25,
ATEZOLIZUMAB 1200 MG/20ML IV SOLN,RX-163008,CDM,J9022,HCPCS,636,RC,,outpatient,20,ML,22494.13,20244.72,,0.95,,21369.42,Percent of total billed charges,,,0.98,,22044.25,Percent of total billed charges,,,0.95,,21369.42,Percent of total billed charges,,,0.95,,21369.42,Percent of total billed charges,,,0.97,,21819.31,Percent of total billed charges,,,0.96,,21594.36,Percent of total billed charges,,,0.95,,21369.42,Percent of total billed charges,,,,,,,,,0.95,,21369.42,Percent of total billed charges,,21369.42,22044.25,
GLIMEPIRIDE 2 MG PO TABS,RX-16356,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.37,6.63,,0.95,,7,Percent of total billed charges,,,0.98,,7.22,Percent of total billed charges,,,0.95,,7,Percent of total billed charges,,,0.97,,7.15,Percent of total billed charges,,,0.97,,7.15,Percent of total billed charges,,,0.96,,7.08,Percent of total billed charges,,,0.95,,7,Percent of total billed charges,,,,,,,,,0.95,,7,Percent of total billed charges,,7,7.22,
GLIMEPIRIDE 2 MG PO TABS,RX-16356,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.37,6.63,,0.95,,7,Percent of total billed charges,,,0.98,,7.22,Percent of total billed charges,,,0.95,,7,Percent of total billed charges,,,0.95,,7,Percent of total billed charges,,,0.97,,7.15,Percent of total billed charges,,,0.96,,7.08,Percent of total billed charges,,,0.95,,7,Percent of total billed charges,,,,,,,,,0.95,,7,Percent of total billed charges,,7,7.22,
CEFEPIME HCL 1 G INJECTION SOLR,RX-16369,CDM,J0692,HCPCS,636,RC,,inpatient,5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
CEFEPIME HCL 1 G INJECTION SOLR,RX-16369,CDM,J0692,HCPCS,636,RC,,outpatient,5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
CARFILZOMIB 30 MG IV SOLR,RX-165596,CDM,J9047,HCPCS,636,RC,,inpatient,15,ML,2517.18,2265.46,,0.95,,2391.32,Percent of total billed charges,,,0.98,,2466.84,Percent of total billed charges,,,0.95,,2391.32,Percent of total billed charges,,,0.97,,2441.66,Percent of total billed charges,,,0.97,,2441.66,Percent of total billed charges,,,0.96,,2416.49,Percent of total billed charges,,,0.95,,2391.32,Percent of total billed charges,,,,,,,,,0.95,,2391.32,Percent of total billed charges,,2391.32,2466.84,
CARFILZOMIB 30 MG IV SOLR,RX-165596,CDM,J9047,HCPCS,636,RC,,outpatient,15,ML,2517.18,2265.46,,0.95,,2391.32,Percent of total billed charges,,,0.98,,2466.84,Percent of total billed charges,,,0.95,,2391.32,Percent of total billed charges,,,0.95,,2391.32,Percent of total billed charges,,,0.97,,2441.66,Percent of total billed charges,,,0.96,,2416.49,Percent of total billed charges,,,0.95,,2391.32,Percent of total billed charges,,,,,,,,,0.95,,2391.32,Percent of total billed charges,,2391.32,2466.84,
CHLORTHALIDONE 25 MG PO TABS,RX-1661,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,15.12,13.61,,0.95,,14.36,Percent of total billed charges,,,0.98,,14.82,Percent of total billed charges,,,0.95,,14.36,Percent of total billed charges,,,0.97,,14.67,Percent of total billed charges,,,0.97,,14.67,Percent of total billed charges,,,0.96,,14.52,Percent of total billed charges,,,0.95,,14.36,Percent of total billed charges,,,,,,,,,0.95,,14.36,Percent of total billed charges,,14.36,14.82,
CHLORTHALIDONE 25 MG PO TABS,RX-1661,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,15.12,13.61,,0.95,,14.36,Percent of total billed charges,,,0.98,,14.82,Percent of total billed charges,,,0.95,,14.36,Percent of total billed charges,,,0.95,,14.36,Percent of total billed charges,,,0.97,,14.67,Percent of total billed charges,,,0.96,,14.52,Percent of total billed charges,,,0.95,,14.36,Percent of total billed charges,,,,,,,,,0.95,,14.36,Percent of total billed charges,,14.36,14.82,
METHYLENE BLUE (ANTIDOTE) 50 MG/10ML IV SOLN,RX-166617,CDM,Q9968,HCPCS,636,RC,,inpatient,10,ML,679.51,611.56,,0.95,,645.53,Percent of total billed charges,,,0.98,,665.92,Percent of total billed charges,,,0.95,,645.53,Percent of total billed charges,,,0.97,,659.12,Percent of total billed charges,,,0.97,,659.12,Percent of total billed charges,,,0.96,,652.33,Percent of total billed charges,,,0.95,,645.53,Percent of total billed charges,,,,,,,,,0.95,,645.53,Percent of total billed charges,,645.53,665.92,
METHYLENE BLUE (ANTIDOTE) 50 MG/10ML IV SOLN,RX-166617,CDM,Q9968,HCPCS,636,RC,,outpatient,10,ML,679.51,611.56,,0.95,,645.53,Percent of total billed charges,,,0.98,,665.92,Percent of total billed charges,,,0.95,,645.53,Percent of total billed charges,,,0.95,,645.53,Percent of total billed charges,,,0.97,,659.12,Percent of total billed charges,,,0.96,,652.33,Percent of total billed charges,,,0.95,,645.53,Percent of total billed charges,,,,,,,,,0.95,,645.53,Percent of total billed charges,,645.53,665.92,
NALOXONE HCL 2 MG/2ML INJECTION SOSY,RX-167132,CDM,J2310,HCPCS,636,RC,,inpatient,0.4,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
NALOXONE HCL 2 MG/2ML INJECTION SOSY,RX-167132,CDM,J2310,HCPCS,636,RC,,outpatient,0.4,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
USTEKINUMAB 130 MG/26ML IV SOLN,RX-167435,CDM,J3358,HCPCS,636,RC,,inpatient,26,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
USTEKINUMAB 130 MG/26ML IV SOLN,RX-167435,CDM,J3358,HCPCS,636,RC,,outpatient,26,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
INFLIXIMAB-DYYB 100 MG IV SOLR,RX-167735,CDM,Q5103,HCPCS,636,RC,,inpatient,10,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
INFLIXIMAB-DYYB 100 MG IV SOLR,RX-167735,CDM,Q5103,HCPCS,636,RC,,outpatient,10,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
MELATONIN 3 MG PO TABS,RX-16830,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.32,5.69,,0.95,,6,Percent of total billed charges,,,0.98,,6.19,Percent of total billed charges,,,0.95,,6,Percent of total billed charges,,,0.97,,6.13,Percent of total billed charges,,,0.97,,6.13,Percent of total billed charges,,,0.96,,6.07,Percent of total billed charges,,,0.95,,6,Percent of total billed charges,,,,,,,,,0.95,,6,Percent of total billed charges,,6,6.19,
MELATONIN 3 MG PO TABS,RX-16830,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.32,5.69,,0.95,,6,Percent of total billed charges,,,0.98,,6.19,Percent of total billed charges,,,0.95,,6,Percent of total billed charges,,,0.95,,6,Percent of total billed charges,,,0.97,,6.13,Percent of total billed charges,,,0.96,,6.07,Percent of total billed charges,,,0.95,,6,Percent of total billed charges,,,,,,,,,0.95,,6,Percent of total billed charges,,6,6.19,
BEZLOTOXUMAB 1000 MG/40ML IV SOLN,RX-168493,CDM,J0565,HCPCS,636,RC,,inpatient,40,ML,6425.75,5783.18,,0.95,,6104.46,Percent of total billed charges,,,0.98,,6297.24,Percent of total billed charges,,,0.95,,6104.46,Percent of total billed charges,,,0.97,,6232.98,Percent of total billed charges,,,0.97,,6232.98,Percent of total billed charges,,,0.96,,6168.72,Percent of total billed charges,,,0.95,,6104.46,Percent of total billed charges,,,,,,,,,0.95,,6104.46,Percent of total billed charges,,6104.46,6297.24,
BEZLOTOXUMAB 1000 MG/40ML IV SOLN,RX-168493,CDM,J0565,HCPCS,636,RC,,outpatient,40,ML,6425.75,5783.18,,0.95,,6104.46,Percent of total billed charges,,,0.98,,6297.24,Percent of total billed charges,,,0.95,,6104.46,Percent of total billed charges,,,0.95,,6104.46,Percent of total billed charges,,,0.97,,6232.98,Percent of total billed charges,,,0.96,,6168.72,Percent of total billed charges,,,0.95,,6104.46,Percent of total billed charges,,,,,,,,,0.95,,6104.46,Percent of total billed charges,,6104.46,6297.24,
MORPHINE SULFATE-NACL 150-0.9 MG/30ML-% IV SOSY,RX-169573,CDM,J2270,HCPCS,636,RC,,inpatient,30,ML,69.92,62.93,,0.95,,66.42,Percent of total billed charges,,,0.98,,68.52,Percent of total billed charges,,,0.95,,66.42,Percent of total billed charges,,,0.97,,67.82,Percent of total billed charges,,,0.97,,67.82,Percent of total billed charges,,,0.96,,67.12,Percent of total billed charges,,,0.95,,66.42,Percent of total billed charges,,,,,,,,,0.95,,66.42,Percent of total billed charges,,66.42,68.52,
MORPHINE SULFATE-NACL 150-0.9 MG/30ML-% IV SOSY,RX-169573,CDM,J2270,HCPCS,636,RC,,outpatient,30,ML,69.92,62.93,,0.95,,66.42,Percent of total billed charges,,,0.98,,68.52,Percent of total billed charges,,,0.95,,66.42,Percent of total billed charges,,,0.95,,66.42,Percent of total billed charges,,,0.97,,67.82,Percent of total billed charges,,,0.96,,67.12,Percent of total billed charges,,,0.95,,66.42,Percent of total billed charges,,,,,,,,,0.95,,66.42,Percent of total billed charges,,66.42,68.52,
MAGNESIUM SULFATE IN D5W 1-5 GM/100ML-% IV SOLN,RX-169599,CDM,J3475,HCPCS,636,RC,,inpatient,100,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
MAGNESIUM SULFATE IN D5W 1-5 GM/100ML-% IV SOLN,RX-169599,CDM,J3475,HCPCS,636,RC,,outpatient,100,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
ATROPINE SULFATE 8 MG/20ML INJECTION SOLN,RX-169613,CDM,J0461,HCPCS,636,RC,,inpatient,0.5,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
ATROPINE SULFATE 8 MG/20ML INJECTION SOLN,RX-169613,CDM,J0461,HCPCS,636,RC,,outpatient,0.5,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
OCRELIZUMAB 300 MG/10ML IV SOLN,RX-169866,CDM,J2350,HCPCS,636,RC,,inpatient,10,ML,33003.7,29703.33,,0.95,,31353.52,Percent of total billed charges,,,0.98,,32343.63,Percent of total billed charges,,,0.95,,31353.52,Percent of total billed charges,,,0.97,,32013.59,Percent of total billed charges,,,0.97,,32013.59,Percent of total billed charges,,,0.96,,31683.55,Percent of total billed charges,,,0.95,,31353.52,Percent of total billed charges,,,,,,,,,0.95,,31353.52,Percent of total billed charges,,31353.52,32343.63,
OCRELIZUMAB 300 MG/10ML IV SOLN,RX-169866,CDM,J2350,HCPCS,636,RC,,outpatient,10,ML,33003.7,29703.33,,0.95,,31353.52,Percent of total billed charges,,,0.98,,32343.63,Percent of total billed charges,,,0.95,,31353.52,Percent of total billed charges,,,0.95,,31353.52,Percent of total billed charges,,,0.97,,32013.59,Percent of total billed charges,,,0.96,,31683.55,Percent of total billed charges,,,0.95,,31353.52,Percent of total billed charges,,,,,,,,,0.95,,31353.52,Percent of total billed charges,,31353.52,32343.63,
CITRATE OF MAGNESIA PO SOLN,RX-1701,CDM,J3490,HCPCS,637,RC,,inpatient,296,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
CITRATE OF MAGNESIA PO SOLN,RX-1701,CDM,J3490,HCPCS,637,RC,,outpatient,296,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
BLEOMYCIN SULFATE 30 UNITS INJECTION SOLR,RX-17012,CDM,J9040,HCPCS,636,RC,,inpatient,5,ML,231.03,207.93,,0.95,,219.48,Percent of total billed charges,,,0.98,,226.41,Percent of total billed charges,,,0.95,,219.48,Percent of total billed charges,,,0.97,,224.1,Percent of total billed charges,,,0.97,,224.1,Percent of total billed charges,,,0.96,,221.79,Percent of total billed charges,,,0.95,,219.48,Percent of total billed charges,,,,,,,,,0.95,,219.48,Percent of total billed charges,,219.48,226.41,
BLEOMYCIN SULFATE 30 UNITS INJECTION SOLR,RX-17012,CDM,J9040,HCPCS,636,RC,,outpatient,5,ML,231.03,207.93,,0.95,,219.48,Percent of total billed charges,,,0.98,,226.41,Percent of total billed charges,,,0.95,,219.48,Percent of total billed charges,,,0.95,,219.48,Percent of total billed charges,,,0.97,,224.1,Percent of total billed charges,,,0.96,,221.79,Percent of total billed charges,,,0.95,,219.48,Percent of total billed charges,,,,,,,,,0.95,,219.48,Percent of total billed charges,,219.48,226.41,
RITUXIMAB-HYALURONIDASE HUMAN 1600-26800 MG -UT/13.4ML SUBQ SOLN,RX-171270,CDM,J9311,HCPCS,636,RC,,inpatient,13.4,ML,12709.74,11438.77,,0.95,,12074.25,Percent of total billed charges,,,0.98,,12455.55,Percent of total billed charges,,,0.95,,12074.25,Percent of total billed charges,,,0.97,,12328.45,Percent of total billed charges,,,0.97,,12328.45,Percent of total billed charges,,,0.96,,12201.35,Percent of total billed charges,,,0.95,,12074.25,Percent of total billed charges,,,,,,,,,0.95,,12074.25,Percent of total billed charges,,12074.25,12455.55,
RITUXIMAB-HYALURONIDASE HUMAN 1600-26800 MG -UT/13.4ML SUBQ SOLN,RX-171270,CDM,J9311,HCPCS,636,RC,,outpatient,13.4,ML,12709.74,11438.77,,0.95,,12074.25,Percent of total billed charges,,,0.98,,12455.55,Percent of total billed charges,,,0.95,,12074.25,Percent of total billed charges,,,0.95,,12074.25,Percent of total billed charges,,,0.97,,12328.45,Percent of total billed charges,,,0.96,,12201.35,Percent of total billed charges,,,0.95,,12074.25,Percent of total billed charges,,,,,,,,,0.95,,12074.25,Percent of total billed charges,,12074.25,12455.55,
INFLIXIMAB-ABDA 100 MG IV SOLR,RX-171429,CDM,Q5104,HCPCS,636,RC,,inpatient,10,ML,820.81,738.73,,0.95,,779.77,Percent of total billed charges,,,0.98,,804.39,Percent of total billed charges,,,0.95,,779.77,Percent of total billed charges,,,0.97,,796.19,Percent of total billed charges,,,0.97,,796.19,Percent of total billed charges,,,0.96,,787.98,Percent of total billed charges,,,0.95,,779.77,Percent of total billed charges,,,,,,,,,0.95,,779.77,Percent of total billed charges,,779.77,804.39,
INFLIXIMAB-ABDA 100 MG IV SOLR,RX-171429,CDM,Q5104,HCPCS,636,RC,,outpatient,10,ML,820.81,738.73,,0.95,,779.77,Percent of total billed charges,,,0.98,,804.39,Percent of total billed charges,,,0.95,,779.77,Percent of total billed charges,,,0.95,,779.77,Percent of total billed charges,,,0.97,,796.19,Percent of total billed charges,,,0.96,,787.98,Percent of total billed charges,,,0.95,,779.77,Percent of total billed charges,,,,,,,,,0.95,,779.77,Percent of total billed charges,,779.77,804.39,
ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSR,RX-172574,CDM,90750,HCPCS,636,RC,,inpatient,0.5,ML,606.74,546.07,,0.95,,576.4,Percent of total billed charges,,,0.98,,594.61,Percent of total billed charges,,,0.95,,576.4,Percent of total billed charges,,,0.97,,588.54,Percent of total billed charges,,,0.97,,588.54,Percent of total billed charges,,,0.96,,582.47,Percent of total billed charges,,,0.95,,576.4,Percent of total billed charges,,,,,,,,,0.95,,576.4,Percent of total billed charges,,576.4,594.61,
ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSR,RX-172574,CDM,90750,HCPCS,636,RC,,outpatient,0.5,ML,606.74,546.07,,0.95,,576.4,Percent of total billed charges,,,0.98,,594.61,Percent of total billed charges,,,0.95,,576.4,Percent of total billed charges,,,0.95,,576.4,Percent of total billed charges,,,0.97,,588.54,Percent of total billed charges,,,0.96,,582.47,Percent of total billed charges,,,0.95,,576.4,Percent of total billed charges,,,,,,,,,0.95,,576.4,Percent of total billed charges,,576.4,594.61,
BENRALIZUMAB 30 MG/ML SUBQ SOSY,RX-172770,CDM,J0517,HCPCS,636,RC,,inpatient,1,ML,8495.47,7645.92,,0.95,,8070.7,Percent of total billed charges,,,0.98,,8325.56,Percent of total billed charges,,,0.95,,8070.7,Percent of total billed charges,,,0.97,,8240.61,Percent of total billed charges,,,0.97,,8240.61,Percent of total billed charges,,,0.96,,8155.65,Percent of total billed charges,,,0.95,,8070.7,Percent of total billed charges,,,,,,,,,0.95,,8070.7,Percent of total billed charges,,8070.7,8325.56,
BENRALIZUMAB 30 MG/ML SUBQ SOSY,RX-172770,CDM,J0517,HCPCS,636,RC,,outpatient,1,ML,8495.47,7645.92,,0.95,,8070.7,Percent of total billed charges,,,0.98,,8325.56,Percent of total billed charges,,,0.95,,8070.7,Percent of total billed charges,,,0.95,,8070.7,Percent of total billed charges,,,0.97,,8240.61,Percent of total billed charges,,,0.96,,8155.65,Percent of total billed charges,,,0.95,,8070.7,Percent of total billed charges,,,,,,,,,0.95,,8070.7,Percent of total billed charges,,8070.7,8325.56,
BECLOMETHASONE DIPROP HFA 80 MCG/ACT INHAL AERB,RX-172983,CDM,J3490,HCPCS,637,RC,,inpatient,10.6,GR,877.94,790.15,,0.95,,834.04,Percent of total billed charges,,,0.98,,860.38,Percent of total billed charges,,,0.95,,834.04,Percent of total billed charges,,,0.97,,851.6,Percent of total billed charges,,,0.97,,851.6,Percent of total billed charges,,,0.96,,842.82,Percent of total billed charges,,,0.95,,834.04,Percent of total billed charges,,,,,,,,,0.95,,834.04,Percent of total billed charges,,834.04,860.38,
BECLOMETHASONE DIPROP HFA 80 MCG/ACT INHAL AERB,RX-172983,CDM,J3490,HCPCS,637,RC,,outpatient,10.6,GR,877.94,790.15,,0.95,,834.04,Percent of total billed charges,,,0.98,,860.38,Percent of total billed charges,,,0.95,,834.04,Percent of total billed charges,,,0.95,,834.04,Percent of total billed charges,,,0.97,,851.6,Percent of total billed charges,,,0.96,,842.82,Percent of total billed charges,,,0.95,,834.04,Percent of total billed charges,,,,,,,,,0.95,,834.04,Percent of total billed charges,,834.04,860.38,
NIVOLUMAB 240 MG/24ML IV SOLN,RX-173195,CDM,J9299,HCPCS,636,RC,,inpatient,24,ML,15751.75,14176.58,,0.95,,14964.16,Percent of total billed charges,,,0.98,,15436.72,Percent of total billed charges,,,0.95,,14964.16,Percent of total billed charges,,,0.97,,15279.2,Percent of total billed charges,,,0.97,,15279.2,Percent of total billed charges,,,0.96,,15121.68,Percent of total billed charges,,,0.95,,14964.16,Percent of total billed charges,,,,,,,,,0.95,,14964.16,Percent of total billed charges,,14964.16,15436.72,
NIVOLUMAB 240 MG/24ML IV SOLN,RX-173195,CDM,J9299,HCPCS,636,RC,,outpatient,24,ML,15751.75,14176.58,,0.95,,14964.16,Percent of total billed charges,,,0.98,,15436.72,Percent of total billed charges,,,0.95,,14964.16,Percent of total billed charges,,,0.95,,14964.16,Percent of total billed charges,,,0.97,,15279.2,Percent of total billed charges,,,0.96,,15121.68,Percent of total billed charges,,,0.95,,14964.16,Percent of total billed charges,,,,,,,,,0.95,,14964.16,Percent of total billed charges,,14964.16,15436.72,
MEROPENEM 500 MG IV SOLR,RX-17379,CDM,J2185,HCPCS,636,RC,,inpatient,10,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
MEROPENEM 500 MG IV SOLR,RX-17379,CDM,J2185,HCPCS,636,RC,,outpatient,10,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
MEROPENEM 1 G IV SOLR,RX-17380,CDM,J2185,HCPCS,636,RC,,inpatient,1000,ME,24.61,22.15,,0.95,,23.38,Percent of total billed charges,,,0.98,,24.12,Percent of total billed charges,,,0.95,,23.38,Percent of total billed charges,,,0.97,,23.87,Percent of total billed charges,,,0.97,,23.87,Percent of total billed charges,,,0.96,,23.63,Percent of total billed charges,,,0.95,,23.38,Percent of total billed charges,,,,,,,,,0.95,,23.38,Percent of total billed charges,,23.38,24.12,
MEROPENEM 1 G IV SOLR,RX-17380,CDM,J2185,HCPCS,636,RC,,outpatient,1000,ME,24.61,22.15,,0.95,,23.38,Percent of total billed charges,,,0.98,,24.12,Percent of total billed charges,,,0.95,,23.38,Percent of total billed charges,,,0.95,,23.38,Percent of total billed charges,,,0.97,,23.87,Percent of total billed charges,,,0.96,,23.63,Percent of total billed charges,,,0.95,,23.38,Percent of total billed charges,,,,,,,,,0.95,,23.38,Percent of total billed charges,,23.38,24.12,
CLINDAMYCIN HCL 150 MG PO CAPS,RX-1740,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.49,5.84,,0.95,,6.17,Percent of total billed charges,,,0.98,,6.36,Percent of total billed charges,,,0.95,,6.17,Percent of total billed charges,,,0.97,,6.3,Percent of total billed charges,,,0.97,,6.3,Percent of total billed charges,,,0.96,,6.23,Percent of total billed charges,,,0.95,,6.17,Percent of total billed charges,,,,,,,,,0.95,,6.17,Percent of total billed charges,,6.17,6.36,
CLINDAMYCIN HCL 150 MG PO CAPS,RX-1740,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.49,5.84,,0.95,,6.17,Percent of total billed charges,,,0.98,,6.36,Percent of total billed charges,,,0.95,,6.17,Percent of total billed charges,,,0.95,,6.17,Percent of total billed charges,,,0.97,,6.3,Percent of total billed charges,,,0.96,,6.23,Percent of total billed charges,,,0.95,,6.17,Percent of total billed charges,,,,,,,,,0.95,,6.17,Percent of total billed charges,,6.17,6.36,
INSULIN LISPRO 100 UNIT/ML INJECTION SOLN,RX-17405,CDM,J1815,HCPCS,637,RC,,inpatient,10,ML,170.23,153.21,,0.95,,161.72,Percent of total billed charges,,,0.98,,166.83,Percent of total billed charges,,,0.95,,161.72,Percent of total billed charges,,,0.97,,165.12,Percent of total billed charges,,,0.97,,165.12,Percent of total billed charges,,,0.96,,163.42,Percent of total billed charges,,,0.95,,161.72,Percent of total billed charges,,,,,,,,,0.95,,161.72,Percent of total billed charges,,161.72,166.83,
INSULIN LISPRO 100 UNIT/ML INJECTION SOLN,RX-17405,CDM,J1815,HCPCS,637,RC,,outpatient,10,ML,170.23,153.21,,0.95,,161.72,Percent of total billed charges,,,0.98,,166.83,Percent of total billed charges,,,0.95,,161.72,Percent of total billed charges,,,0.95,,161.72,Percent of total billed charges,,,0.97,,165.12,Percent of total billed charges,,,0.96,,163.42,Percent of total billed charges,,,0.95,,161.72,Percent of total billed charges,,,,,,,,,0.95,,161.72,Percent of total billed charges,,161.72,166.83,
VANCOMYCIN HCL 25 MG/ML PO SOLR,RX-174381,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,12.21,10.99,,0.95,,11.6,Percent of total billed charges,,,0.98,,11.97,Percent of total billed charges,,,0.95,,11.6,Percent of total billed charges,,,0.97,,11.84,Percent of total billed charges,,,0.97,,11.84,Percent of total billed charges,,,0.96,,11.72,Percent of total billed charges,,,0.95,,11.6,Percent of total billed charges,,,,,,,,,0.95,,11.6,Percent of total billed charges,,11.6,11.97,
VANCOMYCIN HCL 25 MG/ML PO SOLR,RX-174381,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,12.21,10.99,,0.95,,11.6,Percent of total billed charges,,,0.98,,11.97,Percent of total billed charges,,,0.95,,11.6,Percent of total billed charges,,,0.95,,11.6,Percent of total billed charges,,,0.97,,11.84,Percent of total billed charges,,,0.96,,11.72,Percent of total billed charges,,,0.95,,11.6,Percent of total billed charges,,,,,,,,,0.95,,11.6,Percent of total billed charges,,11.6,11.97,
MIRTAZAPINE 15 MG PO TABS,RX-17466,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.55,5.9,,0.95,,6.22,Percent of total billed charges,,,0.98,,6.42,Percent of total billed charges,,,0.95,,6.22,Percent of total billed charges,,,0.97,,6.35,Percent of total billed charges,,,0.97,,6.35,Percent of total billed charges,,,0.96,,6.29,Percent of total billed charges,,,0.95,,6.22,Percent of total billed charges,,,,,,,,,0.95,,6.22,Percent of total billed charges,,6.22,6.42,
MIRTAZAPINE 15 MG PO TABS,RX-17466,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.55,5.9,,0.95,,6.22,Percent of total billed charges,,,0.98,,6.42,Percent of total billed charges,,,0.95,,6.22,Percent of total billed charges,,,0.95,,6.22,Percent of total billed charges,,,0.97,,6.35,Percent of total billed charges,,,0.96,,6.29,Percent of total billed charges,,,0.95,,6.22,Percent of total billed charges,,,,,,,,,0.95,,6.22,Percent of total billed charges,,6.22,6.42,
ASCORBIC ACID 25000 MG/50ML IV SOLN,RX-175334,CDM,J3490,HCPCS,250,RC,,inpatient,50,ML,830.52,747.47,,0.95,,788.99,Percent of total billed charges,,,0.98,,813.91,Percent of total billed charges,,,0.95,,788.99,Percent of total billed charges,,,0.97,,805.6,Percent of total billed charges,,,0.97,,805.6,Percent of total billed charges,,,0.96,,797.3,Percent of total billed charges,,,0.95,,788.99,Percent of total billed charges,,,,,,,,,0.95,,788.99,Percent of total billed charges,,788.99,813.91,
ASCORBIC ACID 25000 MG/50ML IV SOLN,RX-175334,CDM,J3490,HCPCS,250,RC,,outpatient,50,ML,830.52,747.47,,0.95,,788.99,Percent of total billed charges,,,0.98,,813.91,Percent of total billed charges,,,0.95,,788.99,Percent of total billed charges,,,0.95,,788.99,Percent of total billed charges,,,0.97,,805.6,Percent of total billed charges,,,0.96,,797.3,Percent of total billed charges,,,0.95,,788.99,Percent of total billed charges,,,,,,,,,0.95,,788.99,Percent of total billed charges,,788.99,813.91,
EPOETIN ALFA-EPBX 40000 UNIT/ML INJECTION SOLN,RX-175446,CDM,Q5106,HCPCS,636,RC,,inpatient,1,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
EPOETIN ALFA-EPBX 40000 UNIT/ML INJECTION SOLN,RX-175446,CDM,Q5106,HCPCS,636,RC,,outpatient,1,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
CLONIDINE HCL 0.1 MG PO TABS,RX-1755,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.17,6.45,,0.95,,6.81,Percent of total billed charges,,,0.98,,7.03,Percent of total billed charges,,,0.95,,6.81,Percent of total billed charges,,,0.97,,6.95,Percent of total billed charges,,,0.97,,6.95,Percent of total billed charges,,,0.96,,6.88,Percent of total billed charges,,,0.95,,6.81,Percent of total billed charges,,,,,,,,,0.95,,6.81,Percent of total billed charges,,6.81,7.03,
CLONIDINE HCL 0.1 MG PO TABS,RX-1755,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.17,6.45,,0.95,,6.81,Percent of total billed charges,,,0.98,,7.03,Percent of total billed charges,,,0.95,,6.81,Percent of total billed charges,,,0.95,,6.81,Percent of total billed charges,,,0.97,,6.95,Percent of total billed charges,,,0.96,,6.88,Percent of total billed charges,,,0.95,,6.81,Percent of total billed charges,,,,,,,,,0.95,,6.81,Percent of total billed charges,,6.81,7.03,
CLOTRIMAZOLE 1 % EX CREA,RX-1767,CDM,J3490,HCPCS,637,RC,,inpatient,30,GR,21.14,19.03,,0.95,,20.08,Percent of total billed charges,,,0.98,,20.72,Percent of total billed charges,,,0.95,,20.08,Percent of total billed charges,,,0.97,,20.51,Percent of total billed charges,,,0.97,,20.51,Percent of total billed charges,,,0.96,,20.29,Percent of total billed charges,,,0.95,,20.08,Percent of total billed charges,,,,,,,,,0.95,,20.08,Percent of total billed charges,,20.08,20.72,
CLOTRIMAZOLE 1 % EX CREA,RX-1767,CDM,J3490,HCPCS,637,RC,,outpatient,30,GR,21.14,19.03,,0.95,,20.08,Percent of total billed charges,,,0.98,,20.72,Percent of total billed charges,,,0.95,,20.08,Percent of total billed charges,,,0.95,,20.08,Percent of total billed charges,,,0.97,,20.51,Percent of total billed charges,,,0.96,,20.29,Percent of total billed charges,,,0.95,,20.08,Percent of total billed charges,,,,,,,,,0.95,,20.08,Percent of total billed charges,,20.08,20.72,
CARFILZOMIB 10 MG IV SOLR,RX-177194,CDM,J9047,HCPCS,636,RC,,inpatient,5,ML,1221.75,1099.58,,0.95,,1160.66,Percent of total billed charges,,,0.98,,1197.32,Percent of total billed charges,,,0.95,,1160.66,Percent of total billed charges,,,0.97,,1185.1,Percent of total billed charges,,,0.97,,1185.1,Percent of total billed charges,,,0.96,,1172.88,Percent of total billed charges,,,0.95,,1160.66,Percent of total billed charges,,,,,,,,,0.95,,1160.66,Percent of total billed charges,,1160.66,1197.32,
CARFILZOMIB 10 MG IV SOLR,RX-177194,CDM,J9047,HCPCS,636,RC,,outpatient,5,ML,1221.75,1099.58,,0.95,,1160.66,Percent of total billed charges,,,0.98,,1197.32,Percent of total billed charges,,,0.95,,1160.66,Percent of total billed charges,,,0.95,,1160.66,Percent of total billed charges,,,0.97,,1185.1,Percent of total billed charges,,,0.96,,1172.88,Percent of total billed charges,,,0.95,,1160.66,Percent of total billed charges,,,,,,,,,0.95,,1160.66,Percent of total billed charges,,1160.66,1197.32,
CLONIDINE 0.1 MG/24HR TD PTWK,RX-177670,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,57.18,51.46,,0.95,,54.32,Percent of total billed charges,,,0.98,,56.04,Percent of total billed charges,,,0.95,,54.32,Percent of total billed charges,,,0.97,,55.46,Percent of total billed charges,,,0.97,,55.46,Percent of total billed charges,,,0.96,,54.89,Percent of total billed charges,,,0.95,,54.32,Percent of total billed charges,,,,,,,,,0.95,,54.32,Percent of total billed charges,,54.32,56.04,
CLONIDINE 0.1 MG/24HR TD PTWK,RX-177670,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,57.18,51.46,,0.95,,54.32,Percent of total billed charges,,,0.98,,56.04,Percent of total billed charges,,,0.95,,54.32,Percent of total billed charges,,,0.95,,54.32,Percent of total billed charges,,,0.97,,55.46,Percent of total billed charges,,,0.96,,54.89,Percent of total billed charges,,,0.95,,54.32,Percent of total billed charges,,,,,,,,,0.95,,54.32,Percent of total billed charges,,54.32,56.04,
VANCOMYCIN HCL 1 G IV SOLR,RX-177674,CDM,J3370,HCPCS,636,RC,,inpatient,1000,ME,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
VANCOMYCIN HCL 1 G IV SOLR,RX-177674,CDM,J3370,HCPCS,636,RC,,outpatient,1000,ME,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
ALBUTEROL SULFATE HFA 108 (90 BASE) MCG/ACT INHAL AERS,RX-17837,CDM,J3490,HCPCS,637,RC,,inpatient,18,GR,148.07,133.26,,0.95,,140.67,Percent of total billed charges,,,0.98,,145.11,Percent of total billed charges,,,0.95,,140.67,Percent of total billed charges,,,0.97,,143.63,Percent of total billed charges,,,0.97,,143.63,Percent of total billed charges,,,0.96,,142.15,Percent of total billed charges,,,0.95,,140.67,Percent of total billed charges,,,,,,,,,0.95,,140.67,Percent of total billed charges,,140.67,145.11,
ALBUTEROL SULFATE HFA 108 (90 BASE) MCG/ACT INHAL AERS,RX-17837,CDM,J3490,HCPCS,637,RC,,outpatient,18,GR,148.07,133.26,,0.95,,140.67,Percent of total billed charges,,,0.98,,145.11,Percent of total billed charges,,,0.95,,140.67,Percent of total billed charges,,,0.95,,140.67,Percent of total billed charges,,,0.97,,143.63,Percent of total billed charges,,,0.96,,142.15,Percent of total billed charges,,,0.95,,140.67,Percent of total billed charges,,,,,,,,,0.95,,140.67,Percent of total billed charges,,140.67,145.11,
OMALIZUMAB 150 MG/ML SUBQ SOSY,RX-178794,CDM,J2357,HCPCS,636,RC,,inpatient,0.5,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
OMALIZUMAB 150 MG/ML SUBQ SOSY,RX-178794,CDM,J2357,HCPCS,636,RC,,outpatient,0.5,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
OMALIZUMAB 75 MG/0.5ML SUBQ SOSY,RX-178795,CDM,J2357,HCPCS,636,RC,,inpatient,0.5,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
OMALIZUMAB 75 MG/0.5ML SUBQ SOSY,RX-178795,CDM,J2357,HCPCS,636,RC,,outpatient,0.5,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
PEGFILGRASTIM-CBQV 6 MG/0.6ML SUBQ SOSY,RX-179156,CDM,Q5111,HCPCS,636,RC,,inpatient,0.6,ML,3313.64,2982.28,,0.95,,3147.96,Percent of total billed charges,,,0.98,,3247.37,Percent of total billed charges,,,0.95,,3147.96,Percent of total billed charges,,,0.97,,3214.23,Percent of total billed charges,,,0.97,,3214.23,Percent of total billed charges,,,0.96,,3181.09,Percent of total billed charges,,,0.95,,3147.96,Percent of total billed charges,,,,,,,,,0.95,,3147.96,Percent of total billed charges,,3147.96,3247.37,
PEGFILGRASTIM-CBQV 6 MG/0.6ML SUBQ SOSY,RX-179156,CDM,Q5111,HCPCS,636,RC,,outpatient,0.6,ML,3313.64,2982.28,,0.95,,3147.96,Percent of total billed charges,,,0.98,,3247.37,Percent of total billed charges,,,0.95,,3147.96,Percent of total billed charges,,,0.95,,3147.96,Percent of total billed charges,,,0.97,,3214.23,Percent of total billed charges,,,0.96,,3181.09,Percent of total billed charges,,,0.95,,3147.96,Percent of total billed charges,,,,,,,,,0.95,,3147.96,Percent of total billed charges,,3147.96,3247.37,
OLANZAPINE 5 MG PO TABS,RX-17936,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.4,5.76,,0.95,,6.08,Percent of total billed charges,,,0.98,,6.27,Percent of total billed charges,,,0.95,,6.08,Percent of total billed charges,,,0.97,,6.21,Percent of total billed charges,,,0.97,,6.21,Percent of total billed charges,,,0.96,,6.14,Percent of total billed charges,,,0.95,,6.08,Percent of total billed charges,,,,,,,,,0.95,,6.08,Percent of total billed charges,,6.08,6.27,
OLANZAPINE 5 MG PO TABS,RX-17936,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.4,5.76,,0.95,,6.08,Percent of total billed charges,,,0.98,,6.27,Percent of total billed charges,,,0.95,,6.08,Percent of total billed charges,,,0.95,,6.08,Percent of total billed charges,,,0.97,,6.21,Percent of total billed charges,,,0.96,,6.14,Percent of total billed charges,,,0.95,,6.08,Percent of total billed charges,,,,,,,,,0.95,,6.08,Percent of total billed charges,,6.08,6.27,
DEXAMETHASONE 1 MG/ML PO CONC,RX-17946,CDM,J8540,HCPCS,636,RC,,inpatient,1,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
DEXAMETHASONE 1 MG/ML PO CONC,RX-17946,CDM,J8540,HCPCS,636,RC,,outpatient,1,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
PROCHLORPERAZINE EDISYLATE 10 MG/2ML INJECTION SOLN,RX-180479,CDM,J0780,HCPCS,636,RC,,inpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
PROCHLORPERAZINE EDISYLATE 10 MG/2ML INJECTION SOLN,RX-180479,CDM,J0780,HCPCS,636,RC,,outpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
DENOSUMAB 60 MG/ML SUBQ SOSY,RX-180510,CDM,J0897,HCPCS,636,RC,,inpatient,1,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
DENOSUMAB 60 MG/ML SUBQ SOSY,RX-180510,CDM,J0897,HCPCS,636,RC,,outpatient,1,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
VANCOMYCIN HCL 1000 MG/200ML IV SOLN,RX-180524,CDM,J3372,HCPCS,636,RC,,inpatient,200,ML,43.99,39.59,,0.95,,41.79,Percent of total billed charges,,,0.98,,43.11,Percent of total billed charges,,,0.95,,41.79,Percent of total billed charges,,,0.97,,42.67,Percent of total billed charges,,,0.97,,42.67,Percent of total billed charges,,,0.96,,42.23,Percent of total billed charges,,,0.95,,41.79,Percent of total billed charges,,,,,,,,,0.95,,41.79,Percent of total billed charges,,41.79,43.11,
VANCOMYCIN HCL 1000 MG/200ML IV SOLN,RX-180524,CDM,J3372,HCPCS,636,RC,,outpatient,200,ML,43.99,39.59,,0.95,,41.79,Percent of total billed charges,,,0.98,,43.11,Percent of total billed charges,,,0.95,,41.79,Percent of total billed charges,,,0.95,,41.79,Percent of total billed charges,,,0.97,,42.67,Percent of total billed charges,,,0.96,,42.23,Percent of total billed charges,,,0.95,,41.79,Percent of total billed charges,,,,,,,,,0.95,,41.79,Percent of total billed charges,,41.79,43.11,
ATEZOLIZUMAB 840 MG/14ML IV SOLN,RX-180573,CDM,J9022,HCPCS,636,RC,,inpatient,14,ML,12930.88,11637.79,,0.95,,12284.34,Percent of total billed charges,,,0.98,,12672.26,Percent of total billed charges,,,0.95,,12284.34,Percent of total billed charges,,,0.97,,12542.95,Percent of total billed charges,,,0.97,,12542.95,Percent of total billed charges,,,0.96,,12413.64,Percent of total billed charges,,,0.95,,12284.34,Percent of total billed charges,,,,,,,,,0.95,,12284.34,Percent of total billed charges,,12284.34,12672.26,
ATEZOLIZUMAB 840 MG/14ML IV SOLN,RX-180573,CDM,J9022,HCPCS,636,RC,,outpatient,14,ML,12930.88,11637.79,,0.95,,12284.34,Percent of total billed charges,,,0.98,,12672.26,Percent of total billed charges,,,0.95,,12284.34,Percent of total billed charges,,,0.95,,12284.34,Percent of total billed charges,,,0.97,,12542.95,Percent of total billed charges,,,0.96,,12413.64,Percent of total billed charges,,,0.95,,12284.34,Percent of total billed charges,,,,,,,,,0.95,,12284.34,Percent of total billed charges,,12284.34,12672.26,
MEPOLIZUMAB 100 MG/ML SUBQ SOSY,RX-181868,CDM,J2182,HCPCS,636,RC,,inpatient,1,ML,6993.93,6294.54,,0.95,,6644.23,Percent of total billed charges,,,0.98,,6854.05,Percent of total billed charges,,,0.95,,6644.23,Percent of total billed charges,,,0.97,,6784.11,Percent of total billed charges,,,0.97,,6784.11,Percent of total billed charges,,,0.96,,6714.17,Percent of total billed charges,,,0.95,,6644.23,Percent of total billed charges,,,,,,,,,0.95,,6644.23,Percent of total billed charges,,6644.23,6854.05,
MEPOLIZUMAB 100 MG/ML SUBQ SOSY,RX-181868,CDM,J2182,HCPCS,636,RC,,outpatient,1,ML,6993.93,6294.54,,0.95,,6644.23,Percent of total billed charges,,,0.98,,6854.05,Percent of total billed charges,,,0.95,,6644.23,Percent of total billed charges,,,0.95,,6644.23,Percent of total billed charges,,,0.97,,6784.11,Percent of total billed charges,,,0.96,,6714.17,Percent of total billed charges,,,0.95,,6644.23,Percent of total billed charges,,,,,,,,,0.95,,6644.23,Percent of total billed charges,,6644.23,6854.05,
ROPIVACAINE HCL 5 MG/ML INJECTION SOLN,RX-18195,CDM,J2795,HCPCS,636,RC,,inpatient,5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
ROPIVACAINE HCL 5 MG/ML INJECTION SOLN,RX-18195,CDM,J2795,HCPCS,636,RC,,outpatient,5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
TORSEMIDE 20 MG PO TABS,RX-18293,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
TORSEMIDE 20 MG PO TABS,RX-18293,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
SODIUM CHLORIDE (PF) 0.9 % INJECTION SOLN,RX-182953,CDM,A4216,HCPCS,250,RC,,inpatient,0.5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
SODIUM CHLORIDE (PF) 0.9 % INJECTION SOLN,RX-182953,CDM,A4216,HCPCS,250,RC,,outpatient,0.5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
PIPERACILLIN SOD-TAZOBACTAM SO 4.5 (4-0.5) G IV SOLR,RX-18302,CDM,J2543,HCPCS,636,RC,,inpatient,4.5,GR,20.72,18.65,,0.95,,19.68,Percent of total billed charges,,,0.98,,20.31,Percent of total billed charges,,,0.95,,19.68,Percent of total billed charges,,,0.97,,20.1,Percent of total billed charges,,,0.97,,20.1,Percent of total billed charges,,,0.96,,19.89,Percent of total billed charges,,,0.95,,19.68,Percent of total billed charges,,,,,,,,,0.95,,19.68,Percent of total billed charges,,19.68,20.31,
PIPERACILLIN SOD-TAZOBACTAM SO 4.5 (4-0.5) G IV SOLR,RX-18302,CDM,J2543,HCPCS,636,RC,,outpatient,4.5,GR,20.72,18.65,,0.95,,19.68,Percent of total billed charges,,,0.98,,20.31,Percent of total billed charges,,,0.95,,19.68,Percent of total billed charges,,,0.95,,19.68,Percent of total billed charges,,,0.97,,20.1,Percent of total billed charges,,,0.96,,19.89,Percent of total billed charges,,,0.95,,19.68,Percent of total billed charges,,,,,,,,,0.95,,19.68,Percent of total billed charges,,19.68,20.31,
GABAPENTIN 300 MG PO CAPS,RX-18308,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.32,5.69,,0.95,,6,Percent of total billed charges,,,0.98,,6.19,Percent of total billed charges,,,0.95,,6,Percent of total billed charges,,,0.97,,6.13,Percent of total billed charges,,,0.97,,6.13,Percent of total billed charges,,,0.96,,6.07,Percent of total billed charges,,,0.95,,6,Percent of total billed charges,,,,,,,,,0.95,,6,Percent of total billed charges,,6,6.19,
GABAPENTIN 300 MG PO CAPS,RX-18308,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.32,5.69,,0.95,,6,Percent of total billed charges,,,0.98,,6.19,Percent of total billed charges,,,0.95,,6,Percent of total billed charges,,,0.95,,6,Percent of total billed charges,,,0.97,,6.13,Percent of total billed charges,,,0.96,,6.07,Percent of total billed charges,,,0.95,,6,Percent of total billed charges,,,,,,,,,0.95,,6,Percent of total billed charges,,6,6.19,
GABAPENTIN 100 MG PO CAPS,RX-18309,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.09,5.48,,0.95,,5.79,Percent of total billed charges,,,0.98,,5.97,Percent of total billed charges,,,0.95,,5.79,Percent of total billed charges,,,0.97,,5.91,Percent of total billed charges,,,0.97,,5.91,Percent of total billed charges,,,0.96,,5.85,Percent of total billed charges,,,0.95,,5.79,Percent of total billed charges,,,,,,,,,0.95,,5.79,Percent of total billed charges,,5.79,5.97,
GABAPENTIN 100 MG PO CAPS,RX-18309,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.09,5.48,,0.95,,5.79,Percent of total billed charges,,,0.98,,5.97,Percent of total billed charges,,,0.95,,5.79,Percent of total billed charges,,,0.95,,5.79,Percent of total billed charges,,,0.97,,5.91,Percent of total billed charges,,,0.96,,5.85,Percent of total billed charges,,,0.95,,5.79,Percent of total billed charges,,,,,,,,,0.95,,5.79,Percent of total billed charges,,5.79,5.97,
RISPERIDONE 1 MG PO TABS,RX-18313,CDM,J3490,HCPCS,637,RC,,inpatient,0.5,UN,5.67,5.1,,0.95,,5.39,Percent of total billed charges,,,0.98,,5.56,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,0.97,,5.5,Percent of total billed charges,,,0.97,,5.5,Percent of total billed charges,,,0.96,,5.44,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,,,,,,,0.95,,5.39,Percent of total billed charges,,5.39,5.56,
RISPERIDONE 1 MG PO TABS,RX-18313,CDM,J3490,HCPCS,637,RC,,outpatient,0.5,UN,5.67,5.1,,0.95,,5.39,Percent of total billed charges,,,0.98,,5.56,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,0.97,,5.5,Percent of total billed charges,,,0.96,,5.44,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,,,,,,,0.95,,5.39,Percent of total billed charges,,5.39,5.56,
TRASTUZUMAB-DKST 420 MG IV SOLR,RX-183531,CDM,Q5114,HCPCS,636,RC,,inpatient,20,ML,2805.19,2524.67,,0.95,,2664.93,Percent of total billed charges,,,0.98,,2749.09,Percent of total billed charges,,,0.95,,2664.93,Percent of total billed charges,,,0.97,,2721.03,Percent of total billed charges,,,0.97,,2721.03,Percent of total billed charges,,,0.96,,2692.98,Percent of total billed charges,,,0.95,,2664.93,Percent of total billed charges,,,,,,,,,0.95,,2664.93,Percent of total billed charges,,2664.93,2749.09,
TRASTUZUMAB-DKST 420 MG IV SOLR,RX-183531,CDM,Q5114,HCPCS,636,RC,,outpatient,20,ML,2805.19,2524.67,,0.95,,2664.93,Percent of total billed charges,,,0.98,,2749.09,Percent of total billed charges,,,0.95,,2664.93,Percent of total billed charges,,,0.95,,2664.93,Percent of total billed charges,,,0.97,,2721.03,Percent of total billed charges,,,0.96,,2692.98,Percent of total billed charges,,,0.95,,2664.93,Percent of total billed charges,,,,,,,,,0.95,,2664.93,Percent of total billed charges,,2664.93,2749.09,
VANCOMYCIN HCL 500 MG/100ML IV SOLN,RX-183534,CDM,J3372,HCPCS,636,RC,,inpatient,100,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
VANCOMYCIN HCL 500 MG/100ML IV SOLN,RX-183534,CDM,J3372,HCPCS,636,RC,,outpatient,100,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
TRASTUZUMAB-DKST 150 MG IV SOLR,RX-183535,CDM,Q5114,HCPCS,636,RC,,inpatient,150,ME,1069.04,962.14,,0.95,,1015.59,Percent of total billed charges,,,0.98,,1047.66,Percent of total billed charges,,,0.95,,1015.59,Percent of total billed charges,,,0.97,,1036.97,Percent of total billed charges,,,0.97,,1036.97,Percent of total billed charges,,,0.96,,1026.28,Percent of total billed charges,,,0.95,,1015.59,Percent of total billed charges,,,,,,,,,0.95,,1015.59,Percent of total billed charges,,1015.59,1047.66,
TRASTUZUMAB-DKST 150 MG IV SOLR,RX-183535,CDM,Q5114,HCPCS,636,RC,,outpatient,150,ME,1069.04,962.14,,0.95,,1015.59,Percent of total billed charges,,,0.98,,1047.66,Percent of total billed charges,,,0.95,,1015.59,Percent of total billed charges,,,0.95,,1015.59,Percent of total billed charges,,,0.97,,1036.97,Percent of total billed charges,,,0.96,,1026.28,Percent of total billed charges,,,0.95,,1015.59,Percent of total billed charges,,,,,,,,,0.95,,1015.59,Percent of total billed charges,,1015.59,1047.66,
RITUXIMAB-ABBS 500 MG/50ML IV SOLN,RX-183796,CDM,Q5115,HCPCS,636,RC,,inpatient,50,ML,5292.97,4763.67,,0.95,,5028.32,Percent of total billed charges,,,0.98,,5187.11,Percent of total billed charges,,,0.95,,5028.32,Percent of total billed charges,,,0.97,,5134.18,Percent of total billed charges,,,0.97,,5134.18,Percent of total billed charges,,,0.96,,5081.25,Percent of total billed charges,,,0.95,,5028.32,Percent of total billed charges,,,,,,,,,0.95,,5028.32,Percent of total billed charges,,5028.32,5187.11,
RITUXIMAB-ABBS 500 MG/50ML IV SOLN,RX-183796,CDM,Q5115,HCPCS,636,RC,,outpatient,50,ML,5292.97,4763.67,,0.95,,5028.32,Percent of total billed charges,,,0.98,,5187.11,Percent of total billed charges,,,0.95,,5028.32,Percent of total billed charges,,,0.95,,5028.32,Percent of total billed charges,,,0.97,,5134.18,Percent of total billed charges,,,0.96,,5081.25,Percent of total billed charges,,,0.95,,5028.32,Percent of total billed charges,,,,,,,,,0.95,,5028.32,Percent of total billed charges,,5028.32,5187.11,
LUSPATERCEPT-AAMT 25 MG SUBQ SOLR,RX-183852,CDM,J0896,HCPCS,636,RC,,inpatient,0.5,ML,6685.24,6016.72,,0.95,,6350.98,Percent of total billed charges,,,0.98,,6551.54,Percent of total billed charges,,,0.95,,6350.98,Percent of total billed charges,,,0.97,,6484.68,Percent of total billed charges,,,0.97,,6484.68,Percent of total billed charges,,,0.96,,6417.83,Percent of total billed charges,,,0.95,,6350.98,Percent of total billed charges,,,,,,,,,0.95,,6350.98,Percent of total billed charges,,6350.98,6551.54,
LUSPATERCEPT-AAMT 25 MG SUBQ SOLR,RX-183852,CDM,J0896,HCPCS,636,RC,,outpatient,0.5,ML,6685.24,6016.72,,0.95,,6350.98,Percent of total billed charges,,,0.98,,6551.54,Percent of total billed charges,,,0.95,,6350.98,Percent of total billed charges,,,0.95,,6350.98,Percent of total billed charges,,,0.97,,6484.68,Percent of total billed charges,,,0.96,,6417.83,Percent of total billed charges,,,0.95,,6350.98,Percent of total billed charges,,,,,,,,,0.95,,6350.98,Percent of total billed charges,,6350.98,6551.54,
LUSPATERCEPT-AAMT 75 MG SUBQ SOLR,RX-183853,CDM,J0896,HCPCS,636,RC,,inpatient,1.5,ML,20055.67,18050.1,,0.95,,19052.89,Percent of total billed charges,,,0.98,,19654.56,Percent of total billed charges,,,0.95,,19052.89,Percent of total billed charges,,,0.97,,19454,Percent of total billed charges,,,0.97,,19454,Percent of total billed charges,,,0.96,,19253.44,Percent of total billed charges,,,0.95,,19052.89,Percent of total billed charges,,,,,,,,,0.95,,19052.89,Percent of total billed charges,,19052.89,19654.56,
LUSPATERCEPT-AAMT 75 MG SUBQ SOLR,RX-183853,CDM,J0896,HCPCS,636,RC,,outpatient,1.5,ML,20055.67,18050.1,,0.95,,19052.89,Percent of total billed charges,,,0.98,,19654.56,Percent of total billed charges,,,0.95,,19052.89,Percent of total billed charges,,,0.95,,19052.89,Percent of total billed charges,,,0.97,,19454,Percent of total billed charges,,,0.96,,19253.44,Percent of total billed charges,,,0.95,,19052.89,Percent of total billed charges,,,,,,,,,0.95,,19052.89,Percent of total billed charges,,19052.89,19654.56,
ENFORTUMAB VEDOTIN-EJFV 20 MG IV SOLR,RX-184108,CDM,J9177,HCPCS,636,RC,,inpatient,2,ML,4770.18,4293.16,,0.95,,4531.67,Percent of total billed charges,,,0.98,,4674.78,Percent of total billed charges,,,0.95,,4531.67,Percent of total billed charges,,,0.97,,4627.07,Percent of total billed charges,,,0.97,,4627.07,Percent of total billed charges,,,0.96,,4579.37,Percent of total billed charges,,,0.95,,4531.67,Percent of total billed charges,,,,,,,,,0.95,,4531.67,Percent of total billed charges,,4531.67,4674.78,
ENFORTUMAB VEDOTIN-EJFV 20 MG IV SOLR,RX-184108,CDM,J9177,HCPCS,636,RC,,outpatient,2,ML,4770.18,4293.16,,0.95,,4531.67,Percent of total billed charges,,,0.98,,4674.78,Percent of total billed charges,,,0.95,,4531.67,Percent of total billed charges,,,0.95,,4531.67,Percent of total billed charges,,,0.97,,4627.07,Percent of total billed charges,,,0.96,,4579.37,Percent of total billed charges,,,0.95,,4531.67,Percent of total billed charges,,,,,,,,,0.95,,4531.67,Percent of total billed charges,,4531.67,4674.78,
FAM-TRASTUZUMAB DERUXTEC-NXKI 100 MG IV SOLR,RX-184234,CDM,J9358,HCPCS,636,RC,,inpatient,5,ML,5859.32,5273.39,,0.95,,5566.35,Percent of total billed charges,,,0.98,,5742.13,Percent of total billed charges,,,0.95,,5566.35,Percent of total billed charges,,,0.97,,5683.54,Percent of total billed charges,,,0.97,,5683.54,Percent of total billed charges,,,0.96,,5624.95,Percent of total billed charges,,,0.95,,5566.35,Percent of total billed charges,,,,,,,,,0.95,,5566.35,Percent of total billed charges,,5566.35,5742.13,
FAM-TRASTUZUMAB DERUXTEC-NXKI 100 MG IV SOLR,RX-184234,CDM,J9358,HCPCS,636,RC,,outpatient,5,ML,5859.32,5273.39,,0.95,,5566.35,Percent of total billed charges,,,0.98,,5742.13,Percent of total billed charges,,,0.95,,5566.35,Percent of total billed charges,,,0.95,,5566.35,Percent of total billed charges,,,0.97,,5683.54,Percent of total billed charges,,,0.96,,5624.95,Percent of total billed charges,,,0.95,,5566.35,Percent of total billed charges,,,,,,,,,0.95,,5566.35,Percent of total billed charges,,5566.35,5742.13,
BEVACIZUMAB-BVZR 100 MG/4ML IV SOLN,RX-184350,CDM,Q5118,HCPCS,636,RC,,inpatient,4,ML,1062.1,955.89,,0.95,,1009,Percent of total billed charges,,,0.98,,1040.86,Percent of total billed charges,,,0.95,,1009,Percent of total billed charges,,,0.97,,1030.24,Percent of total billed charges,,,0.97,,1030.24,Percent of total billed charges,,,0.96,,1019.62,Percent of total billed charges,,,0.95,,1009,Percent of total billed charges,,,,,,,,,0.95,,1009,Percent of total billed charges,,1009,1040.86,
BEVACIZUMAB-BVZR 100 MG/4ML IV SOLN,RX-184350,CDM,Q5118,HCPCS,636,RC,,outpatient,4,ML,1062.1,955.89,,0.95,,1009,Percent of total billed charges,,,0.98,,1040.86,Percent of total billed charges,,,0.95,,1009,Percent of total billed charges,,,0.95,,1009,Percent of total billed charges,,,0.97,,1030.24,Percent of total billed charges,,,0.96,,1019.62,Percent of total billed charges,,,0.95,,1009,Percent of total billed charges,,,,,,,,,0.95,,1009,Percent of total billed charges,,1009,1040.86,
RITUXIMAB-PVVR 500 MG/50ML IV SOLN,RX-184354,CDM,Q5119,HCPCS,636,RC,,inpatient,50,ML,5247.24,4722.52,,0.95,,4984.88,Percent of total billed charges,,,0.98,,5142.3,Percent of total billed charges,,,0.95,,4984.88,Percent of total billed charges,,,0.97,,5089.82,Percent of total billed charges,,,0.97,,5089.82,Percent of total billed charges,,,0.96,,5037.35,Percent of total billed charges,,,0.95,,4984.88,Percent of total billed charges,,,,,,,,,0.95,,4984.88,Percent of total billed charges,,4984.88,5142.3,
RITUXIMAB-PVVR 500 MG/50ML IV SOLN,RX-184354,CDM,Q5119,HCPCS,636,RC,,outpatient,50,ML,5247.24,4722.52,,0.95,,4984.88,Percent of total billed charges,,,0.98,,5142.3,Percent of total billed charges,,,0.95,,4984.88,Percent of total billed charges,,,0.95,,4984.88,Percent of total billed charges,,,0.97,,5089.82,Percent of total billed charges,,,0.96,,5037.35,Percent of total billed charges,,,0.95,,4984.88,Percent of total billed charges,,,,,,,,,0.95,,4984.88,Percent of total billed charges,,4984.88,5142.3,
OXACILLIN SODIUM 10 G IV SOLR,RX-186181,CDM,J2700,HCPCS,636,RC,,inpatient,100,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
OXACILLIN SODIUM 10 G IV SOLR,RX-186181,CDM,J2700,HCPCS,636,RC,,outpatient,100,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
ISATUXIMAB-IRFC 100 MG/5ML IV SOLN,RX-186239,CDM,J9227,HCPCS,636,RC,,inpatient,5,ML,1725.32,1552.79,,0.95,,1639.05,Percent of total billed charges,,,0.98,,1690.81,Percent of total billed charges,,,0.95,,1639.05,Percent of total billed charges,,,0.97,,1673.56,Percent of total billed charges,,,0.97,,1673.56,Percent of total billed charges,,,0.96,,1656.31,Percent of total billed charges,,,0.95,,1639.05,Percent of total billed charges,,,,,,,,,0.95,,1639.05,Percent of total billed charges,,1639.05,1690.81,
ISATUXIMAB-IRFC 100 MG/5ML IV SOLN,RX-186239,CDM,J9227,HCPCS,636,RC,,outpatient,5,ML,1725.32,1552.79,,0.95,,1639.05,Percent of total billed charges,,,0.98,,1690.81,Percent of total billed charges,,,0.95,,1639.05,Percent of total billed charges,,,0.95,,1639.05,Percent of total billed charges,,,0.97,,1673.56,Percent of total billed charges,,,0.96,,1656.31,Percent of total billed charges,,,0.95,,1639.05,Percent of total billed charges,,,,,,,,,0.95,,1639.05,Percent of total billed charges,,1639.05,1690.81,
DARATUMUMAB-HYALURONIDASE-FIHJ 1800-30000 MG-UT/15ML SUBQ SOLN,RX-187062,CDM,J9144,HCPCS,636,RC,,inpatient,15,ML,19871.56,17884.4,,0.95,,18877.98,Percent of total billed charges,,,0.98,,19474.13,Percent of total billed charges,,,0.95,,18877.98,Percent of total billed charges,,,0.97,,19275.41,Percent of total billed charges,,,0.97,,19275.41,Percent of total billed charges,,,0.96,,19076.7,Percent of total billed charges,,,0.95,,18877.98,Percent of total billed charges,,,,,,,,,0.95,,18877.98,Percent of total billed charges,,18877.98,19474.13,
DARATUMUMAB-HYALURONIDASE-FIHJ 1800-30000 MG-UT/15ML SUBQ SOLN,RX-187062,CDM,J9144,HCPCS,636,RC,,outpatient,15,ML,19871.56,17884.4,,0.95,,18877.98,Percent of total billed charges,,,0.98,,19474.13,Percent of total billed charges,,,0.95,,18877.98,Percent of total billed charges,,,0.95,,18877.98,Percent of total billed charges,,,0.97,,19275.41,Percent of total billed charges,,,0.96,,19076.7,Percent of total billed charges,,,0.95,,18877.98,Percent of total billed charges,,,,,,,,,0.95,,18877.98,Percent of total billed charges,,18877.98,19474.13,
INFLIXIMAB-AXXQ 100 MG IV SOLR,RX-187176,CDM,Q5121,HCPCS,636,RC,,inpatient,10,ML,1181.57,1063.41,,0.95,,1122.49,Percent of total billed charges,,,0.98,,1157.94,Percent of total billed charges,,,0.95,,1122.49,Percent of total billed charges,,,0.97,,1146.12,Percent of total billed charges,,,0.97,,1146.12,Percent of total billed charges,,,0.96,,1134.31,Percent of total billed charges,,,0.95,,1122.49,Percent of total billed charges,,,,,,,,,0.95,,1122.49,Percent of total billed charges,,1122.49,1157.94,
INFLIXIMAB-AXXQ 100 MG IV SOLR,RX-187176,CDM,Q5121,HCPCS,636,RC,,outpatient,10,ML,1181.57,1063.41,,0.95,,1122.49,Percent of total billed charges,,,0.98,,1157.94,Percent of total billed charges,,,0.95,,1122.49,Percent of total billed charges,,,0.95,,1122.49,Percent of total billed charges,,,0.97,,1146.12,Percent of total billed charges,,,0.96,,1134.31,Percent of total billed charges,,,0.95,,1122.49,Percent of total billed charges,,,,,,,,,0.95,,1122.49,Percent of total billed charges,,1122.49,1157.94,
LURBINECTEDIN 4 MG IV SOLR,RX-187652,CDM,J9223,HCPCS,636,RC,,inpatient,8,ML,16562.1,14905.89,,0.95,,15734,Percent of total billed charges,,,0.98,,16230.86,Percent of total billed charges,,,0.95,,15734,Percent of total billed charges,,,0.97,,16065.24,Percent of total billed charges,,,0.97,,16065.24,Percent of total billed charges,,,0.96,,15899.62,Percent of total billed charges,,,0.95,,15734,Percent of total billed charges,,,,,,,,,0.95,,15734,Percent of total billed charges,,15734,16230.86,
LURBINECTEDIN 4 MG IV SOLR,RX-187652,CDM,J9223,HCPCS,636,RC,,outpatient,8,ML,16562.1,14905.89,,0.95,,15734,Percent of total billed charges,,,0.98,,16230.86,Percent of total billed charges,,,0.95,,15734,Percent of total billed charges,,,0.95,,15734,Percent of total billed charges,,,0.97,,16065.24,Percent of total billed charges,,,0.96,,15899.62,Percent of total billed charges,,,0.95,,15734,Percent of total billed charges,,,,,,,,,0.95,,15734,Percent of total billed charges,,15734,16230.86,
DONEPEZIL HCL 5 MG PO TABS,RX-18786,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.3,5.67,,0.95,,5.99,Percent of total billed charges,,,0.98,,6.17,Percent of total billed charges,,,0.95,,5.99,Percent of total billed charges,,,0.97,,6.11,Percent of total billed charges,,,0.97,,6.11,Percent of total billed charges,,,0.96,,6.05,Percent of total billed charges,,,0.95,,5.99,Percent of total billed charges,,,,,,,,,0.95,,5.99,Percent of total billed charges,,5.99,6.17,
DONEPEZIL HCL 5 MG PO TABS,RX-18786,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.3,5.67,,0.95,,5.99,Percent of total billed charges,,,0.98,,6.17,Percent of total billed charges,,,0.95,,5.99,Percent of total billed charges,,,0.95,,5.99,Percent of total billed charges,,,0.97,,6.11,Percent of total billed charges,,,0.96,,6.05,Percent of total billed charges,,,0.95,,5.99,Percent of total billed charges,,,,,,,,,0.95,,5.99,Percent of total billed charges,,5.99,6.17,
VANCOMYCIN HCL 750 MG/150ML IV SOLN,RX-188308,CDM,J3372,HCPCS,636,RC,,inpatient,150,ML,32.99,29.69,,0.95,,31.34,Percent of total billed charges,,,0.98,,32.33,Percent of total billed charges,,,0.95,,31.34,Percent of total billed charges,,,0.97,,32,Percent of total billed charges,,,0.97,,32,Percent of total billed charges,,,0.96,,31.67,Percent of total billed charges,,,0.95,,31.34,Percent of total billed charges,,,,,,,,,0.95,,31.34,Percent of total billed charges,,31.34,32.33,
VANCOMYCIN HCL 750 MG/150ML IV SOLN,RX-188308,CDM,J3372,HCPCS,636,RC,,outpatient,150,ML,32.99,29.69,,0.95,,31.34,Percent of total billed charges,,,0.98,,32.33,Percent of total billed charges,,,0.95,,31.34,Percent of total billed charges,,,0.95,,31.34,Percent of total billed charges,,,0.97,,32,Percent of total billed charges,,,0.96,,31.67,Percent of total billed charges,,,0.95,,31.34,Percent of total billed charges,,,,,,,,,0.95,,31.34,Percent of total billed charges,,31.34,32.33,
ONDANSETRON HCL 4 MG/5ML PO SOLN,RX-18877,CDM,Q0162,HCPCS,636,RC,,inpatient,5,ML,35.95,32.36,,0.95,,34.15,Percent of total billed charges,,,0.98,,35.23,Percent of total billed charges,,,0.95,,34.15,Percent of total billed charges,,,0.97,,34.87,Percent of total billed charges,,,0.97,,34.87,Percent of total billed charges,,,0.96,,34.51,Percent of total billed charges,,,0.95,,34.15,Percent of total billed charges,,,,,,,,,0.95,,34.15,Percent of total billed charges,,34.15,35.23,
ONDANSETRON HCL 4 MG/5ML PO SOLN,RX-18877,CDM,Q0162,HCPCS,636,RC,,outpatient,5,ML,35.95,32.36,,0.95,,34.15,Percent of total billed charges,,,0.98,,35.23,Percent of total billed charges,,,0.95,,34.15,Percent of total billed charges,,,0.95,,34.15,Percent of total billed charges,,,0.97,,34.87,Percent of total billed charges,,,0.96,,34.51,Percent of total billed charges,,,0.95,,34.15,Percent of total billed charges,,,,,,,,,0.95,,34.15,Percent of total billed charges,,34.15,35.23,
NITROPRUSSIDE SODIUM 25 MG/ML IV SOLN,RX-18908,CDM,J3490,HCPCS,250,RC,,inpatient,2,ML,49.23,44.31,,0.95,,46.77,Percent of total billed charges,,,0.98,,48.25,Percent of total billed charges,,,0.95,,46.77,Percent of total billed charges,,,0.97,,47.75,Percent of total billed charges,,,0.97,,47.75,Percent of total billed charges,,,0.96,,47.26,Percent of total billed charges,,,0.95,,46.77,Percent of total billed charges,,,,,,,,,0.95,,46.77,Percent of total billed charges,,46.77,48.25,
NITROPRUSSIDE SODIUM 25 MG/ML IV SOLN,RX-18908,CDM,J3490,HCPCS,250,RC,,outpatient,2,ML,49.23,44.31,,0.95,,46.77,Percent of total billed charges,,,0.98,,48.25,Percent of total billed charges,,,0.95,,46.77,Percent of total billed charges,,,0.95,,46.77,Percent of total billed charges,,,0.97,,47.75,Percent of total billed charges,,,0.96,,47.26,Percent of total billed charges,,,0.95,,46.77,Percent of total billed charges,,,,,,,,,0.95,,46.77,Percent of total billed charges,,46.77,48.25,
LEVOFLOXACIN 250 MG PO TABS,RX-18918,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.67,6,,0.95,,6.34,Percent of total billed charges,,,0.98,,6.54,Percent of total billed charges,,,0.95,,6.34,Percent of total billed charges,,,0.97,,6.47,Percent of total billed charges,,,0.97,,6.47,Percent of total billed charges,,,0.96,,6.4,Percent of total billed charges,,,0.95,,6.34,Percent of total billed charges,,,,,,,,,0.95,,6.34,Percent of total billed charges,,6.34,6.54,
LEVOFLOXACIN 250 MG PO TABS,RX-18918,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.67,6,,0.95,,6.34,Percent of total billed charges,,,0.98,,6.54,Percent of total billed charges,,,0.95,,6.34,Percent of total billed charges,,,0.95,,6.34,Percent of total billed charges,,,0.97,,6.47,Percent of total billed charges,,,0.96,,6.4,Percent of total billed charges,,,0.95,,6.34,Percent of total billed charges,,,,,,,,,0.95,,6.34,Percent of total billed charges,,6.34,6.54,
LEVOFLOXACIN 500 MG PO TABS,RX-18919,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.93,6.24,,0.95,,6.58,Percent of total billed charges,,,0.98,,6.79,Percent of total billed charges,,,0.95,,6.58,Percent of total billed charges,,,0.97,,6.72,Percent of total billed charges,,,0.97,,6.72,Percent of total billed charges,,,0.96,,6.65,Percent of total billed charges,,,0.95,,6.58,Percent of total billed charges,,,,,,,,,0.95,,6.58,Percent of total billed charges,,6.58,6.79,
LEVOFLOXACIN 500 MG PO TABS,RX-18919,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.93,6.24,,0.95,,6.58,Percent of total billed charges,,,0.98,,6.79,Percent of total billed charges,,,0.95,,6.58,Percent of total billed charges,,,0.95,,6.58,Percent of total billed charges,,,0.97,,6.72,Percent of total billed charges,,,0.96,,6.65,Percent of total billed charges,,,0.95,,6.58,Percent of total billed charges,,,,,,,,,0.95,,6.58,Percent of total billed charges,,6.58,6.79,
TOPIRAMATE 25 MG PO TABS,RX-18920,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.74,6.07,,0.95,,6.4,Percent of total billed charges,,,0.98,,6.61,Percent of total billed charges,,,0.95,,6.4,Percent of total billed charges,,,0.97,,6.54,Percent of total billed charges,,,0.97,,6.54,Percent of total billed charges,,,0.96,,6.47,Percent of total billed charges,,,0.95,,6.4,Percent of total billed charges,,,,,,,,,0.95,,6.4,Percent of total billed charges,,6.4,6.61,
TOPIRAMATE 25 MG PO TABS,RX-18920,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.74,6.07,,0.95,,6.4,Percent of total billed charges,,,0.98,,6.61,Percent of total billed charges,,,0.95,,6.4,Percent of total billed charges,,,0.95,,6.4,Percent of total billed charges,,,0.97,,6.54,Percent of total billed charges,,,0.96,,6.47,Percent of total billed charges,,,0.95,,6.4,Percent of total billed charges,,,,,,,,,0.95,,6.4,Percent of total billed charges,,6.4,6.61,
DICLOFENAC SODIUM 1 % EX GEL,RX-189253,CDM,J3490,HCPCS,637,RC,,inpatient,100,GR,83.9,75.51,,0.95,,79.71,Percent of total billed charges,,,0.98,,82.22,Percent of total billed charges,,,0.95,,79.71,Percent of total billed charges,,,0.97,,81.38,Percent of total billed charges,,,0.97,,81.38,Percent of total billed charges,,,0.96,,80.54,Percent of total billed charges,,,0.95,,79.71,Percent of total billed charges,,,,,,,,,0.95,,79.71,Percent of total billed charges,,79.71,82.22,
DICLOFENAC SODIUM 1 % EX GEL,RX-189253,CDM,J3490,HCPCS,637,RC,,outpatient,100,GR,83.9,75.51,,0.95,,79.71,Percent of total billed charges,,,0.98,,82.22,Percent of total billed charges,,,0.95,,79.71,Percent of total billed charges,,,0.95,,79.71,Percent of total billed charges,,,0.97,,81.38,Percent of total billed charges,,,0.96,,80.54,Percent of total billed charges,,,0.95,,79.71,Percent of total billed charges,,,,,,,,,0.95,,79.71,Percent of total billed charges,,79.71,82.22,
ATORVASTATIN CALCIUM 10 MG PO TABS,RX-19176,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.3,6.57,,0.95,,6.94,Percent of total billed charges,,,0.98,,7.15,Percent of total billed charges,,,0.95,,6.94,Percent of total billed charges,,,0.97,,7.08,Percent of total billed charges,,,0.97,,7.08,Percent of total billed charges,,,0.96,,7.01,Percent of total billed charges,,,0.95,,6.94,Percent of total billed charges,,,,,,,,,0.95,,6.94,Percent of total billed charges,,6.94,7.15,
ATORVASTATIN CALCIUM 10 MG PO TABS,RX-19176,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.3,6.57,,0.95,,6.94,Percent of total billed charges,,,0.98,,7.15,Percent of total billed charges,,,0.95,,6.94,Percent of total billed charges,,,0.95,,6.94,Percent of total billed charges,,,0.97,,7.08,Percent of total billed charges,,,0.96,,7.01,Percent of total billed charges,,,0.95,,6.94,Percent of total billed charges,,,,,,,,,0.95,,6.94,Percent of total billed charges,,6.94,7.15,
ATORVASTATIN CALCIUM 40 MG PO TABS,RX-19177,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.97,6.27,,0.95,,6.62,Percent of total billed charges,,,0.98,,6.83,Percent of total billed charges,,,0.95,,6.62,Percent of total billed charges,,,0.97,,6.76,Percent of total billed charges,,,0.97,,6.76,Percent of total billed charges,,,0.96,,6.69,Percent of total billed charges,,,0.95,,6.62,Percent of total billed charges,,,,,,,,,0.95,,6.62,Percent of total billed charges,,6.62,6.83,
ATORVASTATIN CALCIUM 40 MG PO TABS,RX-19177,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.97,6.27,,0.95,,6.62,Percent of total billed charges,,,0.98,,6.83,Percent of total billed charges,,,0.95,,6.62,Percent of total billed charges,,,0.95,,6.62,Percent of total billed charges,,,0.97,,6.76,Percent of total billed charges,,,0.96,,6.69,Percent of total billed charges,,,0.95,,6.62,Percent of total billed charges,,,,,,,,,0.95,,6.62,Percent of total billed charges,,6.62,6.83,
ATORVASTATIN CALCIUM 20 MG PO TABS,RX-19178,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.62,6.86,,0.95,,7.24,Percent of total billed charges,,,0.98,,7.47,Percent of total billed charges,,,0.95,,7.24,Percent of total billed charges,,,0.97,,7.39,Percent of total billed charges,,,0.97,,7.39,Percent of total billed charges,,,0.96,,7.32,Percent of total billed charges,,,0.95,,7.24,Percent of total billed charges,,,,,,,,,0.95,,7.24,Percent of total billed charges,,7.24,7.47,
ATORVASTATIN CALCIUM 20 MG PO TABS,RX-19178,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.62,6.86,,0.95,,7.24,Percent of total billed charges,,,0.98,,7.47,Percent of total billed charges,,,0.95,,7.24,Percent of total billed charges,,,0.95,,7.24,Percent of total billed charges,,,0.97,,7.39,Percent of total billed charges,,,0.96,,7.32,Percent of total billed charges,,,0.95,,7.24,Percent of total billed charges,,,,,,,,,0.95,,7.24,Percent of total billed charges,,7.24,7.47,
BUPIVACAINE-MELOXICAM ER 400-12 MG/14ML INJECTION SOLN,RX-192444,CDM,C9088,HCPCS,636,RC,,inpatient,14,ML,896.02,806.42,,0.95,,851.22,Percent of total billed charges,,,0.98,,878.1,Percent of total billed charges,,,0.95,,851.22,Percent of total billed charges,,,0.97,,869.14,Percent of total billed charges,,,0.97,,869.14,Percent of total billed charges,,,0.96,,860.18,Percent of total billed charges,,,0.95,,851.22,Percent of total billed charges,,,,,,,,,0.95,,851.22,Percent of total billed charges,,851.22,878.1,
BUPIVACAINE-MELOXICAM ER 400-12 MG/14ML INJECTION SOLN,RX-192444,CDM,C9088,HCPCS,636,RC,,outpatient,14,ML,896.02,806.42,,0.95,,851.22,Percent of total billed charges,,,0.98,,878.1,Percent of total billed charges,,,0.95,,851.22,Percent of total billed charges,,,0.95,,851.22,Percent of total billed charges,,,0.97,,869.14,Percent of total billed charges,,,0.96,,860.18,Percent of total billed charges,,,0.95,,851.22,Percent of total billed charges,,,,,,,,,0.95,,851.22,Percent of total billed charges,,851.22,878.1,
PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML IM SUSY,RX-193193,CDM,90677,HCPCS,636,RC,,inpatient,0.5,ML,730.9,657.81,,0.95,,694.36,Percent of total billed charges,,,0.98,,716.28,Percent of total billed charges,,,0.95,,694.36,Percent of total billed charges,,,0.97,,708.97,Percent of total billed charges,,,0.97,,708.97,Percent of total billed charges,,,0.96,,701.66,Percent of total billed charges,,,0.95,,694.36,Percent of total billed charges,,,,,,,,,0.95,,694.36,Percent of total billed charges,,694.36,716.28,
PNEUMOCOCCAL 20-VAL CONJ VACC 0.5 ML IM SUSY,RX-193193,CDM,90677,HCPCS,636,RC,,outpatient,0.5,ML,730.9,657.81,,0.95,,694.36,Percent of total billed charges,,,0.98,,716.28,Percent of total billed charges,,,0.95,,694.36,Percent of total billed charges,,,0.95,,694.36,Percent of total billed charges,,,0.97,,708.97,Percent of total billed charges,,,0.96,,701.66,Percent of total billed charges,,,0.95,,694.36,Percent of total billed charges,,,,,,,,,0.95,,694.36,Percent of total billed charges,,694.36,716.28,
FAT EMULSION PLANT BASED (SOY) 20 % IV EMUL,RX-193523,CDM,J3490,HCPCS,250,RC,,inpatient,250,ML,122.45,110.21,,0.95,,116.33,Percent of total billed charges,,,0.98,,120,Percent of total billed charges,,,0.95,,116.33,Percent of total billed charges,,,0.97,,118.78,Percent of total billed charges,,,0.97,,118.78,Percent of total billed charges,,,0.96,,117.55,Percent of total billed charges,,,0.95,,116.33,Percent of total billed charges,,,,,,,,,0.95,,116.33,Percent of total billed charges,,116.33,120,
FAT EMULSION PLANT BASED (SOY) 20 % IV EMUL,RX-193523,CDM,J3490,HCPCS,250,RC,,outpatient,250,ML,122.45,110.21,,0.95,,116.33,Percent of total billed charges,,,0.98,,120,Percent of total billed charges,,,0.95,,116.33,Percent of total billed charges,,,0.95,,116.33,Percent of total billed charges,,,0.97,,118.78,Percent of total billed charges,,,0.96,,117.55,Percent of total billed charges,,,0.95,,116.33,Percent of total billed charges,,,,,,,,,0.95,,116.33,Percent of total billed charges,,116.33,120,
MENING ACY&W-135 TETANUS CONJ IM SOLN,RX-193539,CDM,90734,HCPCS,636,RC,,inpatient,0.5,ML,351.58,316.42,,0.95,,334,Percent of total billed charges,,,0.98,,344.55,Percent of total billed charges,,,0.95,,334,Percent of total billed charges,,,0.97,,341.03,Percent of total billed charges,,,0.97,,341.03,Percent of total billed charges,,,0.96,,337.52,Percent of total billed charges,,,0.95,,334,Percent of total billed charges,,,,,,,,,0.95,,334,Percent of total billed charges,,334,344.55,
MENING ACY&W-135 TETANUS CONJ IM SOLN,RX-193539,CDM,90734,HCPCS,636,RC,,outpatient,0.5,ML,351.58,316.42,,0.95,,334,Percent of total billed charges,,,0.98,,344.55,Percent of total billed charges,,,0.95,,334,Percent of total billed charges,,,0.95,,334,Percent of total billed charges,,,0.97,,341.03,Percent of total billed charges,,,0.96,,337.52,Percent of total billed charges,,,0.95,,334,Percent of total billed charges,,,,,,,,,0.95,,334,Percent of total billed charges,,334,344.55,
MORPHINE SULFATE 4 MG/ML IV SOLN,RX-193543,CDM,J2270,HCPCS,636,RC,,inpatient,0.75,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
MORPHINE SULFATE 4 MG/ML IV SOLN,RX-193543,CDM,J2270,HCPCS,636,RC,,outpatient,0.75,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
TETANUS IMMUNE GLOBULIN 250 UNIT/ML IM SOSY,RX-193550,CDM,J1670,HCPCS,636,RC,,inpatient,1,ML,995.7,896.13,,0.95,,945.92,Percent of total billed charges,,,0.98,,975.79,Percent of total billed charges,,,0.95,,945.92,Percent of total billed charges,,,0.97,,965.83,Percent of total billed charges,,,0.97,,965.83,Percent of total billed charges,,,0.96,,955.87,Percent of total billed charges,,,0.95,,945.92,Percent of total billed charges,,,,,,,,,0.95,,945.92,Percent of total billed charges,,945.92,975.79,
TETANUS IMMUNE GLOBULIN 250 UNIT/ML IM SOSY,RX-193550,CDM,J1670,HCPCS,636,RC,,outpatient,1,ML,995.7,896.13,,0.95,,945.92,Percent of total billed charges,,,0.98,,975.79,Percent of total billed charges,,,0.95,,945.92,Percent of total billed charges,,,0.95,,945.92,Percent of total billed charges,,,0.97,,965.83,Percent of total billed charges,,,0.96,,955.87,Percent of total billed charges,,,0.95,,945.92,Percent of total billed charges,,,,,,,,,0.95,,945.92,Percent of total billed charges,,945.92,975.79,
NIVOLUMAB 120 MG/12ML IV SOLN,RX-193715,CDM,J9299,HCPCS,636,RC,,inpatient,12,ML,7927.33,7134.6,,0.95,,7530.96,Percent of total billed charges,,,0.98,,7768.78,Percent of total billed charges,,,0.95,,7530.96,Percent of total billed charges,,,0.97,,7689.51,Percent of total billed charges,,,0.97,,7689.51,Percent of total billed charges,,,0.96,,7610.24,Percent of total billed charges,,,0.95,,7530.96,Percent of total billed charges,,,,,,,,,0.95,,7530.96,Percent of total billed charges,,7530.96,7768.78,
NIVOLUMAB 120 MG/12ML IV SOLN,RX-193715,CDM,J9299,HCPCS,636,RC,,outpatient,12,ML,7927.33,7134.6,,0.95,,7530.96,Percent of total billed charges,,,0.98,,7768.78,Percent of total billed charges,,,0.95,,7530.96,Percent of total billed charges,,,0.95,,7530.96,Percent of total billed charges,,,0.97,,7689.51,Percent of total billed charges,,,0.96,,7610.24,Percent of total billed charges,,,0.95,,7530.96,Percent of total billed charges,,,,,,,,,0.95,,7530.96,Percent of total billed charges,,7530.96,7768.78,
SODIUM THIOSULFATE 250 MG/ML IV SOLN,RX-193867,CDM,J0209,HCPCS,636,RC,,inpatient,1.6,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
SODIUM THIOSULFATE 250 MG/ML IV SOLN,RX-193867,CDM,J0209,HCPCS,636,RC,,outpatient,1.6,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
OLOPATADINE HCL 0.1 % OP SOLN,RX-19452,CDM,J3490,HCPCS,637,RC,,inpatient,1,ML,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
OLOPATADINE HCL 0.1 % OP SOLN,RX-19452,CDM,J3490,HCPCS,637,RC,,outpatient,1,ML,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
BACITRACIN-POLYMYXIN B OP OINT,RX-19584,CDM,J3490,HCPCS,637,RC,,inpatient,3.5,GR,83.51,75.16,,0.95,,79.33,Percent of total billed charges,,,0.98,,81.84,Percent of total billed charges,,,0.95,,79.33,Percent of total billed charges,,,0.97,,81,Percent of total billed charges,,,0.97,,81,Percent of total billed charges,,,0.96,,80.17,Percent of total billed charges,,,0.95,,79.33,Percent of total billed charges,,,,,,,,,0.95,,79.33,Percent of total billed charges,,79.33,81.84,
BACITRACIN-POLYMYXIN B OP OINT,RX-19584,CDM,J3490,HCPCS,637,RC,,outpatient,3.5,GR,83.51,75.16,,0.95,,79.33,Percent of total billed charges,,,0.98,,81.84,Percent of total billed charges,,,0.95,,79.33,Percent of total billed charges,,,0.95,,79.33,Percent of total billed charges,,,0.97,,81,Percent of total billed charges,,,0.96,,80.17,Percent of total billed charges,,,0.95,,79.33,Percent of total billed charges,,,,,,,,,0.95,,79.33,Percent of total billed charges,,79.33,81.84,
CEFAZOLIN SODIUM 2 G INJECTION SOLR,RX-195882,CDM,J0690,HCPCS,636,RC,,inpatient,0.25,GR,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
CEFAZOLIN SODIUM 2 G INJECTION SOLR,RX-195882,CDM,J0690,HCPCS,636,RC,,outpatient,0.25,GR,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
BENZOCAINE (TOPICAL) 20 % EX AERO,RX-19677,CDM,J3490,HCPCS,637,RC,,inpatient,57,GR,24.27,21.84,,0.95,,23.06,Percent of total billed charges,,,0.98,,23.78,Percent of total billed charges,,,0.95,,23.06,Percent of total billed charges,,,0.97,,23.54,Percent of total billed charges,,,0.97,,23.54,Percent of total billed charges,,,0.96,,23.3,Percent of total billed charges,,,0.95,,23.06,Percent of total billed charges,,,,,,,,,0.95,,23.06,Percent of total billed charges,,23.06,23.78,
BENZOCAINE (TOPICAL) 20 % EX AERO,RX-19677,CDM,J3490,HCPCS,637,RC,,outpatient,57,GR,24.27,21.84,,0.95,,23.06,Percent of total billed charges,,,0.98,,23.78,Percent of total billed charges,,,0.95,,23.06,Percent of total billed charges,,,0.95,,23.06,Percent of total billed charges,,,0.97,,23.54,Percent of total billed charges,,,0.96,,23.3,Percent of total billed charges,,,0.95,,23.06,Percent of total billed charges,,,,,,,,,0.95,,23.06,Percent of total billed charges,,23.06,23.78,
BENZOCAINE 20 % MOUTH/THROAT SOLN,RX-19696,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,43.05,38.75,,0.95,,40.9,Percent of total billed charges,,,0.98,,42.19,Percent of total billed charges,,,0.95,,40.9,Percent of total billed charges,,,0.97,,41.76,Percent of total billed charges,,,0.97,,41.76,Percent of total billed charges,,,0.96,,41.33,Percent of total billed charges,,,0.95,,40.9,Percent of total billed charges,,,,,,,,,0.95,,40.9,Percent of total billed charges,,40.9,42.19,
BENZOCAINE 20 % MOUTH/THROAT SOLN,RX-19696,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,43.05,38.75,,0.95,,40.9,Percent of total billed charges,,,0.98,,42.19,Percent of total billed charges,,,0.95,,40.9,Percent of total billed charges,,,0.95,,40.9,Percent of total billed charges,,,0.97,,41.76,Percent of total billed charges,,,0.96,,41.33,Percent of total billed charges,,,0.95,,40.9,Percent of total billed charges,,,,,,,,,0.95,,40.9,Percent of total billed charges,,40.9,42.19,
CARBACHOL 0.01 % INTRAOCULAR SOLN,RX-19704,CDM,J3490,HCPCS,637,RC,,inpatient,1.5,ML,58.05,52.25,,0.95,,55.15,Percent of total billed charges,,,0.98,,56.89,Percent of total billed charges,,,0.95,,55.15,Percent of total billed charges,,,0.97,,56.31,Percent of total billed charges,,,0.97,,56.31,Percent of total billed charges,,,0.96,,55.73,Percent of total billed charges,,,0.95,,55.15,Percent of total billed charges,,,,,,,,,0.95,,55.15,Percent of total billed charges,,55.15,56.89,
CARBACHOL 0.01 % INTRAOCULAR SOLN,RX-19704,CDM,J3490,HCPCS,637,RC,,outpatient,1.5,ML,58.05,52.25,,0.95,,55.15,Percent of total billed charges,,,0.98,,56.89,Percent of total billed charges,,,0.95,,55.15,Percent of total billed charges,,,0.95,,55.15,Percent of total billed charges,,,0.97,,56.31,Percent of total billed charges,,,0.96,,55.73,Percent of total billed charges,,,0.95,,55.15,Percent of total billed charges,,,,,,,,,0.95,,55.15,Percent of total billed charges,,55.15,56.89,
OFLOXACIN 0.3 % OP SOLN,RX-19746,CDM,J3490,HCPCS,250,RC,,inpatient,10,ML,59.1,53.19,,0.95,,56.15,Percent of total billed charges,,,0.98,,57.92,Percent of total billed charges,,,0.95,,56.15,Percent of total billed charges,,,0.97,,57.33,Percent of total billed charges,,,0.97,,57.33,Percent of total billed charges,,,0.96,,56.74,Percent of total billed charges,,,0.95,,56.15,Percent of total billed charges,,,,,,,,,0.95,,56.15,Percent of total billed charges,,56.15,57.92,
OFLOXACIN 0.3 % OP SOLN,RX-19746,CDM,J3490,HCPCS,250,RC,,outpatient,10,ML,59.1,53.19,,0.95,,56.15,Percent of total billed charges,,,0.98,,57.92,Percent of total billed charges,,,0.95,,56.15,Percent of total billed charges,,,0.95,,56.15,Percent of total billed charges,,,0.97,,57.33,Percent of total billed charges,,,0.96,,56.74,Percent of total billed charges,,,0.95,,56.15,Percent of total billed charges,,,,,,,,,0.95,,56.15,Percent of total billed charges,,56.15,57.92,
SODIUM CHLORIDE 0.9 % EX SOLN,RX-19758,CDM,J3490,HCPCS,250,RC,,inpatient,30,ML,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
SODIUM CHLORIDE 0.9 % EX SOLN,RX-19758,CDM,J3490,HCPCS,250,RC,,outpatient,30,ML,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
CYANOCOBALAMIN 1000 MCG/ML INJECTION SOLN,RX-2007,CDM,J3420,HCPCS,636,RC,,inpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
CYANOCOBALAMIN 1000 MCG/ML INJECTION SOLN,RX-2007,CDM,J3420,HCPCS,636,RC,,outpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
CYANOCOBALAMIN 1000 MCG PO TABS,RX-2009,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,5.84,5.26,,0.95,,5.55,Percent of total billed charges,,,0.98,,5.72,Percent of total billed charges,,,0.95,,5.55,Percent of total billed charges,,,0.97,,5.66,Percent of total billed charges,,,0.97,,5.66,Percent of total billed charges,,,0.96,,5.61,Percent of total billed charges,,,0.95,,5.55,Percent of total billed charges,,,,,,,,,0.95,,5.55,Percent of total billed charges,,5.55,5.72,
CYANOCOBALAMIN 1000 MCG PO TABS,RX-2009,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,5.84,5.26,,0.95,,5.55,Percent of total billed charges,,,0.98,,5.72,Percent of total billed charges,,,0.95,,5.55,Percent of total billed charges,,,0.95,,5.55,Percent of total billed charges,,,0.97,,5.66,Percent of total billed charges,,,0.96,,5.61,Percent of total billed charges,,,0.95,,5.55,Percent of total billed charges,,,,,,,,,0.95,,5.55,Percent of total billed charges,,5.55,5.72,
CYCLOBENZAPRINE HCL 10 MG PO TABS,RX-2017,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.6,5.94,,0.95,,6.27,Percent of total billed charges,,,0.98,,6.47,Percent of total billed charges,,,0.95,,6.27,Percent of total billed charges,,,0.97,,6.4,Percent of total billed charges,,,0.97,,6.4,Percent of total billed charges,,,0.96,,6.34,Percent of total billed charges,,,0.95,,6.27,Percent of total billed charges,,,,,,,,,0.95,,6.27,Percent of total billed charges,,6.27,6.47,
CYCLOBENZAPRINE HCL 10 MG PO TABS,RX-2017,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.6,5.94,,0.95,,6.27,Percent of total billed charges,,,0.98,,6.47,Percent of total billed charges,,,0.95,,6.27,Percent of total billed charges,,,0.95,,6.27,Percent of total billed charges,,,0.97,,6.4,Percent of total billed charges,,,0.96,,6.34,Percent of total billed charges,,,0.95,,6.27,Percent of total billed charges,,,,,,,,,0.95,,6.27,Percent of total billed charges,,6.27,6.47,
CYCLOPENTOLATE HCL 1 % OP SOLN,RX-2025,CDM,J3490,HCPCS,250,RC,,inpatient,2,ML,115.32,103.79,,0.95,,109.55,Percent of total billed charges,,,0.98,,113.01,Percent of total billed charges,,,0.95,,109.55,Percent of total billed charges,,,0.97,,111.86,Percent of total billed charges,,,0.97,,111.86,Percent of total billed charges,,,0.96,,110.71,Percent of total billed charges,,,0.95,,109.55,Percent of total billed charges,,,,,,,,,0.95,,109.55,Percent of total billed charges,,109.55,113.01,
CYCLOPENTOLATE HCL 1 % OP SOLN,RX-2025,CDM,J3490,HCPCS,250,RC,,outpatient,2,ML,115.32,103.79,,0.95,,109.55,Percent of total billed charges,,,0.98,,113.01,Percent of total billed charges,,,0.95,,109.55,Percent of total billed charges,,,0.95,,109.55,Percent of total billed charges,,,0.97,,111.86,Percent of total billed charges,,,0.96,,110.71,Percent of total billed charges,,,0.95,,109.55,Percent of total billed charges,,,,,,,,,0.95,,109.55,Percent of total billed charges,,109.55,113.01,
ETOMIDATE 2 MG/ML IV SOLN,RX-20472,CDM,J7999,HCPCS,250,RC,,inpatient,5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
ETOMIDATE 2 MG/ML IV SOLN,RX-20472,CDM,J7999,HCPCS,250,RC,,outpatient,5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
ACTIDOSE WITH SORBITOL 50 GM/240ML PO SUSP,RX-20589,CDM,J3490,HCPCS,637,RC,,inpatient,120,ML,40.05,36.05,,0.95,,38.05,Percent of total billed charges,,,0.98,,39.25,Percent of total billed charges,,,0.95,,38.05,Percent of total billed charges,,,0.97,,38.85,Percent of total billed charges,,,0.97,,38.85,Percent of total billed charges,,,0.96,,38.45,Percent of total billed charges,,,0.95,,38.05,Percent of total billed charges,,,,,,,,,0.95,,38.05,Percent of total billed charges,,38.05,39.25,
ACTIDOSE WITH SORBITOL 50 GM/240ML PO SUSP,RX-20589,CDM,J3490,HCPCS,637,RC,,outpatient,120,ML,40.05,36.05,,0.95,,38.05,Percent of total billed charges,,,0.98,,39.25,Percent of total billed charges,,,0.95,,38.05,Percent of total billed charges,,,0.95,,38.05,Percent of total billed charges,,,0.97,,38.85,Percent of total billed charges,,,0.96,,38.45,Percent of total billed charges,,,0.95,,38.05,Percent of total billed charges,,,,,,,,,0.95,,38.05,Percent of total billed charges,,38.05,39.25,
VALPROATE SODIUM 100 MG/ML IV SOLN,RX-20887,CDM,J3490,HCPCS,636,RC,,inpatient,5,ML,28.77,25.89,,0.95,,27.33,Percent of total billed charges,,,0.98,,28.19,Percent of total billed charges,,,0.95,,27.33,Percent of total billed charges,,,0.97,,27.91,Percent of total billed charges,,,0.97,,27.91,Percent of total billed charges,,,0.96,,27.62,Percent of total billed charges,,,0.95,,27.33,Percent of total billed charges,,,,,,,,,0.95,,27.33,Percent of total billed charges,,27.33,28.19,
VALPROATE SODIUM 100 MG/ML IV SOLN,RX-20887,CDM,J3490,HCPCS,636,RC,,outpatient,5,ML,28.77,25.89,,0.95,,27.33,Percent of total billed charges,,,0.98,,28.19,Percent of total billed charges,,,0.95,,27.33,Percent of total billed charges,,,0.95,,27.33,Percent of total billed charges,,,0.97,,27.91,Percent of total billed charges,,,0.96,,27.62,Percent of total billed charges,,,0.95,,27.33,Percent of total billed charges,,,,,,,,,0.95,,27.33,Percent of total billed charges,,27.33,28.19,
LEUPROLIDE ACETATE (3 MONTH) 11.25 MG IM KIT,RX-21044,CDM,J1950,HCPCS,636,RC,,inpatient,11.25,ME,6922.29,6230.06,,0.95,,6576.18,Percent of total billed charges,,,0.98,,6783.84,Percent of total billed charges,,,0.95,,6576.18,Percent of total billed charges,,,0.97,,6714.62,Percent of total billed charges,,,0.97,,6714.62,Percent of total billed charges,,,0.96,,6645.4,Percent of total billed charges,,,0.95,,6576.18,Percent of total billed charges,,,,,,,,,0.95,,6576.18,Percent of total billed charges,,6576.18,6783.84,
LEUPROLIDE ACETATE (3 MONTH) 11.25 MG IM KIT,RX-21044,CDM,J1950,HCPCS,636,RC,,outpatient,11.25,ME,6922.29,6230.06,,0.95,,6576.18,Percent of total billed charges,,,0.98,,6783.84,Percent of total billed charges,,,0.95,,6576.18,Percent of total billed charges,,,0.95,,6576.18,Percent of total billed charges,,,0.97,,6714.62,Percent of total billed charges,,,0.96,,6645.4,Percent of total billed charges,,,0.95,,6576.18,Percent of total billed charges,,,,,,,,,0.95,,6576.18,Percent of total billed charges,,6576.18,6783.84,
CITALOPRAM HYDROBROMIDE 20 MG PO TABS,RX-21062,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,5.99,5.39,,0.95,,5.69,Percent of total billed charges,,,0.98,,5.87,Percent of total billed charges,,,0.95,,5.69,Percent of total billed charges,,,0.97,,5.81,Percent of total billed charges,,,0.97,,5.81,Percent of total billed charges,,,0.96,,5.75,Percent of total billed charges,,,0.95,,5.69,Percent of total billed charges,,,,,,,,,0.95,,5.69,Percent of total billed charges,,5.69,5.87,
CITALOPRAM HYDROBROMIDE 20 MG PO TABS,RX-21062,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,5.99,5.39,,0.95,,5.69,Percent of total billed charges,,,0.98,,5.87,Percent of total billed charges,,,0.95,,5.69,Percent of total billed charges,,,0.95,,5.69,Percent of total billed charges,,,0.97,,5.81,Percent of total billed charges,,,0.96,,5.75,Percent of total billed charges,,,0.95,,5.69,Percent of total billed charges,,,,,,,,,0.95,,5.69,Percent of total billed charges,,5.69,5.87,
METHYLPREDNISOLONE NA SUC (PF) 40 MG INJECTION SOLR,RX-210752,CDM,J2919,HCPCS,636,RC,,inpatient,0.5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
METHYLPREDNISOLONE NA SUC (PF) 40 MG INJECTION SOLR,RX-210752,CDM,J2919,HCPCS,636,RC,,outpatient,0.5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
METHYLPREDNISOLONE NA SUC (PF) 125 MG INJECTION SOLR,RX-210753,CDM,J2919,HCPCS,636,RC,,inpatient,0.96,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
METHYLPREDNISOLONE NA SUC (PF) 125 MG INJECTION SOLR,RX-210753,CDM,J2919,HCPCS,636,RC,,outpatient,0.96,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
PRAMIPEXOLE DIHYDROCHLORIDE 0.25 MG PO TABS,RX-21290,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
PRAMIPEXOLE DIHYDROCHLORIDE 0.25 MG PO TABS,RX-21290,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
PENTOXIFYLLINE ER 400 MG PO TBCR,RX-21300,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.73,6.06,,0.95,,6.39,Percent of total billed charges,,,0.98,,6.6,Percent of total billed charges,,,0.95,,6.39,Percent of total billed charges,,,0.97,,6.53,Percent of total billed charges,,,0.97,,6.53,Percent of total billed charges,,,0.96,,6.46,Percent of total billed charges,,,0.95,,6.39,Percent of total billed charges,,,,,,,,,0.95,,6.39,Percent of total billed charges,,6.39,6.6,
PENTOXIFYLLINE ER 400 MG PO TBCR,RX-21300,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.73,6.06,,0.95,,6.39,Percent of total billed charges,,,0.98,,6.6,Percent of total billed charges,,,0.95,,6.39,Percent of total billed charges,,,0.95,,6.39,Percent of total billed charges,,,0.97,,6.53,Percent of total billed charges,,,0.96,,6.46,Percent of total billed charges,,,0.95,,6.39,Percent of total billed charges,,,,,,,,,0.95,,6.39,Percent of total billed charges,,6.39,6.6,
BCG LIVE 50 MG INTRAVESICAL SUSR,RX-21570,CDM,J9030,HCPCS,636,RC,,inpatient,1,ML,614.46,553.01,,0.95,,583.74,Percent of total billed charges,,,0.98,,602.17,Percent of total billed charges,,,0.95,,583.74,Percent of total billed charges,,,0.97,,596.03,Percent of total billed charges,,,0.97,,596.03,Percent of total billed charges,,,0.96,,589.88,Percent of total billed charges,,,0.95,,583.74,Percent of total billed charges,,,,,,,,,0.95,,583.74,Percent of total billed charges,,583.74,602.17,
BCG LIVE 50 MG INTRAVESICAL SUSR,RX-21570,CDM,J9030,HCPCS,636,RC,,outpatient,1,ML,614.46,553.01,,0.95,,583.74,Percent of total billed charges,,,0.98,,602.17,Percent of total billed charges,,,0.95,,583.74,Percent of total billed charges,,,0.95,,583.74,Percent of total billed charges,,,0.97,,596.03,Percent of total billed charges,,,0.96,,589.88,Percent of total billed charges,,,0.95,,583.74,Percent of total billed charges,,,,,,,,,0.95,,583.74,Percent of total billed charges,,583.74,602.17,
ROPINIROLE HCL 0.25 MG PO TABS,RX-21688,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.57,6.81,,0.95,,7.19,Percent of total billed charges,,,0.98,,7.42,Percent of total billed charges,,,0.95,,7.19,Percent of total billed charges,,,0.97,,7.34,Percent of total billed charges,,,0.97,,7.34,Percent of total billed charges,,,0.96,,7.27,Percent of total billed charges,,,0.95,,7.19,Percent of total billed charges,,,,,,,,,0.95,,7.19,Percent of total billed charges,,7.19,7.42,
ROPINIROLE HCL 0.25 MG PO TABS,RX-21688,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.57,6.81,,0.95,,7.19,Percent of total billed charges,,,0.98,,7.42,Percent of total billed charges,,,0.95,,7.19,Percent of total billed charges,,,0.95,,7.19,Percent of total billed charges,,,0.97,,7.34,Percent of total billed charges,,,0.96,,7.27,Percent of total billed charges,,,0.95,,7.19,Percent of total billed charges,,,,,,,,,0.95,,7.19,Percent of total billed charges,,7.19,7.42,
ROPINIROLE HCL 1 MG PO TABS,RX-21689,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.95,7.16,,0.95,,7.55,Percent of total billed charges,,,0.98,,7.79,Percent of total billed charges,,,0.95,,7.55,Percent of total billed charges,,,0.97,,7.71,Percent of total billed charges,,,0.97,,7.71,Percent of total billed charges,,,0.96,,7.63,Percent of total billed charges,,,0.95,,7.55,Percent of total billed charges,,,,,,,,,0.95,,7.55,Percent of total billed charges,,7.55,7.79,
ROPINIROLE HCL 1 MG PO TABS,RX-21689,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.95,7.16,,0.95,,7.55,Percent of total billed charges,,,0.98,,7.79,Percent of total billed charges,,,0.95,,7.55,Percent of total billed charges,,,0.95,,7.55,Percent of total billed charges,,,0.97,,7.71,Percent of total billed charges,,,0.96,,7.63,Percent of total billed charges,,,0.95,,7.55,Percent of total billed charges,,,,,,,,,0.95,,7.55,Percent of total billed charges,,7.55,7.79,
ICY HOT BALM EXTRA STRENGTH 7.6-29 % EX OINT,RX-21692,CDM,J3490,HCPCS,637,RC,,inpatient,100,GR,45.52,40.97,,0.95,,43.24,Percent of total billed charges,,,0.98,,44.61,Percent of total billed charges,,,0.95,,43.24,Percent of total billed charges,,,0.97,,44.15,Percent of total billed charges,,,0.97,,44.15,Percent of total billed charges,,,0.96,,43.7,Percent of total billed charges,,,0.95,,43.24,Percent of total billed charges,,,,,,,,,0.95,,43.24,Percent of total billed charges,,43.24,44.61,
ICY HOT BALM EXTRA STRENGTH 7.6-29 % EX OINT,RX-21692,CDM,J3490,HCPCS,637,RC,,outpatient,100,GR,45.52,40.97,,0.95,,43.24,Percent of total billed charges,,,0.98,,44.61,Percent of total billed charges,,,0.95,,43.24,Percent of total billed charges,,,0.95,,43.24,Percent of total billed charges,,,0.97,,44.15,Percent of total billed charges,,,0.96,,43.7,Percent of total billed charges,,,0.95,,43.24,Percent of total billed charges,,,,,,,,,0.95,,43.24,Percent of total billed charges,,43.24,44.61,
QUETIAPINE FUMARATE 25 MG PO TABS,RX-21823,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.54,5.89,,0.95,,6.21,Percent of total billed charges,,,0.98,,6.41,Percent of total billed charges,,,0.95,,6.21,Percent of total billed charges,,,0.97,,6.34,Percent of total billed charges,,,0.97,,6.34,Percent of total billed charges,,,0.96,,6.28,Percent of total billed charges,,,0.95,,6.21,Percent of total billed charges,,,,,,,,,0.95,,6.21,Percent of total billed charges,,6.21,6.41,
QUETIAPINE FUMARATE 25 MG PO TABS,RX-21823,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.54,5.89,,0.95,,6.21,Percent of total billed charges,,,0.98,,6.41,Percent of total billed charges,,,0.95,,6.21,Percent of total billed charges,,,0.95,,6.21,Percent of total billed charges,,,0.97,,6.34,Percent of total billed charges,,,0.96,,6.28,Percent of total billed charges,,,0.95,,6.21,Percent of total billed charges,,,,,,,,,0.95,,6.21,Percent of total billed charges,,6.21,6.41,
QUETIAPINE FUMARATE 100 MG PO TABS,RX-21824,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.75,6.08,,0.95,,6.41,Percent of total billed charges,,,0.98,,6.62,Percent of total billed charges,,,0.95,,6.41,Percent of total billed charges,,,0.97,,6.55,Percent of total billed charges,,,0.97,,6.55,Percent of total billed charges,,,0.96,,6.48,Percent of total billed charges,,,0.95,,6.41,Percent of total billed charges,,,,,,,,,0.95,,6.41,Percent of total billed charges,,6.41,6.62,
QUETIAPINE FUMARATE 100 MG PO TABS,RX-21824,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.75,6.08,,0.95,,6.41,Percent of total billed charges,,,0.98,,6.62,Percent of total billed charges,,,0.95,,6.41,Percent of total billed charges,,,0.95,,6.41,Percent of total billed charges,,,0.97,,6.55,Percent of total billed charges,,,0.96,,6.48,Percent of total billed charges,,,0.95,,6.41,Percent of total billed charges,,,,,,,,,0.95,,6.41,Percent of total billed charges,,6.41,6.62,
CLOPIDOGREL BISULFATE 75 MG PO TABS,RX-22142,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.64,5.98,,0.95,,6.31,Percent of total billed charges,,,0.98,,6.51,Percent of total billed charges,,,0.95,,6.31,Percent of total billed charges,,,0.97,,6.44,Percent of total billed charges,,,0.97,,6.44,Percent of total billed charges,,,0.96,,6.37,Percent of total billed charges,,,0.95,,6.31,Percent of total billed charges,,,,,,,,,0.95,,6.31,Percent of total billed charges,,6.31,6.51,
CLOPIDOGREL BISULFATE 75 MG PO TABS,RX-22142,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.64,5.98,,0.95,,6.31,Percent of total billed charges,,,0.98,,6.51,Percent of total billed charges,,,0.95,,6.31,Percent of total billed charges,,,0.95,,6.31,Percent of total billed charges,,,0.97,,6.44,Percent of total billed charges,,,0.96,,6.37,Percent of total billed charges,,,0.95,,6.31,Percent of total billed charges,,,,,,,,,0.95,,6.31,Percent of total billed charges,,6.31,6.51,
NICOTINE 10 MG INHAL INHA,RX-22150,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,169.95,152.96,,0.95,,161.45,Percent of total billed charges,,,0.98,,166.55,Percent of total billed charges,,,0.95,,161.45,Percent of total billed charges,,,0.97,,164.85,Percent of total billed charges,,,0.97,,164.85,Percent of total billed charges,,,0.96,,163.15,Percent of total billed charges,,,0.95,,161.45,Percent of total billed charges,,,,,,,,,0.95,,161.45,Percent of total billed charges,,161.45,166.55,
NICOTINE 10 MG INHAL INHA,RX-22150,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,169.95,152.96,,0.95,,161.45,Percent of total billed charges,,,0.98,,166.55,Percent of total billed charges,,,0.95,,161.45,Percent of total billed charges,,,0.95,,161.45,Percent of total billed charges,,,0.97,,164.85,Percent of total billed charges,,,0.96,,163.15,Percent of total billed charges,,,0.95,,161.45,Percent of total billed charges,,,,,,,,,0.95,,161.45,Percent of total billed charges,,161.45,166.55,
FOMEPIZOLE 1 GM/ML IV SOLN,RX-22185,CDM,J1451,HCPCS,636,RC,,inpatient,1.5,ML,1049.1,944.19,,0.95,,996.65,Percent of total billed charges,,,0.98,,1028.12,Percent of total billed charges,,,0.95,,996.65,Percent of total billed charges,,,0.97,,1017.63,Percent of total billed charges,,,0.97,,1017.63,Percent of total billed charges,,,0.96,,1007.14,Percent of total billed charges,,,0.95,,996.65,Percent of total billed charges,,,,,,,,,0.95,,996.65,Percent of total billed charges,,996.65,1028.12,
FOMEPIZOLE 1 GM/ML IV SOLN,RX-22185,CDM,J1451,HCPCS,636,RC,,outpatient,1.5,ML,1049.1,944.19,,0.95,,996.65,Percent of total billed charges,,,0.98,,1028.12,Percent of total billed charges,,,0.95,,996.65,Percent of total billed charges,,,0.95,,996.65,Percent of total billed charges,,,0.97,,1017.63,Percent of total billed charges,,,0.96,,1007.14,Percent of total billed charges,,,0.95,,996.65,Percent of total billed charges,,,,,,,,,0.95,,996.65,Percent of total billed charges,,996.65,1028.12,
MUPIROCIN CALCIUM 2 % EX CREA,RX-22251,CDM,J3490,HCPCS,637,RC,,inpatient,15,GR,606.57,545.91,,0.95,,576.24,Percent of total billed charges,,,0.98,,594.44,Percent of total billed charges,,,0.95,,576.24,Percent of total billed charges,,,0.97,,588.37,Percent of total billed charges,,,0.97,,588.37,Percent of total billed charges,,,0.96,,582.31,Percent of total billed charges,,,0.95,,576.24,Percent of total billed charges,,,,,,,,,0.95,,576.24,Percent of total billed charges,,576.24,594.44,
MUPIROCIN CALCIUM 2 % EX CREA,RX-22251,CDM,J3490,HCPCS,637,RC,,outpatient,15,GR,606.57,545.91,,0.95,,576.24,Percent of total billed charges,,,0.98,,594.44,Percent of total billed charges,,,0.95,,576.24,Percent of total billed charges,,,0.95,,576.24,Percent of total billed charges,,,0.97,,588.37,Percent of total billed charges,,,0.96,,582.31,Percent of total billed charges,,,0.95,,576.24,Percent of total billed charges,,,,,,,,,0.95,,576.24,Percent of total billed charges,,576.24,594.44,
CEFDINIR 300 MG PO CAPS,RX-22289,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,15.14,13.63,,0.95,,14.38,Percent of total billed charges,,,0.98,,14.84,Percent of total billed charges,,,0.95,,14.38,Percent of total billed charges,,,0.97,,14.69,Percent of total billed charges,,,0.97,,14.69,Percent of total billed charges,,,0.96,,14.53,Percent of total billed charges,,,0.95,,14.38,Percent of total billed charges,,,,,,,,,0.95,,14.38,Percent of total billed charges,,14.38,14.84,
CEFDINIR 300 MG PO CAPS,RX-22289,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,15.14,13.63,,0.95,,14.38,Percent of total billed charges,,,0.98,,14.84,Percent of total billed charges,,,0.95,,14.38,Percent of total billed charges,,,0.95,,14.38,Percent of total billed charges,,,0.97,,14.69,Percent of total billed charges,,,0.96,,14.53,Percent of total billed charges,,,0.95,,14.38,Percent of total billed charges,,,,,,,,,0.95,,14.38,Percent of total billed charges,,14.38,14.84,
CEFDINIR 125 MG/5ML PO SUSR,RX-22290,CDM,J3490,HCPCS,637,RC,,inpatient,12,ML,9.32,8.39,,0.95,,8.85,Percent of total billed charges,,,0.98,,9.13,Percent of total billed charges,,,0.95,,8.85,Percent of total billed charges,,,0.97,,9.04,Percent of total billed charges,,,0.97,,9.04,Percent of total billed charges,,,0.96,,8.95,Percent of total billed charges,,,0.95,,8.85,Percent of total billed charges,,,,,,,,,0.95,,8.85,Percent of total billed charges,,8.85,9.13,
CEFDINIR 125 MG/5ML PO SUSR,RX-22290,CDM,J3490,HCPCS,637,RC,,outpatient,12,ML,9.32,8.39,,0.95,,8.85,Percent of total billed charges,,,0.98,,9.13,Percent of total billed charges,,,0.95,,8.85,Percent of total billed charges,,,0.95,,8.85,Percent of total billed charges,,,0.97,,9.04,Percent of total billed charges,,,0.96,,8.95,Percent of total billed charges,,,0.95,,8.85,Percent of total billed charges,,,,,,,,,0.95,,8.85,Percent of total billed charges,,8.85,9.13,
KETOROLAC TROMETHAMINE 15 MG/ML INJECTION SOLN,RX-22472,CDM,J1885,HCPCS,636,RC,,inpatient,1,ML,39.14,35.23,,0.95,,37.18,Percent of total billed charges,,,0.98,,38.36,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,0.97,,37.97,Percent of total billed charges,,,0.97,,37.97,Percent of total billed charges,,,0.96,,37.57,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,,,,,,,0.95,,37.18,Percent of total billed charges,,37.18,38.36,
KETOROLAC TROMETHAMINE 15 MG/ML INJECTION SOLN,RX-22472,CDM,J1885,HCPCS,636,RC,,outpatient,1,ML,39.14,35.23,,0.95,,37.18,Percent of total billed charges,,,0.98,,38.36,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,0.97,,37.97,Percent of total billed charges,,,0.96,,37.57,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,,,,,,,0.95,,37.18,Percent of total billed charges,,37.18,38.36,
MONTELUKAST SODIUM 10 MG PO TABS,RX-22509,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.07,6.36,,0.95,,6.72,Percent of total billed charges,,,0.98,,6.93,Percent of total billed charges,,,0.95,,6.72,Percent of total billed charges,,,0.97,,6.86,Percent of total billed charges,,,0.97,,6.86,Percent of total billed charges,,,0.96,,6.79,Percent of total billed charges,,,0.95,,6.72,Percent of total billed charges,,,,,,,,,0.95,,6.72,Percent of total billed charges,,6.72,6.93,
MONTELUKAST SODIUM 10 MG PO TABS,RX-22509,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.07,6.36,,0.95,,6.72,Percent of total billed charges,,,0.98,,6.93,Percent of total billed charges,,,0.95,,6.72,Percent of total billed charges,,,0.95,,6.72,Percent of total billed charges,,,0.97,,6.86,Percent of total billed charges,,,0.96,,6.79,Percent of total billed charges,,,0.95,,6.72,Percent of total billed charges,,,,,,,,,0.95,,6.72,Percent of total billed charges,,6.72,6.93,
SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5ML PO SUSP,RX-22560,CDM,J3490,HCPCS,637,RC,,inpatient,10,ML,15.17,13.65,,0.95,,14.41,Percent of total billed charges,,,0.98,,14.87,Percent of total billed charges,,,0.95,,14.41,Percent of total billed charges,,,0.97,,14.71,Percent of total billed charges,,,0.97,,14.71,Percent of total billed charges,,,0.96,,14.56,Percent of total billed charges,,,0.95,,14.41,Percent of total billed charges,,,,,,,,,0.95,,14.41,Percent of total billed charges,,14.41,14.87,
SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5ML PO SUSP,RX-22560,CDM,J3490,HCPCS,637,RC,,outpatient,10,ML,15.17,13.65,,0.95,,14.41,Percent of total billed charges,,,0.98,,14.87,Percent of total billed charges,,,0.95,,14.41,Percent of total billed charges,,,0.95,,14.41,Percent of total billed charges,,,0.97,,14.71,Percent of total billed charges,,,0.96,,14.56,Percent of total billed charges,,,0.95,,14.41,Percent of total billed charges,,,,,,,,,0.95,,14.41,Percent of total billed charges,,14.41,14.87,
CIPROFLOXACIN 250 MG/5ML (5%) PO SUSR,RX-22987,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,27.72,24.95,,0.95,,26.33,Percent of total billed charges,,,0.98,,27.17,Percent of total billed charges,,,0.95,,26.33,Percent of total billed charges,,,0.97,,26.89,Percent of total billed charges,,,0.97,,26.89,Percent of total billed charges,,,0.96,,26.61,Percent of total billed charges,,,0.95,,26.33,Percent of total billed charges,,,,,,,,,0.95,,26.33,Percent of total billed charges,,26.33,27.17,
CIPROFLOXACIN 250 MG/5ML (5%) PO SUSR,RX-22987,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,27.72,24.95,,0.95,,26.33,Percent of total billed charges,,,0.98,,27.17,Percent of total billed charges,,,0.95,,26.33,Percent of total billed charges,,,0.95,,26.33,Percent of total billed charges,,,0.97,,26.89,Percent of total billed charges,,,0.96,,26.61,Percent of total billed charges,,,0.95,,26.33,Percent of total billed charges,,,,,,,,,0.95,,26.33,Percent of total billed charges,,26.33,27.17,
AMOXICILLIN-POT CLAVULANATE 250-125 MG PO TABS,RX-22992,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,19.37,17.43,,0.95,,18.4,Percent of total billed charges,,,0.98,,18.98,Percent of total billed charges,,,0.95,,18.4,Percent of total billed charges,,,0.97,,18.79,Percent of total billed charges,,,0.97,,18.79,Percent of total billed charges,,,0.96,,18.6,Percent of total billed charges,,,0.95,,18.4,Percent of total billed charges,,,,,,,,,0.95,,18.4,Percent of total billed charges,,18.4,18.98,
AMOXICILLIN-POT CLAVULANATE 250-125 MG PO TABS,RX-22992,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,19.37,17.43,,0.95,,18.4,Percent of total billed charges,,,0.98,,18.98,Percent of total billed charges,,,0.95,,18.4,Percent of total billed charges,,,0.95,,18.4,Percent of total billed charges,,,0.97,,18.79,Percent of total billed charges,,,0.96,,18.6,Percent of total billed charges,,,0.95,,18.4,Percent of total billed charges,,,,,,,,,0.95,,18.4,Percent of total billed charges,,18.4,18.98,
EPTIFIBATIDE 75 MG/100ML IV SOLN,RX-23123,CDM,J1327,HCPCS,636,RC,,inpatient,100,ML,248.03,223.23,,0.95,,235.63,Percent of total billed charges,,,0.98,,243.07,Percent of total billed charges,,,0.95,,235.63,Percent of total billed charges,,,0.97,,240.59,Percent of total billed charges,,,0.97,,240.59,Percent of total billed charges,,,0.96,,238.11,Percent of total billed charges,,,0.95,,235.63,Percent of total billed charges,,,,,,,,,0.95,,235.63,Percent of total billed charges,,235.63,243.07,
EPTIFIBATIDE 75 MG/100ML IV SOLN,RX-23123,CDM,J1327,HCPCS,636,RC,,outpatient,100,ML,248.03,223.23,,0.95,,235.63,Percent of total billed charges,,,0.98,,243.07,Percent of total billed charges,,,0.95,,235.63,Percent of total billed charges,,,0.95,,235.63,Percent of total billed charges,,,0.97,,240.59,Percent of total billed charges,,,0.96,,238.11,Percent of total billed charges,,,0.95,,235.63,Percent of total billed charges,,,,,,,,,0.95,,235.63,Percent of total billed charges,,235.63,243.07,
ACYCLOVIR SODIUM 50 MG/ML IV SOLN,RX-23128,CDM,J0133,HCPCS,636,RC,,inpatient,10,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
ACYCLOVIR SODIUM 50 MG/ML IV SOLN,RX-23128,CDM,J0133,HCPCS,636,RC,,outpatient,10,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
CLINIMIX E/DEXTROSE (4.25/5) 4.25 % IV SOLN,RX-23162,CDM,J3490,HCPCS,250,RC,,inpatient,2000,ML,260.59,234.53,,0.95,,247.56,Percent of total billed charges,,,0.98,,255.38,Percent of total billed charges,,,0.95,,247.56,Percent of total billed charges,,,0.97,,252.77,Percent of total billed charges,,,0.97,,252.77,Percent of total billed charges,,,0.96,,250.17,Percent of total billed charges,,,0.95,,247.56,Percent of total billed charges,,,,,,,,,0.95,,247.56,Percent of total billed charges,,247.56,255.38,
CLINIMIX E/DEXTROSE (4.25/5) 4.25 % IV SOLN,RX-23162,CDM,J3490,HCPCS,250,RC,,outpatient,2000,ML,260.59,234.53,,0.95,,247.56,Percent of total billed charges,,,0.98,,255.38,Percent of total billed charges,,,0.95,,247.56,Percent of total billed charges,,,0.95,,247.56,Percent of total billed charges,,,0.97,,252.77,Percent of total billed charges,,,0.96,,250.17,Percent of total billed charges,,,0.95,,247.56,Percent of total billed charges,,,,,,,,,0.95,,247.56,Percent of total billed charges,,247.56,255.38,
CLINIMIX E/DEXTROSE (4.25/10) 4.25 % IV SOLN,RX-23163,CDM,J3490,HCPCS,250,RC,,inpatient,2000,ML,253.38,228.04,,0.95,,240.71,Percent of total billed charges,,,0.98,,248.31,Percent of total billed charges,,,0.95,,240.71,Percent of total billed charges,,,0.97,,245.78,Percent of total billed charges,,,0.97,,245.78,Percent of total billed charges,,,0.96,,243.24,Percent of total billed charges,,,0.95,,240.71,Percent of total billed charges,,,,,,,,,0.95,,240.71,Percent of total billed charges,,240.71,248.31,
CLINIMIX E/DEXTROSE (4.25/10) 4.25 % IV SOLN,RX-23163,CDM,J3490,HCPCS,250,RC,,outpatient,2000,ML,253.38,228.04,,0.95,,240.71,Percent of total billed charges,,,0.98,,248.31,Percent of total billed charges,,,0.95,,240.71,Percent of total billed charges,,,0.95,,240.71,Percent of total billed charges,,,0.97,,245.78,Percent of total billed charges,,,0.96,,243.24,Percent of total billed charges,,,0.95,,240.71,Percent of total billed charges,,,,,,,,,0.95,,240.71,Percent of total billed charges,,240.71,248.31,
CLINIMIX E/DEXTROSE (5/15) 5 % IV SOLN,RX-23165,CDM,J3490,HCPCS,250,RC,,inpatient,2000,ML,296.64,266.98,,0.95,,281.81,Percent of total billed charges,,,0.98,,290.71,Percent of total billed charges,,,0.95,,281.81,Percent of total billed charges,,,0.97,,287.74,Percent of total billed charges,,,0.97,,287.74,Percent of total billed charges,,,0.96,,284.77,Percent of total billed charges,,,0.95,,281.81,Percent of total billed charges,,,,,,,,,0.95,,281.81,Percent of total billed charges,,281.81,290.71,
CLINIMIX E/DEXTROSE (5/15) 5 % IV SOLN,RX-23165,CDM,J3490,HCPCS,250,RC,,outpatient,2000,ML,296.64,266.98,,0.95,,281.81,Percent of total billed charges,,,0.98,,290.71,Percent of total billed charges,,,0.95,,281.81,Percent of total billed charges,,,0.95,,281.81,Percent of total billed charges,,,0.97,,287.74,Percent of total billed charges,,,0.96,,284.77,Percent of total billed charges,,,0.95,,281.81,Percent of total billed charges,,,,,,,,,0.95,,281.81,Percent of total billed charges,,281.81,290.71,
DEXAMETHASONE 0.5 MG PO TABS,RX-2322,CDM,J8540,HCPCS,636,RC,,inpatient,2,UN,13.14,11.83,,0.95,,12.48,Percent of total billed charges,,,0.98,,12.88,Percent of total billed charges,,,0.95,,12.48,Percent of total billed charges,,,0.97,,12.75,Percent of total billed charges,,,0.97,,12.75,Percent of total billed charges,,,0.96,,12.61,Percent of total billed charges,,,0.95,,12.48,Percent of total billed charges,,,,,,,,,0.95,,12.48,Percent of total billed charges,,12.48,12.88,
DEXAMETHASONE 0.5 MG PO TABS,RX-2322,CDM,J8540,HCPCS,636,RC,,outpatient,2,UN,13.14,11.83,,0.95,,12.48,Percent of total billed charges,,,0.98,,12.88,Percent of total billed charges,,,0.95,,12.48,Percent of total billed charges,,,0.95,,12.48,Percent of total billed charges,,,0.97,,12.75,Percent of total billed charges,,,0.96,,12.61,Percent of total billed charges,,,0.95,,12.48,Percent of total billed charges,,,,,,,,,0.95,,12.48,Percent of total billed charges,,12.48,12.88,
DEXAMETHASONE 4 MG PO TABS,RX-2327,CDM,J8540,HCPCS,636,RC,,inpatient,1,UN,11.12,10.01,,0.95,,10.56,Percent of total billed charges,,,0.98,,10.9,Percent of total billed charges,,,0.95,,10.56,Percent of total billed charges,,,0.97,,10.79,Percent of total billed charges,,,0.97,,10.79,Percent of total billed charges,,,0.96,,10.68,Percent of total billed charges,,,0.95,,10.56,Percent of total billed charges,,,,,,,,,0.95,,10.56,Percent of total billed charges,,10.56,10.9,
DEXAMETHASONE 4 MG PO TABS,RX-2327,CDM,J8540,HCPCS,636,RC,,outpatient,1,UN,11.12,10.01,,0.95,,10.56,Percent of total billed charges,,,0.98,,10.9,Percent of total billed charges,,,0.95,,10.56,Percent of total billed charges,,,0.95,,10.56,Percent of total billed charges,,,0.97,,10.79,Percent of total billed charges,,,0.96,,10.68,Percent of total billed charges,,,0.95,,10.56,Percent of total billed charges,,,,,,,,,0.95,,10.56,Percent of total billed charges,,10.56,10.9,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLN,RX-2331,CDM,J1100,HCPCS,636,RC,,inpatient,0.5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJECTION SOLN,RX-2331,CDM,J1100,HCPCS,636,RC,,outpatient,0.5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLN,RX-2332,CDM,J1100,HCPCS,636,RC,,inpatient,0.5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLN,RX-2332,CDM,J1100,HCPCS,636,RC,,outpatient,0.5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
DEXAMETHASONE SODIUM PHOSPHATE 0.1 % OP SOLN,RX-2335,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,157.51,141.76,,0.95,,149.63,Percent of total billed charges,,,0.98,,154.36,Percent of total billed charges,,,0.95,,149.63,Percent of total billed charges,,,0.97,,152.78,Percent of total billed charges,,,0.97,,152.78,Percent of total billed charges,,,0.96,,151.21,Percent of total billed charges,,,0.95,,149.63,Percent of total billed charges,,,,,,,,,0.95,,149.63,Percent of total billed charges,,149.63,154.36,
DEXAMETHASONE SODIUM PHOSPHATE 0.1 % OP SOLN,RX-2335,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,157.51,141.76,,0.95,,149.63,Percent of total billed charges,,,0.98,,154.36,Percent of total billed charges,,,0.95,,149.63,Percent of total billed charges,,,0.95,,149.63,Percent of total billed charges,,,0.97,,152.78,Percent of total billed charges,,,0.96,,151.21,Percent of total billed charges,,,0.95,,149.63,Percent of total billed charges,,,,,,,,,0.95,,149.63,Percent of total billed charges,,149.63,154.36,
LIDOCAINE 4 % EX CREA,RX-23461,CDM,J3490,HCPCS,637,RC,,inpatient,5,GR,16.04,14.44,,0.95,,15.24,Percent of total billed charges,,,0.98,,15.72,Percent of total billed charges,,,0.95,,15.24,Percent of total billed charges,,,0.97,,15.56,Percent of total billed charges,,,0.97,,15.56,Percent of total billed charges,,,0.96,,15.4,Percent of total billed charges,,,0.95,,15.24,Percent of total billed charges,,,,,,,,,0.95,,15.24,Percent of total billed charges,,15.24,15.72,
LIDOCAINE 4 % EX CREA,RX-23461,CDM,J3490,HCPCS,637,RC,,outpatient,5,GR,16.04,14.44,,0.95,,15.24,Percent of total billed charges,,,0.98,,15.72,Percent of total billed charges,,,0.95,,15.24,Percent of total billed charges,,,0.95,,15.24,Percent of total billed charges,,,0.97,,15.56,Percent of total billed charges,,,0.96,,15.4,Percent of total billed charges,,,0.95,,15.24,Percent of total billed charges,,,,,,,,,0.95,,15.24,Percent of total billed charges,,15.24,15.72,
DEXTROSE 10 % IV SOLN,RX-2357,CDM,J3490,HCPCS,258,RC,,inpatient,250,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
DEXTROSE 10 % IV SOLN,RX-2357,CDM,J3490,HCPCS,258,RC,,outpatient,250,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
DEXTROSE 5 % IV SOLN,RX-2364,CDM,J7060,HCPCS,636,RC,,inpatient,50,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
DEXTROSE 5 % IV SOLN,RX-2364,CDM,J7060,HCPCS,636,RC,,outpatient,50,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
DEXTROSE 50 % IV SOLN,RX-2365,CDM,J3490,HCPCS,250,RC,,inpatient,50,ML,67.91,61.12,,0.95,,64.51,Percent of total billed charges,,,0.98,,66.55,Percent of total billed charges,,,0.95,,64.51,Percent of total billed charges,,,0.97,,65.87,Percent of total billed charges,,,0.97,,65.87,Percent of total billed charges,,,0.96,,65.19,Percent of total billed charges,,,0.95,,64.51,Percent of total billed charges,,,,,,,,,0.95,,64.51,Percent of total billed charges,,64.51,66.55,
DEXTROSE 50 % IV SOLN,RX-2365,CDM,J3490,HCPCS,250,RC,,outpatient,50,ML,67.91,61.12,,0.95,,64.51,Percent of total billed charges,,,0.98,,66.55,Percent of total billed charges,,,0.95,,64.51,Percent of total billed charges,,,0.95,,64.51,Percent of total billed charges,,,0.97,,65.87,Percent of total billed charges,,,0.96,,65.19,Percent of total billed charges,,,0.95,,64.51,Percent of total billed charges,,,,,,,,,0.95,,64.51,Percent of total billed charges,,64.51,66.55,
INFLIXIMAB 100 MG IV SOLR,RX-23796,CDM,J1745,HCPCS,636,RC,,inpatient,10,ML,829.39,746.45,,0.95,,787.92,Percent of total billed charges,,,0.98,,812.8,Percent of total billed charges,,,0.95,,787.92,Percent of total billed charges,,,0.97,,804.51,Percent of total billed charges,,,0.97,,804.51,Percent of total billed charges,,,0.96,,796.21,Percent of total billed charges,,,0.95,,787.92,Percent of total billed charges,,,,,,,,,0.95,,787.92,Percent of total billed charges,,787.92,812.8,
INFLIXIMAB 100 MG IV SOLR,RX-23796,CDM,J1745,HCPCS,636,RC,,outpatient,10,ML,829.39,746.45,,0.95,,787.92,Percent of total billed charges,,,0.98,,812.8,Percent of total billed charges,,,0.95,,787.92,Percent of total billed charges,,,0.95,,787.92,Percent of total billed charges,,,0.97,,804.51,Percent of total billed charges,,,0.96,,796.21,Percent of total billed charges,,,0.95,,787.92,Percent of total billed charges,,,,,,,,,0.95,,787.92,Percent of total billed charges,,787.92,812.8,
DIAZEPAM 5 MG/ML INJECTION SOLN,RX-2401,CDM,J3360,HCPCS,636,RC,,inpatient,1,ML,39.34,35.41,,0.95,,37.37,Percent of total billed charges,,,0.98,,38.55,Percent of total billed charges,,,0.95,,37.37,Percent of total billed charges,,,0.97,,38.16,Percent of total billed charges,,,0.97,,38.16,Percent of total billed charges,,,0.96,,37.77,Percent of total billed charges,,,0.95,,37.37,Percent of total billed charges,,,,,,,,,0.95,,37.37,Percent of total billed charges,,37.37,38.55,
DIAZEPAM 5 MG/ML INJECTION SOLN,RX-2401,CDM,J3360,HCPCS,636,RC,,outpatient,1,ML,39.34,35.41,,0.95,,37.37,Percent of total billed charges,,,0.98,,38.55,Percent of total billed charges,,,0.95,,37.37,Percent of total billed charges,,,0.95,,37.37,Percent of total billed charges,,,0.97,,38.16,Percent of total billed charges,,,0.96,,37.77,Percent of total billed charges,,,0.95,,37.37,Percent of total billed charges,,,,,,,,,0.95,,37.37,Percent of total billed charges,,37.37,38.55,
DIAZEPAM 5 MG PO TABS,RX-2405,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.34,5.71,,0.95,,6.02,Percent of total billed charges,,,0.98,,6.21,Percent of total billed charges,,,0.95,,6.02,Percent of total billed charges,,,0.97,,6.15,Percent of total billed charges,,,0.97,,6.15,Percent of total billed charges,,,0.96,,6.09,Percent of total billed charges,,,0.95,,6.02,Percent of total billed charges,,,,,,,,,0.95,,6.02,Percent of total billed charges,,6.02,6.21,
DIAZEPAM 5 MG PO TABS,RX-2405,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.34,5.71,,0.95,,6.02,Percent of total billed charges,,,0.98,,6.21,Percent of total billed charges,,,0.95,,6.02,Percent of total billed charges,,,0.95,,6.02,Percent of total billed charges,,,0.97,,6.15,Percent of total billed charges,,,0.96,,6.09,Percent of total billed charges,,,0.95,,6.02,Percent of total billed charges,,,,,,,,,0.95,,6.02,Percent of total billed charges,,6.02,6.21,
DICLOXACILLIN SODIUM 250 MG PO CAPS,RX-2414,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.17,7.35,,0.95,,7.76,Percent of total billed charges,,,0.98,,8.01,Percent of total billed charges,,,0.95,,7.76,Percent of total billed charges,,,0.97,,7.92,Percent of total billed charges,,,0.97,,7.92,Percent of total billed charges,,,0.96,,7.84,Percent of total billed charges,,,0.95,,7.76,Percent of total billed charges,,,,,,,,,0.95,,7.76,Percent of total billed charges,,7.76,8.01,
DICLOXACILLIN SODIUM 250 MG PO CAPS,RX-2414,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.17,7.35,,0.95,,7.76,Percent of total billed charges,,,0.98,,8.01,Percent of total billed charges,,,0.95,,7.76,Percent of total billed charges,,,0.95,,7.76,Percent of total billed charges,,,0.97,,7.92,Percent of total billed charges,,,0.96,,7.84,Percent of total billed charges,,,0.95,,7.76,Percent of total billed charges,,,,,,,,,0.95,,7.76,Percent of total billed charges,,7.76,8.01,
MIDAZOLAM HCL 2 MG/ML PO SYRP,RX-24176,CDM,J3490,HCPCS,637,RC,,inpatient,2.5,ML,12.77,11.49,,0.95,,12.13,Percent of total billed charges,,,0.98,,12.51,Percent of total billed charges,,,0.95,,12.13,Percent of total billed charges,,,0.97,,12.39,Percent of total billed charges,,,0.97,,12.39,Percent of total billed charges,,,0.96,,12.26,Percent of total billed charges,,,0.95,,12.13,Percent of total billed charges,,,,,,,,,0.95,,12.13,Percent of total billed charges,,12.13,12.51,
MIDAZOLAM HCL 2 MG/ML PO SYRP,RX-24176,CDM,J3490,HCPCS,637,RC,,outpatient,2.5,ML,12.77,11.49,,0.95,,12.13,Percent of total billed charges,,,0.98,,12.51,Percent of total billed charges,,,0.95,,12.13,Percent of total billed charges,,,0.95,,12.13,Percent of total billed charges,,,0.97,,12.39,Percent of total billed charges,,,0.96,,12.26,Percent of total billed charges,,,0.95,,12.13,Percent of total billed charges,,,,,,,,,0.95,,12.13,Percent of total billed charges,,12.13,12.51,
DICYCLOMINE HCL 10 MG PO CAPS,RX-2418,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.19,7.37,,0.95,,7.78,Percent of total billed charges,,,0.98,,8.03,Percent of total billed charges,,,0.95,,7.78,Percent of total billed charges,,,0.97,,7.94,Percent of total billed charges,,,0.97,,7.94,Percent of total billed charges,,,0.96,,7.86,Percent of total billed charges,,,0.95,,7.78,Percent of total billed charges,,,,,,,,,0.95,,7.78,Percent of total billed charges,,7.78,8.03,
DICYCLOMINE HCL 10 MG PO CAPS,RX-2418,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.19,7.37,,0.95,,7.78,Percent of total billed charges,,,0.98,,8.03,Percent of total billed charges,,,0.95,,7.78,Percent of total billed charges,,,0.95,,7.78,Percent of total billed charges,,,0.97,,7.94,Percent of total billed charges,,,0.96,,7.86,Percent of total billed charges,,,0.95,,7.78,Percent of total billed charges,,,,,,,,,0.95,,7.78,Percent of total billed charges,,7.78,8.03,
CROMOLYN SODIUM 5.2 MG/ACT INTRANASAL AERS,RX-24325,CDM,J3490,HCPCS,637,RC,,inpatient,0.13,ML,169.95,152.96,,0.95,,161.45,Percent of total billed charges,,,0.98,,166.55,Percent of total billed charges,,,0.95,,161.45,Percent of total billed charges,,,0.97,,164.85,Percent of total billed charges,,,0.97,,164.85,Percent of total billed charges,,,0.96,,163.15,Percent of total billed charges,,,0.95,,161.45,Percent of total billed charges,,,,,,,,,0.95,,161.45,Percent of total billed charges,,161.45,166.55,
CROMOLYN SODIUM 5.2 MG/ACT INTRANASAL AERS,RX-24325,CDM,J3490,HCPCS,637,RC,,outpatient,0.13,ML,169.95,152.96,,0.95,,161.45,Percent of total billed charges,,,0.98,,166.55,Percent of total billed charges,,,0.95,,161.45,Percent of total billed charges,,,0.95,,161.45,Percent of total billed charges,,,0.97,,164.85,Percent of total billed charges,,,0.96,,163.15,Percent of total billed charges,,,0.95,,161.45,Percent of total billed charges,,,,,,,,,0.95,,161.45,Percent of total billed charges,,161.45,166.55,
HEPARIN SOD (PORCINE) IN D5W 100 UNIT/ML IV SOLN,RX-24329,CDM,J1644,HCPCS,636,RC,,inpatient,250,ML,108.15,97.34,,0.95,,102.74,Percent of total billed charges,,,0.98,,105.99,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,0.97,,104.91,Percent of total billed charges,,,0.97,,104.91,Percent of total billed charges,,,0.96,,103.82,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,,,,,,,0.95,,102.74,Percent of total billed charges,,102.74,105.99,
HEPARIN SOD (PORCINE) IN D5W 100 UNIT/ML IV SOLN,RX-24329,CDM,J1644,HCPCS,636,RC,,outpatient,250,ML,108.15,97.34,,0.95,,102.74,Percent of total billed charges,,,0.98,,105.99,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,0.97,,104.91,Percent of total billed charges,,,0.96,,103.82,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,,,,,,,0.95,,102.74,Percent of total billed charges,,102.74,105.99,
DIGOXIN 0.25 MG/ML INJECTION SOLN,RX-2442,CDM,J1160,HCPCS,636,RC,,inpatient,2,ML,23.59,21.23,,0.95,,22.41,Percent of total billed charges,,,0.98,,23.12,Percent of total billed charges,,,0.95,,22.41,Percent of total billed charges,,,0.97,,22.88,Percent of total billed charges,,,0.97,,22.88,Percent of total billed charges,,,0.96,,22.65,Percent of total billed charges,,,0.95,,22.41,Percent of total billed charges,,,,,,,,,0.95,,22.41,Percent of total billed charges,,22.41,23.12,
DIGOXIN 0.25 MG/ML INJECTION SOLN,RX-2442,CDM,J1160,HCPCS,636,RC,,outpatient,2,ML,23.59,21.23,,0.95,,22.41,Percent of total billed charges,,,0.98,,23.12,Percent of total billed charges,,,0.95,,22.41,Percent of total billed charges,,,0.95,,22.41,Percent of total billed charges,,,0.97,,22.88,Percent of total billed charges,,,0.96,,22.65,Percent of total billed charges,,,0.95,,22.41,Percent of total billed charges,,,,,,,,,0.95,,22.41,Percent of total billed charges,,22.41,23.12,
OCTREOTIDE ACETATE 10 MG IM KIT,RX-24434,CDM,J2353,HCPCS,636,RC,,inpatient,10,ME,6093.76,5484.38,,0.95,,5789.07,Percent of total billed charges,,,0.98,,5971.88,Percent of total billed charges,,,0.95,,5789.07,Percent of total billed charges,,,0.97,,5910.95,Percent of total billed charges,,,0.97,,5910.95,Percent of total billed charges,,,0.96,,5850.01,Percent of total billed charges,,,0.95,,5789.07,Percent of total billed charges,,,,,,,,,0.95,,5789.07,Percent of total billed charges,,5789.07,5971.88,
OCTREOTIDE ACETATE 10 MG IM KIT,RX-24434,CDM,J2353,HCPCS,636,RC,,outpatient,10,ME,6093.76,5484.38,,0.95,,5789.07,Percent of total billed charges,,,0.98,,5971.88,Percent of total billed charges,,,0.95,,5789.07,Percent of total billed charges,,,0.95,,5789.07,Percent of total billed charges,,,0.97,,5910.95,Percent of total billed charges,,,0.96,,5850.01,Percent of total billed charges,,,0.95,,5789.07,Percent of total billed charges,,,,,,,,,0.95,,5789.07,Percent of total billed charges,,5789.07,5971.88,
OCTREOTIDE ACETATE 20 MG IM KIT,RX-24435,CDM,J2353,HCPCS,636,RC,,inpatient,20,ME,7120.74,6408.67,,0.95,,6764.7,Percent of total billed charges,,,0.98,,6978.33,Percent of total billed charges,,,0.95,,6764.7,Percent of total billed charges,,,0.97,,6907.12,Percent of total billed charges,,,0.97,,6907.12,Percent of total billed charges,,,0.96,,6835.91,Percent of total billed charges,,,0.95,,6764.7,Percent of total billed charges,,,,,,,,,0.95,,6764.7,Percent of total billed charges,,6764.7,6978.33,
OCTREOTIDE ACETATE 20 MG IM KIT,RX-24435,CDM,J2353,HCPCS,636,RC,,outpatient,20,ME,7120.74,6408.67,,0.95,,6764.7,Percent of total billed charges,,,0.98,,6978.33,Percent of total billed charges,,,0.95,,6764.7,Percent of total billed charges,,,0.95,,6764.7,Percent of total billed charges,,,0.97,,6907.12,Percent of total billed charges,,,0.96,,6835.91,Percent of total billed charges,,,0.95,,6764.7,Percent of total billed charges,,,,,,,,,0.95,,6764.7,Percent of total billed charges,,6764.7,6978.33,
OCTREOTIDE ACETATE 30 MG IM KIT,RX-24436,CDM,J2353,HCPCS,636,RC,,inpatient,30,ME,10662.77,9596.49,,0.95,,10129.63,Percent of total billed charges,,,0.98,,10449.51,Percent of total billed charges,,,0.95,,10129.63,Percent of total billed charges,,,0.97,,10342.89,Percent of total billed charges,,,0.97,,10342.89,Percent of total billed charges,,,0.96,,10236.26,Percent of total billed charges,,,0.95,,10129.63,Percent of total billed charges,,,,,,,,,0.95,,10129.63,Percent of total billed charges,,10129.63,10449.51,
OCTREOTIDE ACETATE 30 MG IM KIT,RX-24436,CDM,J2353,HCPCS,636,RC,,outpatient,30,ME,10662.77,9596.49,,0.95,,10129.63,Percent of total billed charges,,,0.98,,10449.51,Percent of total billed charges,,,0.95,,10129.63,Percent of total billed charges,,,0.95,,10129.63,Percent of total billed charges,,,0.97,,10342.89,Percent of total billed charges,,,0.96,,10236.26,Percent of total billed charges,,,0.95,,10129.63,Percent of total billed charges,,,,,,,,,0.95,,10129.63,Percent of total billed charges,,10129.63,10449.51,
DIGOXIN 125 MCG PO TABS,RX-2444,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,11.14,10.03,,0.95,,10.58,Percent of total billed charges,,,0.98,,10.92,Percent of total billed charges,,,0.95,,10.58,Percent of total billed charges,,,0.97,,10.81,Percent of total billed charges,,,0.97,,10.81,Percent of total billed charges,,,0.96,,10.69,Percent of total billed charges,,,0.95,,10.58,Percent of total billed charges,,,,,,,,,0.95,,10.58,Percent of total billed charges,,10.58,10.92,
DIGOXIN 125 MCG PO TABS,RX-2444,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,11.14,10.03,,0.95,,10.58,Percent of total billed charges,,,0.98,,10.92,Percent of total billed charges,,,0.95,,10.58,Percent of total billed charges,,,0.95,,10.58,Percent of total billed charges,,,0.97,,10.81,Percent of total billed charges,,,0.96,,10.69,Percent of total billed charges,,,0.95,,10.58,Percent of total billed charges,,,,,,,,,0.95,,10.58,Percent of total billed charges,,10.58,10.92,
DIGOXIN 250 MCG PO TABS,RX-2445,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.79,9.71,,0.95,,10.25,Percent of total billed charges,,,0.98,,10.57,Percent of total billed charges,,,0.95,,10.25,Percent of total billed charges,,,0.97,,10.47,Percent of total billed charges,,,0.97,,10.47,Percent of total billed charges,,,0.96,,10.36,Percent of total billed charges,,,0.95,,10.25,Percent of total billed charges,,,,,,,,,0.95,,10.25,Percent of total billed charges,,10.25,10.57,
DIGOXIN 250 MCG PO TABS,RX-2445,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.79,9.71,,0.95,,10.25,Percent of total billed charges,,,0.98,,10.57,Percent of total billed charges,,,0.95,,10.25,Percent of total billed charges,,,0.95,,10.25,Percent of total billed charges,,,0.97,,10.47,Percent of total billed charges,,,0.96,,10.36,Percent of total billed charges,,,0.95,,10.25,Percent of total billed charges,,,,,,,,,0.95,,10.25,Percent of total billed charges,,10.25,10.57,
OXYBUTYNIN CHLORIDE ER 5 MG PO TB24,RX-24470,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,13.58,12.22,,0.95,,12.9,Percent of total billed charges,,,0.98,,13.31,Percent of total billed charges,,,0.95,,12.9,Percent of total billed charges,,,0.97,,13.17,Percent of total billed charges,,,0.97,,13.17,Percent of total billed charges,,,0.96,,13.04,Percent of total billed charges,,,0.95,,12.9,Percent of total billed charges,,,,,,,,,0.95,,12.9,Percent of total billed charges,,12.9,13.31,
OXYBUTYNIN CHLORIDE ER 5 MG PO TB24,RX-24470,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,13.58,12.22,,0.95,,12.9,Percent of total billed charges,,,0.98,,13.31,Percent of total billed charges,,,0.95,,12.9,Percent of total billed charges,,,0.95,,12.9,Percent of total billed charges,,,0.97,,13.17,Percent of total billed charges,,,0.96,,13.04,Percent of total billed charges,,,0.95,,12.9,Percent of total billed charges,,,,,,,,,0.95,,12.9,Percent of total billed charges,,12.9,13.31,
CILOSTAZOL 100 MG PO TABS,RX-24474,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.99,9.89,,0.95,,10.44,Percent of total billed charges,,,0.98,,10.77,Percent of total billed charges,,,0.95,,10.44,Percent of total billed charges,,,0.97,,10.66,Percent of total billed charges,,,0.97,,10.66,Percent of total billed charges,,,0.96,,10.55,Percent of total billed charges,,,0.95,,10.44,Percent of total billed charges,,,,,,,,,0.95,,10.44,Percent of total billed charges,,10.44,10.77,
CILOSTAZOL 100 MG PO TABS,RX-24474,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.99,9.89,,0.95,,10.44,Percent of total billed charges,,,0.98,,10.77,Percent of total billed charges,,,0.95,,10.44,Percent of total billed charges,,,0.95,,10.44,Percent of total billed charges,,,0.97,,10.66,Percent of total billed charges,,,0.96,,10.55,Percent of total billed charges,,,0.95,,10.44,Percent of total billed charges,,,,,,,,,0.95,,10.44,Percent of total billed charges,,10.44,10.77,
CELECOXIB 100 MG PO CAPS,RX-24500,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,9.79,8.81,,0.95,,9.3,Percent of total billed charges,,,0.98,,9.59,Percent of total billed charges,,,0.95,,9.3,Percent of total billed charges,,,0.97,,9.5,Percent of total billed charges,,,0.97,,9.5,Percent of total billed charges,,,0.96,,9.4,Percent of total billed charges,,,0.95,,9.3,Percent of total billed charges,,,,,,,,,0.95,,9.3,Percent of total billed charges,,9.3,9.59,
CELECOXIB 100 MG PO CAPS,RX-24500,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,9.79,8.81,,0.95,,9.3,Percent of total billed charges,,,0.98,,9.59,Percent of total billed charges,,,0.95,,9.3,Percent of total billed charges,,,0.95,,9.3,Percent of total billed charges,,,0.97,,9.5,Percent of total billed charges,,,0.96,,9.4,Percent of total billed charges,,,0.95,,9.3,Percent of total billed charges,,,,,,,,,0.95,,9.3,Percent of total billed charges,,9.3,9.59,
ISOSORBIDE MONONITRATE ER 30 MG PO TB24,RX-24521,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.14,6.43,,0.95,,6.78,Percent of total billed charges,,,0.98,,7,Percent of total billed charges,,,0.95,,6.78,Percent of total billed charges,,,0.97,,6.93,Percent of total billed charges,,,0.97,,6.93,Percent of total billed charges,,,0.96,,6.85,Percent of total billed charges,,,0.95,,6.78,Percent of total billed charges,,,,,,,,,0.95,,6.78,Percent of total billed charges,,6.78,7,
ISOSORBIDE MONONITRATE ER 30 MG PO TB24,RX-24521,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.14,6.43,,0.95,,6.78,Percent of total billed charges,,,0.98,,7,Percent of total billed charges,,,0.95,,6.78,Percent of total billed charges,,,0.95,,6.78,Percent of total billed charges,,,0.97,,6.93,Percent of total billed charges,,,0.96,,6.85,Percent of total billed charges,,,0.95,,6.78,Percent of total billed charges,,,,,,,,,0.95,,6.78,Percent of total billed charges,,6.78,7,
DILTIAZEM HCL 60 MG PO TABS,RX-2476,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.92,6.23,,0.95,,6.57,Percent of total billed charges,,,0.98,,6.78,Percent of total billed charges,,,0.95,,6.57,Percent of total billed charges,,,0.97,,6.71,Percent of total billed charges,,,0.97,,6.71,Percent of total billed charges,,,0.96,,6.64,Percent of total billed charges,,,0.95,,6.57,Percent of total billed charges,,,,,,,,,0.95,,6.57,Percent of total billed charges,,6.57,6.78,
DILTIAZEM HCL 60 MG PO TABS,RX-2476,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.92,6.23,,0.95,,6.57,Percent of total billed charges,,,0.98,,6.78,Percent of total billed charges,,,0.95,,6.57,Percent of total billed charges,,,0.95,,6.57,Percent of total billed charges,,,0.97,,6.71,Percent of total billed charges,,,0.96,,6.64,Percent of total billed charges,,,0.95,,6.57,Percent of total billed charges,,,,,,,,,0.95,,6.57,Percent of total billed charges,,6.57,6.78,
NA FERRIC GLUC CPLX IN SUCROSE 12.5 MG/ML IV SOLN,RX-24932,CDM,J2916,HCPCS,636,RC,,inpatient,5,ML,120.12,108.11,,0.95,,114.11,Percent of total billed charges,,,0.98,,117.72,Percent of total billed charges,,,0.95,,114.11,Percent of total billed charges,,,0.97,,116.52,Percent of total billed charges,,,0.97,,116.52,Percent of total billed charges,,,0.96,,115.32,Percent of total billed charges,,,0.95,,114.11,Percent of total billed charges,,,,,,,,,0.95,,114.11,Percent of total billed charges,,114.11,117.72,
NA FERRIC GLUC CPLX IN SUCROSE 12.5 MG/ML IV SOLN,RX-24932,CDM,J2916,HCPCS,636,RC,,outpatient,5,ML,120.12,108.11,,0.95,,114.11,Percent of total billed charges,,,0.98,,117.72,Percent of total billed charges,,,0.95,,114.11,Percent of total billed charges,,,0.95,,114.11,Percent of total billed charges,,,0.97,,116.52,Percent of total billed charges,,,0.96,,115.32,Percent of total billed charges,,,0.95,,114.11,Percent of total billed charges,,,,,,,,,0.95,,114.11,Percent of total billed charges,,114.11,117.72,
ALBUTEROL SULFATE (2.5 MG/3ML) 0.083% INHAL NEBU,RX-250,CDM,J7613,HCPCS,636,RC,,inpatient,1.5,ML,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
ALBUTEROL SULFATE (2.5 MG/3ML) 0.083% INHAL NEBU,RX-250,CDM,J7613,HCPCS,636,RC,,outpatient,1.5,ML,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
DIPHENHYDRAMINE HCL 50 MG/ML INJECTION SOLN,RX-2508,CDM,J1200,HCPCS,636,RC,,inpatient,0.25,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
DIPHENHYDRAMINE HCL 50 MG/ML INJECTION SOLN,RX-2508,CDM,J1200,HCPCS,636,RC,,outpatient,0.25,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
CRANBERRY JUICE POWDER 425 MG PO CAPS,RX-25134,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,5.85,5.27,,0.95,,5.56,Percent of total billed charges,,,0.98,,5.73,Percent of total billed charges,,,0.95,,5.56,Percent of total billed charges,,,0.97,,5.67,Percent of total billed charges,,,0.97,,5.67,Percent of total billed charges,,,0.96,,5.62,Percent of total billed charges,,,0.95,,5.56,Percent of total billed charges,,,,,,,,,0.95,,5.56,Percent of total billed charges,,5.56,5.73,
CRANBERRY JUICE POWDER 425 MG PO CAPS,RX-25134,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,5.85,5.27,,0.95,,5.56,Percent of total billed charges,,,0.98,,5.73,Percent of total billed charges,,,0.95,,5.56,Percent of total billed charges,,,0.95,,5.56,Percent of total billed charges,,,0.97,,5.67,Percent of total billed charges,,,0.96,,5.62,Percent of total billed charges,,,0.95,,5.56,Percent of total billed charges,,,,,,,,,0.95,,5.56,Percent of total billed charges,,5.56,5.73,
HETASTARCH-NACL 6-0.9 % IV SOLN,RX-25174,CDM,J3490,HCPCS,250,RC,,inpatient,250,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
HETASTARCH-NACL 6-0.9 % IV SOLN,RX-25174,CDM,J3490,HCPCS,250,RC,,outpatient,250,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
ALBUTEROL SULFATE 2 MG/5ML PO SYRP,RX-252,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
ALBUTEROL SULFATE 2 MG/5ML PO SYRP,RX-252,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
AMOXICILLIN 400 MG/5ML PO SUSR,RX-25246,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
AMOXICILLIN 400 MG/5ML PO SUSR,RX-25246,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
DISULFIRAM 250 MG PO TABS,RX-2540,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,15.82,14.24,,0.95,,15.03,Percent of total billed charges,,,0.98,,15.5,Percent of total billed charges,,,0.95,,15.03,Percent of total billed charges,,,0.97,,15.35,Percent of total billed charges,,,0.97,,15.35,Percent of total billed charges,,,0.96,,15.19,Percent of total billed charges,,,0.95,,15.03,Percent of total billed charges,,,,,,,,,0.95,,15.03,Percent of total billed charges,,15.03,15.5,
DISULFIRAM 250 MG PO TABS,RX-2540,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,15.82,14.24,,0.95,,15.03,Percent of total billed charges,,,0.98,,15.5,Percent of total billed charges,,,0.95,,15.03,Percent of total billed charges,,,0.95,,15.03,Percent of total billed charges,,,0.97,,15.35,Percent of total billed charges,,,0.96,,15.19,Percent of total billed charges,,,0.95,,15.03,Percent of total billed charges,,,,,,,,,0.95,,15.03,Percent of total billed charges,,15.03,15.5,
DIVALPROEX SODIUM 250 MG PO TBEC,RX-2552,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.48,5.83,,0.95,,6.16,Percent of total billed charges,,,0.98,,6.35,Percent of total billed charges,,,0.95,,6.16,Percent of total billed charges,,,0.97,,6.29,Percent of total billed charges,,,0.97,,6.29,Percent of total billed charges,,,0.96,,6.22,Percent of total billed charges,,,0.95,,6.16,Percent of total billed charges,,,,,,,,,0.95,,6.16,Percent of total billed charges,,6.16,6.35,
DIVALPROEX SODIUM 250 MG PO TBEC,RX-2552,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.48,5.83,,0.95,,6.16,Percent of total billed charges,,,0.98,,6.35,Percent of total billed charges,,,0.95,,6.16,Percent of total billed charges,,,0.95,,6.16,Percent of total billed charges,,,0.97,,6.29,Percent of total billed charges,,,0.96,,6.22,Percent of total billed charges,,,0.95,,6.16,Percent of total billed charges,,,,,,,,,0.95,,6.16,Percent of total billed charges,,6.16,6.35,
DOCUSATE SODIUM 100 MG PO CAPS,RX-2566,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.63,5.97,,0.95,,6.3,Percent of total billed charges,,,0.98,,6.5,Percent of total billed charges,,,0.95,,6.3,Percent of total billed charges,,,0.97,,6.43,Percent of total billed charges,,,0.97,,6.43,Percent of total billed charges,,,0.96,,6.36,Percent of total billed charges,,,0.95,,6.3,Percent of total billed charges,,,,,,,,,0.95,,6.3,Percent of total billed charges,,6.3,6.5,
DOCUSATE SODIUM 100 MG PO CAPS,RX-2566,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.63,5.97,,0.95,,6.3,Percent of total billed charges,,,0.98,,6.5,Percent of total billed charges,,,0.95,,6.3,Percent of total billed charges,,,0.95,,6.3,Percent of total billed charges,,,0.97,,6.43,Percent of total billed charges,,,0.96,,6.36,Percent of total billed charges,,,0.95,,6.3,Percent of total billed charges,,,,,,,,,0.95,,6.3,Percent of total billed charges,,6.3,6.5,
DOCUSATE SODIUM 250 MG PO CAPS,RX-2567,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.99,6.29,,0.95,,6.64,Percent of total billed charges,,,0.98,,6.85,Percent of total billed charges,,,0.95,,6.64,Percent of total billed charges,,,0.97,,6.78,Percent of total billed charges,,,0.97,,6.78,Percent of total billed charges,,,0.96,,6.71,Percent of total billed charges,,,0.95,,6.64,Percent of total billed charges,,,,,,,,,0.95,,6.64,Percent of total billed charges,,6.64,6.85,
DOCUSATE SODIUM 250 MG PO CAPS,RX-2567,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.99,6.29,,0.95,,6.64,Percent of total billed charges,,,0.98,,6.85,Percent of total billed charges,,,0.95,,6.64,Percent of total billed charges,,,0.95,,6.64,Percent of total billed charges,,,0.97,,6.78,Percent of total billed charges,,,0.96,,6.71,Percent of total billed charges,,,0.95,,6.64,Percent of total billed charges,,,,,,,,,0.95,,6.64,Percent of total billed charges,,6.64,6.85,
CLINIMIX/DEXTROSE (4.25/5) 4.25 % IV SOLN,RX-25749,CDM,J3490,HCPCS,250,RC,,inpatient,2000,ML,253.38,228.04,,0.95,,240.71,Percent of total billed charges,,,0.98,,248.31,Percent of total billed charges,,,0.95,,240.71,Percent of total billed charges,,,0.97,,245.78,Percent of total billed charges,,,0.97,,245.78,Percent of total billed charges,,,0.96,,243.24,Percent of total billed charges,,,0.95,,240.71,Percent of total billed charges,,,,,,,,,0.95,,240.71,Percent of total billed charges,,240.71,248.31,
CLINIMIX/DEXTROSE (4.25/5) 4.25 % IV SOLN,RX-25749,CDM,J3490,HCPCS,250,RC,,outpatient,2000,ML,253.38,228.04,,0.95,,240.71,Percent of total billed charges,,,0.98,,248.31,Percent of total billed charges,,,0.95,,240.71,Percent of total billed charges,,,0.95,,240.71,Percent of total billed charges,,,0.97,,245.78,Percent of total billed charges,,,0.96,,243.24,Percent of total billed charges,,,0.95,,240.71,Percent of total billed charges,,,,,,,,,0.95,,240.71,Percent of total billed charges,,240.71,248.31,
CLINIMIX/DEXTROSE (5/15) 5 % IV SOLN,RX-25752,CDM,J3490,HCPCS,250,RC,,inpatient,2000,ML,289.43,260.49,,0.95,,274.96,Percent of total billed charges,,,0.98,,283.64,Percent of total billed charges,,,0.95,,274.96,Percent of total billed charges,,,0.97,,280.75,Percent of total billed charges,,,0.97,,280.75,Percent of total billed charges,,,0.96,,277.85,Percent of total billed charges,,,0.95,,274.96,Percent of total billed charges,,,,,,,,,0.95,,274.96,Percent of total billed charges,,274.96,283.64,
CLINIMIX/DEXTROSE (5/15) 5 % IV SOLN,RX-25752,CDM,J3490,HCPCS,250,RC,,outpatient,2000,ML,289.43,260.49,,0.95,,274.96,Percent of total billed charges,,,0.98,,283.64,Percent of total billed charges,,,0.95,,274.96,Percent of total billed charges,,,0.95,,274.96,Percent of total billed charges,,,0.97,,280.75,Percent of total billed charges,,,0.96,,277.85,Percent of total billed charges,,,0.95,,274.96,Percent of total billed charges,,,,,,,,,0.95,,274.96,Percent of total billed charges,,274.96,283.64,
IVERMECTIN 3 MG PO TABS,RX-25820,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,18.58,16.72,,0.95,,17.65,Percent of total billed charges,,,0.98,,18.21,Percent of total billed charges,,,0.95,,17.65,Percent of total billed charges,,,0.97,,18.02,Percent of total billed charges,,,0.97,,18.02,Percent of total billed charges,,,0.96,,17.84,Percent of total billed charges,,,0.95,,17.65,Percent of total billed charges,,,,,,,,,0.95,,17.65,Percent of total billed charges,,17.65,18.21,
IVERMECTIN 3 MG PO TABS,RX-25820,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,18.58,16.72,,0.95,,17.65,Percent of total billed charges,,,0.98,,18.21,Percent of total billed charges,,,0.95,,17.65,Percent of total billed charges,,,0.95,,17.65,Percent of total billed charges,,,0.97,,18.02,Percent of total billed charges,,,0.96,,17.84,Percent of total billed charges,,,0.95,,17.65,Percent of total billed charges,,,,,,,,,0.95,,17.65,Percent of total billed charges,,17.65,18.21,
DOXEPIN HCL 25 MG PO CAPS,RX-2611,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,9.22,8.3,,0.95,,8.76,Percent of total billed charges,,,0.98,,9.04,Percent of total billed charges,,,0.95,,8.76,Percent of total billed charges,,,0.97,,8.94,Percent of total billed charges,,,0.97,,8.94,Percent of total billed charges,,,0.96,,8.85,Percent of total billed charges,,,0.95,,8.76,Percent of total billed charges,,,,,,,,,0.95,,8.76,Percent of total billed charges,,8.76,9.04,
DOXEPIN HCL 25 MG PO CAPS,RX-2611,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,9.22,8.3,,0.95,,8.76,Percent of total billed charges,,,0.98,,9.04,Percent of total billed charges,,,0.95,,8.76,Percent of total billed charges,,,0.95,,8.76,Percent of total billed charges,,,0.97,,8.94,Percent of total billed charges,,,0.96,,8.85,Percent of total billed charges,,,0.95,,8.76,Percent of total billed charges,,,,,,,,,0.95,,8.76,Percent of total billed charges,,8.76,9.04,
DOXYCYCLINE HYCLATE 100 MG IV SOLR,RX-2622,CDM,J3490,HCPCS,250,RC,,inpatient,10,ML,70.08,63.07,,0.95,,66.58,Percent of total billed charges,,,0.98,,68.68,Percent of total billed charges,,,0.95,,66.58,Percent of total billed charges,,,0.97,,67.98,Percent of total billed charges,,,0.97,,67.98,Percent of total billed charges,,,0.96,,67.28,Percent of total billed charges,,,0.95,,66.58,Percent of total billed charges,,,,,,,,,0.95,,66.58,Percent of total billed charges,,66.58,68.68,
DOXYCYCLINE HYCLATE 100 MG IV SOLR,RX-2622,CDM,J3490,HCPCS,250,RC,,outpatient,10,ML,70.08,63.07,,0.95,,66.58,Percent of total billed charges,,,0.98,,68.68,Percent of total billed charges,,,0.95,,66.58,Percent of total billed charges,,,0.95,,66.58,Percent of total billed charges,,,0.97,,67.98,Percent of total billed charges,,,0.96,,67.28,Percent of total billed charges,,,0.95,,66.58,Percent of total billed charges,,,,,,,,,0.95,,66.58,Percent of total billed charges,,66.58,68.68,
PANTOPRAZOLE SODIUM 40 MG PO TBEC,RX-26225,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.75,6.08,,0.95,,6.41,Percent of total billed charges,,,0.98,,6.62,Percent of total billed charges,,,0.95,,6.41,Percent of total billed charges,,,0.97,,6.55,Percent of total billed charges,,,0.97,,6.55,Percent of total billed charges,,,0.96,,6.48,Percent of total billed charges,,,0.95,,6.41,Percent of total billed charges,,,,,,,,,0.95,,6.41,Percent of total billed charges,,6.41,6.62,
PANTOPRAZOLE SODIUM 40 MG PO TBEC,RX-26225,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.75,6.08,,0.95,,6.41,Percent of total billed charges,,,0.98,,6.62,Percent of total billed charges,,,0.95,,6.41,Percent of total billed charges,,,0.95,,6.41,Percent of total billed charges,,,0.97,,6.55,Percent of total billed charges,,,0.96,,6.48,Percent of total billed charges,,,0.95,,6.41,Percent of total billed charges,,,,,,,,,0.95,,6.41,Percent of total billed charges,,6.41,6.62,
PANTOPRAZOLE SODIUM 40 MG IV SOLR,RX-26226,CDM,J2470,HCPCS,636,RC,,inpatient,10,ML,22.43,20.19,,0.95,,21.31,Percent of total billed charges,,,0.98,,21.98,Percent of total billed charges,,,0.95,,21.31,Percent of total billed charges,,,0.97,,21.76,Percent of total billed charges,,,0.97,,21.76,Percent of total billed charges,,,0.96,,21.53,Percent of total billed charges,,,0.95,,21.31,Percent of total billed charges,,,,,,,,,0.95,,21.31,Percent of total billed charges,,21.31,21.98,
PANTOPRAZOLE SODIUM 40 MG IV SOLR,RX-26226,CDM,J2470,HCPCS,636,RC,,outpatient,10,ML,22.43,20.19,,0.95,,21.31,Percent of total billed charges,,,0.98,,21.98,Percent of total billed charges,,,0.95,,21.31,Percent of total billed charges,,,0.95,,21.31,Percent of total billed charges,,,0.97,,21.76,Percent of total billed charges,,,0.96,,21.53,Percent of total billed charges,,,0.95,,21.31,Percent of total billed charges,,,,,,,,,0.95,,21.31,Percent of total billed charges,,21.31,21.98,
DOXYCYCLINE HYCLATE 100 MG PO TABS,RX-2625,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,13.66,12.29,,0.95,,12.98,Percent of total billed charges,,,0.98,,13.39,Percent of total billed charges,,,0.95,,12.98,Percent of total billed charges,,,0.97,,13.25,Percent of total billed charges,,,0.97,,13.25,Percent of total billed charges,,,0.96,,13.11,Percent of total billed charges,,,0.95,,12.98,Percent of total billed charges,,,,,,,,,0.95,,12.98,Percent of total billed charges,,12.98,13.39,
DOXYCYCLINE HYCLATE 100 MG PO TABS,RX-2625,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,13.66,12.29,,0.95,,12.98,Percent of total billed charges,,,0.98,,13.39,Percent of total billed charges,,,0.95,,12.98,Percent of total billed charges,,,0.95,,12.98,Percent of total billed charges,,,0.97,,13.25,Percent of total billed charges,,,0.96,,13.11,Percent of total billed charges,,,0.95,,12.98,Percent of total billed charges,,,,,,,,,0.95,,12.98,Percent of total billed charges,,12.98,13.39,
DROPERIDOL 2.5 MG/ML INJECTION SOLN,RX-2654,CDM,J1790,HCPCS,636,RC,,inpatient,2,ML,33.66,30.29,,0.95,,31.98,Percent of total billed charges,,,0.98,,32.99,Percent of total billed charges,,,0.95,,31.98,Percent of total billed charges,,,0.97,,32.65,Percent of total billed charges,,,0.97,,32.65,Percent of total billed charges,,,0.96,,32.31,Percent of total billed charges,,,0.95,,31.98,Percent of total billed charges,,,,,,,,,0.95,,31.98,Percent of total billed charges,,31.98,32.99,
DROPERIDOL 2.5 MG/ML INJECTION SOLN,RX-2654,CDM,J1790,HCPCS,636,RC,,outpatient,2,ML,33.66,30.29,,0.95,,31.98,Percent of total billed charges,,,0.98,,32.99,Percent of total billed charges,,,0.95,,31.98,Percent of total billed charges,,,0.95,,31.98,Percent of total billed charges,,,0.97,,32.65,Percent of total billed charges,,,0.96,,32.31,Percent of total billed charges,,,0.95,,31.98,Percent of total billed charges,,,,,,,,,0.95,,31.98,Percent of total billed charges,,31.98,32.99,
OSELTAMIVIR PHOSPHATE 75 MG PO CAPS,RX-26546,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,11.77,10.59,,0.95,,11.18,Percent of total billed charges,,,0.98,,11.53,Percent of total billed charges,,,0.95,,11.18,Percent of total billed charges,,,0.97,,11.42,Percent of total billed charges,,,0.97,,11.42,Percent of total billed charges,,,0.96,,11.3,Percent of total billed charges,,,0.95,,11.18,Percent of total billed charges,,,,,,,,,0.95,,11.18,Percent of total billed charges,,11.18,11.53,
OSELTAMIVIR PHOSPHATE 75 MG PO CAPS,RX-26546,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,11.77,10.59,,0.95,,11.18,Percent of total billed charges,,,0.98,,11.53,Percent of total billed charges,,,0.95,,11.18,Percent of total billed charges,,,0.95,,11.18,Percent of total billed charges,,,0.97,,11.42,Percent of total billed charges,,,0.96,,11.3,Percent of total billed charges,,,0.95,,11.18,Percent of total billed charges,,,,,,,,,0.95,,11.18,Percent of total billed charges,,11.18,11.53,
LEVETIRACETAM 500 MG PO TABS,RX-26817,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.43,5.79,,0.95,,6.11,Percent of total billed charges,,,0.98,,6.3,Percent of total billed charges,,,0.95,,6.11,Percent of total billed charges,,,0.97,,6.24,Percent of total billed charges,,,0.97,,6.24,Percent of total billed charges,,,0.96,,6.17,Percent of total billed charges,,,0.95,,6.11,Percent of total billed charges,,,,,,,,,0.95,,6.11,Percent of total billed charges,,6.11,6.3,
LEVETIRACETAM 500 MG PO TABS,RX-26817,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.43,5.79,,0.95,,6.11,Percent of total billed charges,,,0.98,,6.3,Percent of total billed charges,,,0.95,,6.11,Percent of total billed charges,,,0.95,,6.11,Percent of total billed charges,,,0.97,,6.24,Percent of total billed charges,,,0.96,,6.17,Percent of total billed charges,,,0.95,,6.11,Percent of total billed charges,,,,,,,,,0.95,,6.11,Percent of total billed charges,,6.11,6.3,
TERBINAFINE HCL 1 % EX CREA,RX-27023,CDM,J3490,HCPCS,637,RC,,inpatient,30,GR,40.89,36.8,,0.95,,38.85,Percent of total billed charges,,,0.98,,40.07,Percent of total billed charges,,,0.95,,38.85,Percent of total billed charges,,,0.97,,39.66,Percent of total billed charges,,,0.97,,39.66,Percent of total billed charges,,,0.96,,39.25,Percent of total billed charges,,,0.95,,38.85,Percent of total billed charges,,,,,,,,,0.95,,38.85,Percent of total billed charges,,38.85,40.07,
TERBINAFINE HCL 1 % EX CREA,RX-27023,CDM,J3490,HCPCS,637,RC,,outpatient,30,GR,40.89,36.8,,0.95,,38.85,Percent of total billed charges,,,0.98,,40.07,Percent of total billed charges,,,0.95,,38.85,Percent of total billed charges,,,0.95,,38.85,Percent of total billed charges,,,0.97,,39.66,Percent of total billed charges,,,0.96,,39.25,Percent of total billed charges,,,0.95,,38.85,Percent of total billed charges,,,,,,,,,0.95,,38.85,Percent of total billed charges,,38.85,40.07,
NITROGLYCERIN 0.4 MG/SPRAY TRANSLINGUAL SOLN,RX-27096,CDM,J3490,HCPCS,637,RC,,inpatient,5,GR,1189.76,1070.78,,0.95,,1130.27,Percent of total billed charges,,,0.98,,1165.96,Percent of total billed charges,,,0.95,,1130.27,Percent of total billed charges,,,0.97,,1154.07,Percent of total billed charges,,,0.97,,1154.07,Percent of total billed charges,,,0.96,,1142.17,Percent of total billed charges,,,0.95,,1130.27,Percent of total billed charges,,,,,,,,,0.95,,1130.27,Percent of total billed charges,,1130.27,1165.96,
NITROGLYCERIN 0.4 MG/SPRAY TRANSLINGUAL SOLN,RX-27096,CDM,J3490,HCPCS,637,RC,,outpatient,5,GR,1189.76,1070.78,,0.95,,1130.27,Percent of total billed charges,,,0.98,,1165.96,Percent of total billed charges,,,0.95,,1130.27,Percent of total billed charges,,,0.95,,1130.27,Percent of total billed charges,,,0.97,,1154.07,Percent of total billed charges,,,0.96,,1142.17,Percent of total billed charges,,,0.95,,1130.27,Percent of total billed charges,,,,,,,,,0.95,,1130.27,Percent of total billed charges,,1130.27,1165.96,
CHARCOAL ACTIVATED PO LIQD,RX-27099,CDM,J3490,HCPCS,637,RC,,inpatient,120,ML,40.05,36.05,,0.95,,38.05,Percent of total billed charges,,,0.98,,39.25,Percent of total billed charges,,,0.95,,38.05,Percent of total billed charges,,,0.97,,38.85,Percent of total billed charges,,,0.97,,38.85,Percent of total billed charges,,,0.96,,38.45,Percent of total billed charges,,,0.95,,38.05,Percent of total billed charges,,,,,,,,,0.95,,38.05,Percent of total billed charges,,38.05,39.25,
CHARCOAL ACTIVATED PO LIQD,RX-27099,CDM,J3490,HCPCS,637,RC,,outpatient,120,ML,40.05,36.05,,0.95,,38.05,Percent of total billed charges,,,0.98,,39.25,Percent of total billed charges,,,0.95,,38.05,Percent of total billed charges,,,0.95,,38.05,Percent of total billed charges,,,0.97,,38.85,Percent of total billed charges,,,0.96,,38.45,Percent of total billed charges,,,0.95,,38.05,Percent of total billed charges,,,,,,,,,0.95,,38.05,Percent of total billed charges,,38.05,39.25,
CEFTAZIDIME 2 G IV SOLR,RX-27291,CDM,J0713,HCPCS,636,RC,,inpatient,20,ML,38.25,34.43,,0.95,,36.34,Percent of total billed charges,,,0.98,,37.49,Percent of total billed charges,,,0.95,,36.34,Percent of total billed charges,,,0.97,,37.1,Percent of total billed charges,,,0.97,,37.1,Percent of total billed charges,,,0.96,,36.72,Percent of total billed charges,,,0.95,,36.34,Percent of total billed charges,,,,,,,,,0.95,,36.34,Percent of total billed charges,,36.34,37.49,
CEFTAZIDIME 2 G IV SOLR,RX-27291,CDM,J0713,HCPCS,636,RC,,outpatient,20,ML,38.25,34.43,,0.95,,36.34,Percent of total billed charges,,,0.98,,37.49,Percent of total billed charges,,,0.95,,36.34,Percent of total billed charges,,,0.95,,36.34,Percent of total billed charges,,,0.97,,37.1,Percent of total billed charges,,,0.96,,36.72,Percent of total billed charges,,,0.95,,36.34,Percent of total billed charges,,,,,,,,,0.95,,36.34,Percent of total billed charges,,36.34,37.49,
CEFEPIME HCL 2 G IV SOLR,RX-27311,CDM,J0692,HCPCS,636,RC,,inpatient,12.5,ML,20.77,18.69,,0.95,,19.73,Percent of total billed charges,,,0.98,,20.35,Percent of total billed charges,,,0.95,,19.73,Percent of total billed charges,,,0.97,,20.15,Percent of total billed charges,,,0.97,,20.15,Percent of total billed charges,,,0.96,,19.94,Percent of total billed charges,,,0.95,,19.73,Percent of total billed charges,,,,,,,,,0.95,,19.73,Percent of total billed charges,,19.73,20.35,
CEFEPIME HCL 2 G IV SOLR,RX-27311,CDM,J0692,HCPCS,636,RC,,outpatient,12.5,ML,20.77,18.69,,0.95,,19.73,Percent of total billed charges,,,0.98,,20.35,Percent of total billed charges,,,0.95,,19.73,Percent of total billed charges,,,0.95,,19.73,Percent of total billed charges,,,0.97,,20.15,Percent of total billed charges,,,0.96,,19.94,Percent of total billed charges,,,0.95,,19.73,Percent of total billed charges,,,,,,,,,0.95,,19.73,Percent of total billed charges,,19.73,20.35,
DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5ML PO SYRP,RX-27345,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,8.93,8.04,,0.95,,8.48,Percent of total billed charges,,,0.98,,8.75,Percent of total billed charges,,,0.95,,8.48,Percent of total billed charges,,,0.97,,8.66,Percent of total billed charges,,,0.97,,8.66,Percent of total billed charges,,,0.96,,8.57,Percent of total billed charges,,,0.95,,8.48,Percent of total billed charges,,,,,,,,,0.95,,8.48,Percent of total billed charges,,8.48,8.75,
DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5ML PO SYRP,RX-27345,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,8.93,8.04,,0.95,,8.48,Percent of total billed charges,,,0.98,,8.75,Percent of total billed charges,,,0.95,,8.48,Percent of total billed charges,,,0.95,,8.48,Percent of total billed charges,,,0.97,,8.66,Percent of total billed charges,,,0.96,,8.57,Percent of total billed charges,,,0.95,,8.48,Percent of total billed charges,,,,,,,,,0.95,,8.48,Percent of total billed charges,,8.48,8.75,
MORPHINE SULFATE 10 MG/ML IV SOLN,RX-27390,CDM,J2270,HCPCS,636,RC,,inpatient,1,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
MORPHINE SULFATE 10 MG/ML IV SOLN,RX-27390,CDM,J2270,HCPCS,636,RC,,outpatient,1,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
DOXORUBICIN HCL LIPOSOMAL 2 MG/ML IV SUSP,RX-27431,CDM,Q2050,HCPCS,636,RC,,inpatient,25,ML,826.63,743.97,,0.95,,785.3,Percent of total billed charges,,,0.98,,810.1,Percent of total billed charges,,,0.95,,785.3,Percent of total billed charges,,,0.97,,801.83,Percent of total billed charges,,,0.97,,801.83,Percent of total billed charges,,,0.96,,793.56,Percent of total billed charges,,,0.95,,785.3,Percent of total billed charges,,,,,,,,,0.95,,785.3,Percent of total billed charges,,785.3,810.1,
DOXORUBICIN HCL LIPOSOMAL 2 MG/ML IV SUSP,RX-27431,CDM,Q2050,HCPCS,636,RC,,outpatient,25,ML,826.63,743.97,,0.95,,785.3,Percent of total billed charges,,,0.98,,810.1,Percent of total billed charges,,,0.95,,785.3,Percent of total billed charges,,,0.95,,785.3,Percent of total billed charges,,,0.97,,801.83,Percent of total billed charges,,,0.96,,793.56,Percent of total billed charges,,,0.95,,785.3,Percent of total billed charges,,,,,,,,,0.95,,785.3,Percent of total billed charges,,785.3,810.1,
DINOPROSTONE 10 MG VAGINAL INST,RX-27467,CDM,J3490,HCPCS,250,RC,,inpatient,1,UN,742.19,667.97,,0.95,,705.08,Percent of total billed charges,,,0.98,,727.35,Percent of total billed charges,,,0.95,,705.08,Percent of total billed charges,,,0.97,,719.92,Percent of total billed charges,,,0.97,,719.92,Percent of total billed charges,,,0.96,,712.5,Percent of total billed charges,,,0.95,,705.08,Percent of total billed charges,,,,,,,,,0.95,,705.08,Percent of total billed charges,,705.08,727.35,
DINOPROSTONE 10 MG VAGINAL INST,RX-27467,CDM,J3490,HCPCS,250,RC,,outpatient,1,UN,742.19,667.97,,0.95,,705.08,Percent of total billed charges,,,0.98,,727.35,Percent of total billed charges,,,0.95,,705.08,Percent of total billed charges,,,0.95,,705.08,Percent of total billed charges,,,0.97,,719.92,Percent of total billed charges,,,0.96,,712.5,Percent of total billed charges,,,0.95,,705.08,Percent of total billed charges,,,,,,,,,0.95,,705.08,Percent of total billed charges,,705.08,727.35,
NITROGLYCERIN 0.2 MG/HR TD PT24,RX-27472,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
NITROGLYCERIN 0.2 MG/HR TD PT24,RX-27472,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
NITROGLYCERIN 0.4 MG/HR TD PT24,RX-27474,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
NITROGLYCERIN 0.4 MG/HR TD PT24,RX-27474,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
ASPIRIN-DIPYRIDAMOLE ER 25-200 MG PO CP12,RX-27644,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,30.34,27.31,,0.95,,28.82,Percent of total billed charges,,,0.98,,29.73,Percent of total billed charges,,,0.95,,28.82,Percent of total billed charges,,,0.97,,29.43,Percent of total billed charges,,,0.97,,29.43,Percent of total billed charges,,,0.96,,29.13,Percent of total billed charges,,,0.95,,28.82,Percent of total billed charges,,,,,,,,,0.95,,28.82,Percent of total billed charges,,28.82,29.73,
ASPIRIN-DIPYRIDAMOLE ER 25-200 MG PO CP12,RX-27644,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,30.34,27.31,,0.95,,28.82,Percent of total billed charges,,,0.98,,29.73,Percent of total billed charges,,,0.95,,28.82,Percent of total billed charges,,,0.95,,28.82,Percent of total billed charges,,,0.97,,29.43,Percent of total billed charges,,,0.96,,29.13,Percent of total billed charges,,,0.95,,28.82,Percent of total billed charges,,,,,,,,,0.95,,28.82,Percent of total billed charges,,28.82,29.73,
NIFEDIPINE ER OSMOTIC RELEASE 90 MG PO TB24,RX-27660,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.86,9.77,,0.95,,10.32,Percent of total billed charges,,,0.98,,10.64,Percent of total billed charges,,,0.95,,10.32,Percent of total billed charges,,,0.97,,10.53,Percent of total billed charges,,,0.97,,10.53,Percent of total billed charges,,,0.96,,10.43,Percent of total billed charges,,,0.95,,10.32,Percent of total billed charges,,,,,,,,,0.95,,10.32,Percent of total billed charges,,10.32,10.64,
NIFEDIPINE ER OSMOTIC RELEASE 90 MG PO TB24,RX-27660,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.86,9.77,,0.95,,10.32,Percent of total billed charges,,,0.98,,10.64,Percent of total billed charges,,,0.95,,10.32,Percent of total billed charges,,,0.95,,10.32,Percent of total billed charges,,,0.97,,10.53,Percent of total billed charges,,,0.96,,10.43,Percent of total billed charges,,,0.95,,10.32,Percent of total billed charges,,,,,,,,,0.95,,10.32,Percent of total billed charges,,10.32,10.64,
FLUORESCEIN SODIUM 1 MG OP STRP,RX-27663,CDM,J3490,HCPCS,250,RC,,inpatient,1,UN,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
FLUORESCEIN SODIUM 1 MG OP STRP,RX-27663,CDM,J3490,HCPCS,250,RC,,outpatient,1,UN,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
TROLAMINE SALICYLATE 10 % EX CREA,RX-27680,CDM,J3490,HCPCS,637,RC,,inpatient,100,GR,35.23,31.71,,0.95,,33.47,Percent of total billed charges,,,0.98,,34.53,Percent of total billed charges,,,0.95,,33.47,Percent of total billed charges,,,0.97,,34.17,Percent of total billed charges,,,0.97,,34.17,Percent of total billed charges,,,0.96,,33.82,Percent of total billed charges,,,0.95,,33.47,Percent of total billed charges,,,,,,,,,0.95,,33.47,Percent of total billed charges,,33.47,34.53,
TROLAMINE SALICYLATE 10 % EX CREA,RX-27680,CDM,J3490,HCPCS,637,RC,,outpatient,100,GR,35.23,31.71,,0.95,,33.47,Percent of total billed charges,,,0.98,,34.53,Percent of total billed charges,,,0.95,,33.47,Percent of total billed charges,,,0.95,,33.47,Percent of total billed charges,,,0.97,,34.17,Percent of total billed charges,,,0.96,,33.82,Percent of total billed charges,,,0.95,,33.47,Percent of total billed charges,,,,,,,,,0.95,,33.47,Percent of total billed charges,,33.47,34.53,
ONDANSETRON 4 MG PO TBDP,RX-27697,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.85,7.97,,0.95,,8.41,Percent of total billed charges,,,0.98,,8.67,Percent of total billed charges,,,0.95,,8.41,Percent of total billed charges,,,0.97,,8.58,Percent of total billed charges,,,0.97,,8.58,Percent of total billed charges,,,0.96,,8.5,Percent of total billed charges,,,0.95,,8.41,Percent of total billed charges,,,,,,,,,0.95,,8.41,Percent of total billed charges,,8.41,8.67,
ONDANSETRON 4 MG PO TBDP,RX-27697,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.85,7.97,,0.95,,8.41,Percent of total billed charges,,,0.98,,8.67,Percent of total billed charges,,,0.95,,8.41,Percent of total billed charges,,,0.95,,8.41,Percent of total billed charges,,,0.97,,8.58,Percent of total billed charges,,,0.96,,8.5,Percent of total billed charges,,,0.95,,8.41,Percent of total billed charges,,,,,,,,,0.95,,8.41,Percent of total billed charges,,8.41,8.67,
ONDANSETRON 8 MG PO TBDP,RX-27698,CDM,Q0162,HCPCS,636,RC,,inpatient,1,UN,39.14,35.23,,0.95,,37.18,Percent of total billed charges,,,0.98,,38.36,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,0.97,,37.97,Percent of total billed charges,,,0.97,,37.97,Percent of total billed charges,,,0.96,,37.57,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,,,,,,,0.95,,37.18,Percent of total billed charges,,37.18,38.36,
ONDANSETRON 8 MG PO TBDP,RX-27698,CDM,Q0162,HCPCS,636,RC,,outpatient,1,UN,39.14,35.23,,0.95,,37.18,Percent of total billed charges,,,0.98,,38.36,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,0.97,,37.97,Percent of total billed charges,,,0.96,,37.57,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,,,,,,,0.95,,37.18,Percent of total billed charges,,37.18,38.36,
SODIUM CHLORIDE 0.9 % IV SOLN,RX-27838,CDM,J7030,HCPCS,636,RC,,inpatient,1000,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
SODIUM CHLORIDE 0.9 % IV SOLN,RX-27838,CDM,J7030,HCPCS,636,RC,,outpatient,1000,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
VENLAFAXINE HCL ER 75 MG PO CP24,RX-27858,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.4,7.56,,0.95,,7.98,Percent of total billed charges,,,0.98,,8.23,Percent of total billed charges,,,0.95,,7.98,Percent of total billed charges,,,0.97,,8.15,Percent of total billed charges,,,0.97,,8.15,Percent of total billed charges,,,0.96,,8.06,Percent of total billed charges,,,0.95,,7.98,Percent of total billed charges,,,,,,,,,0.95,,7.98,Percent of total billed charges,,7.98,8.23,
VENLAFAXINE HCL ER 75 MG PO CP24,RX-27858,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.4,7.56,,0.95,,7.98,Percent of total billed charges,,,0.98,,8.23,Percent of total billed charges,,,0.95,,7.98,Percent of total billed charges,,,0.95,,7.98,Percent of total billed charges,,,0.97,,8.15,Percent of total billed charges,,,0.96,,8.06,Percent of total billed charges,,,0.95,,7.98,Percent of total billed charges,,,,,,,,,0.95,,7.98,Percent of total billed charges,,7.98,8.23,
NICOTINE 7 MG/24HR TD PT24,RX-27860,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
NICOTINE 7 MG/24HR TD PT24,RX-27860,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
NICOTINE 14 MG/24HR TD PT24,RX-27862,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
NICOTINE 14 MG/24HR TD PT24,RX-27862,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
NICOTINE 21 MG/24HR TD PT24,RX-27863,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,15.71,14.14,,0.95,,14.92,Percent of total billed charges,,,0.98,,15.4,Percent of total billed charges,,,0.95,,14.92,Percent of total billed charges,,,0.97,,15.24,Percent of total billed charges,,,0.97,,15.24,Percent of total billed charges,,,0.96,,15.08,Percent of total billed charges,,,0.95,,14.92,Percent of total billed charges,,,,,,,,,0.95,,14.92,Percent of total billed charges,,14.92,15.4,
NICOTINE 21 MG/24HR TD PT24,RX-27863,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,15.71,14.14,,0.95,,14.92,Percent of total billed charges,,,0.98,,15.4,Percent of total billed charges,,,0.95,,14.92,Percent of total billed charges,,,0.95,,14.92,Percent of total billed charges,,,0.97,,15.24,Percent of total billed charges,,,0.96,,15.08,Percent of total billed charges,,,0.95,,14.92,Percent of total billed charges,,,,,,,,,0.95,,14.92,Percent of total billed charges,,14.92,15.4,
LIDOCAINE VISCOUS HCL 2 % MOUTH/THROAT SOLN,RX-27898,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,9.69,8.72,,0.95,,9.21,Percent of total billed charges,,,0.98,,9.5,Percent of total billed charges,,,0.95,,9.21,Percent of total billed charges,,,0.97,,9.4,Percent of total billed charges,,,0.97,,9.4,Percent of total billed charges,,,0.96,,9.3,Percent of total billed charges,,,0.95,,9.21,Percent of total billed charges,,,,,,,,,0.95,,9.21,Percent of total billed charges,,9.21,9.5,
LIDOCAINE VISCOUS HCL 2 % MOUTH/THROAT SOLN,RX-27898,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,9.69,8.72,,0.95,,9.21,Percent of total billed charges,,,0.98,,9.5,Percent of total billed charges,,,0.95,,9.21,Percent of total billed charges,,,0.95,,9.21,Percent of total billed charges,,,0.97,,9.4,Percent of total billed charges,,,0.96,,9.3,Percent of total billed charges,,,0.95,,9.21,Percent of total billed charges,,,,,,,,,0.95,,9.21,Percent of total billed charges,,9.21,9.5,
FENTANYL 25 MCG/HR TD PT72,RX-27905,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,20.51,18.46,,0.95,,19.48,Percent of total billed charges,,,0.98,,20.1,Percent of total billed charges,,,0.95,,19.48,Percent of total billed charges,,,0.97,,19.89,Percent of total billed charges,,,0.97,,19.89,Percent of total billed charges,,,0.96,,19.69,Percent of total billed charges,,,0.95,,19.48,Percent of total billed charges,,,,,,,,,0.95,,19.48,Percent of total billed charges,,19.48,20.1,
FENTANYL 25 MCG/HR TD PT72,RX-27905,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,20.51,18.46,,0.95,,19.48,Percent of total billed charges,,,0.98,,20.1,Percent of total billed charges,,,0.95,,19.48,Percent of total billed charges,,,0.95,,19.48,Percent of total billed charges,,,0.97,,19.89,Percent of total billed charges,,,0.96,,19.69,Percent of total billed charges,,,0.95,,19.48,Percent of total billed charges,,,,,,,,,0.95,,19.48,Percent of total billed charges,,19.48,20.1,
FENTANYL 50 MCG/HR TD PT72,RX-27906,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,34.13,30.72,,0.95,,32.42,Percent of total billed charges,,,0.98,,33.45,Percent of total billed charges,,,0.95,,32.42,Percent of total billed charges,,,0.97,,33.11,Percent of total billed charges,,,0.97,,33.11,Percent of total billed charges,,,0.96,,32.76,Percent of total billed charges,,,0.95,,32.42,Percent of total billed charges,,,,,,,,,0.95,,32.42,Percent of total billed charges,,32.42,33.45,
FENTANYL 50 MCG/HR TD PT72,RX-27906,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,34.13,30.72,,0.95,,32.42,Percent of total billed charges,,,0.98,,33.45,Percent of total billed charges,,,0.95,,32.42,Percent of total billed charges,,,0.95,,32.42,Percent of total billed charges,,,0.97,,33.11,Percent of total billed charges,,,0.96,,32.76,Percent of total billed charges,,,0.95,,32.42,Percent of total billed charges,,,,,,,,,0.95,,32.42,Percent of total billed charges,,32.42,33.45,
FENTANYL 75 MCG/HR TD PT72,RX-27907,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,88.16,79.34,,0.95,,83.75,Percent of total billed charges,,,0.98,,86.4,Percent of total billed charges,,,0.95,,83.75,Percent of total billed charges,,,0.97,,85.52,Percent of total billed charges,,,0.97,,85.52,Percent of total billed charges,,,0.96,,84.63,Percent of total billed charges,,,0.95,,83.75,Percent of total billed charges,,,,,,,,,0.95,,83.75,Percent of total billed charges,,83.75,86.4,
FENTANYL 75 MCG/HR TD PT72,RX-27907,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,88.16,79.34,,0.95,,83.75,Percent of total billed charges,,,0.98,,86.4,Percent of total billed charges,,,0.95,,83.75,Percent of total billed charges,,,0.95,,83.75,Percent of total billed charges,,,0.97,,85.52,Percent of total billed charges,,,0.96,,84.63,Percent of total billed charges,,,0.95,,83.75,Percent of total billed charges,,,,,,,,,0.95,,83.75,Percent of total billed charges,,83.75,86.4,
FENTANYL 100 MCG/HR TD PT72,RX-27908,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,107.87,97.08,,0.95,,102.48,Percent of total billed charges,,,0.98,,105.71,Percent of total billed charges,,,0.95,,102.48,Percent of total billed charges,,,0.97,,104.63,Percent of total billed charges,,,0.97,,104.63,Percent of total billed charges,,,0.96,,103.56,Percent of total billed charges,,,0.95,,102.48,Percent of total billed charges,,,,,,,,,0.95,,102.48,Percent of total billed charges,,102.48,105.71,
FENTANYL 100 MCG/HR TD PT72,RX-27908,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,107.87,97.08,,0.95,,102.48,Percent of total billed charges,,,0.98,,105.71,Percent of total billed charges,,,0.95,,102.48,Percent of total billed charges,,,0.95,,102.48,Percent of total billed charges,,,0.97,,104.63,Percent of total billed charges,,,0.96,,103.56,Percent of total billed charges,,,0.95,,102.48,Percent of total billed charges,,,,,,,,,0.95,,102.48,Percent of total billed charges,,102.48,105.71,
POLYVINYL ALCOHOL 1.4 % OP SOLN,RX-27994,CDM,J3490,HCPCS,637,RC,,inpatient,15,ML,25.24,22.72,,0.95,,23.98,Percent of total billed charges,,,0.98,,24.74,Percent of total billed charges,,,0.95,,23.98,Percent of total billed charges,,,0.97,,24.48,Percent of total billed charges,,,0.97,,24.48,Percent of total billed charges,,,0.96,,24.23,Percent of total billed charges,,,0.95,,23.98,Percent of total billed charges,,,,,,,,,0.95,,23.98,Percent of total billed charges,,23.98,24.74,
POLYVINYL ALCOHOL 1.4 % OP SOLN,RX-27994,CDM,J3490,HCPCS,637,RC,,outpatient,15,ML,25.24,22.72,,0.95,,23.98,Percent of total billed charges,,,0.98,,24.74,Percent of total billed charges,,,0.95,,23.98,Percent of total billed charges,,,0.95,,23.98,Percent of total billed charges,,,0.97,,24.48,Percent of total billed charges,,,0.96,,24.23,Percent of total billed charges,,,0.95,,23.98,Percent of total billed charges,,,,,,,,,0.95,,23.98,Percent of total billed charges,,23.98,24.74,
MINERAL OIL-HYDROPHIL PETROLAT EX OINT,RX-27996,CDM,J3490,HCPCS,637,RC,,inpatient,454,GR,162.74,146.47,,0.95,,154.6,Percent of total billed charges,,,0.98,,159.49,Percent of total billed charges,,,0.95,,154.6,Percent of total billed charges,,,0.97,,157.86,Percent of total billed charges,,,0.97,,157.86,Percent of total billed charges,,,0.96,,156.23,Percent of total billed charges,,,0.95,,154.6,Percent of total billed charges,,,,,,,,,0.95,,154.6,Percent of total billed charges,,154.6,159.49,
MINERAL OIL-HYDROPHIL PETROLAT EX OINT,RX-27996,CDM,J3490,HCPCS,637,RC,,outpatient,454,GR,162.74,146.47,,0.95,,154.6,Percent of total billed charges,,,0.98,,159.49,Percent of total billed charges,,,0.95,,154.6,Percent of total billed charges,,,0.95,,154.6,Percent of total billed charges,,,0.97,,157.86,Percent of total billed charges,,,0.96,,156.23,Percent of total billed charges,,,0.95,,154.6,Percent of total billed charges,,,,,,,,,0.95,,154.6,Percent of total billed charges,,154.6,159.49,
SODIUM POLYSTYRENE SULFONATE 15 GM/60ML COMBINATION SUSP,RX-27999,CDM,J3490,HCPCS,637,RC,,inpatient,60,ML,91.22,82.1,,0.95,,86.66,Percent of total billed charges,,,0.98,,89.4,Percent of total billed charges,,,0.95,,86.66,Percent of total billed charges,,,0.97,,88.48,Percent of total billed charges,,,0.97,,88.48,Percent of total billed charges,,,0.96,,87.57,Percent of total billed charges,,,0.95,,86.66,Percent of total billed charges,,,,,,,,,0.95,,86.66,Percent of total billed charges,,86.66,89.4,
SODIUM POLYSTYRENE SULFONATE 15 GM/60ML COMBINATION SUSP,RX-27999,CDM,J3490,HCPCS,637,RC,,outpatient,60,ML,91.22,82.1,,0.95,,86.66,Percent of total billed charges,,,0.98,,89.4,Percent of total billed charges,,,0.95,,86.66,Percent of total billed charges,,,0.95,,86.66,Percent of total billed charges,,,0.97,,88.48,Percent of total billed charges,,,0.96,,87.57,Percent of total billed charges,,,0.95,,86.66,Percent of total billed charges,,,,,,,,,0.95,,86.66,Percent of total billed charges,,86.66,89.4,
BENZOCAINE-MENTHOL 20-0.5 % EX AERO,RX-28048,CDM,J3490,HCPCS,637,RC,,inpatient,56,GR,19.46,17.51,,0.95,,18.49,Percent of total billed charges,,,0.98,,19.07,Percent of total billed charges,,,0.95,,18.49,Percent of total billed charges,,,0.97,,18.88,Percent of total billed charges,,,0.97,,18.88,Percent of total billed charges,,,0.96,,18.68,Percent of total billed charges,,,0.95,,18.49,Percent of total billed charges,,,,,,,,,0.95,,18.49,Percent of total billed charges,,18.49,19.07,
BENZOCAINE-MENTHOL 20-0.5 % EX AERO,RX-28048,CDM,J3490,HCPCS,637,RC,,outpatient,56,GR,19.46,17.51,,0.95,,18.49,Percent of total billed charges,,,0.98,,19.07,Percent of total billed charges,,,0.95,,18.49,Percent of total billed charges,,,0.95,,18.49,Percent of total billed charges,,,0.97,,18.88,Percent of total billed charges,,,0.96,,18.68,Percent of total billed charges,,,0.95,,18.49,Percent of total billed charges,,,,,,,,,0.95,,18.49,Percent of total billed charges,,18.49,19.07,
OLANZAPINE 5 MG PO TBDP,RX-28159,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,15.28,13.75,,0.95,,14.52,Percent of total billed charges,,,0.98,,14.97,Percent of total billed charges,,,0.95,,14.52,Percent of total billed charges,,,0.97,,14.82,Percent of total billed charges,,,0.97,,14.82,Percent of total billed charges,,,0.96,,14.67,Percent of total billed charges,,,0.95,,14.52,Percent of total billed charges,,,,,,,,,0.95,,14.52,Percent of total billed charges,,14.52,14.97,
OLANZAPINE 5 MG PO TBDP,RX-28159,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,15.28,13.75,,0.95,,14.52,Percent of total billed charges,,,0.98,,14.97,Percent of total billed charges,,,0.95,,14.52,Percent of total billed charges,,,0.95,,14.52,Percent of total billed charges,,,0.97,,14.82,Percent of total billed charges,,,0.96,,14.67,Percent of total billed charges,,,0.95,,14.52,Percent of total billed charges,,,,,,,,,0.95,,14.52,Percent of total billed charges,,14.52,14.97,
LINEZOLID 600 MG PO TABS,RX-28224,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,19.53,17.58,,0.95,,18.55,Percent of total billed charges,,,0.98,,19.14,Percent of total billed charges,,,0.95,,18.55,Percent of total billed charges,,,0.97,,18.94,Percent of total billed charges,,,0.97,,18.94,Percent of total billed charges,,,0.96,,18.75,Percent of total billed charges,,,0.95,,18.55,Percent of total billed charges,,,,,,,,,0.95,,18.55,Percent of total billed charges,,18.55,19.14,
LINEZOLID 600 MG PO TABS,RX-28224,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,19.53,17.58,,0.95,,18.55,Percent of total billed charges,,,0.98,,19.14,Percent of total billed charges,,,0.95,,18.55,Percent of total billed charges,,,0.95,,18.55,Percent of total billed charges,,,0.97,,18.94,Percent of total billed charges,,,0.96,,18.75,Percent of total billed charges,,,0.95,,18.55,Percent of total billed charges,,,,,,,,,0.95,,18.55,Percent of total billed charges,,18.55,19.14,
RIVASTIGMINE TARTRATE 3 MG PO CAPS,RX-28279,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.41,6.67,,0.95,,7.04,Percent of total billed charges,,,0.98,,7.26,Percent of total billed charges,,,0.95,,7.04,Percent of total billed charges,,,0.97,,7.19,Percent of total billed charges,,,0.97,,7.19,Percent of total billed charges,,,0.96,,7.11,Percent of total billed charges,,,0.95,,7.04,Percent of total billed charges,,,,,,,,,0.95,,7.04,Percent of total billed charges,,7.04,7.26,
RIVASTIGMINE TARTRATE 3 MG PO CAPS,RX-28279,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.41,6.67,,0.95,,7.04,Percent of total billed charges,,,0.98,,7.26,Percent of total billed charges,,,0.95,,7.04,Percent of total billed charges,,,0.95,,7.04,Percent of total billed charges,,,0.97,,7.19,Percent of total billed charges,,,0.96,,7.11,Percent of total billed charges,,,0.95,,7.04,Percent of total billed charges,,,,,,,,,0.95,,7.04,Percent of total billed charges,,7.04,7.26,
INSULIN GLARGINE 100 UNIT/ML SUBQ SOLN,RX-28282,CDM,J1815,HCPCS,637,RC,,inpatient,10,ML,202.71,182.44,,0.95,,192.57,Percent of total billed charges,,,0.98,,198.66,Percent of total billed charges,,,0.95,,192.57,Percent of total billed charges,,,0.97,,196.63,Percent of total billed charges,,,0.97,,196.63,Percent of total billed charges,,,0.96,,194.6,Percent of total billed charges,,,0.95,,192.57,Percent of total billed charges,,,,,,,,,0.95,,192.57,Percent of total billed charges,,192.57,198.66,
INSULIN GLARGINE 100 UNIT/ML SUBQ SOLN,RX-28282,CDM,J1815,HCPCS,637,RC,,outpatient,10,ML,202.71,182.44,,0.95,,192.57,Percent of total billed charges,,,0.98,,198.66,Percent of total billed charges,,,0.95,,192.57,Percent of total billed charges,,,0.95,,192.57,Percent of total billed charges,,,0.97,,196.63,Percent of total billed charges,,,0.96,,194.6,Percent of total billed charges,,,0.95,,192.57,Percent of total billed charges,,,,,,,,,0.95,,192.57,Percent of total billed charges,,192.57,198.66,
HYDROCODONE-ACETAMINOPHEN 10-325 MG PO TABS,RX-28384,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.75,7.88,,0.95,,8.31,Percent of total billed charges,,,0.98,,8.58,Percent of total billed charges,,,0.95,,8.31,Percent of total billed charges,,,0.97,,8.49,Percent of total billed charges,,,0.97,,8.49,Percent of total billed charges,,,0.96,,8.4,Percent of total billed charges,,,0.95,,8.31,Percent of total billed charges,,,,,,,,,0.95,,8.31,Percent of total billed charges,,8.31,8.58,
HYDROCODONE-ACETAMINOPHEN 10-325 MG PO TABS,RX-28384,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.75,7.88,,0.95,,8.31,Percent of total billed charges,,,0.98,,8.58,Percent of total billed charges,,,0.95,,8.31,Percent of total billed charges,,,0.95,,8.31,Percent of total billed charges,,,0.97,,8.49,Percent of total billed charges,,,0.96,,8.4,Percent of total billed charges,,,0.95,,8.31,Percent of total billed charges,,,,,,,,,0.95,,8.31,Percent of total billed charges,,8.31,8.58,
INSULIN ASPART 100 UNIT/ML INJECTION SOLN,RX-28534,CDM,J1815,HCPCS,637,RC,,inpatient,10,ML,239.09,215.18,,0.95,,227.14,Percent of total billed charges,,,0.98,,234.31,Percent of total billed charges,,,0.95,,227.14,Percent of total billed charges,,,0.97,,231.92,Percent of total billed charges,,,0.97,,231.92,Percent of total billed charges,,,0.96,,229.53,Percent of total billed charges,,,0.95,,227.14,Percent of total billed charges,,,,,,,,,0.95,,227.14,Percent of total billed charges,,227.14,234.31,
INSULIN ASPART 100 UNIT/ML INJECTION SOLN,RX-28534,CDM,J1815,HCPCS,637,RC,,outpatient,10,ML,239.09,215.18,,0.95,,227.14,Percent of total billed charges,,,0.98,,234.31,Percent of total billed charges,,,0.95,,227.14,Percent of total billed charges,,,0.95,,227.14,Percent of total billed charges,,,0.97,,231.92,Percent of total billed charges,,,0.96,,229.53,Percent of total billed charges,,,0.95,,227.14,Percent of total billed charges,,,,,,,,,0.95,,227.14,Percent of total billed charges,,227.14,234.31,
NIFEDIPINE ER OSMOTIC RELEASE 30 MG PO TB24,RX-28643,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,9.71,8.74,,0.95,,9.22,Percent of total billed charges,,,0.98,,9.52,Percent of total billed charges,,,0.95,,9.22,Percent of total billed charges,,,0.97,,9.42,Percent of total billed charges,,,0.97,,9.42,Percent of total billed charges,,,0.96,,9.32,Percent of total billed charges,,,0.95,,9.22,Percent of total billed charges,,,,,,,,,0.95,,9.22,Percent of total billed charges,,9.22,9.52,
NIFEDIPINE ER OSMOTIC RELEASE 30 MG PO TB24,RX-28643,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,9.71,8.74,,0.95,,9.22,Percent of total billed charges,,,0.98,,9.52,Percent of total billed charges,,,0.95,,9.22,Percent of total billed charges,,,0.95,,9.22,Percent of total billed charges,,,0.97,,9.42,Percent of total billed charges,,,0.96,,9.32,Percent of total billed charges,,,0.95,,9.22,Percent of total billed charges,,,,,,,,,0.95,,9.22,Percent of total billed charges,,9.22,9.52,
BUDESONIDE 0.5 MG/2ML INHAL SUSP,RX-28775,CDM,J7626,HCPCS,636,RC,,inpatient,1,ML,16.61,14.95,,0.95,,15.78,Percent of total billed charges,,,0.98,,16.28,Percent of total billed charges,,,0.95,,15.78,Percent of total billed charges,,,0.97,,16.11,Percent of total billed charges,,,0.97,,16.11,Percent of total billed charges,,,0.96,,15.95,Percent of total billed charges,,,0.95,,15.78,Percent of total billed charges,,,,,,,,,0.95,,15.78,Percent of total billed charges,,15.78,16.28,
BUDESONIDE 0.5 MG/2ML INHAL SUSP,RX-28775,CDM,J7626,HCPCS,636,RC,,outpatient,1,ML,16.61,14.95,,0.95,,15.78,Percent of total billed charges,,,0.98,,16.28,Percent of total billed charges,,,0.95,,15.78,Percent of total billed charges,,,0.95,,15.78,Percent of total billed charges,,,0.97,,16.11,Percent of total billed charges,,,0.96,,15.95,Percent of total billed charges,,,0.95,,15.78,Percent of total billed charges,,,,,,,,,0.95,,15.78,Percent of total billed charges,,15.78,16.28,
NEOMYCIN-POLYMYXIN-HC 3.5-10000-1 OTIC SUSP,RX-28810,CDM,J3490,HCPCS,637,RC,,inpatient,10,ML,266.83,240.15,,0.95,,253.49,Percent of total billed charges,,,0.98,,261.49,Percent of total billed charges,,,0.95,,253.49,Percent of total billed charges,,,0.97,,258.83,Percent of total billed charges,,,0.97,,258.83,Percent of total billed charges,,,0.96,,256.16,Percent of total billed charges,,,0.95,,253.49,Percent of total billed charges,,,,,,,,,0.95,,253.49,Percent of total billed charges,,253.49,261.49,
NEOMYCIN-POLYMYXIN-HC 3.5-10000-1 OTIC SUSP,RX-28810,CDM,J3490,HCPCS,637,RC,,outpatient,10,ML,266.83,240.15,,0.95,,253.49,Percent of total billed charges,,,0.98,,261.49,Percent of total billed charges,,,0.95,,253.49,Percent of total billed charges,,,0.95,,253.49,Percent of total billed charges,,,0.97,,258.83,Percent of total billed charges,,,0.96,,256.16,Percent of total billed charges,,,0.95,,253.49,Percent of total billed charges,,,,,,,,,0.95,,253.49,Percent of total billed charges,,253.49,261.49,
HYDROCORTISONE (PERIANAL) 2.5 % EX CREA,RX-28824,CDM,J3490,HCPCS,637,RC,,inpatient,30,GR,38.38,34.54,,0.95,,36.46,Percent of total billed charges,,,0.98,,37.61,Percent of total billed charges,,,0.95,,36.46,Percent of total billed charges,,,0.97,,37.23,Percent of total billed charges,,,0.97,,37.23,Percent of total billed charges,,,0.96,,36.84,Percent of total billed charges,,,0.95,,36.46,Percent of total billed charges,,,,,,,,,0.95,,36.46,Percent of total billed charges,,36.46,37.61,
HYDROCORTISONE (PERIANAL) 2.5 % EX CREA,RX-28824,CDM,J3490,HCPCS,637,RC,,outpatient,30,GR,38.38,34.54,,0.95,,36.46,Percent of total billed charges,,,0.98,,37.61,Percent of total billed charges,,,0.95,,36.46,Percent of total billed charges,,,0.95,,36.46,Percent of total billed charges,,,0.97,,37.23,Percent of total billed charges,,,0.96,,36.84,Percent of total billed charges,,,0.95,,36.46,Percent of total billed charges,,,,,,,,,0.95,,36.46,Percent of total billed charges,,36.46,37.61,
MAGNESIUM HYDROXIDE 400 MG/5ML PO SUSP,RX-28836,CDM,J3490,HCPCS,637,RC,,inpatient,30,ML,10.2,9.18,,0.95,,9.69,Percent of total billed charges,,,0.98,,10,Percent of total billed charges,,,0.95,,9.69,Percent of total billed charges,,,0.97,,9.89,Percent of total billed charges,,,0.97,,9.89,Percent of total billed charges,,,0.96,,9.79,Percent of total billed charges,,,0.95,,9.69,Percent of total billed charges,,,,,,,,,0.95,,9.69,Percent of total billed charges,,9.69,10,
MAGNESIUM HYDROXIDE 400 MG/5ML PO SUSP,RX-28836,CDM,J3490,HCPCS,637,RC,,outpatient,30,ML,10.2,9.18,,0.95,,9.69,Percent of total billed charges,,,0.98,,10,Percent of total billed charges,,,0.95,,9.69,Percent of total billed charges,,,0.95,,9.69,Percent of total billed charges,,,0.97,,9.89,Percent of total billed charges,,,0.96,,9.79,Percent of total billed charges,,,0.95,,9.69,Percent of total billed charges,,,,,,,,,0.95,,9.69,Percent of total billed charges,,9.69,10,
CYCLOSPORINE MODIFIED 100 MG PO CAPS,RX-28843,CDM,J7502,HCPCS,636,RC,,inpatient,1,UN,14.18,12.76,,0.95,,13.47,Percent of total billed charges,,,0.98,,13.9,Percent of total billed charges,,,0.95,,13.47,Percent of total billed charges,,,0.97,,13.75,Percent of total billed charges,,,0.97,,13.75,Percent of total billed charges,,,0.96,,13.61,Percent of total billed charges,,,0.95,,13.47,Percent of total billed charges,,,,,,,,,0.95,,13.47,Percent of total billed charges,,13.47,13.9,
CYCLOSPORINE MODIFIED 100 MG PO CAPS,RX-28843,CDM,J7502,HCPCS,636,RC,,outpatient,1,UN,14.18,12.76,,0.95,,13.47,Percent of total billed charges,,,0.98,,13.9,Percent of total billed charges,,,0.95,,13.47,Percent of total billed charges,,,0.95,,13.47,Percent of total billed charges,,,0.97,,13.75,Percent of total billed charges,,,0.96,,13.61,Percent of total billed charges,,,0.95,,13.47,Percent of total billed charges,,,,,,,,,0.95,,13.47,Percent of total billed charges,,13.47,13.9,
ERYTHROMYCIN 5 MG/GM OP OINT,RX-2888,CDM,J3490,HCPCS,637,RC,,inpatient,1,GR,26.43,23.79,,0.95,,25.11,Percent of total billed charges,,,0.98,,25.9,Percent of total billed charges,,,0.95,,25.11,Percent of total billed charges,,,0.97,,25.64,Percent of total billed charges,,,0.97,,25.64,Percent of total billed charges,,,0.96,,25.37,Percent of total billed charges,,,0.95,,25.11,Percent of total billed charges,,,,,,,,,0.95,,25.11,Percent of total billed charges,,25.11,25.9,
ERYTHROMYCIN 5 MG/GM OP OINT,RX-2888,CDM,J3490,HCPCS,637,RC,,outpatient,1,GR,26.43,23.79,,0.95,,25.11,Percent of total billed charges,,,0.98,,25.9,Percent of total billed charges,,,0.95,,25.11,Percent of total billed charges,,,0.95,,25.11,Percent of total billed charges,,,0.97,,25.64,Percent of total billed charges,,,0.96,,25.37,Percent of total billed charges,,,0.95,,25.11,Percent of total billed charges,,,,,,,,,0.95,,25.11,Percent of total billed charges,,25.11,25.9,
METFORMIN HCL ER 500 MG PO TB24,RX-28995,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8,7.2,,0.95,,7.6,Percent of total billed charges,,,0.98,,7.84,Percent of total billed charges,,,0.95,,7.6,Percent of total billed charges,,,0.97,,7.76,Percent of total billed charges,,,0.97,,7.76,Percent of total billed charges,,,0.96,,7.68,Percent of total billed charges,,,0.95,,7.6,Percent of total billed charges,,,,,,,,,0.95,,7.6,Percent of total billed charges,,7.6,7.84,
METFORMIN HCL ER 500 MG PO TB24,RX-28995,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8,7.2,,0.95,,7.6,Percent of total billed charges,,,0.98,,7.84,Percent of total billed charges,,,0.95,,7.6,Percent of total billed charges,,,0.95,,7.6,Percent of total billed charges,,,0.97,,7.76,Percent of total billed charges,,,0.96,,7.68,Percent of total billed charges,,,0.95,,7.6,Percent of total billed charges,,,,,,,,,0.95,,7.6,Percent of total billed charges,,7.6,7.84,
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5ML PO SUSR,RX-2900,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,78.78,70.9,,0.95,,74.84,Percent of total billed charges,,,0.98,,77.2,Percent of total billed charges,,,0.95,,74.84,Percent of total billed charges,,,0.97,,76.42,Percent of total billed charges,,,0.97,,76.42,Percent of total billed charges,,,0.96,,75.63,Percent of total billed charges,,,0.95,,74.84,Percent of total billed charges,,,,,,,,,0.95,,74.84,Percent of total billed charges,,74.84,77.2,
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5ML PO SUSR,RX-2900,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,78.78,70.9,,0.95,,74.84,Percent of total billed charges,,,0.98,,77.2,Percent of total billed charges,,,0.95,,74.84,Percent of total billed charges,,,0.95,,74.84,Percent of total billed charges,,,0.97,,76.42,Percent of total billed charges,,,0.96,,75.63,Percent of total billed charges,,,0.95,,74.84,Percent of total billed charges,,,,,,,,,0.95,,74.84,Percent of total billed charges,,74.84,77.2,
ALENDRONATE SODIUM 70 MG PO TABS,RX-29048,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,16.3,14.67,,0.95,,15.49,Percent of total billed charges,,,0.98,,15.97,Percent of total billed charges,,,0.95,,15.49,Percent of total billed charges,,,0.97,,15.81,Percent of total billed charges,,,0.97,,15.81,Percent of total billed charges,,,0.96,,15.65,Percent of total billed charges,,,0.95,,15.49,Percent of total billed charges,,,,,,,,,0.95,,15.49,Percent of total billed charges,,15.49,15.97,
ALENDRONATE SODIUM 70 MG PO TABS,RX-29048,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,16.3,14.67,,0.95,,15.49,Percent of total billed charges,,,0.98,,15.97,Percent of total billed charges,,,0.95,,15.49,Percent of total billed charges,,,0.95,,15.49,Percent of total billed charges,,,0.97,,15.81,Percent of total billed charges,,,0.96,,15.65,Percent of total billed charges,,,0.95,,15.49,Percent of total billed charges,,,,,,,,,0.95,,15.49,Percent of total billed charges,,15.49,15.97,
IRON SUCROSE 20 MG/ML IV SOLN,RX-29132,CDM,J1756,HCPCS,636,RC,,inpatient,2.5,ML,75.44,67.9,,0.95,,71.67,Percent of total billed charges,,,0.98,,73.93,Percent of total billed charges,,,0.95,,71.67,Percent of total billed charges,,,0.97,,73.18,Percent of total billed charges,,,0.97,,73.18,Percent of total billed charges,,,0.96,,72.42,Percent of total billed charges,,,0.95,,71.67,Percent of total billed charges,,,,,,,,,0.95,,71.67,Percent of total billed charges,,71.67,73.93,
IRON SUCROSE 20 MG/ML IV SOLN,RX-29132,CDM,J1756,HCPCS,636,RC,,outpatient,2.5,ML,75.44,67.9,,0.95,,71.67,Percent of total billed charges,,,0.98,,73.93,Percent of total billed charges,,,0.95,,71.67,Percent of total billed charges,,,0.95,,71.67,Percent of total billed charges,,,0.97,,73.18,Percent of total billed charges,,,0.96,,72.42,Percent of total billed charges,,,0.95,,71.67,Percent of total billed charges,,,,,,,,,0.95,,71.67,Percent of total billed charges,,71.67,73.93,
DILTIAZEM HCL ER COATED BEADS 120 MG PO CP24,RX-29270,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.85,7.07,,0.95,,7.46,Percent of total billed charges,,,0.98,,7.69,Percent of total billed charges,,,0.95,,7.46,Percent of total billed charges,,,0.97,,7.61,Percent of total billed charges,,,0.97,,7.61,Percent of total billed charges,,,0.96,,7.54,Percent of total billed charges,,,0.95,,7.46,Percent of total billed charges,,,,,,,,,0.95,,7.46,Percent of total billed charges,,7.46,7.69,
DILTIAZEM HCL ER COATED BEADS 120 MG PO CP24,RX-29270,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.85,7.07,,0.95,,7.46,Percent of total billed charges,,,0.98,,7.69,Percent of total billed charges,,,0.95,,7.46,Percent of total billed charges,,,0.95,,7.46,Percent of total billed charges,,,0.97,,7.61,Percent of total billed charges,,,0.96,,7.54,Percent of total billed charges,,,0.95,,7.46,Percent of total billed charges,,,,,,,,,0.95,,7.46,Percent of total billed charges,,7.46,7.69,
DILTIAZEM HCL ER COATED BEADS 180 MG PO CP24,RX-29272,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.47,6.72,,0.95,,7.1,Percent of total billed charges,,,0.98,,7.32,Percent of total billed charges,,,0.95,,7.1,Percent of total billed charges,,,0.97,,7.25,Percent of total billed charges,,,0.97,,7.25,Percent of total billed charges,,,0.96,,7.17,Percent of total billed charges,,,0.95,,7.1,Percent of total billed charges,,,,,,,,,0.95,,7.1,Percent of total billed charges,,7.1,7.32,
DILTIAZEM HCL ER COATED BEADS 180 MG PO CP24,RX-29272,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.47,6.72,,0.95,,7.1,Percent of total billed charges,,,0.98,,7.32,Percent of total billed charges,,,0.95,,7.1,Percent of total billed charges,,,0.95,,7.1,Percent of total billed charges,,,0.97,,7.25,Percent of total billed charges,,,0.96,,7.17,Percent of total billed charges,,,0.95,,7.1,Percent of total billed charges,,,,,,,,,0.95,,7.1,Percent of total billed charges,,7.1,7.32,
ESTRADIOL CYPIONATE 5 MG/ML IM OIL,RX-2929,CDM,J1000,HCPCS,636,RC,,inpatient,1,ML,153.19,137.87,,0.95,,145.53,Percent of total billed charges,,,0.98,,150.13,Percent of total billed charges,,,0.95,,145.53,Percent of total billed charges,,,0.97,,148.59,Percent of total billed charges,,,0.97,,148.59,Percent of total billed charges,,,0.96,,147.06,Percent of total billed charges,,,0.95,,145.53,Percent of total billed charges,,,,,,,,,0.95,,145.53,Percent of total billed charges,,145.53,150.13,
ESTRADIOL CYPIONATE 5 MG/ML IM OIL,RX-2929,CDM,J1000,HCPCS,636,RC,,outpatient,1,ML,153.19,137.87,,0.95,,145.53,Percent of total billed charges,,,0.98,,150.13,Percent of total billed charges,,,0.95,,145.53,Percent of total billed charges,,,0.95,,145.53,Percent of total billed charges,,,0.97,,148.59,Percent of total billed charges,,,0.96,,147.06,Percent of total billed charges,,,0.95,,145.53,Percent of total billed charges,,,,,,,,,0.95,,145.53,Percent of total billed charges,,145.53,150.13,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5ML PO SOLN,RX-29302,CDM,J7510,HCPCS,636,RC,,inpatient,5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5ML PO SOLN,RX-29302,CDM,J7510,HCPCS,636,RC,,outpatient,5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
CROTALIDAE POLYVAL IMMUNE FAB IV SOLR,RX-29313,CDM,J0840,HCPCS,636,RC,,inpatient,1,UN,2234.72,2011.25,,0.95,,2122.98,Percent of total billed charges,,,0.98,,2190.03,Percent of total billed charges,,,0.95,,2122.98,Percent of total billed charges,,,0.97,,2167.68,Percent of total billed charges,,,0.97,,2167.68,Percent of total billed charges,,,0.96,,2145.33,Percent of total billed charges,,,0.95,,2122.98,Percent of total billed charges,,,,,,,,,0.95,,2122.98,Percent of total billed charges,,2122.98,2190.03,
CROTALIDAE POLYVAL IMMUNE FAB IV SOLR,RX-29313,CDM,J0840,HCPCS,636,RC,,outpatient,1,UN,2234.72,2011.25,,0.95,,2122.98,Percent of total billed charges,,,0.98,,2190.03,Percent of total billed charges,,,0.95,,2122.98,Percent of total billed charges,,,0.95,,2122.98,Percent of total billed charges,,,0.97,,2167.68,Percent of total billed charges,,,0.96,,2145.33,Percent of total billed charges,,,0.95,,2122.98,Percent of total billed charges,,,,,,,,,0.95,,2122.98,Percent of total billed charges,,2122.98,2190.03,
CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % EX CREA,RX-29424,CDM,J3490,HCPCS,637,RC,,inpatient,15,GR,84.2,75.78,,0.95,,79.99,Percent of total billed charges,,,0.98,,82.52,Percent of total billed charges,,,0.95,,79.99,Percent of total billed charges,,,0.97,,81.67,Percent of total billed charges,,,0.97,,81.67,Percent of total billed charges,,,0.96,,80.83,Percent of total billed charges,,,0.95,,79.99,Percent of total billed charges,,,,,,,,,0.95,,79.99,Percent of total billed charges,,79.99,82.52,
CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % EX CREA,RX-29424,CDM,J3490,HCPCS,637,RC,,outpatient,15,GR,84.2,75.78,,0.95,,79.99,Percent of total billed charges,,,0.98,,82.52,Percent of total billed charges,,,0.95,,79.99,Percent of total billed charges,,,0.95,,79.99,Percent of total billed charges,,,0.97,,81.67,Percent of total billed charges,,,0.96,,80.83,Percent of total billed charges,,,0.95,,79.99,Percent of total billed charges,,,,,,,,,0.95,,79.99,Percent of total billed charges,,79.99,82.52,
TOLTERODINE TARTRATE ER 4 MG PO CP24,RX-29435,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.75,6.98,,0.95,,7.36,Percent of total billed charges,,,0.98,,7.6,Percent of total billed charges,,,0.95,,7.36,Percent of total billed charges,,,0.97,,7.52,Percent of total billed charges,,,0.97,,7.52,Percent of total billed charges,,,0.96,,7.44,Percent of total billed charges,,,0.95,,7.36,Percent of total billed charges,,,,,,,,,0.95,,7.36,Percent of total billed charges,,7.36,7.6,
TOLTERODINE TARTRATE ER 4 MG PO CP24,RX-29435,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.75,6.98,,0.95,,7.36,Percent of total billed charges,,,0.98,,7.6,Percent of total billed charges,,,0.95,,7.36,Percent of total billed charges,,,0.95,,7.36,Percent of total billed charges,,,0.97,,7.52,Percent of total billed charges,,,0.96,,7.44,Percent of total billed charges,,,0.95,,7.36,Percent of total billed charges,,,,,,,,,0.95,,7.36,Percent of total billed charges,,7.36,7.6,
MORPHINE SULFATE (PF) 0.5 MG/ML INJECTION SOLN,RX-29464,CDM,J2274,HCPCS,636,RC,,inpatient,0.5,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
MORPHINE SULFATE (PF) 0.5 MG/ML INJECTION SOLN,RX-29464,CDM,J2274,HCPCS,636,RC,,outpatient,0.5,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
ZIPRASIDONE HCL 80 MG PO CAPS,RX-29781,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.51,9.46,,0.95,,9.98,Percent of total billed charges,,,0.98,,10.3,Percent of total billed charges,,,0.95,,9.98,Percent of total billed charges,,,0.97,,10.19,Percent of total billed charges,,,0.97,,10.19,Percent of total billed charges,,,0.96,,10.09,Percent of total billed charges,,,0.95,,9.98,Percent of total billed charges,,,,,,,,,0.95,,9.98,Percent of total billed charges,,9.98,10.3,
ZIPRASIDONE HCL 80 MG PO CAPS,RX-29781,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.51,9.46,,0.95,,9.98,Percent of total billed charges,,,0.98,,10.3,Percent of total billed charges,,,0.95,,9.98,Percent of total billed charges,,,0.95,,9.98,Percent of total billed charges,,,0.97,,10.19,Percent of total billed charges,,,0.96,,10.09,Percent of total billed charges,,,0.95,,9.98,Percent of total billed charges,,,,,,,,,0.95,,9.98,Percent of total billed charges,,9.98,10.3,
ESMOLOL HCL-SODIUM CHLORIDE 2500 MG/250ML IV SOLN,RX-29805,CDM,J1805,HCPCS,636,RC,,inpatient,250,ML,663.65,597.29,,0.95,,630.47,Percent of total billed charges,,,0.98,,650.38,Percent of total billed charges,,,0.95,,630.47,Percent of total billed charges,,,0.97,,643.74,Percent of total billed charges,,,0.97,,643.74,Percent of total billed charges,,,0.96,,637.1,Percent of total billed charges,,,0.95,,630.47,Percent of total billed charges,,,,,,,,,0.95,,630.47,Percent of total billed charges,,630.47,650.38,
ESMOLOL HCL-SODIUM CHLORIDE 2500 MG/250ML IV SOLN,RX-29805,CDM,J1805,HCPCS,636,RC,,outpatient,250,ML,663.65,597.29,,0.95,,630.47,Percent of total billed charges,,,0.98,,650.38,Percent of total billed charges,,,0.95,,630.47,Percent of total billed charges,,,0.95,,630.47,Percent of total billed charges,,,0.97,,643.74,Percent of total billed charges,,,0.96,,637.1,Percent of total billed charges,,,0.95,,630.47,Percent of total billed charges,,,,,,,,,0.95,,630.47,Percent of total billed charges,,630.47,650.38,
METOPROLOL SUCCINATE ER 25 MG PO TB24,RX-29858,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
METOPROLOL SUCCINATE ER 25 MG PO TB24,RX-29858,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
EYE WASH OP SOLN,RX-3000,CDM,J3490,HCPCS,637,RC,,inpatient,30,ML,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
EYE WASH OP SOLN,RX-3000,CDM,J3490,HCPCS,637,RC,,outpatient,30,ML,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
METOPROLOL SUCCINATE ER 50 MG PO TB24,RX-30070,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
METOPROLOL SUCCINATE ER 50 MG PO TB24,RX-30070,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
FERROUS SULFATE 300 (60 FE) MG/5ML PO SOLN,RX-3071,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,10.43,9.39,,0.95,,9.91,Percent of total billed charges,,,0.98,,10.22,Percent of total billed charges,,,0.95,,9.91,Percent of total billed charges,,,0.97,,10.12,Percent of total billed charges,,,0.97,,10.12,Percent of total billed charges,,,0.96,,10.01,Percent of total billed charges,,,0.95,,9.91,Percent of total billed charges,,,,,,,,,0.95,,9.91,Percent of total billed charges,,9.91,10.22,
FERROUS SULFATE 300 (60 FE) MG/5ML PO SOLN,RX-3071,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,10.43,9.39,,0.95,,9.91,Percent of total billed charges,,,0.98,,10.22,Percent of total billed charges,,,0.95,,9.91,Percent of total billed charges,,,0.95,,9.91,Percent of total billed charges,,,0.97,,10.12,Percent of total billed charges,,,0.96,,10.01,Percent of total billed charges,,,0.95,,9.91,Percent of total billed charges,,,,,,,,,0.95,,9.91,Percent of total billed charges,,9.91,10.22,
FERROUS SULFATE 325 (65 FE) MG PO TABS,RX-3074,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,5.83,5.25,,0.95,,5.54,Percent of total billed charges,,,0.98,,5.71,Percent of total billed charges,,,0.95,,5.54,Percent of total billed charges,,,0.97,,5.66,Percent of total billed charges,,,0.97,,5.66,Percent of total billed charges,,,0.96,,5.6,Percent of total billed charges,,,0.95,,5.54,Percent of total billed charges,,,,,,,,,0.95,,5.54,Percent of total billed charges,,5.54,5.71,
FERROUS SULFATE 325 (65 FE) MG PO TABS,RX-3074,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,5.83,5.25,,0.95,,5.54,Percent of total billed charges,,,0.98,,5.71,Percent of total billed charges,,,0.95,,5.54,Percent of total billed charges,,,0.95,,5.54,Percent of total billed charges,,,0.97,,5.66,Percent of total billed charges,,,0.96,,5.6,Percent of total billed charges,,,0.95,,5.54,Percent of total billed charges,,,,,,,,,0.95,,5.54,Percent of total billed charges,,5.54,5.71,
PACLITAXEL 100 MG/16.7ML IV CONC,RX-31096,CDM,J9267,HCPCS,636,RC,,inpatient,17,ML,196.16,176.54,,0.95,,186.35,Percent of total billed charges,,,0.98,,192.24,Percent of total billed charges,,,0.95,,186.35,Percent of total billed charges,,,0.97,,190.28,Percent of total billed charges,,,0.97,,190.28,Percent of total billed charges,,,0.96,,188.31,Percent of total billed charges,,,0.95,,186.35,Percent of total billed charges,,,,,,,,,0.95,,186.35,Percent of total billed charges,,186.35,192.24,
PACLITAXEL 100 MG/16.7ML IV CONC,RX-31096,CDM,J9267,HCPCS,636,RC,,outpatient,17,ML,196.16,176.54,,0.95,,186.35,Percent of total billed charges,,,0.98,,192.24,Percent of total billed charges,,,0.95,,186.35,Percent of total billed charges,,,0.95,,186.35,Percent of total billed charges,,,0.97,,190.28,Percent of total billed charges,,,0.96,,188.31,Percent of total billed charges,,,0.95,,186.35,Percent of total billed charges,,,,,,,,,0.95,,186.35,Percent of total billed charges,,186.35,192.24,
PACLITAXEL 300 MG/50ML IV CONC,RX-31097,CDM,J9267,HCPCS,636,RC,,inpatient,50,ML,237.93,214.14,,0.95,,226.03,Percent of total billed charges,,,0.98,,233.17,Percent of total billed charges,,,0.95,,226.03,Percent of total billed charges,,,0.97,,230.79,Percent of total billed charges,,,0.97,,230.79,Percent of total billed charges,,,0.96,,228.41,Percent of total billed charges,,,0.95,,226.03,Percent of total billed charges,,,,,,,,,0.95,,226.03,Percent of total billed charges,,226.03,233.17,
PACLITAXEL 300 MG/50ML IV CONC,RX-31097,CDM,J9267,HCPCS,636,RC,,outpatient,50,ML,237.93,214.14,,0.95,,226.03,Percent of total billed charges,,,0.98,,233.17,Percent of total billed charges,,,0.95,,226.03,Percent of total billed charges,,,0.95,,226.03,Percent of total billed charges,,,0.97,,230.79,Percent of total billed charges,,,0.96,,228.41,Percent of total billed charges,,,0.95,,226.03,Percent of total billed charges,,,,,,,,,0.95,,226.03,Percent of total billed charges,,226.03,233.17,
ALLOPURINOL 300 MG PO TABS,RX-311,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.57,7.71,,0.95,,8.14,Percent of total billed charges,,,0.98,,8.4,Percent of total billed charges,,,0.95,,8.14,Percent of total billed charges,,,0.97,,8.31,Percent of total billed charges,,,0.97,,8.31,Percent of total billed charges,,,0.96,,8.23,Percent of total billed charges,,,0.95,,8.14,Percent of total billed charges,,,,,,,,,0.95,,8.14,Percent of total billed charges,,8.14,8.4,
ALLOPURINOL 300 MG PO TABS,RX-311,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.57,7.71,,0.95,,8.14,Percent of total billed charges,,,0.98,,8.4,Percent of total billed charges,,,0.95,,8.14,Percent of total billed charges,,,0.95,,8.14,Percent of total billed charges,,,0.97,,8.31,Percent of total billed charges,,,0.96,,8.23,Percent of total billed charges,,,0.95,,8.14,Percent of total billed charges,,,,,,,,,0.95,,8.14,Percent of total billed charges,,8.14,8.4,
FISH OIL 1000 MG PO CAPS,RX-3113,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.56,5.9,,0.95,,6.23,Percent of total billed charges,,,0.98,,6.43,Percent of total billed charges,,,0.95,,6.23,Percent of total billed charges,,,0.97,,6.36,Percent of total billed charges,,,0.97,,6.36,Percent of total billed charges,,,0.96,,6.3,Percent of total billed charges,,,0.95,,6.23,Percent of total billed charges,,,,,,,,,0.95,,6.23,Percent of total billed charges,,6.23,6.43,
FISH OIL 1000 MG PO CAPS,RX-3113,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.56,5.9,,0.95,,6.23,Percent of total billed charges,,,0.98,,6.43,Percent of total billed charges,,,0.95,,6.23,Percent of total billed charges,,,0.95,,6.23,Percent of total billed charges,,,0.97,,6.36,Percent of total billed charges,,,0.96,,6.3,Percent of total billed charges,,,0.95,,6.23,Percent of total billed charges,,,,,,,,,0.95,,6.23,Percent of total billed charges,,6.23,6.43,
BRIMONIDINE TARTRATE 0.15 % OP SOLN,RX-31158,CDM,J3490,HCPCS,250,RC,,inpatient,5,ML,477.43,429.69,,0.95,,453.56,Percent of total billed charges,,,0.98,,467.88,Percent of total billed charges,,,0.95,,453.56,Percent of total billed charges,,,0.97,,463.11,Percent of total billed charges,,,0.97,,463.11,Percent of total billed charges,,,0.96,,458.33,Percent of total billed charges,,,0.95,,453.56,Percent of total billed charges,,,,,,,,,0.95,,453.56,Percent of total billed charges,,453.56,467.88,
BRIMONIDINE TARTRATE 0.15 % OP SOLN,RX-31158,CDM,J3490,HCPCS,250,RC,,outpatient,5,ML,477.43,429.69,,0.95,,453.56,Percent of total billed charges,,,0.98,,467.88,Percent of total billed charges,,,0.95,,453.56,Percent of total billed charges,,,0.95,,453.56,Percent of total billed charges,,,0.97,,463.11,Percent of total billed charges,,,0.96,,458.33,Percent of total billed charges,,,0.95,,453.56,Percent of total billed charges,,,,,,,,,0.95,,453.56,Percent of total billed charges,,453.56,467.88,
FLEET ENEMA RECTAL ENEM,RX-3123,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
FLEET ENEMA RECTAL ENEM,RX-3123,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
ALTEPLASE 2 MG INJECTION SOLR,RX-31310,CDM,J2997,HCPCS,636,RC,,inpatient,2,ME,541.23,487.11,,0.95,,514.17,Percent of total billed charges,,,0.98,,530.41,Percent of total billed charges,,,0.95,,514.17,Percent of total billed charges,,,0.97,,524.99,Percent of total billed charges,,,0.97,,524.99,Percent of total billed charges,,,0.96,,519.58,Percent of total billed charges,,,0.95,,514.17,Percent of total billed charges,,,,,,,,,0.95,,514.17,Percent of total billed charges,,514.17,530.41,
ALTEPLASE 2 MG INJECTION SOLR,RX-31310,CDM,J2997,HCPCS,636,RC,,outpatient,2,ME,541.23,487.11,,0.95,,514.17,Percent of total billed charges,,,0.98,,530.41,Percent of total billed charges,,,0.95,,514.17,Percent of total billed charges,,,0.95,,514.17,Percent of total billed charges,,,0.97,,524.99,Percent of total billed charges,,,0.96,,519.58,Percent of total billed charges,,,0.95,,514.17,Percent of total billed charges,,,,,,,,,0.95,,514.17,Percent of total billed charges,,514.17,530.41,
DIGOXIN IMMUNE FAB 40 MG IV SOLR,RX-31432,CDM,J1162,HCPCS,636,RC,,inpatient,4,ML,8355.72,7520.15,,0.95,,7937.93,Percent of total billed charges,,,0.98,,8188.61,Percent of total billed charges,,,0.95,,7937.93,Percent of total billed charges,,,0.97,,8105.05,Percent of total billed charges,,,0.97,,8105.05,Percent of total billed charges,,,0.96,,8021.49,Percent of total billed charges,,,0.95,,7937.93,Percent of total billed charges,,,,,,,,,0.95,,7937.93,Percent of total billed charges,,7937.93,8188.61,
DIGOXIN IMMUNE FAB 40 MG IV SOLR,RX-31432,CDM,J1162,HCPCS,636,RC,,outpatient,4,ML,8355.72,7520.15,,0.95,,7937.93,Percent of total billed charges,,,0.98,,8188.61,Percent of total billed charges,,,0.95,,7937.93,Percent of total billed charges,,,0.95,,7937.93,Percent of total billed charges,,,0.97,,8105.05,Percent of total billed charges,,,0.96,,8021.49,Percent of total billed charges,,,0.95,,7937.93,Percent of total billed charges,,,,,,,,,0.95,,7937.93,Percent of total billed charges,,7937.93,8188.61,
ERTAPENEM SODIUM 1 G INJECTION SOLR,RX-31922,CDM,J1335,HCPCS,636,RC,,inpatient,10,ML,97.23,87.51,,0.95,,92.37,Percent of total billed charges,,,0.98,,95.29,Percent of total billed charges,,,0.95,,92.37,Percent of total billed charges,,,0.97,,94.31,Percent of total billed charges,,,0.97,,94.31,Percent of total billed charges,,,0.96,,93.34,Percent of total billed charges,,,0.95,,92.37,Percent of total billed charges,,,,,,,,,0.95,,92.37,Percent of total billed charges,,92.37,95.29,
ERTAPENEM SODIUM 1 G INJECTION SOLR,RX-31922,CDM,J1335,HCPCS,636,RC,,outpatient,10,ML,97.23,87.51,,0.95,,92.37,Percent of total billed charges,,,0.98,,95.29,Percent of total billed charges,,,0.95,,92.37,Percent of total billed charges,,,0.95,,92.37,Percent of total billed charges,,,0.97,,94.31,Percent of total billed charges,,,0.96,,93.34,Percent of total billed charges,,,0.95,,92.37,Percent of total billed charges,,,,,,,,,0.95,,92.37,Percent of total billed charges,,92.37,95.29,
PRENATAL 19 PO CHEW,RX-32210,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
PRENATAL 19 PO CHEW,RX-32210,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
FOLIC ACID 5 MG/ML INJECTION SOLN,RX-3232,CDM,J3490,HCPCS,250,RC,,inpatient,0.2,ML,206,185.4,,0.95,,195.7,Percent of total billed charges,,,0.98,,201.88,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.96,,197.76,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,,,,,,,0.95,,195.7,Percent of total billed charges,,195.7,201.88,
FOLIC ACID 5 MG/ML INJECTION SOLN,RX-3232,CDM,J3490,HCPCS,250,RC,,outpatient,0.2,ML,206,185.4,,0.95,,195.7,Percent of total billed charges,,,0.98,,201.88,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.96,,197.76,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,,,,,,,0.95,,195.7,Percent of total billed charges,,195.7,201.88,
FOLIC ACID 1 MG PO TABS,RX-3233,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.42,5.78,,0.95,,6.1,Percent of total billed charges,,,0.98,,6.29,Percent of total billed charges,,,0.95,,6.1,Percent of total billed charges,,,0.97,,6.23,Percent of total billed charges,,,0.97,,6.23,Percent of total billed charges,,,0.96,,6.16,Percent of total billed charges,,,0.95,,6.1,Percent of total billed charges,,,,,,,,,0.95,,6.1,Percent of total billed charges,,6.1,6.29,
FOLIC ACID 1 MG PO TABS,RX-3233,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.42,5.78,,0.95,,6.1,Percent of total billed charges,,,0.98,,6.29,Percent of total billed charges,,,0.95,,6.1,Percent of total billed charges,,,0.95,,6.1,Percent of total billed charges,,,0.97,,6.23,Percent of total billed charges,,,0.96,,6.16,Percent of total billed charges,,,0.95,,6.1,Percent of total billed charges,,,,,,,,,0.95,,6.1,Percent of total billed charges,,6.1,6.29,
PAMIDRONATE DISODIUM 90 MG/10ML IV SOLN,RX-32855,CDM,J2430,HCPCS,636,RC,,inpatient,10,ML,105.97,95.37,,0.95,,100.67,Percent of total billed charges,,,0.98,,103.85,Percent of total billed charges,,,0.95,,100.67,Percent of total billed charges,,,0.97,,102.79,Percent of total billed charges,,,0.97,,102.79,Percent of total billed charges,,,0.96,,101.73,Percent of total billed charges,,,0.95,,100.67,Percent of total billed charges,,,,,,,,,0.95,,100.67,Percent of total billed charges,,100.67,103.85,
PAMIDRONATE DISODIUM 90 MG/10ML IV SOLN,RX-32855,CDM,J2430,HCPCS,636,RC,,outpatient,10,ML,105.97,95.37,,0.95,,100.67,Percent of total billed charges,,,0.98,,103.85,Percent of total billed charges,,,0.95,,100.67,Percent of total billed charges,,,0.95,,100.67,Percent of total billed charges,,,0.97,,102.79,Percent of total billed charges,,,0.96,,101.73,Percent of total billed charges,,,0.95,,100.67,Percent of total billed charges,,,,,,,,,0.95,,100.67,Percent of total billed charges,,100.67,103.85,
FUROSEMIDE 10 MG/ML INJECTION SOLN,RX-3291,CDM,J1940,HCPCS,636,RC,,inpatient,2,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
FUROSEMIDE 10 MG/ML INJECTION SOLN,RX-3291,CDM,J1940,HCPCS,636,RC,,outpatient,2,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
FUROSEMIDE 10 MG/ML PO SOLN,RX-3292,CDM,J3490,HCPCS,637,RC,,inpatient,1,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
FUROSEMIDE 10 MG/ML PO SOLN,RX-3292,CDM,J3490,HCPCS,637,RC,,outpatient,1,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
FUROSEMIDE 20 MG PO TABS,RX-3294,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,5.98,5.38,,0.95,,5.68,Percent of total billed charges,,,0.98,,5.86,Percent of total billed charges,,,0.95,,5.68,Percent of total billed charges,,,0.97,,5.8,Percent of total billed charges,,,0.97,,5.8,Percent of total billed charges,,,0.96,,5.74,Percent of total billed charges,,,0.95,,5.68,Percent of total billed charges,,,,,,,,,0.95,,5.68,Percent of total billed charges,,5.68,5.86,
FUROSEMIDE 20 MG PO TABS,RX-3294,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,5.98,5.38,,0.95,,5.68,Percent of total billed charges,,,0.98,,5.86,Percent of total billed charges,,,0.95,,5.68,Percent of total billed charges,,,0.95,,5.68,Percent of total billed charges,,,0.97,,5.8,Percent of total billed charges,,,0.96,,5.74,Percent of total billed charges,,,0.95,,5.68,Percent of total billed charges,,,,,,,,,0.95,,5.68,Percent of total billed charges,,5.68,5.86,
FUROSEMIDE 40 MG PO TABS,RX-3295,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.66,5.99,,0.95,,6.33,Percent of total billed charges,,,0.98,,6.53,Percent of total billed charges,,,0.95,,6.33,Percent of total billed charges,,,0.97,,6.46,Percent of total billed charges,,,0.97,,6.46,Percent of total billed charges,,,0.96,,6.39,Percent of total billed charges,,,0.95,,6.33,Percent of total billed charges,,,,,,,,,0.95,,6.33,Percent of total billed charges,,6.33,6.53,
FUROSEMIDE 40 MG PO TABS,RX-3295,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.66,5.99,,0.95,,6.33,Percent of total billed charges,,,0.98,,6.53,Percent of total billed charges,,,0.95,,6.33,Percent of total billed charges,,,0.95,,6.33,Percent of total billed charges,,,0.97,,6.46,Percent of total billed charges,,,0.96,,6.39,Percent of total billed charges,,,0.95,,6.33,Percent of total billed charges,,,,,,,,,0.95,,6.33,Percent of total billed charges,,6.33,6.53,
AMOXICILLIN-POT CLAVULANATE 500-125 MG PO TABS,RX-33227,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.6,9.54,,0.95,,10.07,Percent of total billed charges,,,0.98,,10.39,Percent of total billed charges,,,0.95,,10.07,Percent of total billed charges,,,0.97,,10.28,Percent of total billed charges,,,0.97,,10.28,Percent of total billed charges,,,0.96,,10.18,Percent of total billed charges,,,0.95,,10.07,Percent of total billed charges,,,,,,,,,0.95,,10.07,Percent of total billed charges,,10.07,10.39,
AMOXICILLIN-POT CLAVULANATE 500-125 MG PO TABS,RX-33227,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.6,9.54,,0.95,,10.07,Percent of total billed charges,,,0.98,,10.39,Percent of total billed charges,,,0.95,,10.07,Percent of total billed charges,,,0.95,,10.07,Percent of total billed charges,,,0.97,,10.28,Percent of total billed charges,,,0.96,,10.18,Percent of total billed charges,,,0.95,,10.07,Percent of total billed charges,,,,,,,,,0.95,,10.07,Percent of total billed charges,,10.07,10.39,
AMOXICILLIN-POT CLAVULANATE 875-125 MG PO TABS,RX-33228,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,11.57,10.41,,0.95,,10.99,Percent of total billed charges,,,0.98,,11.34,Percent of total billed charges,,,0.95,,10.99,Percent of total billed charges,,,0.97,,11.22,Percent of total billed charges,,,0.97,,11.22,Percent of total billed charges,,,0.96,,11.11,Percent of total billed charges,,,0.95,,10.99,Percent of total billed charges,,,,,,,,,0.95,,10.99,Percent of total billed charges,,10.99,11.34,
AMOXICILLIN-POT CLAVULANATE 875-125 MG PO TABS,RX-33228,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,11.57,10.41,,0.95,,10.99,Percent of total billed charges,,,0.98,,11.34,Percent of total billed charges,,,0.95,,10.99,Percent of total billed charges,,,0.95,,10.99,Percent of total billed charges,,,0.97,,11.22,Percent of total billed charges,,,0.96,,11.11,Percent of total billed charges,,,0.95,,10.99,Percent of total billed charges,,,,,,,,,0.95,,10.99,Percent of total billed charges,,10.99,11.34,
AMOXICILLIN-POT CLAVULANATE 400-57 MG/5ML PO SUSR,RX-33230,CDM,J3490,HCPCS,637,RC,,inpatient,7.5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
AMOXICILLIN-POT CLAVULANATE 400-57 MG/5ML PO SUSR,RX-33230,CDM,J3490,HCPCS,637,RC,,outpatient,7.5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
ESCITALOPRAM OXALATE 10 MG PO TABS,RX-33512,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.47,5.82,,0.95,,6.15,Percent of total billed charges,,,0.98,,6.34,Percent of total billed charges,,,0.95,,6.15,Percent of total billed charges,,,0.97,,6.28,Percent of total billed charges,,,0.97,,6.28,Percent of total billed charges,,,0.96,,6.21,Percent of total billed charges,,,0.95,,6.15,Percent of total billed charges,,,,,,,,,0.95,,6.15,Percent of total billed charges,,6.15,6.34,
ESCITALOPRAM OXALATE 10 MG PO TABS,RX-33512,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.47,5.82,,0.95,,6.15,Percent of total billed charges,,,0.98,,6.34,Percent of total billed charges,,,0.95,,6.15,Percent of total billed charges,,,0.95,,6.15,Percent of total billed charges,,,0.97,,6.28,Percent of total billed charges,,,0.96,,6.21,Percent of total billed charges,,,0.95,,6.15,Percent of total billed charges,,,,,,,,,0.95,,6.15,Percent of total billed charges,,6.15,6.34,
VALSARTAN 40 MG PO TABS,RX-33541,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.18,7.36,,0.95,,7.77,Percent of total billed charges,,,0.98,,8.02,Percent of total billed charges,,,0.95,,7.77,Percent of total billed charges,,,0.97,,7.93,Percent of total billed charges,,,0.97,,7.93,Percent of total billed charges,,,0.96,,7.85,Percent of total billed charges,,,0.95,,7.77,Percent of total billed charges,,,,,,,,,0.95,,7.77,Percent of total billed charges,,7.77,8.02,
VALSARTAN 40 MG PO TABS,RX-33541,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.18,7.36,,0.95,,7.77,Percent of total billed charges,,,0.98,,8.02,Percent of total billed charges,,,0.95,,7.77,Percent of total billed charges,,,0.95,,7.77,Percent of total billed charges,,,0.97,,7.93,Percent of total billed charges,,,0.96,,7.85,Percent of total billed charges,,,0.95,,7.77,Percent of total billed charges,,,,,,,,,0.95,,7.77,Percent of total billed charges,,7.77,8.02,
LEUPROLIDE ACETATE (3 MONTH) 22.5 MG SUBQ KIT,RX-33669,CDM,J9217,HCPCS,636,RC,,inpatient,22.5,ME,1052.58,947.32,,0.95,,999.95,Percent of total billed charges,,,0.98,,1031.53,Percent of total billed charges,,,0.95,,999.95,Percent of total billed charges,,,0.97,,1021,Percent of total billed charges,,,0.97,,1021,Percent of total billed charges,,,0.96,,1010.48,Percent of total billed charges,,,0.95,,999.95,Percent of total billed charges,,,,,,,,,0.95,,999.95,Percent of total billed charges,,999.95,1031.53,
LEUPROLIDE ACETATE (3 MONTH) 22.5 MG SUBQ KIT,RX-33669,CDM,J9217,HCPCS,636,RC,,outpatient,22.5,ME,1052.58,947.32,,0.95,,999.95,Percent of total billed charges,,,0.98,,1031.53,Percent of total billed charges,,,0.95,,999.95,Percent of total billed charges,,,0.95,,999.95,Percent of total billed charges,,,0.97,,1021,Percent of total billed charges,,,0.96,,1010.48,Percent of total billed charges,,,0.95,,999.95,Percent of total billed charges,,,,,,,,,0.95,,999.95,Percent of total billed charges,,999.95,1031.53,
DUTASTERIDE 0.5 MG PO CAPS,RX-34089,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.36,5.72,,0.95,,6.04,Percent of total billed charges,,,0.98,,6.23,Percent of total billed charges,,,0.95,,6.04,Percent of total billed charges,,,0.97,,6.17,Percent of total billed charges,,,0.97,,6.17,Percent of total billed charges,,,0.96,,6.11,Percent of total billed charges,,,0.95,,6.04,Percent of total billed charges,,,,,,,,,0.95,,6.04,Percent of total billed charges,,6.04,6.23,
DUTASTERIDE 0.5 MG PO CAPS,RX-34089,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.36,5.72,,0.95,,6.04,Percent of total billed charges,,,0.98,,6.23,Percent of total billed charges,,,0.95,,6.04,Percent of total billed charges,,,0.95,,6.04,Percent of total billed charges,,,0.97,,6.17,Percent of total billed charges,,,0.96,,6.11,Percent of total billed charges,,,0.95,,6.04,Percent of total billed charges,,,,,,,,,0.95,,6.04,Percent of total billed charges,,6.04,6.23,
EZETIMIBE 10 MG PO TABS,RX-34153,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,27.61,24.85,,0.95,,26.23,Percent of total billed charges,,,0.98,,27.06,Percent of total billed charges,,,0.95,,26.23,Percent of total billed charges,,,0.97,,26.78,Percent of total billed charges,,,0.97,,26.78,Percent of total billed charges,,,0.96,,26.51,Percent of total billed charges,,,0.95,,26.23,Percent of total billed charges,,,,,,,,,0.95,,26.23,Percent of total billed charges,,26.23,27.06,
EZETIMIBE 10 MG PO TABS,RX-34153,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,27.61,24.85,,0.95,,26.23,Percent of total billed charges,,,0.98,,27.06,Percent of total billed charges,,,0.95,,26.23,Percent of total billed charges,,,0.95,,26.23,Percent of total billed charges,,,0.97,,26.78,Percent of total billed charges,,,0.96,,26.51,Percent of total billed charges,,,0.95,,26.23,Percent of total billed charges,,,,,,,,,0.95,,26.23,Percent of total billed charges,,26.23,27.06,
GENTAMICIN SULFATE 10 MG/ML INJECTION SOLN,RX-3425,CDM,J1580,HCPCS,636,RC,,inpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
GENTAMICIN SULFATE 10 MG/ML INJECTION SOLN,RX-3425,CDM,J1580,HCPCS,636,RC,,outpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
GENTAMICIN SULFATE 40 MG/ML INJECTION SOLN,RX-3426,CDM,J1580,HCPCS,636,RC,,inpatient,20,ML,94.27,84.84,,0.95,,89.56,Percent of total billed charges,,,0.98,,92.38,Percent of total billed charges,,,0.95,,89.56,Percent of total billed charges,,,0.97,,91.44,Percent of total billed charges,,,0.97,,91.44,Percent of total billed charges,,,0.96,,90.5,Percent of total billed charges,,,0.95,,89.56,Percent of total billed charges,,,,,,,,,0.95,,89.56,Percent of total billed charges,,89.56,92.38,
GENTAMICIN SULFATE 40 MG/ML INJECTION SOLN,RX-3426,CDM,J1580,HCPCS,636,RC,,outpatient,20,ML,94.27,84.84,,0.95,,89.56,Percent of total billed charges,,,0.98,,92.38,Percent of total billed charges,,,0.95,,89.56,Percent of total billed charges,,,0.95,,89.56,Percent of total billed charges,,,0.97,,91.44,Percent of total billed charges,,,0.96,,90.5,Percent of total billed charges,,,0.95,,89.56,Percent of total billed charges,,,,,,,,,0.95,,89.56,Percent of total billed charges,,89.56,92.38,
DIVALPROEX SODIUM ER 250 MG PO TB24,RX-34418,CDM,J3490,HCPCS,637,RC,,inpatient,2,UN,21.5,19.35,,0.95,,20.43,Percent of total billed charges,,,0.98,,21.07,Percent of total billed charges,,,0.95,,20.43,Percent of total billed charges,,,0.97,,20.86,Percent of total billed charges,,,0.97,,20.86,Percent of total billed charges,,,0.96,,20.64,Percent of total billed charges,,,0.95,,20.43,Percent of total billed charges,,,,,,,,,0.95,,20.43,Percent of total billed charges,,20.43,21.07,
DIVALPROEX SODIUM ER 250 MG PO TB24,RX-34418,CDM,J3490,HCPCS,637,RC,,outpatient,2,UN,21.5,19.35,,0.95,,20.43,Percent of total billed charges,,,0.98,,21.07,Percent of total billed charges,,,0.95,,20.43,Percent of total billed charges,,,0.95,,20.43,Percent of total billed charges,,,0.97,,20.86,Percent of total billed charges,,,0.96,,20.64,Percent of total billed charges,,,0.95,,20.43,Percent of total billed charges,,,,,,,,,0.95,,20.43,Percent of total billed charges,,20.43,21.07,
HYDROCODONE-ACETAMINOPHEN 5-325 MG PO TABS,RX-34505,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.39,7.55,,0.95,,7.97,Percent of total billed charges,,,0.98,,8.22,Percent of total billed charges,,,0.95,,7.97,Percent of total billed charges,,,0.97,,8.14,Percent of total billed charges,,,0.97,,8.14,Percent of total billed charges,,,0.96,,8.05,Percent of total billed charges,,,0.95,,7.97,Percent of total billed charges,,,,,,,,,0.95,,7.97,Percent of total billed charges,,7.97,8.22,
HYDROCODONE-ACETAMINOPHEN 5-325 MG PO TABS,RX-34505,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.39,7.55,,0.95,,7.97,Percent of total billed charges,,,0.98,,8.22,Percent of total billed charges,,,0.95,,7.97,Percent of total billed charges,,,0.95,,7.97,Percent of total billed charges,,,0.97,,8.14,Percent of total billed charges,,,0.96,,8.05,Percent of total billed charges,,,0.95,,7.97,Percent of total billed charges,,,,,,,,,0.95,,7.97,Percent of total billed charges,,7.97,8.22,
HYDROCODONE-ACETAMINOPHEN 7.5-325 MG PO TABS,RX-34544,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.02,7.22,,0.95,,7.62,Percent of total billed charges,,,0.98,,7.86,Percent of total billed charges,,,0.95,,7.62,Percent of total billed charges,,,0.97,,7.78,Percent of total billed charges,,,0.97,,7.78,Percent of total billed charges,,,0.96,,7.7,Percent of total billed charges,,,0.95,,7.62,Percent of total billed charges,,,,,,,,,0.95,,7.62,Percent of total billed charges,,7.62,7.86,
HYDROCODONE-ACETAMINOPHEN 7.5-325 MG PO TABS,RX-34544,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.02,7.22,,0.95,,7.62,Percent of total billed charges,,,0.98,,7.86,Percent of total billed charges,,,0.95,,7.62,Percent of total billed charges,,,0.95,,7.62,Percent of total billed charges,,,0.97,,7.78,Percent of total billed charges,,,0.96,,7.7,Percent of total billed charges,,,0.95,,7.62,Percent of total billed charges,,,,,,,,,0.95,,7.62,Percent of total billed charges,,7.62,7.86,
BUPRENORPHINE HCL 2 MG SL SUBL,RX-34711,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,15.55,14,,0.95,,14.77,Percent of total billed charges,,,0.98,,15.24,Percent of total billed charges,,,0.95,,14.77,Percent of total billed charges,,,0.97,,15.08,Percent of total billed charges,,,0.97,,15.08,Percent of total billed charges,,,0.96,,14.93,Percent of total billed charges,,,0.95,,14.77,Percent of total billed charges,,,,,,,,,0.95,,14.77,Percent of total billed charges,,14.77,15.24,
BUPRENORPHINE HCL 2 MG SL SUBL,RX-34711,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,15.55,14,,0.95,,14.77,Percent of total billed charges,,,0.98,,15.24,Percent of total billed charges,,,0.95,,14.77,Percent of total billed charges,,,0.95,,14.77,Percent of total billed charges,,,0.97,,15.08,Percent of total billed charges,,,0.96,,14.93,Percent of total billed charges,,,0.95,,14.77,Percent of total billed charges,,,,,,,,,0.95,,14.77,Percent of total billed charges,,14.77,15.24,
BUPRENORPHINE HCL 8 MG SL SUBL,RX-34712,CDM,J0571,HCPCS,637,RC,,inpatient,1,UN,16.81,15.13,,0.95,,15.97,Percent of total billed charges,,,0.98,,16.47,Percent of total billed charges,,,0.95,,15.97,Percent of total billed charges,,,0.97,,16.31,Percent of total billed charges,,,0.97,,16.31,Percent of total billed charges,,,0.96,,16.14,Percent of total billed charges,,,0.95,,15.97,Percent of total billed charges,,,,,,,,,0.95,,15.97,Percent of total billed charges,,15.97,16.47,
BUPRENORPHINE HCL 8 MG SL SUBL,RX-34712,CDM,J0571,HCPCS,637,RC,,outpatient,1,UN,16.81,15.13,,0.95,,15.97,Percent of total billed charges,,,0.98,,16.47,Percent of total billed charges,,,0.95,,15.97,Percent of total billed charges,,,0.95,,15.97,Percent of total billed charges,,,0.97,,16.31,Percent of total billed charges,,,0.96,,16.14,Percent of total billed charges,,,0.95,,15.97,Percent of total billed charges,,,,,,,,,0.95,,15.97,Percent of total billed charges,,15.97,16.47,
BUPRENORPHINE HCL-NALOXONE HCL 2-0.5 MG SL SUBL,RX-34713,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,15.67,14.1,,0.95,,14.89,Percent of total billed charges,,,0.98,,15.36,Percent of total billed charges,,,0.95,,14.89,Percent of total billed charges,,,0.97,,15.2,Percent of total billed charges,,,0.97,,15.2,Percent of total billed charges,,,0.96,,15.04,Percent of total billed charges,,,0.95,,14.89,Percent of total billed charges,,,,,,,,,0.95,,14.89,Percent of total billed charges,,14.89,15.36,
BUPRENORPHINE HCL-NALOXONE HCL 2-0.5 MG SL SUBL,RX-34713,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,15.67,14.1,,0.95,,14.89,Percent of total billed charges,,,0.98,,15.36,Percent of total billed charges,,,0.95,,14.89,Percent of total billed charges,,,0.95,,14.89,Percent of total billed charges,,,0.97,,15.2,Percent of total billed charges,,,0.96,,15.04,Percent of total billed charges,,,0.95,,14.89,Percent of total billed charges,,,,,,,,,0.95,,14.89,Percent of total billed charges,,14.89,15.36,
BUPRENORPHINE HCL-NALOXONE HCL 8-2 MG SL SUBL,RX-34714,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,20.86,18.77,,0.95,,19.82,Percent of total billed charges,,,0.98,,20.44,Percent of total billed charges,,,0.95,,19.82,Percent of total billed charges,,,0.97,,20.23,Percent of total billed charges,,,0.97,,20.23,Percent of total billed charges,,,0.96,,20.03,Percent of total billed charges,,,0.95,,19.82,Percent of total billed charges,,,,,,,,,0.95,,19.82,Percent of total billed charges,,19.82,20.44,
BUPRENORPHINE HCL-NALOXONE HCL 8-2 MG SL SUBL,RX-34714,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,20.86,18.77,,0.95,,19.82,Percent of total billed charges,,,0.98,,20.44,Percent of total billed charges,,,0.95,,19.82,Percent of total billed charges,,,0.95,,19.82,Percent of total billed charges,,,0.97,,20.23,Percent of total billed charges,,,0.96,,20.03,Percent of total billed charges,,,0.95,,19.82,Percent of total billed charges,,,,,,,,,0.95,,19.82,Percent of total billed charges,,19.82,20.44,
NICOTINE POLACRILEX 2 MG MOUTH/THROAT LOZG,RX-34769,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.95,7.16,,0.95,,7.55,Percent of total billed charges,,,0.98,,7.79,Percent of total billed charges,,,0.95,,7.55,Percent of total billed charges,,,0.97,,7.71,Percent of total billed charges,,,0.97,,7.71,Percent of total billed charges,,,0.96,,7.63,Percent of total billed charges,,,0.95,,7.55,Percent of total billed charges,,,,,,,,,0.95,,7.55,Percent of total billed charges,,7.55,7.79,
NICOTINE POLACRILEX 2 MG MOUTH/THROAT LOZG,RX-34769,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.95,7.16,,0.95,,7.55,Percent of total billed charges,,,0.98,,7.79,Percent of total billed charges,,,0.95,,7.55,Percent of total billed charges,,,0.95,,7.55,Percent of total billed charges,,,0.97,,7.71,Percent of total billed charges,,,0.96,,7.63,Percent of total billed charges,,,0.95,,7.55,Percent of total billed charges,,,,,,,,,0.95,,7.55,Percent of total billed charges,,7.55,7.79,
GLYBURIDE 5 MG PO TABS,RX-3489,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.02,6.32,,0.95,,6.67,Percent of total billed charges,,,0.98,,6.88,Percent of total billed charges,,,0.95,,6.67,Percent of total billed charges,,,0.97,,6.81,Percent of total billed charges,,,0.97,,6.81,Percent of total billed charges,,,0.96,,6.74,Percent of total billed charges,,,0.95,,6.67,Percent of total billed charges,,,,,,,,,0.95,,6.67,Percent of total billed charges,,6.67,6.88,
GLYBURIDE 5 MG PO TABS,RX-3489,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.02,6.32,,0.95,,6.67,Percent of total billed charges,,,0.98,,6.88,Percent of total billed charges,,,0.95,,6.67,Percent of total billed charges,,,0.95,,6.67,Percent of total billed charges,,,0.97,,6.81,Percent of total billed charges,,,0.96,,6.74,Percent of total billed charges,,,0.95,,6.67,Percent of total billed charges,,,,,,,,,0.95,,6.67,Percent of total billed charges,,6.67,6.88,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLN,RX-3497,CDM,J1596,HCPCS,636,RC,,inpatient,0.5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLN,RX-3497,CDM,J1596,HCPCS,636,RC,,outpatient,0.5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
ROSUVASTATIN CALCIUM 10 MG PO TABS,RX-35134,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,11.98,10.78,,0.95,,11.38,Percent of total billed charges,,,0.98,,11.74,Percent of total billed charges,,,0.95,,11.38,Percent of total billed charges,,,0.97,,11.62,Percent of total billed charges,,,0.97,,11.62,Percent of total billed charges,,,0.96,,11.5,Percent of total billed charges,,,0.95,,11.38,Percent of total billed charges,,,,,,,,,0.95,,11.38,Percent of total billed charges,,11.38,11.74,
ROSUVASTATIN CALCIUM 10 MG PO TABS,RX-35134,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,11.98,10.78,,0.95,,11.38,Percent of total billed charges,,,0.98,,11.74,Percent of total billed charges,,,0.95,,11.38,Percent of total billed charges,,,0.95,,11.38,Percent of total billed charges,,,0.97,,11.62,Percent of total billed charges,,,0.96,,11.5,Percent of total billed charges,,,0.95,,11.38,Percent of total billed charges,,,,,,,,,0.95,,11.38,Percent of total billed charges,,11.38,11.74,
CEFAZOLIN SODIUM-DEXTROSE 1-4 GM-%(50ML) IV SOLR,RX-35274,CDM,J0690,HCPCS,636,RC,,inpatient,50,ML,70.29,63.26,,0.95,,66.78,Percent of total billed charges,,,0.98,,68.88,Percent of total billed charges,,,0.95,,66.78,Percent of total billed charges,,,0.97,,68.18,Percent of total billed charges,,,0.97,,68.18,Percent of total billed charges,,,0.96,,67.48,Percent of total billed charges,,,0.95,,66.78,Percent of total billed charges,,,,,,,,,0.95,,66.78,Percent of total billed charges,,66.78,68.88,
CEFAZOLIN SODIUM-DEXTROSE 1-4 GM-%(50ML) IV SOLR,RX-35274,CDM,J0690,HCPCS,636,RC,,outpatient,50,ML,70.29,63.26,,0.95,,66.78,Percent of total billed charges,,,0.98,,68.88,Percent of total billed charges,,,0.95,,66.78,Percent of total billed charges,,,0.95,,66.78,Percent of total billed charges,,,0.97,,68.18,Percent of total billed charges,,,0.96,,67.48,Percent of total billed charges,,,0.95,,66.78,Percent of total billed charges,,,,,,,,,0.95,,66.78,Percent of total billed charges,,66.78,68.88,
ALUMINUM HYDROXIDE GEL 320 MG/5ML PO SUSP,RX-353,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
ALUMINUM HYDROXIDE GEL 320 MG/5ML PO SUSP,RX-353,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
MOXIFLOXACIN HCL 0.5 % OP SOLN,RX-35699,CDM,J3490,HCPCS,250,RC,,inpatient,3,ML,126.53,113.88,,0.95,,120.2,Percent of total billed charges,,,0.98,,124,Percent of total billed charges,,,0.95,,120.2,Percent of total billed charges,,,0.97,,122.73,Percent of total billed charges,,,0.97,,122.73,Percent of total billed charges,,,0.96,,121.47,Percent of total billed charges,,,0.95,,120.2,Percent of total billed charges,,,,,,,,,0.95,,120.2,Percent of total billed charges,,120.2,124,
MOXIFLOXACIN HCL 0.5 % OP SOLN,RX-35699,CDM,J3490,HCPCS,250,RC,,outpatient,3,ML,126.53,113.88,,0.95,,120.2,Percent of total billed charges,,,0.98,,124,Percent of total billed charges,,,0.95,,120.2,Percent of total billed charges,,,0.95,,120.2,Percent of total billed charges,,,0.97,,122.73,Percent of total billed charges,,,0.96,,121.47,Percent of total billed charges,,,0.95,,120.2,Percent of total billed charges,,,,,,,,,0.95,,120.2,Percent of total billed charges,,120.2,124,
HALOPERIDOL 0.5 MG PO TABS,RX-3578,CDM,J3490,HCPCS,637,RC,,inpatient,2,UN,14.76,13.28,,0.95,,14.02,Percent of total billed charges,,,0.98,,14.46,Percent of total billed charges,,,0.95,,14.02,Percent of total billed charges,,,0.97,,14.32,Percent of total billed charges,,,0.97,,14.32,Percent of total billed charges,,,0.96,,14.17,Percent of total billed charges,,,0.95,,14.02,Percent of total billed charges,,,,,,,,,0.95,,14.02,Percent of total billed charges,,14.02,14.46,
HALOPERIDOL 0.5 MG PO TABS,RX-3578,CDM,J3490,HCPCS,637,RC,,outpatient,2,UN,14.76,13.28,,0.95,,14.02,Percent of total billed charges,,,0.98,,14.46,Percent of total billed charges,,,0.95,,14.02,Percent of total billed charges,,,0.95,,14.02,Percent of total billed charges,,,0.97,,14.32,Percent of total billed charges,,,0.96,,14.17,Percent of total billed charges,,,0.95,,14.02,Percent of total billed charges,,,,,,,,,0.95,,14.02,Percent of total billed charges,,14.02,14.46,
HALOPERIDOL 1 MG PO TABS,RX-3579,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.52,6.77,,0.95,,7.14,Percent of total billed charges,,,0.98,,7.37,Percent of total billed charges,,,0.95,,7.14,Percent of total billed charges,,,0.97,,7.29,Percent of total billed charges,,,0.97,,7.29,Percent of total billed charges,,,0.96,,7.22,Percent of total billed charges,,,0.95,,7.14,Percent of total billed charges,,,,,,,,,0.95,,7.14,Percent of total billed charges,,7.14,7.37,
HALOPERIDOL 1 MG PO TABS,RX-3579,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.52,6.77,,0.95,,7.14,Percent of total billed charges,,,0.98,,7.37,Percent of total billed charges,,,0.95,,7.14,Percent of total billed charges,,,0.95,,7.14,Percent of total billed charges,,,0.97,,7.29,Percent of total billed charges,,,0.96,,7.22,Percent of total billed charges,,,0.95,,7.14,Percent of total billed charges,,,,,,,,,0.95,,7.14,Percent of total billed charges,,7.14,7.37,
HALOPERIDOL 5 MG PO TABS,RX-3583,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.21,9.19,,0.95,,9.7,Percent of total billed charges,,,0.98,,10.01,Percent of total billed charges,,,0.95,,9.7,Percent of total billed charges,,,0.97,,9.9,Percent of total billed charges,,,0.97,,9.9,Percent of total billed charges,,,0.96,,9.8,Percent of total billed charges,,,0.95,,9.7,Percent of total billed charges,,,,,,,,,0.95,,9.7,Percent of total billed charges,,9.7,10.01,
HALOPERIDOL 5 MG PO TABS,RX-3583,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.21,9.19,,0.95,,9.7,Percent of total billed charges,,,0.98,,10.01,Percent of total billed charges,,,0.95,,9.7,Percent of total billed charges,,,0.95,,9.7,Percent of total billed charges,,,0.97,,9.9,Percent of total billed charges,,,0.96,,9.8,Percent of total billed charges,,,0.95,,9.7,Percent of total billed charges,,,,,,,,,0.95,,9.7,Percent of total billed charges,,9.7,10.01,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLN,RX-3584,CDM,J1630,HCPCS,636,RC,,inpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLN,RX-3584,CDM,J1630,HCPCS,636,RC,,outpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
POTASSIUM CHLORIDE CRYS ER 20 MEQ PO TBCR,RX-35943,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
POTASSIUM CHLORIDE CRYS ER 20 MEQ PO TBCR,RX-35943,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
ARIPIPRAZOLE 5 MG PO TABS,RX-36438,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.15,7.34,,0.95,,7.74,Percent of total billed charges,,,0.98,,7.99,Percent of total billed charges,,,0.95,,7.74,Percent of total billed charges,,,0.97,,7.91,Percent of total billed charges,,,0.97,,7.91,Percent of total billed charges,,,0.96,,7.82,Percent of total billed charges,,,0.95,,7.74,Percent of total billed charges,,,,,,,,,0.95,,7.74,Percent of total billed charges,,7.74,7.99,
ARIPIPRAZOLE 5 MG PO TABS,RX-36438,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.15,7.34,,0.95,,7.74,Percent of total billed charges,,,0.98,,7.99,Percent of total billed charges,,,0.95,,7.74,Percent of total billed charges,,,0.95,,7.74,Percent of total billed charges,,,0.97,,7.91,Percent of total billed charges,,,0.96,,7.82,Percent of total billed charges,,,0.95,,7.74,Percent of total billed charges,,,,,,,,,0.95,,7.74,Percent of total billed charges,,7.74,7.99,
LEVETIRACETAM 100 MG/ML PO SOLN,RX-36590,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,14.39,12.95,,0.95,,13.67,Percent of total billed charges,,,0.98,,14.1,Percent of total billed charges,,,0.95,,13.67,Percent of total billed charges,,,0.97,,13.96,Percent of total billed charges,,,0.97,,13.96,Percent of total billed charges,,,0.96,,13.81,Percent of total billed charges,,,0.95,,13.67,Percent of total billed charges,,,,,,,,,0.95,,13.67,Percent of total billed charges,,13.67,14.1,
LEVETIRACETAM 100 MG/ML PO SOLN,RX-36590,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,14.39,12.95,,0.95,,13.67,Percent of total billed charges,,,0.98,,14.1,Percent of total billed charges,,,0.95,,13.67,Percent of total billed charges,,,0.95,,13.67,Percent of total billed charges,,,0.97,,13.96,Percent of total billed charges,,,0.96,,13.81,Percent of total billed charges,,,0.95,,13.67,Percent of total billed charges,,,,,,,,,0.95,,13.67,Percent of total billed charges,,13.67,14.1,
KETOROLAC TROMETHAMINE 0.4 % OP SOLN,RX-36631,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,200.8,180.72,,0.95,,190.76,Percent of total billed charges,,,0.98,,196.78,Percent of total billed charges,,,0.95,,190.76,Percent of total billed charges,,,0.97,,194.78,Percent of total billed charges,,,0.97,,194.78,Percent of total billed charges,,,0.96,,192.77,Percent of total billed charges,,,0.95,,190.76,Percent of total billed charges,,,,,,,,,0.95,,190.76,Percent of total billed charges,,190.76,196.78,
KETOROLAC TROMETHAMINE 0.4 % OP SOLN,RX-36631,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,200.8,180.72,,0.95,,190.76,Percent of total billed charges,,,0.98,,196.78,Percent of total billed charges,,,0.95,,190.76,Percent of total billed charges,,,0.95,,190.76,Percent of total billed charges,,,0.97,,194.78,Percent of total billed charges,,,0.96,,192.77,Percent of total billed charges,,,0.95,,190.76,Percent of total billed charges,,,,,,,,,0.95,,190.76,Percent of total billed charges,,190.76,196.78,
DOCUSATE SODIUM 50 MG/5ML PO LIQD,RX-36962,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
DOCUSATE SODIUM 50 MG/5ML PO LIQD,RX-36962,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
HYDRALAZINE HCL 20 MG/ML INJECTION SOLN,RX-3697,CDM,J0360,HCPCS,636,RC,,inpatient,0.25,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
HYDRALAZINE HCL 20 MG/ML INJECTION SOLN,RX-3697,CDM,J0360,HCPCS,636,RC,,outpatient,0.25,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
PHENOL 1.4 % MOUTH/THROAT LIQD,RX-36976,CDM,J3490,HCPCS,637,RC,,inpatient,177,ML,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
PHENOL 1.4 % MOUTH/THROAT LIQD,RX-36976,CDM,J3490,HCPCS,637,RC,,outpatient,177,ML,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
HYDRALAZINE HCL 10 MG PO TABS,RX-3698,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.59,5.93,,0.95,,6.26,Percent of total billed charges,,,0.98,,6.46,Percent of total billed charges,,,0.95,,6.26,Percent of total billed charges,,,0.97,,6.39,Percent of total billed charges,,,0.97,,6.39,Percent of total billed charges,,,0.96,,6.33,Percent of total billed charges,,,0.95,,6.26,Percent of total billed charges,,,,,,,,,0.95,,6.26,Percent of total billed charges,,6.26,6.46,
HYDRALAZINE HCL 10 MG PO TABS,RX-3698,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.59,5.93,,0.95,,6.26,Percent of total billed charges,,,0.98,,6.46,Percent of total billed charges,,,0.95,,6.26,Percent of total billed charges,,,0.95,,6.26,Percent of total billed charges,,,0.97,,6.39,Percent of total billed charges,,,0.96,,6.33,Percent of total billed charges,,,0.95,,6.26,Percent of total billed charges,,,,,,,,,0.95,,6.26,Percent of total billed charges,,6.26,6.46,
DAPTOMYCIN 500 MG IV SOLR,RX-36989,CDM,J0878,HCPCS,636,RC,,inpatient,10,ML,216.23,194.61,,0.95,,205.42,Percent of total billed charges,,,0.98,,211.91,Percent of total billed charges,,,0.95,,205.42,Percent of total billed charges,,,0.97,,209.74,Percent of total billed charges,,,0.97,,209.74,Percent of total billed charges,,,0.96,,207.58,Percent of total billed charges,,,0.95,,205.42,Percent of total billed charges,,,,,,,,,0.95,,205.42,Percent of total billed charges,,205.42,211.91,
DAPTOMYCIN 500 MG IV SOLR,RX-36989,CDM,J0878,HCPCS,636,RC,,outpatient,10,ML,216.23,194.61,,0.95,,205.42,Percent of total billed charges,,,0.98,,211.91,Percent of total billed charges,,,0.95,,205.42,Percent of total billed charges,,,0.95,,205.42,Percent of total billed charges,,,0.97,,209.74,Percent of total billed charges,,,0.96,,207.58,Percent of total billed charges,,,0.95,,205.42,Percent of total billed charges,,,,,,,,,0.95,,205.42,Percent of total billed charges,,205.42,211.91,
MEMANTINE HCL 5 MG PO TABS,RX-37170,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.11,6.4,,0.95,,6.75,Percent of total billed charges,,,0.98,,6.97,Percent of total billed charges,,,0.95,,6.75,Percent of total billed charges,,,0.97,,6.9,Percent of total billed charges,,,0.97,,6.9,Percent of total billed charges,,,0.96,,6.83,Percent of total billed charges,,,0.95,,6.75,Percent of total billed charges,,,,,,,,,0.95,,6.75,Percent of total billed charges,,6.75,6.97,
MEMANTINE HCL 5 MG PO TABS,RX-37170,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.11,6.4,,0.95,,6.75,Percent of total billed charges,,,0.98,,6.97,Percent of total billed charges,,,0.95,,6.75,Percent of total billed charges,,,0.95,,6.75,Percent of total billed charges,,,0.97,,6.9,Percent of total billed charges,,,0.96,,6.83,Percent of total billed charges,,,0.95,,6.75,Percent of total billed charges,,,,,,,,,0.95,,6.75,Percent of total billed charges,,6.75,6.97,
HYDROCHLOROTHIAZIDE 25 MG PO TABS,RX-3720,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.71,6.04,,0.95,,6.37,Percent of total billed charges,,,0.98,,6.58,Percent of total billed charges,,,0.95,,6.37,Percent of total billed charges,,,0.97,,6.51,Percent of total billed charges,,,0.97,,6.51,Percent of total billed charges,,,0.96,,6.44,Percent of total billed charges,,,0.95,,6.37,Percent of total billed charges,,,,,,,,,0.95,,6.37,Percent of total billed charges,,6.37,6.58,
HYDROCHLOROTHIAZIDE 25 MG PO TABS,RX-3720,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.71,6.04,,0.95,,6.37,Percent of total billed charges,,,0.98,,6.58,Percent of total billed charges,,,0.95,,6.37,Percent of total billed charges,,,0.95,,6.37,Percent of total billed charges,,,0.97,,6.51,Percent of total billed charges,,,0.96,,6.44,Percent of total billed charges,,,0.95,,6.37,Percent of total billed charges,,,,,,,,,0.95,,6.37,Percent of total billed charges,,6.37,6.58,
HYDROCORTISONE 1 % EX CREA,RX-3726,CDM,J3490,HCPCS,637,RC,,inpatient,28,GR,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
HYDROCORTISONE 1 % EX CREA,RX-3726,CDM,J3490,HCPCS,637,RC,,outpatient,28,GR,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
HYDROCORTISONE 20 MG PO TABS,RX-3734,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.34,7.51,,0.95,,7.92,Percent of total billed charges,,,0.98,,8.17,Percent of total billed charges,,,0.95,,7.92,Percent of total billed charges,,,0.97,,8.09,Percent of total billed charges,,,0.97,,8.09,Percent of total billed charges,,,0.96,,8.01,Percent of total billed charges,,,0.95,,7.92,Percent of total billed charges,,,,,,,,,0.95,,7.92,Percent of total billed charges,,7.92,8.17,
HYDROCORTISONE 20 MG PO TABS,RX-3734,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.34,7.51,,0.95,,7.92,Percent of total billed charges,,,0.98,,8.17,Percent of total billed charges,,,0.95,,7.92,Percent of total billed charges,,,0.95,,7.92,Percent of total billed charges,,,0.97,,8.09,Percent of total billed charges,,,0.96,,8.01,Percent of total billed charges,,,0.95,,7.92,Percent of total billed charges,,,,,,,,,0.95,,7.92,Percent of total billed charges,,7.92,8.17,
SACCHAROMYCES BOULARDII 250 MG PO CAPS,RX-37343,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.93,8.04,,0.95,,8.48,Percent of total billed charges,,,0.98,,8.75,Percent of total billed charges,,,0.95,,8.48,Percent of total billed charges,,,0.97,,8.66,Percent of total billed charges,,,0.97,,8.66,Percent of total billed charges,,,0.96,,8.57,Percent of total billed charges,,,0.95,,8.48,Percent of total billed charges,,,,,,,,,0.95,,8.48,Percent of total billed charges,,8.48,8.75,
SACCHAROMYCES BOULARDII 250 MG PO CAPS,RX-37343,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.93,8.04,,0.95,,8.48,Percent of total billed charges,,,0.98,,8.75,Percent of total billed charges,,,0.95,,8.48,Percent of total billed charges,,,0.95,,8.48,Percent of total billed charges,,,0.97,,8.66,Percent of total billed charges,,,0.96,,8.57,Percent of total billed charges,,,0.95,,8.48,Percent of total billed charges,,,,,,,,,0.95,,8.48,Percent of total billed charges,,8.48,8.75,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPP,RX-3738,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,27.86,25.07,,0.95,,26.47,Percent of total billed charges,,,0.98,,27.3,Percent of total billed charges,,,0.95,,26.47,Percent of total billed charges,,,0.97,,27.02,Percent of total billed charges,,,0.97,,27.02,Percent of total billed charges,,,0.96,,26.75,Percent of total billed charges,,,0.95,,26.47,Percent of total billed charges,,,,,,,,,0.95,,26.47,Percent of total billed charges,,26.47,27.3,
HYDROCORTISONE ACETATE 25 MG RECTAL SUPP,RX-3738,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,27.86,25.07,,0.95,,26.47,Percent of total billed charges,,,0.98,,27.3,Percent of total billed charges,,,0.95,,26.47,Percent of total billed charges,,,0.95,,26.47,Percent of total billed charges,,,0.97,,27.02,Percent of total billed charges,,,0.96,,26.75,Percent of total billed charges,,,0.95,,26.47,Percent of total billed charges,,,,,,,,,0.95,,26.47,Percent of total billed charges,,26.47,27.3,
CHOLESTYRAMINE LIGHT 4 G PO PACK,RX-37482,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.68,9.61,,0.95,,10.15,Percent of total billed charges,,,0.98,,10.47,Percent of total billed charges,,,0.95,,10.15,Percent of total billed charges,,,0.97,,10.36,Percent of total billed charges,,,0.97,,10.36,Percent of total billed charges,,,0.96,,10.25,Percent of total billed charges,,,0.95,,10.15,Percent of total billed charges,,,,,,,,,0.95,,10.15,Percent of total billed charges,,10.15,10.47,
CHOLESTYRAMINE LIGHT 4 G PO PACK,RX-37482,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.68,9.61,,0.95,,10.15,Percent of total billed charges,,,0.98,,10.47,Percent of total billed charges,,,0.95,,10.15,Percent of total billed charges,,,0.95,,10.15,Percent of total billed charges,,,0.97,,10.36,Percent of total billed charges,,,0.96,,10.25,Percent of total billed charges,,,0.95,,10.15,Percent of total billed charges,,,,,,,,,0.95,,10.15,Percent of total billed charges,,10.15,10.47,
GLYCERIN (LAXATIVE) 5.4 GM/DOSE RECTAL ENEM,RX-37495,CDM,J3490,HCPCS,637,RC,,inpatient,7.5,ML,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
GLYCERIN (LAXATIVE) 5.4 GM/DOSE RECTAL ENEM,RX-37495,CDM,J3490,HCPCS,637,RC,,outpatient,7.5,ML,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
HYDROMORPHONE HCL 1 MG/ML INJECTION SOLN,RX-3757,CDM,J1171,HCPCS,636,RC,,inpatient,0.2,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
HYDROMORPHONE HCL 1 MG/ML INJECTION SOLN,RX-3757,CDM,J1171,HCPCS,636,RC,,outpatient,0.2,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
HYDROMORPHONE HCL 2 MG/ML INJECTION SOLN,RX-3758,CDM,J1171,HCPCS,636,RC,,inpatient,0.1,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
HYDROMORPHONE HCL 2 MG/ML INJECTION SOLN,RX-3758,CDM,J1171,HCPCS,636,RC,,outpatient,0.1,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
HYDROMORPHONE HCL 2 MG PO TABS,RX-3760,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.77,6.99,,0.95,,7.38,Percent of total billed charges,,,0.98,,7.61,Percent of total billed charges,,,0.95,,7.38,Percent of total billed charges,,,0.97,,7.54,Percent of total billed charges,,,0.97,,7.54,Percent of total billed charges,,,0.96,,7.46,Percent of total billed charges,,,0.95,,7.38,Percent of total billed charges,,,,,,,,,0.95,,7.38,Percent of total billed charges,,7.38,7.61,
HYDROMORPHONE HCL 2 MG PO TABS,RX-3760,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.77,6.99,,0.95,,7.38,Percent of total billed charges,,,0.98,,7.61,Percent of total billed charges,,,0.95,,7.38,Percent of total billed charges,,,0.95,,7.38,Percent of total billed charges,,,0.97,,7.54,Percent of total billed charges,,,0.96,,7.46,Percent of total billed charges,,,0.95,,7.38,Percent of total billed charges,,,,,,,,,0.95,,7.38,Percent of total billed charges,,7.38,7.61,
GLIPIZIDE ER 5 MG PO TB24,RX-37649,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.45,7.61,,0.95,,8.03,Percent of total billed charges,,,0.98,,8.28,Percent of total billed charges,,,0.95,,8.03,Percent of total billed charges,,,0.97,,8.2,Percent of total billed charges,,,0.97,,8.2,Percent of total billed charges,,,0.96,,8.11,Percent of total billed charges,,,0.95,,8.03,Percent of total billed charges,,,,,,,,,0.95,,8.03,Percent of total billed charges,,8.03,8.28,
GLIPIZIDE ER 5 MG PO TB24,RX-37649,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.45,7.61,,0.95,,8.03,Percent of total billed charges,,,0.98,,8.28,Percent of total billed charges,,,0.95,,8.03,Percent of total billed charges,,,0.95,,8.03,Percent of total billed charges,,,0.97,,8.2,Percent of total billed charges,,,0.96,,8.11,Percent of total billed charges,,,0.95,,8.03,Percent of total billed charges,,,,,,,,,0.95,,8.03,Percent of total billed charges,,8.03,8.28,
GUAIFENESIN ER 600 MG PO TB12,RX-37651,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,9.9,8.91,,0.95,,9.41,Percent of total billed charges,,,0.98,,9.7,Percent of total billed charges,,,0.95,,9.41,Percent of total billed charges,,,0.97,,9.6,Percent of total billed charges,,,0.97,,9.6,Percent of total billed charges,,,0.96,,9.5,Percent of total billed charges,,,0.95,,9.41,Percent of total billed charges,,,,,,,,,0.95,,9.41,Percent of total billed charges,,9.41,9.7,
GUAIFENESIN ER 600 MG PO TB12,RX-37651,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,9.9,8.91,,0.95,,9.41,Percent of total billed charges,,,0.98,,9.7,Percent of total billed charges,,,0.95,,9.41,Percent of total billed charges,,,0.95,,9.41,Percent of total billed charges,,,0.97,,9.6,Percent of total billed charges,,,0.96,,9.5,Percent of total billed charges,,,0.95,,9.41,Percent of total billed charges,,,,,,,,,0.95,,9.41,Percent of total billed charges,,9.41,9.7,
HYDROXYZINE HCL 50 MG/ML IM SOLN,RX-3770,CDM,J3410,HCPCS,636,RC,,inpatient,0.5,ML,43.54,39.19,,0.95,,41.36,Percent of total billed charges,,,0.98,,42.67,Percent of total billed charges,,,0.95,,41.36,Percent of total billed charges,,,0.97,,42.23,Percent of total billed charges,,,0.97,,42.23,Percent of total billed charges,,,0.96,,41.8,Percent of total billed charges,,,0.95,,41.36,Percent of total billed charges,,,,,,,,,0.95,,41.36,Percent of total billed charges,,41.36,42.67,
HYDROXYZINE HCL 50 MG/ML IM SOLN,RX-3770,CDM,J3410,HCPCS,636,RC,,outpatient,0.5,ML,43.54,39.19,,0.95,,41.36,Percent of total billed charges,,,0.98,,42.67,Percent of total billed charges,,,0.95,,41.36,Percent of total billed charges,,,0.95,,41.36,Percent of total billed charges,,,0.97,,42.23,Percent of total billed charges,,,0.96,,41.8,Percent of total billed charges,,,0.95,,41.36,Percent of total billed charges,,,,,,,,,0.95,,41.36,Percent of total billed charges,,41.36,42.67,
HYDROXYZINE HCL 10 MG/5ML PO SYRP,RX-3771,CDM,J3490,HCPCS,637,RC,,inpatient,2.5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
HYDROXYZINE HCL 10 MG/5ML PO SYRP,RX-3771,CDM,J3490,HCPCS,637,RC,,outpatient,2.5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
HYDROXYZINE PAMOATE 25 MG PO CAPS,RX-3777,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.73,6.96,,0.95,,7.34,Percent of total billed charges,,,0.98,,7.58,Percent of total billed charges,,,0.95,,7.34,Percent of total billed charges,,,0.97,,7.5,Percent of total billed charges,,,0.97,,7.5,Percent of total billed charges,,,0.96,,7.42,Percent of total billed charges,,,0.95,,7.34,Percent of total billed charges,,,,,,,,,0.95,,7.34,Percent of total billed charges,,7.34,7.58,
HYDROXYZINE PAMOATE 25 MG PO CAPS,RX-3777,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.73,6.96,,0.95,,7.34,Percent of total billed charges,,,0.98,,7.58,Percent of total billed charges,,,0.95,,7.34,Percent of total billed charges,,,0.95,,7.34,Percent of total billed charges,,,0.97,,7.5,Percent of total billed charges,,,0.96,,7.42,Percent of total billed charges,,,0.95,,7.34,Percent of total billed charges,,,,,,,,,0.95,,7.34,Percent of total billed charges,,7.34,7.58,
HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15ML PO SOLN,RX-37848,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,7.11,6.4,,0.95,,6.75,Percent of total billed charges,,,0.98,,6.97,Percent of total billed charges,,,0.95,,6.75,Percent of total billed charges,,,0.97,,6.9,Percent of total billed charges,,,0.97,,6.9,Percent of total billed charges,,,0.96,,6.83,Percent of total billed charges,,,0.95,,6.75,Percent of total billed charges,,,,,,,,,0.95,,6.75,Percent of total billed charges,,6.75,6.97,
HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15ML PO SOLN,RX-37848,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,7.11,6.4,,0.95,,6.75,Percent of total billed charges,,,0.98,,6.97,Percent of total billed charges,,,0.95,,6.75,Percent of total billed charges,,,0.95,,6.75,Percent of total billed charges,,,0.97,,6.9,Percent of total billed charges,,,0.96,,6.83,Percent of total billed charges,,,0.95,,6.75,Percent of total billed charges,,,,,,,,,0.95,,6.75,Percent of total billed charges,,6.75,6.97,
CETUXIMAB 100 MG/50ML IV SOLN,RX-37989,CDM,J9055,HCPCS,636,RC,,inpatient,50,ML,1621.64,1459.48,,0.95,,1540.56,Percent of total billed charges,,,0.98,,1589.21,Percent of total billed charges,,,0.95,,1540.56,Percent of total billed charges,,,0.97,,1572.99,Percent of total billed charges,,,0.97,,1572.99,Percent of total billed charges,,,0.96,,1556.77,Percent of total billed charges,,,0.95,,1540.56,Percent of total billed charges,,,,,,,,,0.95,,1540.56,Percent of total billed charges,,1540.56,1589.21,
CETUXIMAB 100 MG/50ML IV SOLN,RX-37989,CDM,J9055,HCPCS,636,RC,,outpatient,50,ML,1621.64,1459.48,,0.95,,1540.56,Percent of total billed charges,,,0.98,,1589.21,Percent of total billed charges,,,0.95,,1540.56,Percent of total billed charges,,,0.95,,1540.56,Percent of total billed charges,,,0.97,,1572.99,Percent of total billed charges,,,0.96,,1556.77,Percent of total billed charges,,,0.95,,1540.56,Percent of total billed charges,,,,,,,,,0.95,,1540.56,Percent of total billed charges,,1540.56,1589.21,
LACTULOSE 10 GM/15ML PO SOLN,RX-38245,CDM,J3490,HCPCS,637,RC,,inpatient,15,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
LACTULOSE 10 GM/15ML PO SOLN,RX-38245,CDM,J3490,HCPCS,637,RC,,outpatient,15,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
OLANZAPINE 10 MG IM SOLR,RX-38263,CDM,J2359,HCPCS,636,RC,,inpatient,0.5,ML,21.1,18.99,,0.95,,20.05,Percent of total billed charges,,,0.98,,20.68,Percent of total billed charges,,,0.95,,20.05,Percent of total billed charges,,,0.97,,20.47,Percent of total billed charges,,,0.97,,20.47,Percent of total billed charges,,,0.96,,20.26,Percent of total billed charges,,,0.95,,20.05,Percent of total billed charges,,,,,,,,,0.95,,20.05,Percent of total billed charges,,20.05,20.68,
OLANZAPINE 10 MG IM SOLR,RX-38263,CDM,J2359,HCPCS,636,RC,,outpatient,0.5,ML,21.1,18.99,,0.95,,20.05,Percent of total billed charges,,,0.98,,20.68,Percent of total billed charges,,,0.95,,20.05,Percent of total billed charges,,,0.95,,20.05,Percent of total billed charges,,,0.97,,20.47,Percent of total billed charges,,,0.96,,20.26,Percent of total billed charges,,,0.95,,20.05,Percent of total billed charges,,,,,,,,,0.95,,20.05,Percent of total billed charges,,20.05,20.68,
CYCLOPHOSPHAMIDE 1 G INJECTION SOLR,RX-38270,CDM,J9075,HCPCS,636,RC,,inpatient,50,ML,721,648.9,,0.95,,684.95,Percent of total billed charges,,,0.98,,706.58,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,0.97,,699.37,Percent of total billed charges,,,0.97,,699.37,Percent of total billed charges,,,0.96,,692.16,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,,,,,,,0.95,,684.95,Percent of total billed charges,,684.95,706.58,
CYCLOPHOSPHAMIDE 1 G INJECTION SOLR,RX-38270,CDM,J9075,HCPCS,636,RC,,outpatient,50,ML,721,648.9,,0.95,,684.95,Percent of total billed charges,,,0.98,,706.58,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,0.97,,699.37,Percent of total billed charges,,,0.96,,692.16,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,,,,,,,0.95,,684.95,Percent of total billed charges,,684.95,706.58,
CYCLOPHOSPHAMIDE 500 MG INJECTION SOLR,RX-38271,CDM,J9075,HCPCS,636,RC,,inpatient,25,ML,334.76,301.28,,0.95,,318.02,Percent of total billed charges,,,0.98,,328.06,Percent of total billed charges,,,0.95,,318.02,Percent of total billed charges,,,0.97,,324.72,Percent of total billed charges,,,0.97,,324.72,Percent of total billed charges,,,0.96,,321.37,Percent of total billed charges,,,0.95,,318.02,Percent of total billed charges,,,,,,,,,0.95,,318.02,Percent of total billed charges,,318.02,328.06,
CYCLOPHOSPHAMIDE 500 MG INJECTION SOLR,RX-38271,CDM,J9075,HCPCS,636,RC,,outpatient,25,ML,334.76,301.28,,0.95,,318.02,Percent of total billed charges,,,0.98,,328.06,Percent of total billed charges,,,0.95,,318.02,Percent of total billed charges,,,0.95,,318.02,Percent of total billed charges,,,0.97,,324.72,Percent of total billed charges,,,0.96,,321.37,Percent of total billed charges,,,0.95,,318.02,Percent of total billed charges,,,,,,,,,0.95,,318.02,Percent of total billed charges,,318.02,328.06,
ACETYLCYSTEINE 200 MG/ML IV SOLN,RX-38303,CDM,J0132,HCPCS,636,RC,,inpatient,30,ML,337.53,303.78,,0.95,,320.65,Percent of total billed charges,,,0.98,,330.78,Percent of total billed charges,,,0.95,,320.65,Percent of total billed charges,,,0.97,,327.4,Percent of total billed charges,,,0.97,,327.4,Percent of total billed charges,,,0.96,,324.03,Percent of total billed charges,,,0.95,,320.65,Percent of total billed charges,,,,,,,,,0.95,,320.65,Percent of total billed charges,,320.65,330.78,
ACETYLCYSTEINE 200 MG/ML IV SOLN,RX-38303,CDM,J0132,HCPCS,636,RC,,outpatient,30,ML,337.53,303.78,,0.95,,320.65,Percent of total billed charges,,,0.98,,330.78,Percent of total billed charges,,,0.95,,320.65,Percent of total billed charges,,,0.95,,320.65,Percent of total billed charges,,,0.97,,327.4,Percent of total billed charges,,,0.96,,324.03,Percent of total billed charges,,,0.95,,320.65,Percent of total billed charges,,,,,,,,,0.95,,320.65,Percent of total billed charges,,320.65,330.78,
TIOTROPIUM BROMIDE MONOHYDRATE 18 MCG INHAL CAPS,RX-38315,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,169.95,152.96,,0.95,,161.45,Percent of total billed charges,,,0.98,,166.55,Percent of total billed charges,,,0.95,,161.45,Percent of total billed charges,,,0.97,,164.85,Percent of total billed charges,,,0.97,,164.85,Percent of total billed charges,,,0.96,,163.15,Percent of total billed charges,,,0.95,,161.45,Percent of total billed charges,,,,,,,,,0.95,,161.45,Percent of total billed charges,,161.45,166.55,
TIOTROPIUM BROMIDE MONOHYDRATE 18 MCG INHAL CAPS,RX-38315,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,169.95,152.96,,0.95,,161.45,Percent of total billed charges,,,0.98,,166.55,Percent of total billed charges,,,0.95,,161.45,Percent of total billed charges,,,0.95,,161.45,Percent of total billed charges,,,0.97,,164.85,Percent of total billed charges,,,0.96,,163.15,Percent of total billed charges,,,0.95,,161.45,Percent of total billed charges,,,,,,,,,0.95,,161.45,Percent of total billed charges,,161.45,166.55,
IBUPROFEN 200 MG PO TABS,RX-3841,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,5.95,5.36,,0.95,,5.65,Percent of total billed charges,,,0.98,,5.83,Percent of total billed charges,,,0.95,,5.65,Percent of total billed charges,,,0.97,,5.77,Percent of total billed charges,,,0.97,,5.77,Percent of total billed charges,,,0.96,,5.71,Percent of total billed charges,,,0.95,,5.65,Percent of total billed charges,,,,,,,,,0.95,,5.65,Percent of total billed charges,,5.65,5.83,
IBUPROFEN 200 MG PO TABS,RX-3841,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,5.95,5.36,,0.95,,5.65,Percent of total billed charges,,,0.98,,5.83,Percent of total billed charges,,,0.95,,5.65,Percent of total billed charges,,,0.95,,5.65,Percent of total billed charges,,,0.97,,5.77,Percent of total billed charges,,,0.96,,5.71,Percent of total billed charges,,,0.95,,5.65,Percent of total billed charges,,,,,,,,,0.95,,5.65,Percent of total billed charges,,5.65,5.83,
IBUPROFEN 400 MG PO TABS,RX-3843,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.03,5.43,,0.95,,5.73,Percent of total billed charges,,,0.98,,5.91,Percent of total billed charges,,,0.95,,5.73,Percent of total billed charges,,,0.97,,5.85,Percent of total billed charges,,,0.97,,5.85,Percent of total billed charges,,,0.96,,5.79,Percent of total billed charges,,,0.95,,5.73,Percent of total billed charges,,,,,,,,,0.95,,5.73,Percent of total billed charges,,5.73,5.91,
IBUPROFEN 400 MG PO TABS,RX-3843,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.03,5.43,,0.95,,5.73,Percent of total billed charges,,,0.98,,5.91,Percent of total billed charges,,,0.95,,5.73,Percent of total billed charges,,,0.95,,5.73,Percent of total billed charges,,,0.97,,5.85,Percent of total billed charges,,,0.96,,5.79,Percent of total billed charges,,,0.95,,5.73,Percent of total billed charges,,,,,,,,,0.95,,5.73,Percent of total billed charges,,5.73,5.91,
IBUPROFEN 600 MG PO TABS,RX-3844,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.63,5.97,,0.95,,6.3,Percent of total billed charges,,,0.98,,6.5,Percent of total billed charges,,,0.95,,6.3,Percent of total billed charges,,,0.97,,6.43,Percent of total billed charges,,,0.97,,6.43,Percent of total billed charges,,,0.96,,6.36,Percent of total billed charges,,,0.95,,6.3,Percent of total billed charges,,,,,,,,,0.95,,6.3,Percent of total billed charges,,6.3,6.5,
IBUPROFEN 600 MG PO TABS,RX-3844,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.63,5.97,,0.95,,6.3,Percent of total billed charges,,,0.98,,6.5,Percent of total billed charges,,,0.95,,6.3,Percent of total billed charges,,,0.95,,6.3,Percent of total billed charges,,,0.97,,6.43,Percent of total billed charges,,,0.96,,6.36,Percent of total billed charges,,,0.95,,6.3,Percent of total billed charges,,,,,,,,,0.95,,6.3,Percent of total billed charges,,6.3,6.5,
IBUPROFEN 800 MG PO TABS,RX-3845,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.65,5.99,,0.95,,6.32,Percent of total billed charges,,,0.98,,6.52,Percent of total billed charges,,,0.95,,6.32,Percent of total billed charges,,,0.97,,6.45,Percent of total billed charges,,,0.97,,6.45,Percent of total billed charges,,,0.96,,6.38,Percent of total billed charges,,,0.95,,6.32,Percent of total billed charges,,,,,,,,,0.95,,6.32,Percent of total billed charges,,6.32,6.52,
IBUPROFEN 800 MG PO TABS,RX-3845,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.65,5.99,,0.95,,6.32,Percent of total billed charges,,,0.98,,6.52,Percent of total billed charges,,,0.95,,6.32,Percent of total billed charges,,,0.95,,6.32,Percent of total billed charges,,,0.97,,6.45,Percent of total billed charges,,,0.96,,6.38,Percent of total billed charges,,,0.95,,6.32,Percent of total billed charges,,,,,,,,,0.95,,6.32,Percent of total billed charges,,6.32,6.52,
ADENOSINE 6 MG/2ML IV SOLN,RX-38703,CDM,J0153,HCPCS,636,RC,,inpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
ADENOSINE 6 MG/2ML IV SOLN,RX-38703,CDM,J0153,HCPCS,636,RC,,outpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
INDOMETHACIN 25 MG PO CAPS,RX-3897,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.09,6.38,,0.95,,6.74,Percent of total billed charges,,,0.98,,6.95,Percent of total billed charges,,,0.95,,6.74,Percent of total billed charges,,,0.97,,6.88,Percent of total billed charges,,,0.97,,6.88,Percent of total billed charges,,,0.96,,6.81,Percent of total billed charges,,,0.95,,6.74,Percent of total billed charges,,,,,,,,,0.95,,6.74,Percent of total billed charges,,6.74,6.95,
INDOMETHACIN 25 MG PO CAPS,RX-3897,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.09,6.38,,0.95,,6.74,Percent of total billed charges,,,0.98,,6.95,Percent of total billed charges,,,0.95,,6.74,Percent of total billed charges,,,0.95,,6.74,Percent of total billed charges,,,0.97,,6.88,Percent of total billed charges,,,0.96,,6.81,Percent of total billed charges,,,0.95,,6.74,Percent of total billed charges,,,,,,,,,0.95,,6.74,Percent of total billed charges,,6.74,6.95,
NYSTATIN 100000 UNIT/GM EX POWD,RX-39136,CDM,J3490,HCPCS,637,RC,,inpatient,15,GR,82.46,74.21,,0.95,,78.34,Percent of total billed charges,,,0.98,,80.81,Percent of total billed charges,,,0.95,,78.34,Percent of total billed charges,,,0.97,,79.99,Percent of total billed charges,,,0.97,,79.99,Percent of total billed charges,,,0.96,,79.16,Percent of total billed charges,,,0.95,,78.34,Percent of total billed charges,,,,,,,,,0.95,,78.34,Percent of total billed charges,,78.34,80.81,
NYSTATIN 100000 UNIT/GM EX POWD,RX-39136,CDM,J3490,HCPCS,637,RC,,outpatient,15,GR,82.46,74.21,,0.95,,78.34,Percent of total billed charges,,,0.98,,80.81,Percent of total billed charges,,,0.95,,78.34,Percent of total billed charges,,,0.95,,78.34,Percent of total billed charges,,,0.97,,79.99,Percent of total billed charges,,,0.96,,79.16,Percent of total billed charges,,,0.95,,78.34,Percent of total billed charges,,,,,,,,,0.95,,78.34,Percent of total billed charges,,78.34,80.81,
EMTRICITABINE-TENOFOVIR DF 200-300 MG PO TABS,RX-39255,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,159.47,143.52,,0.95,,151.5,Percent of total billed charges,,,0.98,,156.28,Percent of total billed charges,,,0.95,,151.5,Percent of total billed charges,,,0.97,,154.69,Percent of total billed charges,,,0.97,,154.69,Percent of total billed charges,,,0.96,,153.09,Percent of total billed charges,,,0.95,,151.5,Percent of total billed charges,,,,,,,,,0.95,,151.5,Percent of total billed charges,,151.5,156.28,
EMTRICITABINE-TENOFOVIR DF 200-300 MG PO TABS,RX-39255,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,159.47,143.52,,0.95,,151.5,Percent of total billed charges,,,0.98,,156.28,Percent of total billed charges,,,0.95,,151.5,Percent of total billed charges,,,0.95,,151.5,Percent of total billed charges,,,0.97,,154.69,Percent of total billed charges,,,0.96,,153.09,Percent of total billed charges,,,0.95,,151.5,Percent of total billed charges,,,,,,,,,0.95,,151.5,Percent of total billed charges,,151.5,156.28,
CARBOPLATIN 50 MG/5ML IV SOLN,RX-39265,CDM,J9045,HCPCS,636,RC,,inpatient,5,ML,151.32,136.19,,0.95,,143.75,Percent of total billed charges,,,0.98,,148.29,Percent of total billed charges,,,0.95,,143.75,Percent of total billed charges,,,0.97,,146.78,Percent of total billed charges,,,0.97,,146.78,Percent of total billed charges,,,0.96,,145.27,Percent of total billed charges,,,0.95,,143.75,Percent of total billed charges,,,,,,,,,0.95,,143.75,Percent of total billed charges,,143.75,148.29,
CARBOPLATIN 50 MG/5ML IV SOLN,RX-39265,CDM,J9045,HCPCS,636,RC,,outpatient,5,ML,151.32,136.19,,0.95,,143.75,Percent of total billed charges,,,0.98,,148.29,Percent of total billed charges,,,0.95,,143.75,Percent of total billed charges,,,0.95,,143.75,Percent of total billed charges,,,0.97,,146.78,Percent of total billed charges,,,0.96,,145.27,Percent of total billed charges,,,0.95,,143.75,Percent of total billed charges,,,,,,,,,0.95,,143.75,Percent of total billed charges,,143.75,148.29,
CARBOPLATIN 150 MG/15ML IV SOLN,RX-39266,CDM,J9045,HCPCS,636,RC,,inpatient,15,ML,204.67,184.2,,0.95,,194.44,Percent of total billed charges,,,0.98,,200.58,Percent of total billed charges,,,0.95,,194.44,Percent of total billed charges,,,0.97,,198.53,Percent of total billed charges,,,0.97,,198.53,Percent of total billed charges,,,0.96,,196.48,Percent of total billed charges,,,0.95,,194.44,Percent of total billed charges,,,,,,,,,0.95,,194.44,Percent of total billed charges,,194.44,200.58,
CARBOPLATIN 150 MG/15ML IV SOLN,RX-39266,CDM,J9045,HCPCS,636,RC,,outpatient,15,ML,204.67,184.2,,0.95,,194.44,Percent of total billed charges,,,0.98,,200.58,Percent of total billed charges,,,0.95,,194.44,Percent of total billed charges,,,0.95,,194.44,Percent of total billed charges,,,0.97,,198.53,Percent of total billed charges,,,0.96,,196.48,Percent of total billed charges,,,0.95,,194.44,Percent of total billed charges,,,,,,,,,0.95,,194.44,Percent of total billed charges,,194.44,200.58,
CARBOPLATIN 450 MG/45ML IV SOLN,RX-39267,CDM,J9045,HCPCS,636,RC,,inpatient,45,ML,195.65,176.09,,0.95,,185.87,Percent of total billed charges,,,0.98,,191.74,Percent of total billed charges,,,0.95,,185.87,Percent of total billed charges,,,0.97,,189.78,Percent of total billed charges,,,0.97,,189.78,Percent of total billed charges,,,0.96,,187.82,Percent of total billed charges,,,0.95,,185.87,Percent of total billed charges,,,,,,,,,0.95,,185.87,Percent of total billed charges,,185.87,191.74,
CARBOPLATIN 450 MG/45ML IV SOLN,RX-39267,CDM,J9045,HCPCS,636,RC,,outpatient,45,ML,195.65,176.09,,0.95,,185.87,Percent of total billed charges,,,0.98,,191.74,Percent of total billed charges,,,0.95,,185.87,Percent of total billed charges,,,0.95,,185.87,Percent of total billed charges,,,0.97,,189.78,Percent of total billed charges,,,0.96,,187.82,Percent of total billed charges,,,0.95,,185.87,Percent of total billed charges,,,,,,,,,0.95,,185.87,Percent of total billed charges,,185.87,191.74,
LEVALBUTEROL HCL 1.25 MG/0.5ML INHAL NEBU,RX-39278,CDM,J7612,HCPCS,636,RC,,inpatient,1,ML,32.83,29.55,,0.95,,31.19,Percent of total billed charges,,,0.98,,32.17,Percent of total billed charges,,,0.95,,31.19,Percent of total billed charges,,,0.97,,31.85,Percent of total billed charges,,,0.97,,31.85,Percent of total billed charges,,,0.96,,31.52,Percent of total billed charges,,,0.95,,31.19,Percent of total billed charges,,,,,,,,,0.95,,31.19,Percent of total billed charges,,31.19,32.17,
LEVALBUTEROL HCL 1.25 MG/0.5ML INHAL NEBU,RX-39278,CDM,J7612,HCPCS,636,RC,,outpatient,1,ML,32.83,29.55,,0.95,,31.19,Percent of total billed charges,,,0.98,,32.17,Percent of total billed charges,,,0.95,,31.19,Percent of total billed charges,,,0.95,,31.19,Percent of total billed charges,,,0.97,,31.85,Percent of total billed charges,,,0.96,,31.52,Percent of total billed charges,,,0.95,,31.19,Percent of total billed charges,,,,,,,,,0.95,,31.19,Percent of total billed charges,,31.19,32.17,
ADENOSINE 12 MG/4ML IV SOLN,RX-39477,CDM,J0153,HCPCS,636,RC,,inpatient,2,ML,22.68,20.41,,0.95,,21.55,Percent of total billed charges,,,0.98,,22.23,Percent of total billed charges,,,0.95,,21.55,Percent of total billed charges,,,0.97,,22,Percent of total billed charges,,,0.97,,22,Percent of total billed charges,,,0.96,,21.77,Percent of total billed charges,,,0.95,,21.55,Percent of total billed charges,,,,,,,,,0.95,,21.55,Percent of total billed charges,,21.55,22.23,
ADENOSINE 12 MG/4ML IV SOLN,RX-39477,CDM,J0153,HCPCS,636,RC,,outpatient,2,ML,22.68,20.41,,0.95,,21.55,Percent of total billed charges,,,0.98,,22.23,Percent of total billed charges,,,0.95,,21.55,Percent of total billed charges,,,0.95,,21.55,Percent of total billed charges,,,0.97,,22,Percent of total billed charges,,,0.96,,21.77,Percent of total billed charges,,,0.95,,21.55,Percent of total billed charges,,,,,,,,,0.95,,21.55,Percent of total billed charges,,21.55,22.23,
ACAMPROSATE CALCIUM 333 MG PO TBEC,RX-39720,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,15.53,13.98,,0.95,,14.75,Percent of total billed charges,,,0.98,,15.22,Percent of total billed charges,,,0.95,,14.75,Percent of total billed charges,,,0.97,,15.06,Percent of total billed charges,,,0.97,,15.06,Percent of total billed charges,,,0.96,,14.91,Percent of total billed charges,,,0.95,,14.75,Percent of total billed charges,,,,,,,,,0.95,,14.75,Percent of total billed charges,,14.75,15.22,
ACAMPROSATE CALCIUM 333 MG PO TBEC,RX-39720,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,15.53,13.98,,0.95,,14.75,Percent of total billed charges,,,0.98,,15.22,Percent of total billed charges,,,0.95,,14.75,Percent of total billed charges,,,0.95,,14.75,Percent of total billed charges,,,0.97,,15.06,Percent of total billed charges,,,0.96,,14.91,Percent of total billed charges,,,0.95,,14.75,Percent of total billed charges,,,,,,,,,0.95,,14.75,Percent of total billed charges,,14.75,15.22,
FLUMAZENIL 0.5 MG/5ML IV SOLN,RX-39744,CDM,J3490,HCPCS,636,RC,,inpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
FLUMAZENIL 0.5 MG/5ML IV SOLN,RX-39744,CDM,J3490,HCPCS,636,RC,,outpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
IRON DEXTRAN 50 MG/ML INJECTION SOLN,RX-3990,CDM,J1750,HCPCS,636,RC,,inpatient,0.5,ML,37.71,33.94,,0.95,,35.82,Percent of total billed charges,,,0.98,,36.96,Percent of total billed charges,,,0.95,,35.82,Percent of total billed charges,,,0.97,,36.58,Percent of total billed charges,,,0.97,,36.58,Percent of total billed charges,,,0.96,,36.2,Percent of total billed charges,,,0.95,,35.82,Percent of total billed charges,,,,,,,,,0.95,,35.82,Percent of total billed charges,,35.82,36.96,
IRON DEXTRAN 50 MG/ML INJECTION SOLN,RX-3990,CDM,J1750,HCPCS,636,RC,,outpatient,0.5,ML,37.71,33.94,,0.95,,35.82,Percent of total billed charges,,,0.98,,36.96,Percent of total billed charges,,,0.95,,35.82,Percent of total billed charges,,,0.95,,35.82,Percent of total billed charges,,,0.97,,36.58,Percent of total billed charges,,,0.96,,36.2,Percent of total billed charges,,,0.95,,35.82,Percent of total billed charges,,,,,,,,,0.95,,35.82,Percent of total billed charges,,35.82,36.96,
TOBRAMYCIN SULFATE 80 MG/2ML INJECTION SOLN,RX-39918,CDM,J3260,HCPCS,636,RC,,inpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
TOBRAMYCIN SULFATE 80 MG/2ML INJECTION SOLN,RX-39918,CDM,J3260,HCPCS,636,RC,,outpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
FIRST-MOUTHWASH BLM MOUTH/THROAT SUSP,RX-39986,CDM,J3490,HCPCS,637,RC,,inpatient,237,ML,383.99,345.59,,0.95,,364.79,Percent of total billed charges,,,0.98,,376.31,Percent of total billed charges,,,0.95,,364.79,Percent of total billed charges,,,0.97,,372.47,Percent of total billed charges,,,0.97,,372.47,Percent of total billed charges,,,0.96,,368.63,Percent of total billed charges,,,0.95,,364.79,Percent of total billed charges,,,,,,,,,0.95,,364.79,Percent of total billed charges,,364.79,376.31,
FIRST-MOUTHWASH BLM MOUTH/THROAT SUSP,RX-39986,CDM,J3490,HCPCS,637,RC,,outpatient,237,ML,383.99,345.59,,0.95,,364.79,Percent of total billed charges,,,0.98,,376.31,Percent of total billed charges,,,0.95,,364.79,Percent of total billed charges,,,0.95,,364.79,Percent of total billed charges,,,0.97,,372.47,Percent of total billed charges,,,0.96,,368.63,Percent of total billed charges,,,0.95,,364.79,Percent of total billed charges,,,,,,,,,0.95,,364.79,Percent of total billed charges,,364.79,376.31,
DEXTROSE 5 % AND 0.9 % NACL IV BOLUS,RX-400294,CDM,J7042,HCPCS,636,RC,,inpatient,500,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
DEXTROSE 5 % AND 0.9 % NACL IV BOLUS,RX-400294,CDM,J7042,HCPCS,636,RC,,outpatient,500,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
DEXTROSE 5 % AND 0.9 % NACL IV BOLUS,RX-400294,CDM,J7042,HCPCS,636,RC,,inpatient,500,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
DEXTROSE 5 % AND 0.9 % NACL IV BOLUS,RX-400294,CDM,J7042,HCPCS,636,RC,,outpatient,500,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
DEXTROSE 5 % AND 0.45 % NACL IV BOLUS,RX-400295,CDM,J3490,HCPCS,258,RC,,inpatient,1000,ML,93.99,84.59,,0.95,,89.29,Percent of total billed charges,,,0.98,,92.11,Percent of total billed charges,,,0.95,,89.29,Percent of total billed charges,,,0.97,,91.17,Percent of total billed charges,,,0.97,,91.17,Percent of total billed charges,,,0.96,,90.23,Percent of total billed charges,,,0.95,,89.29,Percent of total billed charges,,,,,,,,,0.95,,89.29,Percent of total billed charges,,89.29,92.11,
DEXTROSE 5 % AND 0.45 % NACL IV BOLUS,RX-400295,CDM,J3490,HCPCS,258,RC,,outpatient,1000,ML,93.99,84.59,,0.95,,89.29,Percent of total billed charges,,,0.98,,92.11,Percent of total billed charges,,,0.95,,89.29,Percent of total billed charges,,,0.95,,89.29,Percent of total billed charges,,,0.97,,91.17,Percent of total billed charges,,,0.96,,90.23,Percent of total billed charges,,,0.95,,89.29,Percent of total billed charges,,,,,,,,,0.95,,89.29,Percent of total billed charges,,89.29,92.11,
DEXTROSE 5 % AND 0.45 % NACL IV BOLUS,RX-400295,CDM,J3490,HCPCS,258,RC,,inpatient,500,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
DEXTROSE 5 % AND 0.45 % NACL IV BOLUS,RX-400295,CDM,J3490,HCPCS,258,RC,,outpatient,500,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
DEXTROSE 5 % IN LACTATED RINGERS IV BOLUS,RX-400297,CDM,J7121,HCPCS,636,RC,,inpatient,1000,ML,93.99,84.59,,0.95,,89.29,Percent of total billed charges,,,0.98,,92.11,Percent of total billed charges,,,0.95,,89.29,Percent of total billed charges,,,0.97,,91.17,Percent of total billed charges,,,0.97,,91.17,Percent of total billed charges,,,0.96,,90.23,Percent of total billed charges,,,0.95,,89.29,Percent of total billed charges,,,,,,,,,0.95,,89.29,Percent of total billed charges,,89.29,92.11,
DEXTROSE 5 % IN LACTATED RINGERS IV BOLUS,RX-400297,CDM,J7121,HCPCS,636,RC,,outpatient,1000,ML,93.99,84.59,,0.95,,89.29,Percent of total billed charges,,,0.98,,92.11,Percent of total billed charges,,,0.95,,89.29,Percent of total billed charges,,,0.95,,89.29,Percent of total billed charges,,,0.97,,91.17,Percent of total billed charges,,,0.96,,90.23,Percent of total billed charges,,,0.95,,89.29,Percent of total billed charges,,,,,,,,,0.95,,89.29,Percent of total billed charges,,89.29,92.11,
CARBOPLATIN 600 MG/60ML IV SOLN,RX-40055,CDM,J9045,HCPCS,636,RC,,inpatient,60,ML,212.43,191.19,,0.95,,201.81,Percent of total billed charges,,,0.98,,208.18,Percent of total billed charges,,,0.95,,201.81,Percent of total billed charges,,,0.97,,206.06,Percent of total billed charges,,,0.97,,206.06,Percent of total billed charges,,,0.96,,203.93,Percent of total billed charges,,,0.95,,201.81,Percent of total billed charges,,,,,,,,,0.95,,201.81,Percent of total billed charges,,201.81,208.18,
CARBOPLATIN 600 MG/60ML IV SOLN,RX-40055,CDM,J9045,HCPCS,636,RC,,outpatient,60,ML,212.43,191.19,,0.95,,201.81,Percent of total billed charges,,,0.98,,208.18,Percent of total billed charges,,,0.95,,201.81,Percent of total billed charges,,,0.95,,201.81,Percent of total billed charges,,,0.97,,206.06,Percent of total billed charges,,,0.96,,203.93,Percent of total billed charges,,,0.95,,201.81,Percent of total billed charges,,,,,,,,,0.95,,201.81,Percent of total billed charges,,201.81,208.18,
ISOFLURANE INHAL SOLN,RX-4008,CDM,J3490,HCPCS,250,RC,,inpatient,100,ML,65.36,58.82,,0.95,,62.09,Percent of total billed charges,,,0.98,,64.05,Percent of total billed charges,,,0.95,,62.09,Percent of total billed charges,,,0.97,,63.4,Percent of total billed charges,,,0.97,,63.4,Percent of total billed charges,,,0.96,,62.75,Percent of total billed charges,,,0.95,,62.09,Percent of total billed charges,,,,,,,,,0.95,,62.09,Percent of total billed charges,,62.09,64.05,
ISOFLURANE INHAL SOLN,RX-4008,CDM,J3490,HCPCS,250,RC,,outpatient,100,ML,65.36,58.82,,0.95,,62.09,Percent of total billed charges,,,0.98,,64.05,Percent of total billed charges,,,0.95,,62.09,Percent of total billed charges,,,0.95,,62.09,Percent of total billed charges,,,0.97,,63.4,Percent of total billed charges,,,0.96,,62.75,Percent of total billed charges,,,0.95,,62.09,Percent of total billed charges,,,,,,,,,0.95,,62.09,Percent of total billed charges,,62.09,64.05,
NATALIZUMAB 300 MG/15ML IV CONC,RX-40120,CDM,J2323,HCPCS,636,RC,,inpatient,15,ML,15642.92,14078.63,,0.95,,14860.77,Percent of total billed charges,,,0.98,,15330.06,Percent of total billed charges,,,0.95,,14860.77,Percent of total billed charges,,,0.97,,15173.63,Percent of total billed charges,,,0.97,,15173.63,Percent of total billed charges,,,0.96,,15017.2,Percent of total billed charges,,,0.95,,14860.77,Percent of total billed charges,,,,,,,,,0.95,,14860.77,Percent of total billed charges,,14860.77,15330.06,
NATALIZUMAB 300 MG/15ML IV CONC,RX-40120,CDM,J2323,HCPCS,636,RC,,outpatient,15,ML,15642.92,14078.63,,0.95,,14860.77,Percent of total billed charges,,,0.98,,15330.06,Percent of total billed charges,,,0.95,,14860.77,Percent of total billed charges,,,0.95,,14860.77,Percent of total billed charges,,,0.97,,15173.63,Percent of total billed charges,,,0.96,,15017.2,Percent of total billed charges,,,0.95,,14860.77,Percent of total billed charges,,,,,,,,,0.95,,14860.77,Percent of total billed charges,,14860.77,15330.06,
BENZOCAINE 20 % RECTAL OINT,RX-40267,CDM,J3490,HCPCS,637,RC,,inpatient,28,GR,24.12,21.71,,0.95,,22.91,Percent of total billed charges,,,0.98,,23.64,Percent of total billed charges,,,0.95,,22.91,Percent of total billed charges,,,0.97,,23.4,Percent of total billed charges,,,0.97,,23.4,Percent of total billed charges,,,0.96,,23.16,Percent of total billed charges,,,0.95,,22.91,Percent of total billed charges,,,,,,,,,0.95,,22.91,Percent of total billed charges,,22.91,23.64,
BENZOCAINE 20 % RECTAL OINT,RX-40267,CDM,J3490,HCPCS,637,RC,,outpatient,28,GR,24.12,21.71,,0.95,,22.91,Percent of total billed charges,,,0.98,,23.64,Percent of total billed charges,,,0.95,,22.91,Percent of total billed charges,,,0.95,,22.91,Percent of total billed charges,,,0.97,,23.4,Percent of total billed charges,,,0.96,,23.16,Percent of total billed charges,,,0.95,,22.91,Percent of total billed charges,,,,,,,,,0.95,,22.91,Percent of total billed charges,,22.91,23.64,
PACLITAXEL PROTEIN-BOUND PART 100 MG IV SUSR,RX-40475,CDM,J9264,HCPCS,636,RC,,inpatient,20,ML,3087.12,2778.41,,0.95,,2932.76,Percent of total billed charges,,,0.98,,3025.38,Percent of total billed charges,,,0.95,,2932.76,Percent of total billed charges,,,0.97,,2994.51,Percent of total billed charges,,,0.97,,2994.51,Percent of total billed charges,,,0.96,,2963.64,Percent of total billed charges,,,0.95,,2932.76,Percent of total billed charges,,,,,,,,,0.95,,2932.76,Percent of total billed charges,,2932.76,3025.38,
PACLITAXEL PROTEIN-BOUND PART 100 MG IV SUSR,RX-40475,CDM,J9264,HCPCS,636,RC,,outpatient,20,ML,3087.12,2778.41,,0.95,,2932.76,Percent of total billed charges,,,0.98,,3025.38,Percent of total billed charges,,,0.95,,2932.76,Percent of total billed charges,,,0.95,,2932.76,Percent of total billed charges,,,0.97,,2994.51,Percent of total billed charges,,,0.96,,2963.64,Percent of total billed charges,,,0.95,,2932.76,Percent of total billed charges,,,,,,,,,0.95,,2932.76,Percent of total billed charges,,2932.76,3025.38,
ISOSORBIDE DINITRATE 10 MG PO TABS,RX-4064,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,9.01,8.11,,0.95,,8.56,Percent of total billed charges,,,0.98,,8.83,Percent of total billed charges,,,0.95,,8.56,Percent of total billed charges,,,0.97,,8.74,Percent of total billed charges,,,0.97,,8.74,Percent of total billed charges,,,0.96,,8.65,Percent of total billed charges,,,0.95,,8.56,Percent of total billed charges,,,,,,,,,0.95,,8.56,Percent of total billed charges,,8.56,8.83,
ISOSORBIDE DINITRATE 10 MG PO TABS,RX-4064,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,9.01,8.11,,0.95,,8.56,Percent of total billed charges,,,0.98,,8.83,Percent of total billed charges,,,0.95,,8.56,Percent of total billed charges,,,0.95,,8.56,Percent of total billed charges,,,0.97,,8.74,Percent of total billed charges,,,0.96,,8.65,Percent of total billed charges,,,0.95,,8.56,Percent of total billed charges,,,,,,,,,0.95,,8.56,Percent of total billed charges,,8.56,8.83,
ISOSORBIDE DINITRATE 5 MG PO TABS,RX-4068,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.08,9.07,,0.95,,9.58,Percent of total billed charges,,,0.98,,9.88,Percent of total billed charges,,,0.95,,9.58,Percent of total billed charges,,,0.97,,9.78,Percent of total billed charges,,,0.97,,9.78,Percent of total billed charges,,,0.96,,9.68,Percent of total billed charges,,,0.95,,9.58,Percent of total billed charges,,,,,,,,,0.95,,9.58,Percent of total billed charges,,9.58,9.88,
ISOSORBIDE DINITRATE 5 MG PO TABS,RX-4068,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.08,9.07,,0.95,,9.58,Percent of total billed charges,,,0.98,,9.88,Percent of total billed charges,,,0.95,,9.58,Percent of total billed charges,,,0.95,,9.58,Percent of total billed charges,,,0.97,,9.78,Percent of total billed charges,,,0.96,,9.68,Percent of total billed charges,,,0.95,,9.58,Percent of total billed charges,,,,,,,,,0.95,,9.58,Percent of total billed charges,,9.58,9.88,
FLUTICASONE PROPIONATE HFA 110 MCG/ACT INHAL AERO,RX-40698,CDM,J3490,HCPCS,637,RC,,inpatient,12,GR,471.68,424.51,,0.95,,448.1,Percent of total billed charges,,,0.98,,462.25,Percent of total billed charges,,,0.95,,448.1,Percent of total billed charges,,,0.97,,457.53,Percent of total billed charges,,,0.97,,457.53,Percent of total billed charges,,,0.96,,452.81,Percent of total billed charges,,,0.95,,448.1,Percent of total billed charges,,,,,,,,,0.95,,448.1,Percent of total billed charges,,448.1,462.25,
FLUTICASONE PROPIONATE HFA 110 MCG/ACT INHAL AERO,RX-40698,CDM,J3490,HCPCS,637,RC,,outpatient,12,GR,471.68,424.51,,0.95,,448.1,Percent of total billed charges,,,0.98,,462.25,Percent of total billed charges,,,0.95,,448.1,Percent of total billed charges,,,0.95,,448.1,Percent of total billed charges,,,0.97,,457.53,Percent of total billed charges,,,0.96,,452.81,Percent of total billed charges,,,0.95,,448.1,Percent of total billed charges,,,,,,,,,0.95,,448.1,Percent of total billed charges,,448.1,462.25,
PROPOFOL INFUSION 10 MG/ML,RX-40840026,CDM,J2704,HCPCS,636,RC,,inpatient,100,ML,108.15,97.34,,0.95,,102.74,Percent of total billed charges,,,0.98,,105.99,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,0.97,,104.91,Percent of total billed charges,,,0.97,,104.91,Percent of total billed charges,,,0.96,,103.82,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,,,,,,,0.95,,102.74,Percent of total billed charges,,102.74,105.99,
PROPOFOL INFUSION 10 MG/ML,RX-40840026,CDM,J2704,HCPCS,636,RC,,outpatient,100,ML,108.15,97.34,,0.95,,102.74,Percent of total billed charges,,,0.98,,105.99,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,0.97,,104.91,Percent of total billed charges,,,0.96,,103.82,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,,,,,,,0.95,,102.74,Percent of total billed charges,,102.74,105.99,
GLYCERIN (LAXATIVE) 2 G RECTAL SUPP,RX-41003,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
GLYCERIN (LAXATIVE) 2 G RECTAL SUPP,RX-41003,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
LINEZOLID IV SYRINGE (PEDIATRICS),RX-411149,CDM,J2020,HCPCS,636,RC,,inpatient,300,ML,73.7,66.33,,0.95,,70.02,Percent of total billed charges,,,0.98,,72.23,Percent of total billed charges,,,0.95,,70.02,Percent of total billed charges,,,0.97,,71.49,Percent of total billed charges,,,0.97,,71.49,Percent of total billed charges,,,0.96,,70.75,Percent of total billed charges,,,0.95,,70.02,Percent of total billed charges,,,,,,,,,0.95,,70.02,Percent of total billed charges,,70.02,72.23,
LINEZOLID IV SYRINGE (PEDIATRICS),RX-411149,CDM,J2020,HCPCS,636,RC,,outpatient,300,ML,73.7,66.33,,0.95,,70.02,Percent of total billed charges,,,0.98,,72.23,Percent of total billed charges,,,0.95,,70.02,Percent of total billed charges,,,0.95,,70.02,Percent of total billed charges,,,0.97,,71.49,Percent of total billed charges,,,0.96,,70.75,Percent of total billed charges,,,0.95,,70.02,Percent of total billed charges,,,,,,,,,0.95,,70.02,Percent of total billed charges,,70.02,72.23,
FENTANYL 12 MCG/HR TD PT72,RX-41382,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,42.44,38.2,,0.95,,40.32,Percent of total billed charges,,,0.98,,41.59,Percent of total billed charges,,,0.95,,40.32,Percent of total billed charges,,,0.97,,41.17,Percent of total billed charges,,,0.97,,41.17,Percent of total billed charges,,,0.96,,40.74,Percent of total billed charges,,,0.95,,40.32,Percent of total billed charges,,,,,,,,,0.95,,40.32,Percent of total billed charges,,40.32,41.59,
FENTANYL 12 MCG/HR TD PT72,RX-41382,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,42.44,38.2,,0.95,,40.32,Percent of total billed charges,,,0.98,,41.59,Percent of total billed charges,,,0.95,,40.32,Percent of total billed charges,,,0.95,,40.32,Percent of total billed charges,,,0.97,,41.17,Percent of total billed charges,,,0.96,,40.74,Percent of total billed charges,,,0.95,,40.32,Percent of total billed charges,,,,,,,,,0.95,,40.32,Percent of total billed charges,,40.32,41.59,
VITAMIN K1 1 MG/0.5ML INJECTION SOLN,RX-41624,CDM,J3430,HCPCS,636,RC,,inpatient,0.5,ML,90.17,81.15,,0.95,,85.66,Percent of total billed charges,,,0.98,,88.37,Percent of total billed charges,,,0.95,,85.66,Percent of total billed charges,,,0.97,,87.46,Percent of total billed charges,,,0.97,,87.46,Percent of total billed charges,,,0.96,,86.56,Percent of total billed charges,,,0.95,,85.66,Percent of total billed charges,,,,,,,,,0.95,,85.66,Percent of total billed charges,,85.66,88.37,
VITAMIN K1 1 MG/0.5ML INJECTION SOLN,RX-41624,CDM,J3430,HCPCS,636,RC,,outpatient,0.5,ML,90.17,81.15,,0.95,,85.66,Percent of total billed charges,,,0.98,,88.37,Percent of total billed charges,,,0.95,,85.66,Percent of total billed charges,,,0.95,,85.66,Percent of total billed charges,,,0.97,,87.46,Percent of total billed charges,,,0.96,,86.56,Percent of total billed charges,,,0.95,,85.66,Percent of total billed charges,,,,,,,,,0.95,,85.66,Percent of total billed charges,,85.66,88.37,
TETANUS-DIPHTH-ACELL PERTUSSIS 5-2-15.5 LF-MCG/0.5 IM SUSP,RX-41628,CDM,90715,HCPCS,636,RC,,inpatient,0.5,ML,136.91,123.22,,0.95,,130.06,Percent of total billed charges,,,0.98,,134.17,Percent of total billed charges,,,0.95,,130.06,Percent of total billed charges,,,0.97,,132.8,Percent of total billed charges,,,0.97,,132.8,Percent of total billed charges,,,0.96,,131.43,Percent of total billed charges,,,0.95,,130.06,Percent of total billed charges,,,,,,,,,0.95,,130.06,Percent of total billed charges,,130.06,134.17,
TETANUS-DIPHTH-ACELL PERTUSSIS 5-2-15.5 LF-MCG/0.5 IM SUSP,RX-41628,CDM,90715,HCPCS,636,RC,,outpatient,0.5,ML,136.91,123.22,,0.95,,130.06,Percent of total billed charges,,,0.98,,134.17,Percent of total billed charges,,,0.95,,130.06,Percent of total billed charges,,,0.95,,130.06,Percent of total billed charges,,,0.97,,132.8,Percent of total billed charges,,,0.96,,131.43,Percent of total billed charges,,,0.95,,130.06,Percent of total billed charges,,,,,,,,,0.95,,130.06,Percent of total billed charges,,130.06,134.17,
MOMETASONE FUROATE 220 MCG/ACT INHAL AEPB,RX-41828,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,169.95,152.96,,0.95,,161.45,Percent of total billed charges,,,0.98,,166.55,Percent of total billed charges,,,0.95,,161.45,Percent of total billed charges,,,0.97,,164.85,Percent of total billed charges,,,0.97,,164.85,Percent of total billed charges,,,0.96,,163.15,Percent of total billed charges,,,0.95,,161.45,Percent of total billed charges,,,,,,,,,0.95,,161.45,Percent of total billed charges,,161.45,166.55,
MOMETASONE FUROATE 220 MCG/ACT INHAL AEPB,RX-41828,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,169.95,152.96,,0.95,,161.45,Percent of total billed charges,,,0.98,,166.55,Percent of total billed charges,,,0.95,,161.45,Percent of total billed charges,,,0.95,,161.45,Percent of total billed charges,,,0.97,,164.85,Percent of total billed charges,,,0.96,,163.15,Percent of total billed charges,,,0.95,,161.45,Percent of total billed charges,,,,,,,,,0.95,,161.45,Percent of total billed charges,,161.45,166.55,
LIDOCAINE 5 % EX OINT,RX-41831,CDM,J3490,HCPCS,637,RC,,inpatient,36,GR,584.64,526.18,,0.95,,555.41,Percent of total billed charges,,,0.98,,572.95,Percent of total billed charges,,,0.95,,555.41,Percent of total billed charges,,,0.97,,567.1,Percent of total billed charges,,,0.97,,567.1,Percent of total billed charges,,,0.96,,561.25,Percent of total billed charges,,,0.95,,555.41,Percent of total billed charges,,,,,,,,,0.95,,555.41,Percent of total billed charges,,555.41,572.95,
LIDOCAINE 5 % EX OINT,RX-41831,CDM,J3490,HCPCS,637,RC,,outpatient,36,GR,584.64,526.18,,0.95,,555.41,Percent of total billed charges,,,0.98,,572.95,Percent of total billed charges,,,0.95,,555.41,Percent of total billed charges,,,0.95,,555.41,Percent of total billed charges,,,0.97,,567.1,Percent of total billed charges,,,0.96,,561.25,Percent of total billed charges,,,0.95,,555.41,Percent of total billed charges,,,,,,,,,0.95,,555.41,Percent of total billed charges,,555.41,572.95,
CEFTRIAXONE SODIUM-DEXTROSE 2-2.22 GM-%(50ML) IV SOLR,RX-42006,CDM,J0696,HCPCS,636,RC,,inpatient,50,ML,117.12,105.41,,0.95,,111.26,Percent of total billed charges,,,0.98,,114.78,Percent of total billed charges,,,0.95,,111.26,Percent of total billed charges,,,0.97,,113.61,Percent of total billed charges,,,0.97,,113.61,Percent of total billed charges,,,0.96,,112.44,Percent of total billed charges,,,0.95,,111.26,Percent of total billed charges,,,,,,,,,0.95,,111.26,Percent of total billed charges,,111.26,114.78,
CEFTRIAXONE SODIUM-DEXTROSE 2-2.22 GM-%(50ML) IV SOLR,RX-42006,CDM,J0696,HCPCS,636,RC,,outpatient,50,ML,117.12,105.41,,0.95,,111.26,Percent of total billed charges,,,0.98,,114.78,Percent of total billed charges,,,0.95,,111.26,Percent of total billed charges,,,0.95,,111.26,Percent of total billed charges,,,0.97,,113.61,Percent of total billed charges,,,0.96,,112.44,Percent of total billed charges,,,0.95,,111.26,Percent of total billed charges,,,,,,,,,0.95,,111.26,Percent of total billed charges,,111.26,114.78,
CEFTRIAXONE SODIUM-DEXTROSE 1-3.74 GM-%(50ML) IV SOLR,RX-42007,CDM,J0696,HCPCS,636,RC,,inpatient,50,ML,98.17,88.35,,0.95,,93.26,Percent of total billed charges,,,0.98,,96.21,Percent of total billed charges,,,0.95,,93.26,Percent of total billed charges,,,0.97,,95.22,Percent of total billed charges,,,0.97,,95.22,Percent of total billed charges,,,0.96,,94.24,Percent of total billed charges,,,0.95,,93.26,Percent of total billed charges,,,,,,,,,0.95,,93.26,Percent of total billed charges,,93.26,96.21,
CEFTRIAXONE SODIUM-DEXTROSE 1-3.74 GM-%(50ML) IV SOLR,RX-42007,CDM,J0696,HCPCS,636,RC,,outpatient,50,ML,98.17,88.35,,0.95,,93.26,Percent of total billed charges,,,0.98,,96.21,Percent of total billed charges,,,0.95,,93.26,Percent of total billed charges,,,0.95,,93.26,Percent of total billed charges,,,0.97,,95.22,Percent of total billed charges,,,0.96,,94.24,Percent of total billed charges,,,0.95,,93.26,Percent of total billed charges,,,,,,,,,0.95,,93.26,Percent of total billed charges,,93.26,96.21,
PREGABALIN 50 MG PO CAPS,RX-42163,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,13.26,11.93,,0.95,,12.6,Percent of total billed charges,,,0.98,,12.99,Percent of total billed charges,,,0.95,,12.6,Percent of total billed charges,,,0.97,,12.86,Percent of total billed charges,,,0.97,,12.86,Percent of total billed charges,,,0.96,,12.73,Percent of total billed charges,,,0.95,,12.6,Percent of total billed charges,,,,,,,,,0.95,,12.6,Percent of total billed charges,,12.6,12.99,
PREGABALIN 50 MG PO CAPS,RX-42163,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,13.26,11.93,,0.95,,12.6,Percent of total billed charges,,,0.98,,12.99,Percent of total billed charges,,,0.95,,12.6,Percent of total billed charges,,,0.95,,12.6,Percent of total billed charges,,,0.97,,12.86,Percent of total billed charges,,,0.96,,12.73,Percent of total billed charges,,,0.95,,12.6,Percent of total billed charges,,,,,,,,,0.95,,12.6,Percent of total billed charges,,12.6,12.99,
PREGABALIN 75 MG PO CAPS,RX-42164,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.5,7.65,,0.95,,8.08,Percent of total billed charges,,,0.98,,8.33,Percent of total billed charges,,,0.95,,8.08,Percent of total billed charges,,,0.97,,8.25,Percent of total billed charges,,,0.97,,8.25,Percent of total billed charges,,,0.96,,8.16,Percent of total billed charges,,,0.95,,8.08,Percent of total billed charges,,,,,,,,,0.95,,8.08,Percent of total billed charges,,8.08,8.33,
PREGABALIN 75 MG PO CAPS,RX-42164,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.5,7.65,,0.95,,8.08,Percent of total billed charges,,,0.98,,8.33,Percent of total billed charges,,,0.95,,8.08,Percent of total billed charges,,,0.95,,8.08,Percent of total billed charges,,,0.97,,8.25,Percent of total billed charges,,,0.96,,8.16,Percent of total billed charges,,,0.95,,8.08,Percent of total billed charges,,,,,,,,,0.95,,8.08,Percent of total billed charges,,8.08,8.33,
KETAMINE HCL 10 MG/ML INJECTION SOLN,RX-4236,CDM,J3490,HCPCS,636,RC,,inpatient,0.5,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
KETAMINE HCL 10 MG/ML INJECTION SOLN,RX-4236,CDM,J3490,HCPCS,636,RC,,outpatient,0.5,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
KETAMINE HCL 100 MG/ML INJECTION SOLN,RX-4237,CDM,J3490,HCPCS,636,RC,,inpatient,1,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
KETAMINE HCL 100 MG/ML INJECTION SOLN,RX-4237,CDM,J3490,HCPCS,636,RC,,outpatient,1,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
PRENATAL 27-0.8 MG PO TABS,RX-43010,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.43,5.79,,0.95,,6.11,Percent of total billed charges,,,0.98,,6.3,Percent of total billed charges,,,0.95,,6.11,Percent of total billed charges,,,0.97,,6.24,Percent of total billed charges,,,0.97,,6.24,Percent of total billed charges,,,0.96,,6.17,Percent of total billed charges,,,0.95,,6.11,Percent of total billed charges,,,,,,,,,0.95,,6.11,Percent of total billed charges,,6.11,6.3,
PRENATAL 27-0.8 MG PO TABS,RX-43010,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.43,5.79,,0.95,,6.11,Percent of total billed charges,,,0.98,,6.3,Percent of total billed charges,,,0.95,,6.11,Percent of total billed charges,,,0.95,,6.11,Percent of total billed charges,,,0.97,,6.24,Percent of total billed charges,,,0.96,,6.17,Percent of total billed charges,,,0.95,,6.11,Percent of total billed charges,,,,,,,,,0.95,,6.11,Percent of total billed charges,,6.11,6.3,
CEFOTETAN 100 MG/ML IV SYRINGE,RX-431004,CDM,J3490,HCPCS,250,RC,,inpatient,10,ML,35.97,32.37,,0.95,,34.17,Percent of total billed charges,,,0.98,,35.25,Percent of total billed charges,,,0.95,,34.17,Percent of total billed charges,,,0.97,,34.89,Percent of total billed charges,,,0.97,,34.89,Percent of total billed charges,,,0.96,,34.53,Percent of total billed charges,,,0.95,,34.17,Percent of total billed charges,,,,,,,,,0.95,,34.17,Percent of total billed charges,,34.17,35.25,
CEFOTETAN 100 MG/ML IV SYRINGE,RX-431004,CDM,J3490,HCPCS,250,RC,,outpatient,10,ML,35.97,32.37,,0.95,,34.17,Percent of total billed charges,,,0.98,,35.25,Percent of total billed charges,,,0.95,,34.17,Percent of total billed charges,,,0.95,,34.17,Percent of total billed charges,,,0.97,,34.89,Percent of total billed charges,,,0.96,,34.53,Percent of total billed charges,,,0.95,,34.17,Percent of total billed charges,,,,,,,,,0.95,,34.17,Percent of total billed charges,,34.17,35.25,
CEFOXITIN 100 MG/ML IV SYRINGE,RX-431005,CDM,J0694,HCPCS,636,RC,,inpatient,10,ML,19.18,17.26,,0.95,,18.22,Percent of total billed charges,,,0.98,,18.8,Percent of total billed charges,,,0.95,,18.22,Percent of total billed charges,,,0.97,,18.6,Percent of total billed charges,,,0.97,,18.6,Percent of total billed charges,,,0.96,,18.41,Percent of total billed charges,,,0.95,,18.22,Percent of total billed charges,,,,,,,,,0.95,,18.22,Percent of total billed charges,,18.22,18.8,
CEFOXITIN 100 MG/ML IV SYRINGE,RX-431005,CDM,J0694,HCPCS,636,RC,,outpatient,10,ML,19.18,17.26,,0.95,,18.22,Percent of total billed charges,,,0.98,,18.8,Percent of total billed charges,,,0.95,,18.22,Percent of total billed charges,,,0.95,,18.22,Percent of total billed charges,,,0.97,,18.6,Percent of total billed charges,,,0.96,,18.41,Percent of total billed charges,,,0.95,,18.22,Percent of total billed charges,,,,,,,,,0.95,,18.22,Percent of total billed charges,,18.22,18.8,
HYDROCORTISONE SOD SUC (PF) 100 MG INJECTION SOLR,RX-431013,CDM,J1720,HCPCS,636,RC,,inpatient,0.5,ML,23.75,21.38,,0.95,,22.56,Percent of total billed charges,,,0.98,,23.28,Percent of total billed charges,,,0.95,,22.56,Percent of total billed charges,,,0.97,,23.04,Percent of total billed charges,,,0.97,,23.04,Percent of total billed charges,,,0.96,,22.8,Percent of total billed charges,,,0.95,,22.56,Percent of total billed charges,,,,,,,,,0.95,,22.56,Percent of total billed charges,,22.56,23.28,
HYDROCORTISONE SOD SUC (PF) 100 MG INJECTION SOLR,RX-431013,CDM,J1720,HCPCS,636,RC,,outpatient,0.5,ML,23.75,21.38,,0.95,,22.56,Percent of total billed charges,,,0.98,,23.28,Percent of total billed charges,,,0.95,,22.56,Percent of total billed charges,,,0.95,,22.56,Percent of total billed charges,,,0.97,,23.04,Percent of total billed charges,,,0.96,,22.8,Percent of total billed charges,,,0.95,,22.56,Percent of total billed charges,,,,,,,,,0.95,,22.56,Percent of total billed charges,,22.56,23.28,
FENTANYL 50 MCG/ML PCA,RX-431015,CDM,J7999,HCPCS,636,RC,,inpatient,30,ML,67.82,61.04,,0.95,,64.43,Percent of total billed charges,,,0.98,,66.46,Percent of total billed charges,,,0.95,,64.43,Percent of total billed charges,,,0.97,,65.79,Percent of total billed charges,,,0.97,,65.79,Percent of total billed charges,,,0.96,,65.11,Percent of total billed charges,,,0.95,,64.43,Percent of total billed charges,,,,,,,,,0.95,,64.43,Percent of total billed charges,,64.43,66.46,
FENTANYL 50 MCG/ML PCA,RX-431015,CDM,J7999,HCPCS,636,RC,,outpatient,30,ML,67.82,61.04,,0.95,,64.43,Percent of total billed charges,,,0.98,,66.46,Percent of total billed charges,,,0.95,,64.43,Percent of total billed charges,,,0.95,,64.43,Percent of total billed charges,,,0.97,,65.79,Percent of total billed charges,,,0.96,,65.11,Percent of total billed charges,,,0.95,,64.43,Percent of total billed charges,,,,,,,,,0.95,,64.43,Percent of total billed charges,,64.43,66.46,
"LORAZEPAM INJECTION (2, 4 MG/ML ADS VARIABLE DOSE)",RX-431032,CDM,J2060,HCPCS,636,RC,,inpatient,1,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
"LORAZEPAM INJECTION (2, 4 MG/ML ADS VARIABLE DOSE)",RX-431032,CDM,J2060,HCPCS,636,RC,,outpatient,1,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
MAGNESIUM SULFATE 2 GM/50ML IV SOLN,RX-431035,CDM,J3475,HCPCS,636,RC,,inpatient,50,ML,80.85,72.77,,0.95,,76.81,Percent of total billed charges,,,0.98,,79.23,Percent of total billed charges,,,0.95,,76.81,Percent of total billed charges,,,0.97,,78.42,Percent of total billed charges,,,0.97,,78.42,Percent of total billed charges,,,0.96,,77.62,Percent of total billed charges,,,0.95,,76.81,Percent of total billed charges,,,,,,,,,0.95,,76.81,Percent of total billed charges,,76.81,79.23,
MAGNESIUM SULFATE 2 GM/50ML IV SOLN,RX-431035,CDM,J3475,HCPCS,636,RC,,outpatient,50,ML,80.85,72.77,,0.95,,76.81,Percent of total billed charges,,,0.98,,79.23,Percent of total billed charges,,,0.95,,76.81,Percent of total billed charges,,,0.95,,76.81,Percent of total billed charges,,,0.97,,78.42,Percent of total billed charges,,,0.96,,77.62,Percent of total billed charges,,,0.95,,76.81,Percent of total billed charges,,,,,,,,,0.95,,76.81,Percent of total billed charges,,76.81,79.23,
MORPHINE 5 MG/ML INFUSION,RX-431044,CDM,J2270,HCPCS,636,RC,,inpatient,30,ML,108.15,97.34,,0.95,,102.74,Percent of total billed charges,,,0.98,,105.99,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,0.97,,104.91,Percent of total billed charges,,,0.97,,104.91,Percent of total billed charges,,,0.96,,103.82,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,,,,,,,0.95,,102.74,Percent of total billed charges,,102.74,105.99,
MORPHINE 5 MG/ML INFUSION,RX-431044,CDM,J2270,HCPCS,636,RC,,outpatient,30,ML,108.15,97.34,,0.95,,102.74,Percent of total billed charges,,,0.98,,105.99,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,0.97,,104.91,Percent of total billed charges,,,0.96,,103.82,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,,,,,,,0.95,,102.74,Percent of total billed charges,,102.74,105.99,
"MORPHINE INJECTION (0.5, 1, 2, 4, 5, 8, 10 MG/ML ADS VARIABLE DOSE)",RX-431049,CDM,J2270,HCPCS,636,RC,,inpatient,10,ME,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
"MORPHINE INJECTION (0.5, 1, 2, 4, 5, 8, 10 MG/ML ADS VARIABLE DOSE)",RX-431049,CDM,J2270,HCPCS,636,RC,,outpatient,10,ME,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
LIDOCAINE HCL URETHRAL/MUCOSAL 2 % EX GEL (URO-JET),RX-431128,CDM,J3490,HCPCS,250,RC,,inpatient,20,ML,43.2,38.88,,0.95,,41.04,Percent of total billed charges,,,0.98,,42.34,Percent of total billed charges,,,0.95,,41.04,Percent of total billed charges,,,0.97,,41.9,Percent of total billed charges,,,0.97,,41.9,Percent of total billed charges,,,0.96,,41.47,Percent of total billed charges,,,0.95,,41.04,Percent of total billed charges,,,,,,,,,0.95,,41.04,Percent of total billed charges,,41.04,42.34,
LIDOCAINE HCL URETHRAL/MUCOSAL 2 % EX GEL (URO-JET),RX-431128,CDM,J3490,HCPCS,250,RC,,outpatient,20,ML,43.2,38.88,,0.95,,41.04,Percent of total billed charges,,,0.98,,42.34,Percent of total billed charges,,,0.95,,41.04,Percent of total billed charges,,,0.95,,41.04,Percent of total billed charges,,,0.97,,41.9,Percent of total billed charges,,,0.96,,41.47,Percent of total billed charges,,,0.95,,41.04,Percent of total billed charges,,,,,,,,,0.95,,41.04,Percent of total billed charges,,41.04,42.34,
SODIUM CHLORIDE 0.9 % IV BOLUS,RX-431133,CDM,J7030,HCPCS,636,RC,,inpatient,1000,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
SODIUM CHLORIDE 0.9 % IV BOLUS,RX-431133,CDM,J7030,HCPCS,636,RC,,outpatient,1000,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
LACTATED RINGERS IV BOLUS,RX-431134,CDM,J7120,HCPCS,636,RC,,inpatient,1000,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
LACTATED RINGERS IV BOLUS,RX-431134,CDM,J7120,HCPCS,636,RC,,outpatient,1000,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
LACTATED RINGERS IV BOLUS,RX-431134,CDM,J7120,HCPCS,636,RC,,inpatient,250,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
LACTATED RINGERS IV BOLUS,RX-431134,CDM,J7120,HCPCS,636,RC,,outpatient,250,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
LACTATED RINGERS IV BOLUS,RX-431134,CDM,J7120,HCPCS,636,RC,,inpatient,500,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
LACTATED RINGERS IV BOLUS,RX-431134,CDM,J7120,HCPCS,636,RC,,outpatient,500,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
DEXTROSE 10 % IV BOLUS,RX-431135,CDM,J3490,HCPCS,258,RC,,inpatient,250,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
DEXTROSE 10 % IV BOLUS,RX-431135,CDM,J3490,HCPCS,258,RC,,outpatient,250,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
DEXTROSE 10 % IV BOLUS,RX-431135,CDM,J3490,HCPCS,258,RC,,inpatient,250,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
DEXTROSE 10 % IV BOLUS,RX-431135,CDM,J3490,HCPCS,258,RC,,outpatient,250,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
DEXTROSE 10 % IV BOLUS,RX-431135,CDM,J3490,HCPCS,258,RC,,inpatient,250,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
DEXTROSE 10 % IV BOLUS,RX-431135,CDM,J3490,HCPCS,258,RC,,outpatient,250,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
AZACITIDINE SUBCUTANEOUS INJECTION,RX-431158,CDM,J9025,HCPCS,636,RC,,inpatient,4,ML,207.74,186.97,,0.95,,197.35,Percent of total billed charges,,,0.98,,203.59,Percent of total billed charges,,,0.95,,197.35,Percent of total billed charges,,,0.97,,201.51,Percent of total billed charges,,,0.97,,201.51,Percent of total billed charges,,,0.96,,199.43,Percent of total billed charges,,,0.95,,197.35,Percent of total billed charges,,,,,,,,,0.95,,197.35,Percent of total billed charges,,197.35,203.59,
AZACITIDINE SUBCUTANEOUS INJECTION,RX-431158,CDM,J9025,HCPCS,636,RC,,outpatient,4,ML,207.74,186.97,,0.95,,197.35,Percent of total billed charges,,,0.98,,203.59,Percent of total billed charges,,,0.95,,197.35,Percent of total billed charges,,,0.95,,197.35,Percent of total billed charges,,,0.97,,201.51,Percent of total billed charges,,,0.96,,199.43,Percent of total billed charges,,,0.95,,197.35,Percent of total billed charges,,,,,,,,,0.95,,197.35,Percent of total billed charges,,197.35,203.59,
BUPIVACAINE 0.125% INJECTION (ANESTHESIA MIX),RX-431171,CDM,J0665,HCPCS,636,RC,,inpatient,5.2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
BUPIVACAINE 0.125% INJECTION (ANESTHESIA MIX),RX-431171,CDM,J0665,HCPCS,636,RC,,outpatient,5.2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
MAGNESIUM SULFATE 4 GM/100ML IV SOLN,RX-431242,CDM,J3475,HCPCS,636,RC,,inpatient,100,ML,39.14,35.23,,0.95,,37.18,Percent of total billed charges,,,0.98,,38.36,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,0.97,,37.97,Percent of total billed charges,,,0.97,,37.97,Percent of total billed charges,,,0.96,,37.57,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,,,,,,,0.95,,37.18,Percent of total billed charges,,37.18,38.36,
MAGNESIUM SULFATE 4 GM/100ML IV SOLN,RX-431242,CDM,J3475,HCPCS,636,RC,,outpatient,100,ML,39.14,35.23,,0.95,,37.18,Percent of total billed charges,,,0.98,,38.36,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,0.97,,37.97,Percent of total billed charges,,,0.96,,37.57,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,,,,,,,0.95,,37.18,Percent of total billed charges,,37.18,38.36,
"HYDROMORPHONE INJECTION (0.5, 1, 2, 4 MG/ML ADS VARIABLE DOSE)",RX-431249,CDM,J1171,HCPCS,636,RC,,inpatient,0.2,ME,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
"HYDROMORPHONE INJECTION (0.5, 1, 2, 4 MG/ML ADS VARIABLE DOSE)",RX-431249,CDM,J1171,HCPCS,636,RC,,outpatient,0.2,ME,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
LACTATED RINGERS IV SOLN,RX-4318,CDM,J7120,HCPCS,636,RC,,inpatient,1000,ML,101.72,91.55,,0.95,,96.63,Percent of total billed charges,,,0.98,,99.69,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,0.97,,98.67,Percent of total billed charges,,,0.97,,98.67,Percent of total billed charges,,,0.96,,97.65,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,,,,,,,0.95,,96.63,Percent of total billed charges,,96.63,99.69,
LACTATED RINGERS IV SOLN,RX-4318,CDM,J7120,HCPCS,636,RC,,outpatient,1000,ML,101.72,91.55,,0.95,,96.63,Percent of total billed charges,,,0.98,,99.69,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,0.97,,98.67,Percent of total billed charges,,,0.96,,97.65,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,,,,,,,0.95,,96.63,Percent of total billed charges,,96.63,99.69,
LACTATED RINGERS IRRIG SOLN,RX-4319,CDM,J3490,HCPCS,250,RC,,inpatient,3000,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
LACTATED RINGERS IRRIG SOLN,RX-4319,CDM,J3490,HCPCS,250,RC,,outpatient,3000,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
AMITRIPTYLINE HCL 10 MG PO TABS,RX-432,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6,5.4,,0.95,,5.7,Percent of total billed charges,,,0.98,,5.88,Percent of total billed charges,,,0.95,,5.7,Percent of total billed charges,,,0.97,,5.82,Percent of total billed charges,,,0.97,,5.82,Percent of total billed charges,,,0.96,,5.76,Percent of total billed charges,,,0.95,,5.7,Percent of total billed charges,,,,,,,,,0.95,,5.7,Percent of total billed charges,,5.7,5.88,
AMITRIPTYLINE HCL 10 MG PO TABS,RX-432,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6,5.4,,0.95,,5.7,Percent of total billed charges,,,0.98,,5.88,Percent of total billed charges,,,0.95,,5.7,Percent of total billed charges,,,0.95,,5.7,Percent of total billed charges,,,0.97,,5.82,Percent of total billed charges,,,0.96,,5.76,Percent of total billed charges,,,0.95,,5.7,Percent of total billed charges,,,,,,,,,0.95,,5.7,Percent of total billed charges,,5.7,5.88,
LIDOCAINE HCL 4 % MOUTH/THROAT SOLN,RX-43717,CDM,J3490,HCPCS,637,RC,,inpatient,1,ML,33.22,29.9,,0.95,,31.56,Percent of total billed charges,,,0.98,,32.56,Percent of total billed charges,,,0.95,,31.56,Percent of total billed charges,,,0.97,,32.22,Percent of total billed charges,,,0.97,,32.22,Percent of total billed charges,,,0.96,,31.89,Percent of total billed charges,,,0.95,,31.56,Percent of total billed charges,,,,,,,,,0.95,,31.56,Percent of total billed charges,,31.56,32.56,
LIDOCAINE HCL 4 % MOUTH/THROAT SOLN,RX-43717,CDM,J3490,HCPCS,637,RC,,outpatient,1,ML,33.22,29.9,,0.95,,31.56,Percent of total billed charges,,,0.98,,32.56,Percent of total billed charges,,,0.95,,31.56,Percent of total billed charges,,,0.95,,31.56,Percent of total billed charges,,,0.97,,32.22,Percent of total billed charges,,,0.96,,31.89,Percent of total billed charges,,,0.95,,31.56,Percent of total billed charges,,,,,,,,,0.95,,31.56,Percent of total billed charges,,31.56,32.56,
LEUCOVORIN CALCIUM 100 MG INJECTION SOLR,RX-4392,CDM,J0640,HCPCS,636,RC,,inpatient,10,ML,29.34,26.41,,0.95,,27.87,Percent of total billed charges,,,0.98,,28.75,Percent of total billed charges,,,0.95,,27.87,Percent of total billed charges,,,0.97,,28.46,Percent of total billed charges,,,0.97,,28.46,Percent of total billed charges,,,0.96,,28.17,Percent of total billed charges,,,0.95,,27.87,Percent of total billed charges,,,,,,,,,0.95,,27.87,Percent of total billed charges,,27.87,28.75,
LEUCOVORIN CALCIUM 100 MG INJECTION SOLR,RX-4392,CDM,J0640,HCPCS,636,RC,,outpatient,10,ML,29.34,26.41,,0.95,,27.87,Percent of total billed charges,,,0.98,,28.75,Percent of total billed charges,,,0.95,,27.87,Percent of total billed charges,,,0.95,,27.87,Percent of total billed charges,,,0.97,,28.46,Percent of total billed charges,,,0.96,,28.17,Percent of total billed charges,,,0.95,,27.87,Percent of total billed charges,,,,,,,,,0.95,,27.87,Percent of total billed charges,,27.87,28.75,
LEUCOVORIN CALCIUM 350 MG INJECTION SOLR,RX-4393,CDM,J0640,HCPCS,636,RC,,inpatient,17.5,ML,53.96,48.56,,0.95,,51.26,Percent of total billed charges,,,0.98,,52.88,Percent of total billed charges,,,0.95,,51.26,Percent of total billed charges,,,0.97,,52.34,Percent of total billed charges,,,0.97,,52.34,Percent of total billed charges,,,0.96,,51.8,Percent of total billed charges,,,0.95,,51.26,Percent of total billed charges,,,,,,,,,0.95,,51.26,Percent of total billed charges,,51.26,52.88,
LEUCOVORIN CALCIUM 350 MG INJECTION SOLR,RX-4393,CDM,J0640,HCPCS,636,RC,,outpatient,17.5,ML,53.96,48.56,,0.95,,51.26,Percent of total billed charges,,,0.98,,52.88,Percent of total billed charges,,,0.95,,51.26,Percent of total billed charges,,,0.95,,51.26,Percent of total billed charges,,,0.97,,52.34,Percent of total billed charges,,,0.96,,51.8,Percent of total billed charges,,,0.95,,51.26,Percent of total billed charges,,,,,,,,,0.95,,51.26,Percent of total billed charges,,51.26,52.88,
LEVOTHYROXINE SODIUM 25 MCG PO TABS,RX-4420,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.64,6.88,,0.95,,7.26,Percent of total billed charges,,,0.98,,7.49,Percent of total billed charges,,,0.95,,7.26,Percent of total billed charges,,,0.97,,7.41,Percent of total billed charges,,,0.97,,7.41,Percent of total billed charges,,,0.96,,7.33,Percent of total billed charges,,,0.95,,7.26,Percent of total billed charges,,,,,,,,,0.95,,7.26,Percent of total billed charges,,7.26,7.49,
LEVOTHYROXINE SODIUM 25 MCG PO TABS,RX-4420,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.64,6.88,,0.95,,7.26,Percent of total billed charges,,,0.98,,7.49,Percent of total billed charges,,,0.95,,7.26,Percent of total billed charges,,,0.95,,7.26,Percent of total billed charges,,,0.97,,7.41,Percent of total billed charges,,,0.96,,7.33,Percent of total billed charges,,,0.95,,7.26,Percent of total billed charges,,,,,,,,,0.95,,7.26,Percent of total billed charges,,7.26,7.49,
LEVOTHYROXINE SODIUM 50 MCG PO TABS,RX-4421,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,13.86,12.47,,0.95,,13.17,Percent of total billed charges,,,0.98,,13.58,Percent of total billed charges,,,0.95,,13.17,Percent of total billed charges,,,0.97,,13.44,Percent of total billed charges,,,0.97,,13.44,Percent of total billed charges,,,0.96,,13.31,Percent of total billed charges,,,0.95,,13.17,Percent of total billed charges,,,,,,,,,0.95,,13.17,Percent of total billed charges,,13.17,13.58,
LEVOTHYROXINE SODIUM 50 MCG PO TABS,RX-4421,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,13.86,12.47,,0.95,,13.17,Percent of total billed charges,,,0.98,,13.58,Percent of total billed charges,,,0.95,,13.17,Percent of total billed charges,,,0.95,,13.17,Percent of total billed charges,,,0.97,,13.44,Percent of total billed charges,,,0.96,,13.31,Percent of total billed charges,,,0.95,,13.17,Percent of total billed charges,,,,,,,,,0.95,,13.17,Percent of total billed charges,,13.17,13.58,
LEVOTHYROXINE SODIUM 75 MCG PO TABS,RX-4422,CDM,J3490,HCPCS,637,RC,,inpatient,2,UN,15.8,14.22,,0.95,,15.01,Percent of total billed charges,,,0.98,,15.48,Percent of total billed charges,,,0.95,,15.01,Percent of total billed charges,,,0.97,,15.33,Percent of total billed charges,,,0.97,,15.33,Percent of total billed charges,,,0.96,,15.17,Percent of total billed charges,,,0.95,,15.01,Percent of total billed charges,,,,,,,,,0.95,,15.01,Percent of total billed charges,,15.01,15.48,
LEVOTHYROXINE SODIUM 75 MCG PO TABS,RX-4422,CDM,J3490,HCPCS,637,RC,,outpatient,2,UN,15.8,14.22,,0.95,,15.01,Percent of total billed charges,,,0.98,,15.48,Percent of total billed charges,,,0.95,,15.01,Percent of total billed charges,,,0.95,,15.01,Percent of total billed charges,,,0.97,,15.33,Percent of total billed charges,,,0.96,,15.17,Percent of total billed charges,,,0.95,,15.01,Percent of total billed charges,,,,,,,,,0.95,,15.01,Percent of total billed charges,,15.01,15.48,
LEVOTHYROXINE SODIUM 100 MCG PO TABS,RX-4423,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.21,7.39,,0.95,,7.8,Percent of total billed charges,,,0.98,,8.05,Percent of total billed charges,,,0.95,,7.8,Percent of total billed charges,,,0.97,,7.96,Percent of total billed charges,,,0.97,,7.96,Percent of total billed charges,,,0.96,,7.88,Percent of total billed charges,,,0.95,,7.8,Percent of total billed charges,,,,,,,,,0.95,,7.8,Percent of total billed charges,,7.8,8.05,
LEVOTHYROXINE SODIUM 100 MCG PO TABS,RX-4423,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.21,7.39,,0.95,,7.8,Percent of total billed charges,,,0.98,,8.05,Percent of total billed charges,,,0.95,,7.8,Percent of total billed charges,,,0.95,,7.8,Percent of total billed charges,,,0.97,,7.96,Percent of total billed charges,,,0.96,,7.88,Percent of total billed charges,,,0.95,,7.8,Percent of total billed charges,,,,,,,,,0.95,,7.8,Percent of total billed charges,,7.8,8.05,
LEVOTHYROXINE SODIUM 125 MCG PO TABS,RX-4424,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.38,7.54,,0.95,,7.96,Percent of total billed charges,,,0.98,,8.21,Percent of total billed charges,,,0.95,,7.96,Percent of total billed charges,,,0.97,,8.13,Percent of total billed charges,,,0.97,,8.13,Percent of total billed charges,,,0.96,,8.04,Percent of total billed charges,,,0.95,,7.96,Percent of total billed charges,,,,,,,,,0.95,,7.96,Percent of total billed charges,,7.96,8.21,
LEVOTHYROXINE SODIUM 125 MCG PO TABS,RX-4424,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.38,7.54,,0.95,,7.96,Percent of total billed charges,,,0.98,,8.21,Percent of total billed charges,,,0.95,,7.96,Percent of total billed charges,,,0.95,,7.96,Percent of total billed charges,,,0.97,,8.13,Percent of total billed charges,,,0.96,,8.04,Percent of total billed charges,,,0.95,,7.96,Percent of total billed charges,,,,,,,,,0.95,,7.96,Percent of total billed charges,,7.96,8.21,
LIDOCAINE HCL 1 % INJECTION SOLN,RX-4452,CDM,J7999,HCPCS,250,RC,,inpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
LIDOCAINE HCL 1 % INJECTION SOLN,RX-4452,CDM,J7999,HCPCS,250,RC,,outpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
LIDOCAINE HCL 2 % INJECTION SOLN,RX-4454,CDM,J3490,HCPCS,250,RC,,inpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
LIDOCAINE HCL 2 % INJECTION SOLN,RX-4454,CDM,J3490,HCPCS,250,RC,,outpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
AMOXICILLIN 250 MG PO CAPS,RX-450,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,5.95,5.36,,0.95,,5.65,Percent of total billed charges,,,0.98,,5.83,Percent of total billed charges,,,0.95,,5.65,Percent of total billed charges,,,0.97,,5.77,Percent of total billed charges,,,0.97,,5.77,Percent of total billed charges,,,0.96,,5.71,Percent of total billed charges,,,0.95,,5.65,Percent of total billed charges,,,,,,,,,0.95,,5.65,Percent of total billed charges,,5.65,5.83,
AMOXICILLIN 250 MG PO CAPS,RX-450,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,5.95,5.36,,0.95,,5.65,Percent of total billed charges,,,0.98,,5.83,Percent of total billed charges,,,0.95,,5.65,Percent of total billed charges,,,0.95,,5.65,Percent of total billed charges,,,0.97,,5.77,Percent of total billed charges,,,0.96,,5.71,Percent of total billed charges,,,0.95,,5.65,Percent of total billed charges,,,,,,,,,0.95,,5.65,Percent of total billed charges,,5.65,5.83,
AMOXICILLIN 500 MG PO CAPS,RX-451,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.58,5.92,,0.95,,6.25,Percent of total billed charges,,,0.98,,6.45,Percent of total billed charges,,,0.95,,6.25,Percent of total billed charges,,,0.97,,6.38,Percent of total billed charges,,,0.97,,6.38,Percent of total billed charges,,,0.96,,6.32,Percent of total billed charges,,,0.95,,6.25,Percent of total billed charges,,,,,,,,,0.95,,6.25,Percent of total billed charges,,6.25,6.45,
AMOXICILLIN 500 MG PO CAPS,RX-451,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.58,5.92,,0.95,,6.25,Percent of total billed charges,,,0.98,,6.45,Percent of total billed charges,,,0.95,,6.25,Percent of total billed charges,,,0.95,,6.25,Percent of total billed charges,,,0.97,,6.38,Percent of total billed charges,,,0.96,,6.32,Percent of total billed charges,,,0.95,,6.25,Percent of total billed charges,,,,,,,,,0.95,,6.25,Percent of total billed charges,,6.25,6.45,
AMOXICILLIN 250 MG PO CHEW,RX-452,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.37,6.63,,0.95,,7,Percent of total billed charges,,,0.98,,7.22,Percent of total billed charges,,,0.95,,7,Percent of total billed charges,,,0.97,,7.15,Percent of total billed charges,,,0.97,,7.15,Percent of total billed charges,,,0.96,,7.08,Percent of total billed charges,,,0.95,,7,Percent of total billed charges,,,,,,,,,0.95,,7,Percent of total billed charges,,7,7.22,
AMOXICILLIN 250 MG PO CHEW,RX-452,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.37,6.63,,0.95,,7,Percent of total billed charges,,,0.98,,7.22,Percent of total billed charges,,,0.95,,7,Percent of total billed charges,,,0.95,,7,Percent of total billed charges,,,0.97,,7.15,Percent of total billed charges,,,0.96,,7.08,Percent of total billed charges,,,0.95,,7,Percent of total billed charges,,,,,,,,,0.95,,7,Percent of total billed charges,,7,7.22,
LISINOPRIL 20 MG PO TABS,RX-4526,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.03,5.43,,0.95,,5.73,Percent of total billed charges,,,0.98,,5.91,Percent of total billed charges,,,0.95,,5.73,Percent of total billed charges,,,0.97,,5.85,Percent of total billed charges,,,0.97,,5.85,Percent of total billed charges,,,0.96,,5.79,Percent of total billed charges,,,0.95,,5.73,Percent of total billed charges,,,,,,,,,0.95,,5.73,Percent of total billed charges,,5.73,5.91,
LISINOPRIL 20 MG PO TABS,RX-4526,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.03,5.43,,0.95,,5.73,Percent of total billed charges,,,0.98,,5.91,Percent of total billed charges,,,0.95,,5.73,Percent of total billed charges,,,0.95,,5.73,Percent of total billed charges,,,0.97,,5.85,Percent of total billed charges,,,0.96,,5.79,Percent of total billed charges,,,0.95,,5.73,Percent of total billed charges,,,,,,,,,0.95,,5.73,Percent of total billed charges,,5.73,5.91,
AMOXICILLIN 125 MG/5ML PO SUSR,RX-453,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
AMOXICILLIN 125 MG/5ML PO SUSR,RX-453,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
LITHIUM CARBONATE 300 MG PO TABS,RX-4531,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.07,6.36,,0.95,,6.72,Percent of total billed charges,,,0.98,,6.93,Percent of total billed charges,,,0.95,,6.72,Percent of total billed charges,,,0.97,,6.86,Percent of total billed charges,,,0.97,,6.86,Percent of total billed charges,,,0.96,,6.79,Percent of total billed charges,,,0.95,,6.72,Percent of total billed charges,,,,,,,,,0.95,,6.72,Percent of total billed charges,,6.72,6.93,
LITHIUM CARBONATE 300 MG PO TABS,RX-4531,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.07,6.36,,0.95,,6.72,Percent of total billed charges,,,0.98,,6.93,Percent of total billed charges,,,0.95,,6.72,Percent of total billed charges,,,0.95,,6.72,Percent of total billed charges,,,0.97,,6.86,Percent of total billed charges,,,0.96,,6.79,Percent of total billed charges,,,0.95,,6.72,Percent of total billed charges,,,,,,,,,0.95,,6.72,Percent of total billed charges,,6.72,6.93,
AMOXICILLIN 250 MG/5ML PO SUSR,RX-454,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
AMOXICILLIN 250 MG/5ML PO SUSR,RX-454,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
LOPERAMIDE HCL 2 MG PO CAPS,RX-4560,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.54,7.69,,0.95,,8.11,Percent of total billed charges,,,0.98,,8.37,Percent of total billed charges,,,0.95,,8.11,Percent of total billed charges,,,0.97,,8.28,Percent of total billed charges,,,0.97,,8.28,Percent of total billed charges,,,0.96,,8.2,Percent of total billed charges,,,0.95,,8.11,Percent of total billed charges,,,,,,,,,0.95,,8.11,Percent of total billed charges,,8.11,8.37,
LOPERAMIDE HCL 2 MG PO CAPS,RX-4560,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.54,7.69,,0.95,,8.11,Percent of total billed charges,,,0.98,,8.37,Percent of total billed charges,,,0.95,,8.11,Percent of total billed charges,,,0.95,,8.11,Percent of total billed charges,,,0.97,,8.28,Percent of total billed charges,,,0.96,,8.2,Percent of total billed charges,,,0.95,,8.11,Percent of total billed charges,,,,,,,,,0.95,,8.11,Percent of total billed charges,,8.11,8.37,
LORAZEPAM 2 MG/ML PO CONC,RX-4571,CDM,J3490,HCPCS,637,RC,,inpatient,0.25,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
LORAZEPAM 2 MG/ML PO CONC,RX-4571,CDM,J3490,HCPCS,637,RC,,outpatient,0.25,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
LORAZEPAM 0.5 MG PO TABS,RX-4572,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.49,5.84,,0.95,,6.17,Percent of total billed charges,,,0.98,,6.36,Percent of total billed charges,,,0.95,,6.17,Percent of total billed charges,,,0.97,,6.3,Percent of total billed charges,,,0.97,,6.3,Percent of total billed charges,,,0.96,,6.23,Percent of total billed charges,,,0.95,,6.17,Percent of total billed charges,,,,,,,,,0.95,,6.17,Percent of total billed charges,,6.17,6.36,
LORAZEPAM 0.5 MG PO TABS,RX-4572,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.49,5.84,,0.95,,6.17,Percent of total billed charges,,,0.98,,6.36,Percent of total billed charges,,,0.95,,6.17,Percent of total billed charges,,,0.95,,6.17,Percent of total billed charges,,,0.97,,6.3,Percent of total billed charges,,,0.96,,6.23,Percent of total billed charges,,,0.95,,6.17,Percent of total billed charges,,,,,,,,,0.95,,6.17,Percent of total billed charges,,6.17,6.36,
LORAZEPAM 1 MG PO TABS,RX-4573,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.45,5.81,,0.95,,6.13,Percent of total billed charges,,,0.98,,6.32,Percent of total billed charges,,,0.95,,6.13,Percent of total billed charges,,,0.97,,6.26,Percent of total billed charges,,,0.97,,6.26,Percent of total billed charges,,,0.96,,6.19,Percent of total billed charges,,,0.95,,6.13,Percent of total billed charges,,,,,,,,,0.95,,6.13,Percent of total billed charges,,6.13,6.32,
LORAZEPAM 1 MG PO TABS,RX-4573,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.45,5.81,,0.95,,6.13,Percent of total billed charges,,,0.98,,6.32,Percent of total billed charges,,,0.95,,6.13,Percent of total billed charges,,,0.95,,6.13,Percent of total billed charges,,,0.97,,6.26,Percent of total billed charges,,,0.96,,6.19,Percent of total billed charges,,,0.95,,6.13,Percent of total billed charges,,,,,,,,,0.95,,6.13,Percent of total billed charges,,6.13,6.32,
AMPICILLIN SODIUM 1 G INJECTION SOLR,RX-469,CDM,J0290,HCPCS,636,RC,,inpatient,1,GR,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
AMPICILLIN SODIUM 1 G INJECTION SOLR,RX-469,CDM,J0290,HCPCS,636,RC,,outpatient,1,GR,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
AMPICILLIN SODIUM 2 G INJECTION SOLR,RX-472,CDM,J0290,HCPCS,636,RC,,inpatient,2,GR,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
AMPICILLIN SODIUM 2 G INJECTION SOLR,RX-472,CDM,J0290,HCPCS,636,RC,,outpatient,2,GR,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
MAGNESIUM SULFATE 50 % INJECTION SOLN,RX-4720,CDM,J3475,HCPCS,636,RC,,inpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
MAGNESIUM SULFATE 50 % INJECTION SOLN,RX-4720,CDM,J3475,HCPCS,636,RC,,outpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
AMPICILLIN SODIUM 250 MG INJECTION SOLR,RX-473,CDM,J0290,HCPCS,636,RC,,inpatient,250,ME,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
AMPICILLIN SODIUM 250 MG INJECTION SOLR,RX-473,CDM,J0290,HCPCS,636,RC,,outpatient,250,ME,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
MANNITOL 20 % IV SOLN,RX-4749,CDM,J7999,HCPCS,636,RC,,inpatient,62.5,ML,108.15,97.34,,0.95,,102.74,Percent of total billed charges,,,0.98,,105.99,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,0.97,,104.91,Percent of total billed charges,,,0.97,,104.91,Percent of total billed charges,,,0.96,,103.82,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,,,,,,,0.95,,102.74,Percent of total billed charges,,102.74,105.99,
MANNITOL 20 % IV SOLN,RX-4749,CDM,J7999,HCPCS,636,RC,,outpatient,62.5,ML,108.15,97.34,,0.95,,102.74,Percent of total billed charges,,,0.98,,105.99,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,0.97,,104.91,Percent of total billed charges,,,0.96,,103.82,Percent of total billed charges,,,0.95,,102.74,Percent of total billed charges,,,,,,,,,0.95,,102.74,Percent of total billed charges,,102.74,105.99,
HYDROCODONE-ACETAMINOPHEN 5-325 MG (ED PREPACK) PO TABS,RX-481001,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,28.83,25.95,,0.95,,27.39,Percent of total billed charges,,,0.98,,28.25,Percent of total billed charges,,,0.95,,27.39,Percent of total billed charges,,,0.97,,27.97,Percent of total billed charges,,,0.97,,27.97,Percent of total billed charges,,,0.96,,27.68,Percent of total billed charges,,,0.95,,27.39,Percent of total billed charges,,,,,,,,,0.95,,27.39,Percent of total billed charges,,27.39,28.25,
HYDROCODONE-ACETAMINOPHEN 5-325 MG (ED PREPACK) PO TABS,RX-481001,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,28.83,25.95,,0.95,,27.39,Percent of total billed charges,,,0.98,,28.25,Percent of total billed charges,,,0.95,,27.39,Percent of total billed charges,,,0.95,,27.39,Percent of total billed charges,,,0.97,,27.97,Percent of total billed charges,,,0.96,,27.68,Percent of total billed charges,,,0.95,,27.39,Percent of total billed charges,,,,,,,,,0.95,,27.39,Percent of total billed charges,,27.39,28.25,
AMOXICILLIN 250 MG (ED PREPACK) PO CAPS,RX-481004,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,23.75,21.38,,0.95,,22.56,Percent of total billed charges,,,0.98,,23.28,Percent of total billed charges,,,0.95,,22.56,Percent of total billed charges,,,0.97,,23.04,Percent of total billed charges,,,0.97,,23.04,Percent of total billed charges,,,0.96,,22.8,Percent of total billed charges,,,0.95,,22.56,Percent of total billed charges,,,,,,,,,0.95,,22.56,Percent of total billed charges,,22.56,23.28,
AMOXICILLIN 250 MG (ED PREPACK) PO CAPS,RX-481004,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,23.75,21.38,,0.95,,22.56,Percent of total billed charges,,,0.98,,23.28,Percent of total billed charges,,,0.95,,22.56,Percent of total billed charges,,,0.95,,22.56,Percent of total billed charges,,,0.97,,23.04,Percent of total billed charges,,,0.96,,22.8,Percent of total billed charges,,,0.95,,22.56,Percent of total billed charges,,,,,,,,,0.95,,22.56,Percent of total billed charges,,22.56,23.28,
AMOXICILLIN-POT CLAVULANATE 875-125 MG (ED PREPACK) PO TABS,RX-481005,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,33.13,29.82,,0.95,,31.47,Percent of total billed charges,,,0.98,,32.47,Percent of total billed charges,,,0.95,,31.47,Percent of total billed charges,,,0.97,,32.14,Percent of total billed charges,,,0.97,,32.14,Percent of total billed charges,,,0.96,,31.8,Percent of total billed charges,,,0.95,,31.47,Percent of total billed charges,,,,,,,,,0.95,,31.47,Percent of total billed charges,,31.47,32.47,
AMOXICILLIN-POT CLAVULANATE 875-125 MG (ED PREPACK) PO TABS,RX-481005,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,33.13,29.82,,0.95,,31.47,Percent of total billed charges,,,0.98,,32.47,Percent of total billed charges,,,0.95,,31.47,Percent of total billed charges,,,0.95,,31.47,Percent of total billed charges,,,0.97,,32.14,Percent of total billed charges,,,0.96,,31.8,Percent of total billed charges,,,0.95,,31.47,Percent of total billed charges,,,,,,,,,0.95,,31.47,Percent of total billed charges,,31.47,32.47,
HYDROMORPHONE HCL 2 MG (ED PREPACK) PO TABS,RX-481010,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,27.56,24.8,,0.95,,26.18,Percent of total billed charges,,,0.98,,27.01,Percent of total billed charges,,,0.95,,26.18,Percent of total billed charges,,,0.97,,26.73,Percent of total billed charges,,,0.97,,26.73,Percent of total billed charges,,,0.96,,26.46,Percent of total billed charges,,,0.95,,26.18,Percent of total billed charges,,,,,,,,,0.95,,26.18,Percent of total billed charges,,26.18,27.01,
HYDROMORPHONE HCL 2 MG (ED PREPACK) PO TABS,RX-481010,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,27.56,24.8,,0.95,,26.18,Percent of total billed charges,,,0.98,,27.01,Percent of total billed charges,,,0.95,,26.18,Percent of total billed charges,,,0.95,,26.18,Percent of total billed charges,,,0.97,,26.73,Percent of total billed charges,,,0.96,,26.46,Percent of total billed charges,,,0.95,,26.18,Percent of total billed charges,,,,,,,,,0.95,,26.18,Percent of total billed charges,,26.18,27.01,
PENICILLIN V POTASSIUM 250 MG (ED PREPACK) PO TABS,RX-481011,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,24.09,21.68,,0.95,,22.89,Percent of total billed charges,,,0.98,,23.61,Percent of total billed charges,,,0.95,,22.89,Percent of total billed charges,,,0.97,,23.37,Percent of total billed charges,,,0.97,,23.37,Percent of total billed charges,,,0.96,,23.13,Percent of total billed charges,,,0.95,,22.89,Percent of total billed charges,,,,,,,,,0.95,,22.89,Percent of total billed charges,,22.89,23.61,
PENICILLIN V POTASSIUM 250 MG (ED PREPACK) PO TABS,RX-481011,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,24.09,21.68,,0.95,,22.89,Percent of total billed charges,,,0.98,,23.61,Percent of total billed charges,,,0.95,,22.89,Percent of total billed charges,,,0.95,,22.89,Percent of total billed charges,,,0.97,,23.37,Percent of total billed charges,,,0.96,,23.13,Percent of total billed charges,,,0.95,,22.89,Percent of total billed charges,,,,,,,,,0.95,,22.89,Percent of total billed charges,,22.89,23.61,
SULFAMETHOXAZOLE-TRIMETHOPRIM 800-160 MG (ED PREPACK) PO TABS,RX-481017,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,26.45,23.81,,0.95,,25.13,Percent of total billed charges,,,0.98,,25.92,Percent of total billed charges,,,0.95,,25.13,Percent of total billed charges,,,0.97,,25.66,Percent of total billed charges,,,0.97,,25.66,Percent of total billed charges,,,0.96,,25.39,Percent of total billed charges,,,0.95,,25.13,Percent of total billed charges,,,,,,,,,0.95,,25.13,Percent of total billed charges,,25.13,25.92,
SULFAMETHOXAZOLE-TRIMETHOPRIM 800-160 MG (ED PREPACK) PO TABS,RX-481017,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,26.45,23.81,,0.95,,25.13,Percent of total billed charges,,,0.98,,25.92,Percent of total billed charges,,,0.95,,25.13,Percent of total billed charges,,,0.95,,25.13,Percent of total billed charges,,,0.97,,25.66,Percent of total billed charges,,,0.96,,25.39,Percent of total billed charges,,,0.95,,25.13,Percent of total billed charges,,,,,,,,,0.95,,25.13,Percent of total billed charges,,25.13,25.92,
CHLORDIAZEPOXIDE HCL 25 MG (ED PREPACK) PO CAPS,RX-481022,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,25.59,23.03,,0.95,,24.31,Percent of total billed charges,,,0.98,,25.08,Percent of total billed charges,,,0.95,,24.31,Percent of total billed charges,,,0.97,,24.82,Percent of total billed charges,,,0.97,,24.82,Percent of total billed charges,,,0.96,,24.57,Percent of total billed charges,,,0.95,,24.31,Percent of total billed charges,,,,,,,,,0.95,,24.31,Percent of total billed charges,,24.31,25.08,
CHLORDIAZEPOXIDE HCL 25 MG (ED PREPACK) PO CAPS,RX-481022,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,25.59,23.03,,0.95,,24.31,Percent of total billed charges,,,0.98,,25.08,Percent of total billed charges,,,0.95,,24.31,Percent of total billed charges,,,0.95,,24.31,Percent of total billed charges,,,0.97,,24.82,Percent of total billed charges,,,0.96,,24.57,Percent of total billed charges,,,0.95,,24.31,Percent of total billed charges,,,,,,,,,0.95,,24.31,Percent of total billed charges,,24.31,25.08,
AMLODIPINE BESYLATE 5 MG (ED PREPACK) PO TABS,RX-481031,CDM,J3490,HCPCS,637,RC,,inpatient,2,UN,12.13,10.92,,0.95,,11.52,Percent of total billed charges,,,0.98,,11.89,Percent of total billed charges,,,0.95,,11.52,Percent of total billed charges,,,0.97,,11.77,Percent of total billed charges,,,0.97,,11.77,Percent of total billed charges,,,0.96,,11.64,Percent of total billed charges,,,0.95,,11.52,Percent of total billed charges,,,,,,,,,0.95,,11.52,Percent of total billed charges,,11.52,11.89,
AMLODIPINE BESYLATE 5 MG (ED PREPACK) PO TABS,RX-481031,CDM,J3490,HCPCS,637,RC,,outpatient,2,UN,12.13,10.92,,0.95,,11.52,Percent of total billed charges,,,0.98,,11.89,Percent of total billed charges,,,0.95,,11.52,Percent of total billed charges,,,0.95,,11.52,Percent of total billed charges,,,0.97,,11.77,Percent of total billed charges,,,0.96,,11.64,Percent of total billed charges,,,0.95,,11.52,Percent of total billed charges,,,,,,,,,0.95,,11.52,Percent of total billed charges,,11.52,11.89,
ATENOLOL 50 MG (ED PREPACK) PO TABS,RX-481032,CDM,J3490,HCPCS,637,RC,,inpatient,2,UN,11.95,10.76,,0.95,,11.35,Percent of total billed charges,,,0.98,,11.71,Percent of total billed charges,,,0.95,,11.35,Percent of total billed charges,,,0.97,,11.59,Percent of total billed charges,,,0.97,,11.59,Percent of total billed charges,,,0.96,,11.47,Percent of total billed charges,,,0.95,,11.35,Percent of total billed charges,,,,,,,,,0.95,,11.35,Percent of total billed charges,,11.35,11.71,
ATENOLOL 50 MG (ED PREPACK) PO TABS,RX-481032,CDM,J3490,HCPCS,637,RC,,outpatient,2,UN,11.95,10.76,,0.95,,11.35,Percent of total billed charges,,,0.98,,11.71,Percent of total billed charges,,,0.95,,11.35,Percent of total billed charges,,,0.95,,11.35,Percent of total billed charges,,,0.97,,11.59,Percent of total billed charges,,,0.96,,11.47,Percent of total billed charges,,,0.95,,11.35,Percent of total billed charges,,,,,,,,,0.95,,11.35,Percent of total billed charges,,11.35,11.71,
COLCHICINE 0.6 MG (ED PREPACK) PO TABS,RX-481035,CDM,J3490,HCPCS,637,RC,,inpatient,6,UN,118.2,106.38,,0.95,,112.29,Percent of total billed charges,,,0.98,,115.84,Percent of total billed charges,,,0.95,,112.29,Percent of total billed charges,,,0.97,,114.65,Percent of total billed charges,,,0.97,,114.65,Percent of total billed charges,,,0.96,,113.47,Percent of total billed charges,,,0.95,,112.29,Percent of total billed charges,,,,,,,,,0.95,,112.29,Percent of total billed charges,,112.29,115.84,
COLCHICINE 0.6 MG (ED PREPACK) PO TABS,RX-481035,CDM,J3490,HCPCS,637,RC,,outpatient,6,UN,118.2,106.38,,0.95,,112.29,Percent of total billed charges,,,0.98,,115.84,Percent of total billed charges,,,0.95,,112.29,Percent of total billed charges,,,0.95,,112.29,Percent of total billed charges,,,0.97,,114.65,Percent of total billed charges,,,0.96,,113.47,Percent of total billed charges,,,0.95,,112.29,Percent of total billed charges,,,,,,,,,0.95,,112.29,Percent of total billed charges,,112.29,115.84,
DIGOXIN 125 MCG (ED PREPACK) PO TABS,RX-481036,CDM,J3490,HCPCS,637,RC,,inpatient,2,UN,36.79,33.11,,0.95,,34.95,Percent of total billed charges,,,0.98,,36.05,Percent of total billed charges,,,0.95,,34.95,Percent of total billed charges,,,0.97,,35.69,Percent of total billed charges,,,0.97,,35.69,Percent of total billed charges,,,0.96,,35.32,Percent of total billed charges,,,0.95,,34.95,Percent of total billed charges,,,,,,,,,0.95,,34.95,Percent of total billed charges,,34.95,36.05,
DIGOXIN 125 MCG (ED PREPACK) PO TABS,RX-481036,CDM,J3490,HCPCS,637,RC,,outpatient,2,UN,36.79,33.11,,0.95,,34.95,Percent of total billed charges,,,0.98,,36.05,Percent of total billed charges,,,0.95,,34.95,Percent of total billed charges,,,0.95,,34.95,Percent of total billed charges,,,0.97,,35.69,Percent of total billed charges,,,0.96,,35.32,Percent of total billed charges,,,0.95,,34.95,Percent of total billed charges,,,,,,,,,0.95,,34.95,Percent of total billed charges,,34.95,36.05,
FUROSEMIDE 20 MG (ED PREPACK) PO TABS,RX-481041,CDM,J3490,HCPCS,637,RC,,inpatient,2,UN,11.85,10.67,,0.95,,11.26,Percent of total billed charges,,,0.98,,11.61,Percent of total billed charges,,,0.95,,11.26,Percent of total billed charges,,,0.97,,11.49,Percent of total billed charges,,,0.97,,11.49,Percent of total billed charges,,,0.96,,11.38,Percent of total billed charges,,,0.95,,11.26,Percent of total billed charges,,,,,,,,,0.95,,11.26,Percent of total billed charges,,11.26,11.61,
FUROSEMIDE 20 MG (ED PREPACK) PO TABS,RX-481041,CDM,J3490,HCPCS,637,RC,,outpatient,2,UN,11.85,10.67,,0.95,,11.26,Percent of total billed charges,,,0.98,,11.61,Percent of total billed charges,,,0.95,,11.26,Percent of total billed charges,,,0.95,,11.26,Percent of total billed charges,,,0.97,,11.49,Percent of total billed charges,,,0.96,,11.38,Percent of total billed charges,,,0.95,,11.26,Percent of total billed charges,,,,,,,,,0.95,,11.26,Percent of total billed charges,,11.26,11.61,
INDOMETHACIN 25 MG (ED PREPACK) PO CAPS,RX-481043,CDM,J3490,HCPCS,637,RC,,inpatient,6,UN,40.25,36.23,,0.95,,38.24,Percent of total billed charges,,,0.98,,39.45,Percent of total billed charges,,,0.95,,38.24,Percent of total billed charges,,,0.97,,39.04,Percent of total billed charges,,,0.97,,39.04,Percent of total billed charges,,,0.96,,38.64,Percent of total billed charges,,,0.95,,38.24,Percent of total billed charges,,,,,,,,,0.95,,38.24,Percent of total billed charges,,38.24,39.45,
INDOMETHACIN 25 MG (ED PREPACK) PO CAPS,RX-481043,CDM,J3490,HCPCS,637,RC,,outpatient,6,UN,40.25,36.23,,0.95,,38.24,Percent of total billed charges,,,0.98,,39.45,Percent of total billed charges,,,0.95,,38.24,Percent of total billed charges,,,0.95,,38.24,Percent of total billed charges,,,0.97,,39.04,Percent of total billed charges,,,0.96,,38.64,Percent of total billed charges,,,0.95,,38.24,Percent of total billed charges,,,,,,,,,0.95,,38.24,Percent of total billed charges,,38.24,39.45,
METFORMIN HCL 500 MG (ED PREPACK) PO TABS,RX-481046,CDM,J3490,HCPCS,637,RC,,inpatient,2,UN,12.06,10.85,,0.95,,11.46,Percent of total billed charges,,,0.98,,11.82,Percent of total billed charges,,,0.95,,11.46,Percent of total billed charges,,,0.97,,11.7,Percent of total billed charges,,,0.97,,11.7,Percent of total billed charges,,,0.96,,11.58,Percent of total billed charges,,,0.95,,11.46,Percent of total billed charges,,,,,,,,,0.95,,11.46,Percent of total billed charges,,11.46,11.82,
METFORMIN HCL 500 MG (ED PREPACK) PO TABS,RX-481046,CDM,J3490,HCPCS,637,RC,,outpatient,2,UN,12.06,10.85,,0.95,,11.46,Percent of total billed charges,,,0.98,,11.82,Percent of total billed charges,,,0.95,,11.46,Percent of total billed charges,,,0.95,,11.46,Percent of total billed charges,,,0.97,,11.7,Percent of total billed charges,,,0.96,,11.58,Percent of total billed charges,,,0.95,,11.46,Percent of total billed charges,,,,,,,,,0.95,,11.46,Percent of total billed charges,,11.46,11.82,
OMEPRAZOLE 20 MG (ED PREPACK) PO CPDR,RX-481048,CDM,J3490,HCPCS,637,RC,,inpatient,2,UN,13.19,11.87,,0.95,,12.53,Percent of total billed charges,,,0.98,,12.93,Percent of total billed charges,,,0.95,,12.53,Percent of total billed charges,,,0.97,,12.79,Percent of total billed charges,,,0.97,,12.79,Percent of total billed charges,,,0.96,,12.66,Percent of total billed charges,,,0.95,,12.53,Percent of total billed charges,,,,,,,,,0.95,,12.53,Percent of total billed charges,,12.53,12.93,
OMEPRAZOLE 20 MG (ED PREPACK) PO CPDR,RX-481048,CDM,J3490,HCPCS,637,RC,,outpatient,2,UN,13.19,11.87,,0.95,,12.53,Percent of total billed charges,,,0.98,,12.93,Percent of total billed charges,,,0.95,,12.53,Percent of total billed charges,,,0.95,,12.53,Percent of total billed charges,,,0.97,,12.79,Percent of total billed charges,,,0.96,,12.66,Percent of total billed charges,,,0.95,,12.53,Percent of total billed charges,,,,,,,,,0.95,,12.53,Percent of total billed charges,,12.53,12.93,
PHENYTOIN SODIUM EXTENDED 100 MG (ED PREPACK) PO CAPS,RX-481049,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,33.13,29.82,,0.95,,31.47,Percent of total billed charges,,,0.98,,32.47,Percent of total billed charges,,,0.95,,31.47,Percent of total billed charges,,,0.97,,32.14,Percent of total billed charges,,,0.97,,32.14,Percent of total billed charges,,,0.96,,31.8,Percent of total billed charges,,,0.95,,31.47,Percent of total billed charges,,,,,,,,,0.95,,31.47,Percent of total billed charges,,31.47,32.47,
PHENYTOIN SODIUM EXTENDED 100 MG (ED PREPACK) PO CAPS,RX-481049,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,33.13,29.82,,0.95,,31.47,Percent of total billed charges,,,0.98,,32.47,Percent of total billed charges,,,0.95,,31.47,Percent of total billed charges,,,0.95,,31.47,Percent of total billed charges,,,0.97,,32.14,Percent of total billed charges,,,0.96,,31.8,Percent of total billed charges,,,0.95,,31.47,Percent of total billed charges,,,,,,,,,0.95,,31.47,Percent of total billed charges,,31.47,32.47,
PREDNISONE 5 MG (ED PREPACK) PO TABS,RX-481052,CDM,J7512,HCPCS,636,RC,,inpatient,1,UN,37.59,33.83,,0.95,,35.71,Percent of total billed charges,,,0.98,,36.84,Percent of total billed charges,,,0.95,,35.71,Percent of total billed charges,,,0.97,,36.46,Percent of total billed charges,,,0.97,,36.46,Percent of total billed charges,,,0.96,,36.09,Percent of total billed charges,,,0.95,,35.71,Percent of total billed charges,,,,,,,,,0.95,,35.71,Percent of total billed charges,,35.71,36.84,
PREDNISONE 5 MG (ED PREPACK) PO TABS,RX-481052,CDM,J7512,HCPCS,636,RC,,outpatient,1,UN,37.59,33.83,,0.95,,35.71,Percent of total billed charges,,,0.98,,36.84,Percent of total billed charges,,,0.95,,35.71,Percent of total billed charges,,,0.95,,35.71,Percent of total billed charges,,,0.97,,36.46,Percent of total billed charges,,,0.96,,36.09,Percent of total billed charges,,,0.95,,35.71,Percent of total billed charges,,,,,,,,,0.95,,35.71,Percent of total billed charges,,35.71,36.84,
SPIRONOLACTONE 25 MG (ED PREPACK) PO TABS,RX-481053,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,25.36,22.82,,0.95,,24.09,Percent of total billed charges,,,0.98,,24.85,Percent of total billed charges,,,0.95,,24.09,Percent of total billed charges,,,0.97,,24.6,Percent of total billed charges,,,0.97,,24.6,Percent of total billed charges,,,0.96,,24.35,Percent of total billed charges,,,0.95,,24.09,Percent of total billed charges,,,,,,,,,0.95,,24.09,Percent of total billed charges,,24.09,24.85,
SPIRONOLACTONE 25 MG (ED PREPACK) PO TABS,RX-481053,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,25.36,22.82,,0.95,,24.09,Percent of total billed charges,,,0.98,,24.85,Percent of total billed charges,,,0.95,,24.09,Percent of total billed charges,,,0.95,,24.09,Percent of total billed charges,,,0.97,,24.6,Percent of total billed charges,,,0.96,,24.35,Percent of total billed charges,,,0.95,,24.09,Percent of total billed charges,,,,,,,,,0.95,,24.09,Percent of total billed charges,,24.09,24.85,
TAMSULOSIN HCL 0.4 MG (ED PREPACK) PO CAPS,RX-481054,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,13.97,12.57,,0.95,,13.27,Percent of total billed charges,,,0.98,,13.69,Percent of total billed charges,,,0.95,,13.27,Percent of total billed charges,,,0.97,,13.55,Percent of total billed charges,,,0.97,,13.55,Percent of total billed charges,,,0.96,,13.41,Percent of total billed charges,,,0.95,,13.27,Percent of total billed charges,,,,,,,,,0.95,,13.27,Percent of total billed charges,,13.27,13.69,
TAMSULOSIN HCL 0.4 MG (ED PREPACK) PO CAPS,RX-481054,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,13.97,12.57,,0.95,,13.27,Percent of total billed charges,,,0.98,,13.69,Percent of total billed charges,,,0.95,,13.27,Percent of total billed charges,,,0.95,,13.27,Percent of total billed charges,,,0.97,,13.55,Percent of total billed charges,,,0.96,,13.41,Percent of total billed charges,,,0.95,,13.27,Percent of total billed charges,,,,,,,,,0.95,,13.27,Percent of total billed charges,,13.27,13.69,
VALACYCLOVIR HCL 500 MG (ED PREPACK) PO TABS,RX-481055,CDM,J3490,HCPCS,637,RC,,inpatient,2,UN,38.32,34.49,,0.95,,36.4,Percent of total billed charges,,,0.98,,37.55,Percent of total billed charges,,,0.95,,36.4,Percent of total billed charges,,,0.97,,37.17,Percent of total billed charges,,,0.97,,37.17,Percent of total billed charges,,,0.96,,36.79,Percent of total billed charges,,,0.95,,36.4,Percent of total billed charges,,,,,,,,,0.95,,36.4,Percent of total billed charges,,36.4,37.55,
VALACYCLOVIR HCL 500 MG (ED PREPACK) PO TABS,RX-481055,CDM,J3490,HCPCS,637,RC,,outpatient,2,UN,38.32,34.49,,0.95,,36.4,Percent of total billed charges,,,0.98,,37.55,Percent of total billed charges,,,0.95,,36.4,Percent of total billed charges,,,0.95,,36.4,Percent of total billed charges,,,0.97,,37.17,Percent of total billed charges,,,0.96,,36.79,Percent of total billed charges,,,0.95,,36.4,Percent of total billed charges,,,,,,,,,0.95,,36.4,Percent of total billed charges,,36.4,37.55,
MEDROXYPROGESTERONE ACETATE 2.5 MG PO TABS,RX-4855,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.25,5.63,,0.95,,5.94,Percent of total billed charges,,,0.98,,6.13,Percent of total billed charges,,,0.95,,5.94,Percent of total billed charges,,,0.97,,6.06,Percent of total billed charges,,,0.97,,6.06,Percent of total billed charges,,,0.96,,6,Percent of total billed charges,,,0.95,,5.94,Percent of total billed charges,,,,,,,,,0.95,,5.94,Percent of total billed charges,,5.94,6.13,
MEDROXYPROGESTERONE ACETATE 2.5 MG PO TABS,RX-4855,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.25,5.63,,0.95,,5.94,Percent of total billed charges,,,0.98,,6.13,Percent of total billed charges,,,0.95,,5.94,Percent of total billed charges,,,0.95,,5.94,Percent of total billed charges,,,0.97,,6.06,Percent of total billed charges,,,0.96,,6,Percent of total billed charges,,,0.95,,5.94,Percent of total billed charges,,,,,,,,,0.95,,5.94,Percent of total billed charges,,5.94,6.13,
METHADONE HCL 5 MG PO TABS,RX-4954,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.6,6.84,,0.95,,7.22,Percent of total billed charges,,,0.98,,7.45,Percent of total billed charges,,,0.95,,7.22,Percent of total billed charges,,,0.97,,7.37,Percent of total billed charges,,,0.97,,7.37,Percent of total billed charges,,,0.96,,7.3,Percent of total billed charges,,,0.95,,7.22,Percent of total billed charges,,,,,,,,,0.95,,7.22,Percent of total billed charges,,7.22,7.45,
METHADONE HCL 5 MG PO TABS,RX-4954,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.6,6.84,,0.95,,7.22,Percent of total billed charges,,,0.98,,7.45,Percent of total billed charges,,,0.95,,7.22,Percent of total billed charges,,,0.95,,7.22,Percent of total billed charges,,,0.97,,7.37,Percent of total billed charges,,,0.96,,7.3,Percent of total billed charges,,,0.95,,7.22,Percent of total billed charges,,,,,,,,,0.95,,7.22,Percent of total billed charges,,7.22,7.45,
METHOCARBAMOL 500 MG PO TABS,RX-4971,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.88,6.19,,0.95,,6.54,Percent of total billed charges,,,0.98,,6.74,Percent of total billed charges,,,0.95,,6.54,Percent of total billed charges,,,0.97,,6.67,Percent of total billed charges,,,0.97,,6.67,Percent of total billed charges,,,0.96,,6.6,Percent of total billed charges,,,0.95,,6.54,Percent of total billed charges,,,,,,,,,0.95,,6.54,Percent of total billed charges,,6.54,6.74,
METHOCARBAMOL 500 MG PO TABS,RX-4971,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.88,6.19,,0.95,,6.54,Percent of total billed charges,,,0.98,,6.74,Percent of total billed charges,,,0.95,,6.54,Percent of total billed charges,,,0.95,,6.54,Percent of total billed charges,,,0.97,,6.67,Percent of total billed charges,,,0.96,,6.6,Percent of total billed charges,,,0.95,,6.54,Percent of total billed charges,,,,,,,,,0.95,,6.54,Percent of total billed charges,,6.54,6.74,
METHOTREXATE SODIUM 2.5 MG PO TABS,RX-4973,CDM,J8610,HCPCS,636,RC,,inpatient,1,UN,128.75,115.88,,0.95,,122.31,Percent of total billed charges,,,0.98,,126.18,Percent of total billed charges,,,0.95,,122.31,Percent of total billed charges,,,0.97,,124.89,Percent of total billed charges,,,0.97,,124.89,Percent of total billed charges,,,0.96,,123.6,Percent of total billed charges,,,0.95,,122.31,Percent of total billed charges,,,,,,,,,0.95,,122.31,Percent of total billed charges,,122.31,126.18,
METHOTREXATE SODIUM 2.5 MG PO TABS,RX-4973,CDM,J8610,HCPCS,636,RC,,outpatient,1,UN,128.75,115.88,,0.95,,122.31,Percent of total billed charges,,,0.98,,126.18,Percent of total billed charges,,,0.95,,122.31,Percent of total billed charges,,,0.95,,122.31,Percent of total billed charges,,,0.97,,124.89,Percent of total billed charges,,,0.96,,123.6,Percent of total billed charges,,,0.95,,122.31,Percent of total billed charges,,,,,,,,,0.95,,122.31,Percent of total billed charges,,122.31,126.18,
METHYLPREDNISOLONE 4 MG PO TABS,RX-4993,CDM,J7509,HCPCS,636,RC,,inpatient,1,UN,7.19,6.47,,0.95,,6.83,Percent of total billed charges,,,0.98,,7.05,Percent of total billed charges,,,0.95,,6.83,Percent of total billed charges,,,0.97,,6.97,Percent of total billed charges,,,0.97,,6.97,Percent of total billed charges,,,0.96,,6.9,Percent of total billed charges,,,0.95,,6.83,Percent of total billed charges,,,,,,,,,0.95,,6.83,Percent of total billed charges,,6.83,7.05,
METHYLPREDNISOLONE 4 MG PO TABS,RX-4993,CDM,J7509,HCPCS,636,RC,,outpatient,1,UN,7.19,6.47,,0.95,,6.83,Percent of total billed charges,,,0.98,,7.05,Percent of total billed charges,,,0.95,,6.83,Percent of total billed charges,,,0.95,,6.83,Percent of total billed charges,,,0.97,,6.97,Percent of total billed charges,,,0.96,,6.9,Percent of total billed charges,,,0.95,,6.83,Percent of total billed charges,,,,,,,,,0.95,,6.83,Percent of total billed charges,,6.83,7.05,
METHYLPREDNISOLONE ACETATE 40 MG/ML INJECTION SUSP,RX-4995,CDM,J1010,HCPCS,636,RC,,inpatient,0.25,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
METHYLPREDNISOLONE ACETATE 40 MG/ML INJECTION SUSP,RX-4995,CDM,J1010,HCPCS,636,RC,,outpatient,0.25,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
METHYLPREDNISOLONE ACETATE 80 MG/ML INJECTION SUSP,RX-4996,CDM,J1010,HCPCS,636,RC,,inpatient,0.75,ML,27.1,24.39,,0.95,,25.75,Percent of total billed charges,,,0.98,,26.56,Percent of total billed charges,,,0.95,,25.75,Percent of total billed charges,,,0.97,,26.29,Percent of total billed charges,,,0.97,,26.29,Percent of total billed charges,,,0.96,,26.02,Percent of total billed charges,,,0.95,,25.75,Percent of total billed charges,,,,,,,,,0.95,,25.75,Percent of total billed charges,,25.75,26.56,
METHYLPREDNISOLONE ACETATE 80 MG/ML INJECTION SUSP,RX-4996,CDM,J1010,HCPCS,636,RC,,outpatient,0.75,ML,27.1,24.39,,0.95,,25.75,Percent of total billed charges,,,0.98,,26.56,Percent of total billed charges,,,0.95,,25.75,Percent of total billed charges,,,0.95,,25.75,Percent of total billed charges,,,0.97,,26.29,Percent of total billed charges,,,0.96,,26.02,Percent of total billed charges,,,0.95,,25.75,Percent of total billed charges,,,,,,,,,0.95,,25.75,Percent of total billed charges,,25.75,26.56,
METOCLOPRAMIDE HCL 5 MG/ML INJECTION SOLN,RX-5002,CDM,J2765,HCPCS,636,RC,,inpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
METOCLOPRAMIDE HCL 5 MG/ML INJECTION SOLN,RX-5002,CDM,J2765,HCPCS,636,RC,,outpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
METOCLOPRAMIDE HCL 5 MG PO TABS,RX-5006,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.67,7.8,,0.95,,8.24,Percent of total billed charges,,,0.98,,8.5,Percent of total billed charges,,,0.95,,8.24,Percent of total billed charges,,,0.97,,8.41,Percent of total billed charges,,,0.97,,8.41,Percent of total billed charges,,,0.96,,8.32,Percent of total billed charges,,,0.95,,8.24,Percent of total billed charges,,,,,,,,,0.95,,8.24,Percent of total billed charges,,8.24,8.5,
METOCLOPRAMIDE HCL 5 MG PO TABS,RX-5006,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.67,7.8,,0.95,,8.24,Percent of total billed charges,,,0.98,,8.5,Percent of total billed charges,,,0.95,,8.24,Percent of total billed charges,,,0.95,,8.24,Percent of total billed charges,,,0.97,,8.41,Percent of total billed charges,,,0.96,,8.32,Percent of total billed charges,,,0.95,,8.24,Percent of total billed charges,,,,,,,,,0.95,,8.24,Percent of total billed charges,,8.24,8.5,
METOPROLOL TARTRATE 50 MG PO TABS,RX-5009,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
METOPROLOL TARTRATE 50 MG PO TABS,RX-5009,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
METRONIDAZOLE 250 MG PO TABS,RX-5015,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.17,6.45,,0.95,,6.81,Percent of total billed charges,,,0.98,,7.03,Percent of total billed charges,,,0.95,,6.81,Percent of total billed charges,,,0.97,,6.95,Percent of total billed charges,,,0.97,,6.95,Percent of total billed charges,,,0.96,,6.88,Percent of total billed charges,,,0.95,,6.81,Percent of total billed charges,,,,,,,,,0.95,,6.81,Percent of total billed charges,,6.81,7.03,
METRONIDAZOLE 250 MG PO TABS,RX-5015,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.17,6.45,,0.95,,6.81,Percent of total billed charges,,,0.98,,7.03,Percent of total billed charges,,,0.95,,6.81,Percent of total billed charges,,,0.95,,6.81,Percent of total billed charges,,,0.97,,6.95,Percent of total billed charges,,,0.96,,6.88,Percent of total billed charges,,,0.95,,6.81,Percent of total billed charges,,,,,,,,,0.95,,6.81,Percent of total billed charges,,6.81,7.03,
MICONAZOLE NITRATE 2 % EX CREA,RX-5039,CDM,J3490,HCPCS,637,RC,,inpatient,28,GR,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
MICONAZOLE NITRATE 2 % EX CREA,RX-5039,CDM,J3490,HCPCS,637,RC,,outpatient,28,GR,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
MINERAL OIL PO OIL,RX-5086,CDM,J3490,HCPCS,637,RC,,inpatient,15,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
MINERAL OIL PO OIL,RX-5086,CDM,J3490,HCPCS,637,RC,,outpatient,15,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
MINERAL OIL RECTAL ENEM,RX-5087,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
MINERAL OIL RECTAL ENEM,RX-5087,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
MINOXIDIL 2.5 MG PO TABS,RX-5115,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8,7.2,,0.95,,7.6,Percent of total billed charges,,,0.98,,7.84,Percent of total billed charges,,,0.95,,7.6,Percent of total billed charges,,,0.97,,7.76,Percent of total billed charges,,,0.97,,7.76,Percent of total billed charges,,,0.96,,7.68,Percent of total billed charges,,,0.95,,7.6,Percent of total billed charges,,,,,,,,,0.95,,7.6,Percent of total billed charges,,7.6,7.84,
MINOXIDIL 2.5 MG PO TABS,RX-5115,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8,7.2,,0.95,,7.6,Percent of total billed charges,,,0.98,,7.84,Percent of total billed charges,,,0.95,,7.6,Percent of total billed charges,,,0.95,,7.6,Percent of total billed charges,,,0.97,,7.76,Percent of total billed charges,,,0.96,,7.68,Percent of total billed charges,,,0.95,,7.6,Percent of total billed charges,,,,,,,,,0.95,,7.6,Percent of total billed charges,,7.6,7.84,
MORPHINE SULFATE 15 MG PO TABS,RX-5178,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.12,9.11,,0.95,,9.61,Percent of total billed charges,,,0.98,,9.92,Percent of total billed charges,,,0.95,,9.61,Percent of total billed charges,,,0.97,,9.82,Percent of total billed charges,,,0.97,,9.82,Percent of total billed charges,,,0.96,,9.72,Percent of total billed charges,,,0.95,,9.61,Percent of total billed charges,,,,,,,,,0.95,,9.61,Percent of total billed charges,,9.61,9.92,
MORPHINE SULFATE 15 MG PO TABS,RX-5178,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.12,9.11,,0.95,,9.61,Percent of total billed charges,,,0.98,,9.92,Percent of total billed charges,,,0.95,,9.61,Percent of total billed charges,,,0.95,,9.61,Percent of total billed charges,,,0.97,,9.82,Percent of total billed charges,,,0.96,,9.72,Percent of total billed charges,,,0.95,,9.61,Percent of total billed charges,,,,,,,,,0.95,,9.61,Percent of total billed charges,,9.61,9.92,
NAFCILLIN SODIUM 1 G INJECTION SOLR,RX-5333,CDM,J7999,HCPCS,250,RC,,inpatient,4,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
NAFCILLIN SODIUM 1 G INJECTION SOLR,RX-5333,CDM,J7999,HCPCS,250,RC,,outpatient,4,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
NAFCILLIN SODIUM 2 G INJECTION SOLR,RX-5335,CDM,J7999,HCPCS,250,RC,,inpatient,2,GR,24.74,22.27,,0.95,,23.5,Percent of total billed charges,,,0.98,,24.25,Percent of total billed charges,,,0.95,,23.5,Percent of total billed charges,,,0.97,,24,Percent of total billed charges,,,0.97,,24,Percent of total billed charges,,,0.96,,23.75,Percent of total billed charges,,,0.95,,23.5,Percent of total billed charges,,,,,,,,,0.95,,23.5,Percent of total billed charges,,23.5,24.25,
NAFCILLIN SODIUM 2 G INJECTION SOLR,RX-5335,CDM,J7999,HCPCS,250,RC,,outpatient,2,GR,24.74,22.27,,0.95,,23.5,Percent of total billed charges,,,0.98,,24.25,Percent of total billed charges,,,0.95,,23.5,Percent of total billed charges,,,0.95,,23.5,Percent of total billed charges,,,0.97,,24,Percent of total billed charges,,,0.96,,23.75,Percent of total billed charges,,,0.95,,23.5,Percent of total billed charges,,,,,,,,,0.95,,23.5,Percent of total billed charges,,23.5,24.25,
NALOXONE HCL 0.4 MG/ML INJECTION SOLN,RX-5373,CDM,J2310,HCPCS,636,RC,,inpatient,0.25,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
NALOXONE HCL 0.4 MG/ML INJECTION SOLN,RX-5373,CDM,J2310,HCPCS,636,RC,,outpatient,0.25,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
NAPROXEN 250 MG PO TABS,RX-5391,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.68,6.01,,0.95,,6.35,Percent of total billed charges,,,0.98,,6.55,Percent of total billed charges,,,0.95,,6.35,Percent of total billed charges,,,0.97,,6.48,Percent of total billed charges,,,0.97,,6.48,Percent of total billed charges,,,0.96,,6.41,Percent of total billed charges,,,0.95,,6.35,Percent of total billed charges,,,,,,,,,0.95,,6.35,Percent of total billed charges,,6.35,6.55,
NAPROXEN 250 MG PO TABS,RX-5391,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.68,6.01,,0.95,,6.35,Percent of total billed charges,,,0.98,,6.55,Percent of total billed charges,,,0.95,,6.35,Percent of total billed charges,,,0.95,,6.35,Percent of total billed charges,,,0.97,,6.48,Percent of total billed charges,,,0.96,,6.41,Percent of total billed charges,,,0.95,,6.35,Percent of total billed charges,,,,,,,,,0.95,,6.35,Percent of total billed charges,,6.35,6.55,
NEOMYCIN SULFATE 500 MG PO TABS,RX-5472,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,9.6,8.64,,0.95,,9.12,Percent of total billed charges,,,0.98,,9.41,Percent of total billed charges,,,0.95,,9.12,Percent of total billed charges,,,0.97,,9.31,Percent of total billed charges,,,0.97,,9.31,Percent of total billed charges,,,0.96,,9.22,Percent of total billed charges,,,0.95,,9.12,Percent of total billed charges,,,,,,,,,0.95,,9.12,Percent of total billed charges,,9.12,9.41,
NEOMYCIN SULFATE 500 MG PO TABS,RX-5472,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,9.6,8.64,,0.95,,9.12,Percent of total billed charges,,,0.98,,9.41,Percent of total billed charges,,,0.95,,9.12,Percent of total billed charges,,,0.95,,9.12,Percent of total billed charges,,,0.97,,9.31,Percent of total billed charges,,,0.96,,9.22,Percent of total billed charges,,,0.95,,9.12,Percent of total billed charges,,,,,,,,,0.95,,9.12,Percent of total billed charges,,9.12,9.41,
NIFEDIPINE 10 MG PO CAPS,RX-5558,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.12,9.11,,0.95,,9.61,Percent of total billed charges,,,0.98,,9.92,Percent of total billed charges,,,0.95,,9.61,Percent of total billed charges,,,0.97,,9.82,Percent of total billed charges,,,0.97,,9.82,Percent of total billed charges,,,0.96,,9.72,Percent of total billed charges,,,0.95,,9.61,Percent of total billed charges,,,,,,,,,0.95,,9.61,Percent of total billed charges,,9.61,9.92,
NIFEDIPINE 10 MG PO CAPS,RX-5558,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.12,9.11,,0.95,,9.61,Percent of total billed charges,,,0.98,,9.92,Percent of total billed charges,,,0.95,,9.61,Percent of total billed charges,,,0.95,,9.61,Percent of total billed charges,,,0.97,,9.82,Percent of total billed charges,,,0.96,,9.72,Percent of total billed charges,,,0.95,,9.61,Percent of total billed charges,,,,,,,,,0.95,,9.61,Percent of total billed charges,,9.61,9.92,
NITROFURANTOIN MACROCRYSTAL 50 MG PO CAPS,RX-5595,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,14.33,12.9,,0.95,,13.61,Percent of total billed charges,,,0.98,,14.04,Percent of total billed charges,,,0.95,,13.61,Percent of total billed charges,,,0.97,,13.9,Percent of total billed charges,,,0.97,,13.9,Percent of total billed charges,,,0.96,,13.76,Percent of total billed charges,,,0.95,,13.61,Percent of total billed charges,,,,,,,,,0.95,,13.61,Percent of total billed charges,,13.61,14.04,
NITROFURANTOIN MACROCRYSTAL 50 MG PO CAPS,RX-5595,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,14.33,12.9,,0.95,,13.61,Percent of total billed charges,,,0.98,,14.04,Percent of total billed charges,,,0.95,,13.61,Percent of total billed charges,,,0.95,,13.61,Percent of total billed charges,,,0.97,,13.9,Percent of total billed charges,,,0.96,,13.76,Percent of total billed charges,,,0.95,,13.61,Percent of total billed charges,,,,,,,,,0.95,,13.61,Percent of total billed charges,,13.61,14.04,
NITROGLYCERIN 0.4 MG SL SUBL,RX-5604,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,1.49,1.34,,0.95,,1.42,Percent of total billed charges,,,0.98,,1.46,Percent of total billed charges,,,0.95,,1.42,Percent of total billed charges,,,0.97,,1.45,Percent of total billed charges,,,0.97,,1.45,Percent of total billed charges,,,0.96,,1.43,Percent of total billed charges,,,0.95,,1.42,Percent of total billed charges,,,,,,,,,0.95,,1.42,Percent of total billed charges,,1.42,1.46,
NITROGLYCERIN 0.4 MG SL SUBL,RX-5604,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,1.49,1.34,,0.95,,1.42,Percent of total billed charges,,,0.98,,1.46,Percent of total billed charges,,,0.95,,1.42,Percent of total billed charges,,,0.95,,1.42,Percent of total billed charges,,,0.97,,1.45,Percent of total billed charges,,,0.96,,1.43,Percent of total billed charges,,,0.95,,1.42,Percent of total billed charges,,,,,,,,,0.95,,1.42,Percent of total billed charges,,1.42,1.46,
NITROGLYCERIN 2 % TD OINT,RX-5606,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
NITROGLYCERIN 2 % TD OINT,RX-5606,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
NYSTATIN 100000 UNIT/GM EX OINT,RX-5750,CDM,J3490,HCPCS,637,RC,,inpatient,15,GR,30.8,27.72,,0.95,,29.26,Percent of total billed charges,,,0.98,,30.18,Percent of total billed charges,,,0.95,,29.26,Percent of total billed charges,,,0.97,,29.88,Percent of total billed charges,,,0.97,,29.88,Percent of total billed charges,,,0.96,,29.57,Percent of total billed charges,,,0.95,,29.26,Percent of total billed charges,,,,,,,,,0.95,,29.26,Percent of total billed charges,,29.26,30.18,
NYSTATIN 100000 UNIT/GM EX OINT,RX-5750,CDM,J3490,HCPCS,637,RC,,outpatient,15,GR,30.8,27.72,,0.95,,29.26,Percent of total billed charges,,,0.98,,30.18,Percent of total billed charges,,,0.95,,29.26,Percent of total billed charges,,,0.95,,29.26,Percent of total billed charges,,,0.97,,29.88,Percent of total billed charges,,,0.96,,29.57,Percent of total billed charges,,,0.95,,29.26,Percent of total billed charges,,,,,,,,,0.95,,29.26,Percent of total billed charges,,29.26,30.18,
NYSTATIN 100000 UNIT/ML MOUTH/THROAT SUSP,RX-5751,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
NYSTATIN 100000 UNIT/ML MOUTH/THROAT SUSP,RX-5751,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
NYSTATIN 500000 UNITS PO TABS,RX-5752,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,11.17,10.05,,0.95,,10.61,Percent of total billed charges,,,0.98,,10.95,Percent of total billed charges,,,0.95,,10.61,Percent of total billed charges,,,0.97,,10.83,Percent of total billed charges,,,0.97,,10.83,Percent of total billed charges,,,0.96,,10.72,Percent of total billed charges,,,0.95,,10.61,Percent of total billed charges,,,,,,,,,0.95,,10.61,Percent of total billed charges,,10.61,10.95,
NYSTATIN 500000 UNITS PO TABS,RX-5752,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,11.17,10.05,,0.95,,10.61,Percent of total billed charges,,,0.98,,10.95,Percent of total billed charges,,,0.95,,10.61,Percent of total billed charges,,,0.95,,10.61,Percent of total billed charges,,,0.97,,10.83,Percent of total billed charges,,,0.96,,10.72,Percent of total billed charges,,,0.95,,10.61,Percent of total billed charges,,,,,,,,,0.95,,10.61,Percent of total billed charges,,10.61,10.95,
ORA-SWEET SF PO SYRP,RX-5853,CDM,J3490,HCPCS,637,RC,,inpatient,473,ML,74.55,67.1,,0.95,,70.82,Percent of total billed charges,,,0.98,,73.06,Percent of total billed charges,,,0.95,,70.82,Percent of total billed charges,,,0.97,,72.31,Percent of total billed charges,,,0.97,,72.31,Percent of total billed charges,,,0.96,,71.57,Percent of total billed charges,,,0.95,,70.82,Percent of total billed charges,,,,,,,,,0.95,,70.82,Percent of total billed charges,,70.82,73.06,
ORA-SWEET SF PO SYRP,RX-5853,CDM,J3490,HCPCS,637,RC,,outpatient,473,ML,74.55,67.1,,0.95,,70.82,Percent of total billed charges,,,0.98,,73.06,Percent of total billed charges,,,0.95,,70.82,Percent of total billed charges,,,0.95,,70.82,Percent of total billed charges,,,0.97,,72.31,Percent of total billed charges,,,0.96,,71.57,Percent of total billed charges,,,0.95,,70.82,Percent of total billed charges,,,,,,,,,0.95,,70.82,Percent of total billed charges,,70.82,73.06,
OXACILLIN SODIUM 2 G INJECTION SOLR,RX-5926,CDM,J2700,HCPCS,636,RC,,inpatient,2000,ME,32.87,29.58,,0.95,,31.23,Percent of total billed charges,,,0.98,,32.21,Percent of total billed charges,,,0.95,,31.23,Percent of total billed charges,,,0.97,,31.88,Percent of total billed charges,,,0.97,,31.88,Percent of total billed charges,,,0.96,,31.56,Percent of total billed charges,,,0.95,,31.23,Percent of total billed charges,,,,,,,,,0.95,,31.23,Percent of total billed charges,,31.23,32.21,
OXACILLIN SODIUM 2 G INJECTION SOLR,RX-5926,CDM,J2700,HCPCS,636,RC,,outpatient,2000,ME,32.87,29.58,,0.95,,31.23,Percent of total billed charges,,,0.98,,32.21,Percent of total billed charges,,,0.95,,31.23,Percent of total billed charges,,,0.95,,31.23,Percent of total billed charges,,,0.97,,31.88,Percent of total billed charges,,,0.96,,31.56,Percent of total billed charges,,,0.95,,31.23,Percent of total billed charges,,,,,,,,,0.95,,31.23,Percent of total billed charges,,31.23,32.21,
OXYBUTYNIN CHLORIDE 5 MG PO TABS,RX-5938,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.45,6.71,,0.95,,7.08,Percent of total billed charges,,,0.98,,7.3,Percent of total billed charges,,,0.95,,7.08,Percent of total billed charges,,,0.97,,7.23,Percent of total billed charges,,,0.97,,7.23,Percent of total billed charges,,,0.96,,7.15,Percent of total billed charges,,,0.95,,7.08,Percent of total billed charges,,,,,,,,,0.95,,7.08,Percent of total billed charges,,7.08,7.3,
OXYBUTYNIN CHLORIDE 5 MG PO TABS,RX-5938,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.45,6.71,,0.95,,7.08,Percent of total billed charges,,,0.98,,7.3,Percent of total billed charges,,,0.95,,7.08,Percent of total billed charges,,,0.95,,7.08,Percent of total billed charges,,,0.97,,7.23,Percent of total billed charges,,,0.96,,7.15,Percent of total billed charges,,,0.95,,7.08,Percent of total billed charges,,,,,,,,,0.95,,7.08,Percent of total billed charges,,7.08,7.3,
OXYTOCIN 10 UNIT/ML INJECTION SOLN,RX-5944,CDM,J2590,HCPCS,636,RC,,inpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
OXYTOCIN 10 UNIT/ML INJECTION SOLN,RX-5944,CDM,J2590,HCPCS,636,RC,,outpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
PENICILLIN G POTASSIUM 5000000 UNITS INJECTION SOLR,RX-6086,CDM,J2540,HCPCS,636,RC,,inpatient,5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
PENICILLIN G POTASSIUM 5000000 UNITS INJECTION SOLR,RX-6086,CDM,J2540,HCPCS,636,RC,,outpatient,5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
PENICILLIN V POTASSIUM 250 MG/5ML PO SOLR,RX-6091,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
PENICILLIN V POTASSIUM 250 MG/5ML PO SOLR,RX-6091,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
PERPHENAZINE 4 MG PO TABS,RX-6158,CDM,Q0175,HCPCS,636,RC,,inpatient,1,UN,7.26,6.53,,0.95,,6.9,Percent of total billed charges,,,0.98,,7.11,Percent of total billed charges,,,0.95,,6.9,Percent of total billed charges,,,0.97,,7.04,Percent of total billed charges,,,0.97,,7.04,Percent of total billed charges,,,0.96,,6.97,Percent of total billed charges,,,0.95,,6.9,Percent of total billed charges,,,,,,,,,0.95,,6.9,Percent of total billed charges,,6.9,7.11,
PERPHENAZINE 4 MG PO TABS,RX-6158,CDM,Q0175,HCPCS,636,RC,,outpatient,1,UN,7.26,6.53,,0.95,,6.9,Percent of total billed charges,,,0.98,,7.11,Percent of total billed charges,,,0.95,,6.9,Percent of total billed charges,,,0.95,,6.9,Percent of total billed charges,,,0.97,,7.04,Percent of total billed charges,,,0.96,,6.97,Percent of total billed charges,,,0.95,,6.9,Percent of total billed charges,,,,,,,,,0.95,,6.9,Percent of total billed charges,,6.9,7.11,
PERPHENAZINE 8 MG PO TABS,RX-6159,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,11.83,10.65,,0.95,,11.24,Percent of total billed charges,,,0.98,,11.59,Percent of total billed charges,,,0.95,,11.24,Percent of total billed charges,,,0.97,,11.48,Percent of total billed charges,,,0.97,,11.48,Percent of total billed charges,,,0.96,,11.36,Percent of total billed charges,,,0.95,,11.24,Percent of total billed charges,,,,,,,,,0.95,,11.24,Percent of total billed charges,,11.24,11.59,
PERPHENAZINE 8 MG PO TABS,RX-6159,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,11.83,10.65,,0.95,,11.24,Percent of total billed charges,,,0.98,,11.59,Percent of total billed charges,,,0.95,,11.24,Percent of total billed charges,,,0.95,,11.24,Percent of total billed charges,,,0.97,,11.48,Percent of total billed charges,,,0.96,,11.36,Percent of total billed charges,,,0.95,,11.24,Percent of total billed charges,,,,,,,,,0.95,,11.24,Percent of total billed charges,,11.24,11.59,
PHENAZOPYRIDINE HCL 100 MG PO TABS,RX-6193,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.35,6.62,,0.95,,6.98,Percent of total billed charges,,,0.98,,7.2,Percent of total billed charges,,,0.95,,6.98,Percent of total billed charges,,,0.97,,7.13,Percent of total billed charges,,,0.97,,7.13,Percent of total billed charges,,,0.96,,7.06,Percent of total billed charges,,,0.95,,6.98,Percent of total billed charges,,,,,,,,,0.95,,6.98,Percent of total billed charges,,6.98,7.2,
PHENAZOPYRIDINE HCL 100 MG PO TABS,RX-6193,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.35,6.62,,0.95,,6.98,Percent of total billed charges,,,0.98,,7.2,Percent of total billed charges,,,0.95,,6.98,Percent of total billed charges,,,0.95,,6.98,Percent of total billed charges,,,0.97,,7.13,Percent of total billed charges,,,0.96,,7.06,Percent of total billed charges,,,0.95,,6.98,Percent of total billed charges,,,,,,,,,0.95,,6.98,Percent of total billed charges,,6.98,7.2,
PHENOBARBITAL SODIUM 130 MG/ML INJECTION SOLN,RX-6221,CDM,J2560,HCPCS,636,RC,,inpatient,0.39,ML,51.56,46.4,,0.95,,48.98,Percent of total billed charges,,,0.98,,50.53,Percent of total billed charges,,,0.95,,48.98,Percent of total billed charges,,,0.97,,50.01,Percent of total billed charges,,,0.97,,50.01,Percent of total billed charges,,,0.96,,49.5,Percent of total billed charges,,,0.95,,48.98,Percent of total billed charges,,,,,,,,,0.95,,48.98,Percent of total billed charges,,48.98,50.53,
PHENOBARBITAL SODIUM 130 MG/ML INJECTION SOLN,RX-6221,CDM,J2560,HCPCS,636,RC,,outpatient,0.39,ML,51.56,46.4,,0.95,,48.98,Percent of total billed charges,,,0.98,,50.53,Percent of total billed charges,,,0.95,,48.98,Percent of total billed charges,,,0.95,,48.98,Percent of total billed charges,,,0.97,,50.01,Percent of total billed charges,,,0.96,,49.5,Percent of total billed charges,,,0.95,,48.98,Percent of total billed charges,,,,,,,,,0.95,,48.98,Percent of total billed charges,,48.98,50.53,
PHENYLEPHRINE HCL 2.5 % OP SOLN,RX-6246,CDM,J3490,HCPCS,250,RC,,inpatient,15,ML,275.07,247.56,,0.95,,261.32,Percent of total billed charges,,,0.98,,269.57,Percent of total billed charges,,,0.95,,261.32,Percent of total billed charges,,,0.97,,266.82,Percent of total billed charges,,,0.97,,266.82,Percent of total billed charges,,,0.96,,264.07,Percent of total billed charges,,,0.95,,261.32,Percent of total billed charges,,,,,,,,,0.95,,261.32,Percent of total billed charges,,261.32,269.57,
PHENYLEPHRINE HCL 2.5 % OP SOLN,RX-6246,CDM,J3490,HCPCS,250,RC,,outpatient,15,ML,275.07,247.56,,0.95,,261.32,Percent of total billed charges,,,0.98,,269.57,Percent of total billed charges,,,0.95,,261.32,Percent of total billed charges,,,0.95,,261.32,Percent of total billed charges,,,0.97,,266.82,Percent of total billed charges,,,0.96,,264.07,Percent of total billed charges,,,0.95,,261.32,Percent of total billed charges,,,,,,,,,0.95,,261.32,Percent of total billed charges,,261.32,269.57,
PHENYTOIN 125 MG/5ML PO SUSP,RX-6255,CDM,J3490,HCPCS,637,RC,,inpatient,4,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
PHENYTOIN 125 MG/5ML PO SUSP,RX-6255,CDM,J3490,HCPCS,637,RC,,outpatient,4,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
PHENYTOIN SODIUM 50 MG/ML INJECTION SOLN,RX-6256,CDM,J1165,HCPCS,636,RC,,inpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
PHENYTOIN SODIUM 50 MG/ML INJECTION SOLN,RX-6256,CDM,J1165,HCPCS,636,RC,,outpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
PILOCARPINE HCL 1 % OP SOLN,RX-6279,CDM,J3490,HCPCS,250,RC,,inpatient,15,ML,159.02,143.12,,0.95,,151.07,Percent of total billed charges,,,0.98,,155.84,Percent of total billed charges,,,0.95,,151.07,Percent of total billed charges,,,0.97,,154.25,Percent of total billed charges,,,0.97,,154.25,Percent of total billed charges,,,0.96,,152.66,Percent of total billed charges,,,0.95,,151.07,Percent of total billed charges,,,,,,,,,0.95,,151.07,Percent of total billed charges,,151.07,155.84,
PILOCARPINE HCL 1 % OP SOLN,RX-6279,CDM,J3490,HCPCS,250,RC,,outpatient,15,ML,159.02,143.12,,0.95,,151.07,Percent of total billed charges,,,0.98,,155.84,Percent of total billed charges,,,0.95,,151.07,Percent of total billed charges,,,0.95,,151.07,Percent of total billed charges,,,0.97,,154.25,Percent of total billed charges,,,0.96,,152.66,Percent of total billed charges,,,0.95,,151.07,Percent of total billed charges,,,,,,,,,0.95,,151.07,Percent of total billed charges,,151.07,155.84,
PILOCARPINE HCL 2 % OP SOLN,RX-6280,CDM,J3490,HCPCS,250,RC,,inpatient,1,ML,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
PILOCARPINE HCL 2 % OP SOLN,RX-6280,CDM,J3490,HCPCS,250,RC,,outpatient,1,ML,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
POLYSPORIN 500-10000 UNIT/GM EX OINT,RX-6396,CDM,J3490,HCPCS,637,RC,,inpatient,1,GR,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
POLYSPORIN 500-10000 UNIT/GM EX OINT,RX-6396,CDM,J3490,HCPCS,637,RC,,outpatient,1,GR,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN,RX-6429,CDM,J3480,HCPCS,636,RC,,inpatient,10,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN,RX-6429,CDM,J3480,HCPCS,636,RC,,outpatient,10,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
POTASSIUM CHLORIDE 20 MEQ PO PACK,RX-6434,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.6,7.74,,0.95,,8.17,Percent of total billed charges,,,0.98,,8.43,Percent of total billed charges,,,0.95,,8.17,Percent of total billed charges,,,0.97,,8.34,Percent of total billed charges,,,0.97,,8.34,Percent of total billed charges,,,0.96,,8.26,Percent of total billed charges,,,0.95,,8.17,Percent of total billed charges,,,,,,,,,0.95,,8.17,Percent of total billed charges,,8.17,8.43,
POTASSIUM CHLORIDE 20 MEQ PO PACK,RX-6434,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.6,7.74,,0.95,,8.17,Percent of total billed charges,,,0.98,,8.43,Percent of total billed charges,,,0.95,,8.17,Percent of total billed charges,,,0.95,,8.17,Percent of total billed charges,,,0.97,,8.34,Percent of total billed charges,,,0.96,,8.26,Percent of total billed charges,,,0.95,,8.17,Percent of total billed charges,,,,,,,,,0.95,,8.17,Percent of total billed charges,,8.17,8.43,
PRALIDOXIME CHLORIDE 1 G IV SOLR,RX-6462,CDM,J2730,HCPCS,636,RC,,inpatient,20,ML,269.02,242.12,,0.95,,255.57,Percent of total billed charges,,,0.98,,263.64,Percent of total billed charges,,,0.95,,255.57,Percent of total billed charges,,,0.97,,260.95,Percent of total billed charges,,,0.97,,260.95,Percent of total billed charges,,,0.96,,258.26,Percent of total billed charges,,,0.95,,255.57,Percent of total billed charges,,,,,,,,,0.95,,255.57,Percent of total billed charges,,255.57,263.64,
PRALIDOXIME CHLORIDE 1 G IV SOLR,RX-6462,CDM,J2730,HCPCS,636,RC,,outpatient,20,ML,269.02,242.12,,0.95,,255.57,Percent of total billed charges,,,0.98,,263.64,Percent of total billed charges,,,0.95,,255.57,Percent of total billed charges,,,0.95,,255.57,Percent of total billed charges,,,0.97,,260.95,Percent of total billed charges,,,0.96,,258.26,Percent of total billed charges,,,0.95,,255.57,Percent of total billed charges,,,,,,,,,0.95,,255.57,Percent of total billed charges,,255.57,263.64,
PRAZOSIN HCL 1 MG PO CAPS,RX-6468,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
PRAZOSIN HCL 1 MG PO CAPS,RX-6468,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
PREDNISOLONE ACETATE 1 % OP SUSP,RX-6487,CDM,J3490,HCPCS,250,RC,,inpatient,10,ML,149.14,134.23,,0.95,,141.68,Percent of total billed charges,,,0.98,,146.16,Percent of total billed charges,,,0.95,,141.68,Percent of total billed charges,,,0.97,,144.67,Percent of total billed charges,,,0.97,,144.67,Percent of total billed charges,,,0.96,,143.17,Percent of total billed charges,,,0.95,,141.68,Percent of total billed charges,,,,,,,,,0.95,,141.68,Percent of total billed charges,,141.68,146.16,
PREDNISOLONE ACETATE 1 % OP SUSP,RX-6487,CDM,J3490,HCPCS,250,RC,,outpatient,10,ML,149.14,134.23,,0.95,,141.68,Percent of total billed charges,,,0.98,,146.16,Percent of total billed charges,,,0.95,,141.68,Percent of total billed charges,,,0.95,,141.68,Percent of total billed charges,,,0.97,,144.67,Percent of total billed charges,,,0.96,,143.17,Percent of total billed charges,,,0.95,,141.68,Percent of total billed charges,,,,,,,,,0.95,,141.68,Percent of total billed charges,,141.68,146.16,
PREDNISONE 1 MG PO TABS,RX-6493,CDM,J7512,HCPCS,636,RC,,inpatient,5,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
PREDNISONE 1 MG PO TABS,RX-6493,CDM,J7512,HCPCS,636,RC,,outpatient,5,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
PREDNISONE 10 MG PO TABS,RX-6494,CDM,J7512,HCPCS,636,RC,,inpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
PREDNISONE 10 MG PO TABS,RX-6494,CDM,J7512,HCPCS,636,RC,,outpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
PREDNISONE 20 MG PO TABS,RX-6496,CDM,J7512,HCPCS,636,RC,,inpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
PREDNISONE 20 MG PO TABS,RX-6496,CDM,J7512,HCPCS,636,RC,,outpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
PREDNISONE 5 MG PO TABS,RX-6497,CDM,J7512,HCPCS,636,RC,,inpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
PREDNISONE 5 MG PO TABS,RX-6497,CDM,J7512,HCPCS,636,RC,,outpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
PRIMIDONE 250 MG PO TABS,RX-6544,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
PRIMIDONE 250 MG PO TABS,RX-6544,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
PROCAINAMIDE HCL 100 MG/ML INJECTION SOLN,RX-6562,CDM,J2690,HCPCS,636,RC,,inpatient,10,ML,172.86,155.57,,0.95,,164.22,Percent of total billed charges,,,0.98,,169.4,Percent of total billed charges,,,0.95,,164.22,Percent of total billed charges,,,0.97,,167.67,Percent of total billed charges,,,0.97,,167.67,Percent of total billed charges,,,0.96,,165.95,Percent of total billed charges,,,0.95,,164.22,Percent of total billed charges,,,,,,,,,0.95,,164.22,Percent of total billed charges,,164.22,169.4,
PROCAINAMIDE HCL 100 MG/ML INJECTION SOLN,RX-6562,CDM,J2690,HCPCS,636,RC,,outpatient,10,ML,172.86,155.57,,0.95,,164.22,Percent of total billed charges,,,0.98,,169.4,Percent of total billed charges,,,0.95,,164.22,Percent of total billed charges,,,0.95,,164.22,Percent of total billed charges,,,0.97,,167.67,Percent of total billed charges,,,0.96,,165.95,Percent of total billed charges,,,0.95,,164.22,Percent of total billed charges,,,,,,,,,0.95,,164.22,Percent of total billed charges,,164.22,169.4,
PROCHLORPERAZINE MALEATE 5 MG PO TABS,RX-6583,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.58,9.52,,0.95,,10.05,Percent of total billed charges,,,0.98,,10.37,Percent of total billed charges,,,0.95,,10.05,Percent of total billed charges,,,0.97,,10.26,Percent of total billed charges,,,0.97,,10.26,Percent of total billed charges,,,0.96,,10.16,Percent of total billed charges,,,0.95,,10.05,Percent of total billed charges,,,,,,,,,0.95,,10.05,Percent of total billed charges,,10.05,10.37,
PROCHLORPERAZINE MALEATE 5 MG PO TABS,RX-6583,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.58,9.52,,0.95,,10.05,Percent of total billed charges,,,0.98,,10.37,Percent of total billed charges,,,0.95,,10.05,Percent of total billed charges,,,0.95,,10.05,Percent of total billed charges,,,0.97,,10.26,Percent of total billed charges,,,0.96,,10.16,Percent of total billed charges,,,0.95,,10.05,Percent of total billed charges,,,,,,,,,0.95,,10.05,Percent of total billed charges,,10.05,10.37,
PROMETHAZINE HCL 25 MG/ML INJECTION SOLN,RX-6618,CDM,J2550,HCPCS,636,RC,,inpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
PROMETHAZINE HCL 25 MG/ML INJECTION SOLN,RX-6618,CDM,J2550,HCPCS,636,RC,,outpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
PROMETHAZINE HCL 25 MG PO TABS,RX-6622,CDM,Q0169,HCPCS,637,RC,,inpatient,1,UN,6.47,5.82,,0.95,,6.15,Percent of total billed charges,,,0.98,,6.34,Percent of total billed charges,,,0.95,,6.15,Percent of total billed charges,,,0.97,,6.28,Percent of total billed charges,,,0.97,,6.28,Percent of total billed charges,,,0.96,,6.21,Percent of total billed charges,,,0.95,,6.15,Percent of total billed charges,,,,,,,,,0.95,,6.15,Percent of total billed charges,,6.15,6.34,
PROMETHAZINE HCL 25 MG PO TABS,RX-6622,CDM,Q0169,HCPCS,637,RC,,outpatient,1,UN,6.47,5.82,,0.95,,6.15,Percent of total billed charges,,,0.98,,6.34,Percent of total billed charges,,,0.95,,6.15,Percent of total billed charges,,,0.95,,6.15,Percent of total billed charges,,,0.97,,6.28,Percent of total billed charges,,,0.96,,6.21,Percent of total billed charges,,,0.95,,6.15,Percent of total billed charges,,,,,,,,,0.95,,6.15,Percent of total billed charges,,6.15,6.34,
PROMETHAZINE-CODEINE 6.25-10 MG/5ML PO SYRP,RX-6627,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,10.54,9.49,,0.95,,10.01,Percent of total billed charges,,,0.98,,10.33,Percent of total billed charges,,,0.95,,10.01,Percent of total billed charges,,,0.97,,10.22,Percent of total billed charges,,,0.97,,10.22,Percent of total billed charges,,,0.96,,10.12,Percent of total billed charges,,,0.95,,10.01,Percent of total billed charges,,,,,,,,,0.95,,10.01,Percent of total billed charges,,10.01,10.33,
PROMETHAZINE-CODEINE 6.25-10 MG/5ML PO SYRP,RX-6627,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,10.54,9.49,,0.95,,10.01,Percent of total billed charges,,,0.98,,10.33,Percent of total billed charges,,,0.95,,10.01,Percent of total billed charges,,,0.95,,10.01,Percent of total billed charges,,,0.97,,10.22,Percent of total billed charges,,,0.96,,10.12,Percent of total billed charges,,,0.95,,10.01,Percent of total billed charges,,,,,,,,,0.95,,10.01,Percent of total billed charges,,10.01,10.33,
ASCORBIC ACID 500 MG PO TABS,RX-664,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,5.84,5.26,,0.95,,5.55,Percent of total billed charges,,,0.98,,5.72,Percent of total billed charges,,,0.95,,5.55,Percent of total billed charges,,,0.97,,5.66,Percent of total billed charges,,,0.97,,5.66,Percent of total billed charges,,,0.96,,5.61,Percent of total billed charges,,,0.95,,5.55,Percent of total billed charges,,,,,,,,,0.95,,5.55,Percent of total billed charges,,5.55,5.72,
ASCORBIC ACID 500 MG PO TABS,RX-664,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,5.84,5.26,,0.95,,5.55,Percent of total billed charges,,,0.98,,5.72,Percent of total billed charges,,,0.95,,5.55,Percent of total billed charges,,,0.95,,5.55,Percent of total billed charges,,,0.97,,5.66,Percent of total billed charges,,,0.96,,5.61,Percent of total billed charges,,,0.95,,5.55,Percent of total billed charges,,,,,,,,,0.95,,5.55,Percent of total billed charges,,5.55,5.72,
PROPARACAINE HCL 0.5 % OP SOLN,RX-6644,CDM,J3490,HCPCS,250,RC,,inpatient,15,ML,137.39,123.65,,0.95,,130.52,Percent of total billed charges,,,0.98,,134.64,Percent of total billed charges,,,0.95,,130.52,Percent of total billed charges,,,0.97,,133.27,Percent of total billed charges,,,0.97,,133.27,Percent of total billed charges,,,0.96,,131.89,Percent of total billed charges,,,0.95,,130.52,Percent of total billed charges,,,,,,,,,0.95,,130.52,Percent of total billed charges,,130.52,134.64,
PROPARACAINE HCL 0.5 % OP SOLN,RX-6644,CDM,J3490,HCPCS,250,RC,,outpatient,15,ML,137.39,123.65,,0.95,,130.52,Percent of total billed charges,,,0.98,,134.64,Percent of total billed charges,,,0.95,,130.52,Percent of total billed charges,,,0.95,,130.52,Percent of total billed charges,,,0.97,,133.27,Percent of total billed charges,,,0.96,,131.89,Percent of total billed charges,,,0.95,,130.52,Percent of total billed charges,,,,,,,,,0.95,,130.52,Percent of total billed charges,,130.52,134.64,
PROPRANOLOL HCL 20 MG PO TABS,RX-6657,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.8,7.02,,0.95,,7.41,Percent of total billed charges,,,0.98,,7.64,Percent of total billed charges,,,0.95,,7.41,Percent of total billed charges,,,0.97,,7.57,Percent of total billed charges,,,0.97,,7.57,Percent of total billed charges,,,0.96,,7.49,Percent of total billed charges,,,0.95,,7.41,Percent of total billed charges,,,,,,,,,0.95,,7.41,Percent of total billed charges,,7.41,7.64,
PROPRANOLOL HCL 20 MG PO TABS,RX-6657,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.8,7.02,,0.95,,7.41,Percent of total billed charges,,,0.98,,7.64,Percent of total billed charges,,,0.95,,7.41,Percent of total billed charges,,,0.95,,7.41,Percent of total billed charges,,,0.97,,7.57,Percent of total billed charges,,,0.96,,7.49,Percent of total billed charges,,,0.95,,7.41,Percent of total billed charges,,,,,,,,,0.95,,7.41,Percent of total billed charges,,7.41,7.64,
PROTAMINE SULFATE 10 MG/ML IV SOLN,RX-6677,CDM,J2720,HCPCS,636,RC,,inpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
PROTAMINE SULFATE 10 MG/ML IV SOLN,RX-6677,CDM,J2720,HCPCS,636,RC,,outpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
PSEUDOEPHEDRINE HCL 30 MG PO TABS,RX-6714,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.35,5.72,,0.95,,6.03,Percent of total billed charges,,,0.98,,6.22,Percent of total billed charges,,,0.95,,6.03,Percent of total billed charges,,,0.97,,6.16,Percent of total billed charges,,,0.97,,6.16,Percent of total billed charges,,,0.96,,6.1,Percent of total billed charges,,,0.95,,6.03,Percent of total billed charges,,,,,,,,,0.95,,6.03,Percent of total billed charges,,6.03,6.22,
PSEUDOEPHEDRINE HCL 30 MG PO TABS,RX-6714,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.35,5.72,,0.95,,6.03,Percent of total billed charges,,,0.98,,6.22,Percent of total billed charges,,,0.95,,6.03,Percent of total billed charges,,,0.95,,6.03,Percent of total billed charges,,,0.97,,6.16,Percent of total billed charges,,,0.96,,6.1,Percent of total billed charges,,,0.95,,6.03,Percent of total billed charges,,,,,,,,,0.95,,6.03,Percent of total billed charges,,6.03,6.22,
PYRIDOXINE HCL 100 MG/ML INJECTION SOLN,RX-6744,CDM,J3415,HCPCS,636,RC,,inpatient,0.25,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
PYRIDOXINE HCL 100 MG/ML INJECTION SOLN,RX-6744,CDM,J3415,HCPCS,636,RC,,outpatient,0.25,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
PYRIDOXINE HCL 50 MG PO TABS,RX-6748,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.89,6.2,,0.95,,6.55,Percent of total billed charges,,,0.98,,6.75,Percent of total billed charges,,,0.95,,6.55,Percent of total billed charges,,,0.97,,6.68,Percent of total billed charges,,,0.97,,6.68,Percent of total billed charges,,,0.96,,6.61,Percent of total billed charges,,,0.95,,6.55,Percent of total billed charges,,,,,,,,,0.95,,6.55,Percent of total billed charges,,6.55,6.75,
PYRIDOXINE HCL 50 MG PO TABS,RX-6748,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.89,6.2,,0.95,,6.55,Percent of total billed charges,,,0.98,,6.75,Percent of total billed charges,,,0.95,,6.55,Percent of total billed charges,,,0.95,,6.55,Percent of total billed charges,,,0.97,,6.68,Percent of total billed charges,,,0.96,,6.61,Percent of total billed charges,,,0.95,,6.55,Percent of total billed charges,,,,,,,,,0.95,,6.55,Percent of total billed charges,,6.55,6.75,
ASPIRIN 300 MG RECTAL SUPP,RX-693,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
ASPIRIN 300 MG RECTAL SUPP,RX-693,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
POTASSIUM & SODIUM PHOSPHATES 280-160-250 MG PO PACK,RX-70284,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
POTASSIUM & SODIUM PHOSPHATES 280-160-250 MG PO PACK,RX-70284,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
ABATACEPT 250 MG IV SOLR,RX-70287,CDM,J0129,HCPCS,636,RC,,inpatient,10,ML,2554.9,2299.41,,0.95,,2427.16,Percent of total billed charges,,,0.98,,2503.8,Percent of total billed charges,,,0.95,,2427.16,Percent of total billed charges,,,0.97,,2478.25,Percent of total billed charges,,,0.97,,2478.25,Percent of total billed charges,,,0.96,,2452.7,Percent of total billed charges,,,0.95,,2427.16,Percent of total billed charges,,,,,,,,,0.95,,2427.16,Percent of total billed charges,,2427.16,2503.8,
ABATACEPT 250 MG IV SOLR,RX-70287,CDM,J0129,HCPCS,636,RC,,outpatient,10,ML,2554.9,2299.41,,0.95,,2427.16,Percent of total billed charges,,,0.98,,2503.8,Percent of total billed charges,,,0.95,,2427.16,Percent of total billed charges,,,0.95,,2427.16,Percent of total billed charges,,,0.97,,2478.25,Percent of total billed charges,,,0.96,,2452.7,Percent of total billed charges,,,0.95,,2427.16,Percent of total billed charges,,,,,,,,,0.95,,2427.16,Percent of total billed charges,,2427.16,2503.8,
SALINE NASAL SPRAY 0.65 % INTRANASAL SOLN,RX-7030,CDM,J3490,HCPCS,637,RC,,inpatient,45,ML,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
SALINE NASAL SPRAY 0.65 % INTRANASAL SOLN,RX-7030,CDM,J3490,HCPCS,637,RC,,outpatient,45,ML,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
FLUTICASONE PROPIONATE 50 MCG/ACT INTRANASAL SUSP,RX-70536,CDM,J3490,HCPCS,637,RC,,inpatient,16,GR,169.95,152.96,,0.95,,161.45,Percent of total billed charges,,,0.98,,166.55,Percent of total billed charges,,,0.95,,161.45,Percent of total billed charges,,,0.97,,164.85,Percent of total billed charges,,,0.97,,164.85,Percent of total billed charges,,,0.96,,163.15,Percent of total billed charges,,,0.95,,161.45,Percent of total billed charges,,,,,,,,,0.95,,161.45,Percent of total billed charges,,161.45,166.55,
FLUTICASONE PROPIONATE 50 MCG/ACT INTRANASAL SUSP,RX-70536,CDM,J3490,HCPCS,637,RC,,outpatient,16,GR,169.95,152.96,,0.95,,161.45,Percent of total billed charges,,,0.98,,166.55,Percent of total billed charges,,,0.95,,161.45,Percent of total billed charges,,,0.95,,161.45,Percent of total billed charges,,,0.97,,164.85,Percent of total billed charges,,,0.96,,163.15,Percent of total billed charges,,,0.95,,161.45,Percent of total billed charges,,,,,,,,,0.95,,161.45,Percent of total billed charges,,161.45,166.55,
ATENOLOL 50 MG PO TABS,RX-718,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.15,5.54,,0.95,,5.84,Percent of total billed charges,,,0.98,,6.03,Percent of total billed charges,,,0.95,,5.84,Percent of total billed charges,,,0.97,,5.97,Percent of total billed charges,,,0.97,,5.97,Percent of total billed charges,,,0.96,,5.9,Percent of total billed charges,,,0.95,,5.84,Percent of total billed charges,,,,,,,,,0.95,,5.84,Percent of total billed charges,,5.84,6.03,
ATENOLOL 50 MG PO TABS,RX-718,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.15,5.54,,0.95,,5.84,Percent of total billed charges,,,0.98,,6.03,Percent of total billed charges,,,0.95,,5.84,Percent of total billed charges,,,0.95,,5.84,Percent of total billed charges,,,0.97,,5.97,Percent of total billed charges,,,0.96,,5.9,Percent of total billed charges,,,0.95,,5.84,Percent of total billed charges,,,,,,,,,0.95,,5.84,Percent of total billed charges,,5.84,6.03,
SILVER SULFADIAZINE 1 % EX CREA,RX-7224,CDM,J3490,HCPCS,637,RC,,inpatient,25,GR,16.58,14.92,,0.95,,15.75,Percent of total billed charges,,,0.98,,16.25,Percent of total billed charges,,,0.95,,15.75,Percent of total billed charges,,,0.97,,16.08,Percent of total billed charges,,,0.97,,16.08,Percent of total billed charges,,,0.96,,15.92,Percent of total billed charges,,,0.95,,15.75,Percent of total billed charges,,,,,,,,,0.95,,15.75,Percent of total billed charges,,15.75,16.25,
SILVER SULFADIAZINE 1 % EX CREA,RX-7224,CDM,J3490,HCPCS,637,RC,,outpatient,25,GR,16.58,14.92,,0.95,,15.75,Percent of total billed charges,,,0.98,,16.25,Percent of total billed charges,,,0.95,,15.75,Percent of total billed charges,,,0.95,,15.75,Percent of total billed charges,,,0.97,,16.08,Percent of total billed charges,,,0.96,,15.92,Percent of total billed charges,,,0.95,,15.75,Percent of total billed charges,,,,,,,,,0.95,,15.75,Percent of total billed charges,,15.75,16.25,
SIMETHICONE 80 MG PO CHEW,RX-7227,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.49,5.84,,0.95,,6.17,Percent of total billed charges,,,0.98,,6.36,Percent of total billed charges,,,0.95,,6.17,Percent of total billed charges,,,0.97,,6.3,Percent of total billed charges,,,0.97,,6.3,Percent of total billed charges,,,0.96,,6.23,Percent of total billed charges,,,0.95,,6.17,Percent of total billed charges,,,,,,,,,0.95,,6.17,Percent of total billed charges,,6.17,6.36,
SIMETHICONE 80 MG PO CHEW,RX-7227,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.49,5.84,,0.95,,6.17,Percent of total billed charges,,,0.98,,6.36,Percent of total billed charges,,,0.95,,6.17,Percent of total billed charges,,,0.95,,6.17,Percent of total billed charges,,,0.97,,6.3,Percent of total billed charges,,,0.96,,6.23,Percent of total billed charges,,,0.95,,6.17,Percent of total billed charges,,,,,,,,,0.95,,6.17,Percent of total billed charges,,6.17,6.36,
SODIUM ACETATE 2 MEQ/ML IV SOLN,RX-7301,CDM,J3490,HCPCS,250,RC,,inpatient,20,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
SODIUM ACETATE 2 MEQ/ML IV SOLN,RX-7301,CDM,J3490,HCPCS,250,RC,,outpatient,20,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
SODIUM BICARBONATE 4.2 % IV SOLN,RX-7306,CDM,J7999,HCPCS,250,RC,,inpatient,5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
SODIUM BICARBONATE 4.2 % IV SOLN,RX-7306,CDM,J7999,HCPCS,250,RC,,outpatient,5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
SODIUM BICARBONATE 8.4 % IV SOLN,RX-7309,CDM,J7999,HCPCS,250,RC,,inpatient,50,ML,29.9,26.91,,0.95,,28.41,Percent of total billed charges,,,0.98,,29.3,Percent of total billed charges,,,0.95,,28.41,Percent of total billed charges,,,0.97,,29,Percent of total billed charges,,,0.97,,29,Percent of total billed charges,,,0.96,,28.7,Percent of total billed charges,,,0.95,,28.41,Percent of total billed charges,,,,,,,,,0.95,,28.41,Percent of total billed charges,,28.41,29.3,
SODIUM BICARBONATE 8.4 % IV SOLN,RX-7309,CDM,J7999,HCPCS,250,RC,,outpatient,50,ML,29.9,26.91,,0.95,,28.41,Percent of total billed charges,,,0.98,,29.3,Percent of total billed charges,,,0.95,,28.41,Percent of total billed charges,,,0.95,,28.41,Percent of total billed charges,,,0.97,,29,Percent of total billed charges,,,0.96,,28.7,Percent of total billed charges,,,0.95,,28.41,Percent of total billed charges,,,,,,,,,0.95,,28.41,Percent of total billed charges,,28.41,29.3,
SODIUM BICARBONATE 650 MG PO TABS,RX-7313,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.31,5.68,,0.95,,5.99,Percent of total billed charges,,,0.98,,6.18,Percent of total billed charges,,,0.95,,5.99,Percent of total billed charges,,,0.97,,6.12,Percent of total billed charges,,,0.97,,6.12,Percent of total billed charges,,,0.96,,6.06,Percent of total billed charges,,,0.95,,5.99,Percent of total billed charges,,,,,,,,,0.95,,5.99,Percent of total billed charges,,5.99,6.18,
SODIUM BICARBONATE 650 MG PO TABS,RX-7313,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.31,5.68,,0.95,,5.99,Percent of total billed charges,,,0.98,,6.18,Percent of total billed charges,,,0.95,,5.99,Percent of total billed charges,,,0.95,,5.99,Percent of total billed charges,,,0.97,,6.12,Percent of total billed charges,,,0.96,,6.06,Percent of total billed charges,,,0.95,,5.99,Percent of total billed charges,,,,,,,,,0.95,,5.99,Percent of total billed charges,,5.99,6.18,
SODIUM CHLORIDE 0.45 % IV SOLN,RX-7318,CDM,J3490,HCPCS,250,RC,,inpatient,500,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
SODIUM CHLORIDE 0.45 % IV SOLN,RX-7318,CDM,J3490,HCPCS,250,RC,,outpatient,500,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
SODIUM CHLORIDE 3 % IV SOLN,RX-7321,CDM,J7131,HCPCS,258,RC,,inpatient,500,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
SODIUM CHLORIDE 3 % IV SOLN,RX-7321,CDM,J7131,HCPCS,258,RC,,outpatient,500,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
SODIUM CHLORIDE 4 MEQ/ML IV SOLN,RX-7322,CDM,J3490,HCPCS,250,RC,,inpatient,30,ML,28.51,25.66,,0.95,,27.08,Percent of total billed charges,,,0.98,,27.94,Percent of total billed charges,,,0.95,,27.08,Percent of total billed charges,,,0.97,,27.65,Percent of total billed charges,,,0.97,,27.65,Percent of total billed charges,,,0.96,,27.37,Percent of total billed charges,,,0.95,,27.08,Percent of total billed charges,,,,,,,,,0.95,,27.08,Percent of total billed charges,,27.08,27.94,
SODIUM CHLORIDE 4 MEQ/ML IV SOLN,RX-7322,CDM,J3490,HCPCS,250,RC,,outpatient,30,ML,28.51,25.66,,0.95,,27.08,Percent of total billed charges,,,0.98,,27.94,Percent of total billed charges,,,0.95,,27.08,Percent of total billed charges,,,0.95,,27.08,Percent of total billed charges,,,0.97,,27.65,Percent of total billed charges,,,0.96,,27.37,Percent of total billed charges,,,0.95,,27.08,Percent of total billed charges,,,,,,,,,0.95,,27.08,Percent of total billed charges,,27.08,27.94,
SODIUM CHLORIDE 0.9 % INHAL NEBU,RX-7325,CDM,J3490,HCPCS,637,RC,,inpatient,3,ML,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
SODIUM CHLORIDE 0.9 % INHAL NEBU,RX-7325,CDM,J3490,HCPCS,637,RC,,outpatient,3,ML,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
SODIUM CHLORIDE 10 % INHAL NEBU,RX-7326,CDM,J3490,HCPCS,637,RC,,inpatient,10,ML,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
SODIUM CHLORIDE 10 % INHAL NEBU,RX-7326,CDM,J3490,HCPCS,637,RC,,outpatient,10,ML,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
SODIUM CHLORIDE 3 % INHAL NEBU,RX-7327,CDM,J7131,HCPCS,636,RC,,inpatient,3,ML,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
SODIUM CHLORIDE 3 % INHAL NEBU,RX-7327,CDM,J7131,HCPCS,636,RC,,outpatient,3,ML,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
SULFACETAMIDE SODIUM 10 % OP SOLN,RX-7359,CDM,J3490,HCPCS,637,RC,,inpatient,15,ML,162.17,145.95,,0.95,,154.06,Percent of total billed charges,,,0.98,,158.93,Percent of total billed charges,,,0.95,,154.06,Percent of total billed charges,,,0.97,,157.3,Percent of total billed charges,,,0.97,,157.3,Percent of total billed charges,,,0.96,,155.68,Percent of total billed charges,,,0.95,,154.06,Percent of total billed charges,,,,,,,,,0.95,,154.06,Percent of total billed charges,,154.06,158.93,
SULFACETAMIDE SODIUM 10 % OP SOLN,RX-7359,CDM,J3490,HCPCS,637,RC,,outpatient,15,ML,162.17,145.95,,0.95,,154.06,Percent of total billed charges,,,0.98,,158.93,Percent of total billed charges,,,0.95,,154.06,Percent of total billed charges,,,0.95,,154.06,Percent of total billed charges,,,0.97,,157.3,Percent of total billed charges,,,0.96,,155.68,Percent of total billed charges,,,0.95,,154.06,Percent of total billed charges,,,,,,,,,0.95,,154.06,Percent of total billed charges,,154.06,158.93,
ATROPINE SULFATE 1 % OP SOLN,RX-736,CDM,J3490,HCPCS,637,RC,,inpatient,2,ML,120.43,108.39,,0.95,,114.41,Percent of total billed charges,,,0.98,,118.02,Percent of total billed charges,,,0.95,,114.41,Percent of total billed charges,,,0.97,,116.82,Percent of total billed charges,,,0.97,,116.82,Percent of total billed charges,,,0.96,,115.61,Percent of total billed charges,,,0.95,,114.41,Percent of total billed charges,,,,,,,,,0.95,,114.41,Percent of total billed charges,,114.41,118.02,
ATROPINE SULFATE 1 % OP SOLN,RX-736,CDM,J3490,HCPCS,637,RC,,outpatient,2,ML,120.43,108.39,,0.95,,114.41,Percent of total billed charges,,,0.98,,118.02,Percent of total billed charges,,,0.95,,114.41,Percent of total billed charges,,,0.95,,114.41,Percent of total billed charges,,,0.97,,116.82,Percent of total billed charges,,,0.96,,115.61,Percent of total billed charges,,,0.95,,114.41,Percent of total billed charges,,,,,,,,,0.95,,114.41,Percent of total billed charges,,114.41,118.02,
SPIRONOLACTONE 25 MG PO TABS,RX-7437,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.59,5.93,,0.95,,6.26,Percent of total billed charges,,,0.98,,6.46,Percent of total billed charges,,,0.95,,6.26,Percent of total billed charges,,,0.97,,6.39,Percent of total billed charges,,,0.97,,6.39,Percent of total billed charges,,,0.96,,6.33,Percent of total billed charges,,,0.95,,6.26,Percent of total billed charges,,,,,,,,,0.95,,6.26,Percent of total billed charges,,6.26,6.46,
SPIRONOLACTONE 25 MG PO TABS,RX-7437,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.59,5.93,,0.95,,6.26,Percent of total billed charges,,,0.98,,6.46,Percent of total billed charges,,,0.95,,6.26,Percent of total billed charges,,,0.95,,6.26,Percent of total billed charges,,,0.97,,6.39,Percent of total billed charges,,,0.96,,6.33,Percent of total billed charges,,,0.95,,6.26,Percent of total billed charges,,,,,,,,,0.95,,6.26,Percent of total billed charges,,6.26,6.46,
IBUPROFEN 600 MG (ED PREPACK-OR) PO TABS,RX-74700346,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,24,21.6,,0.95,,22.8,Percent of total billed charges,,,0.98,,23.52,Percent of total billed charges,,,0.95,,22.8,Percent of total billed charges,,,0.97,,23.28,Percent of total billed charges,,,0.97,,23.28,Percent of total billed charges,,,0.96,,23.04,Percent of total billed charges,,,0.95,,22.8,Percent of total billed charges,,,,,,,,,0.95,,22.8,Percent of total billed charges,,22.8,23.52,
IBUPROFEN 600 MG (ED PREPACK-OR) PO TABS,RX-74700346,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,24,21.6,,0.95,,22.8,Percent of total billed charges,,,0.98,,23.52,Percent of total billed charges,,,0.95,,22.8,Percent of total billed charges,,,0.95,,22.8,Percent of total billed charges,,,0.97,,23.28,Percent of total billed charges,,,0.96,,23.04,Percent of total billed charges,,,0.95,,22.8,Percent of total billed charges,,,,,,,,,0.95,,22.8,Percent of total billed charges,,22.8,23.52,
PIPERACILLIN-TAZOBACTAM 2.25 G/20ML IV SYRINGE,RX-74700386,CDM,J2543,HCPCS,636,RC,,inpatient,20,ML,68.03,61.23,,0.95,,64.63,Percent of total billed charges,,,0.98,,66.67,Percent of total billed charges,,,0.95,,64.63,Percent of total billed charges,,,0.97,,65.99,Percent of total billed charges,,,0.97,,65.99,Percent of total billed charges,,,0.96,,65.31,Percent of total billed charges,,,0.95,,64.63,Percent of total billed charges,,,,,,,,,0.95,,64.63,Percent of total billed charges,,64.63,66.67,
PIPERACILLIN-TAZOBACTAM 2.25 G/20ML IV SYRINGE,RX-74700386,CDM,J2543,HCPCS,636,RC,,outpatient,20,ML,68.03,61.23,,0.95,,64.63,Percent of total billed charges,,,0.98,,66.67,Percent of total billed charges,,,0.95,,64.63,Percent of total billed charges,,,0.95,,64.63,Percent of total billed charges,,,0.97,,65.99,Percent of total billed charges,,,0.96,,65.31,Percent of total billed charges,,,0.95,,64.63,Percent of total billed charges,,,,,,,,,0.95,,64.63,Percent of total billed charges,,64.63,66.67,
PIPERACILLIN-TAZOBACTAM 3.375 G/30ML IV SYRINGE,RX-74700387,CDM,J2543,HCPCS,636,RC,,inpatient,30,ML,88.68,79.81,,0.95,,84.25,Percent of total billed charges,,,0.98,,86.91,Percent of total billed charges,,,0.95,,84.25,Percent of total billed charges,,,0.97,,86.02,Percent of total billed charges,,,0.97,,86.02,Percent of total billed charges,,,0.96,,85.13,Percent of total billed charges,,,0.95,,84.25,Percent of total billed charges,,,,,,,,,0.95,,84.25,Percent of total billed charges,,84.25,86.91,
PIPERACILLIN-TAZOBACTAM 3.375 G/30ML IV SYRINGE,RX-74700387,CDM,J2543,HCPCS,636,RC,,outpatient,30,ML,88.68,79.81,,0.95,,84.25,Percent of total billed charges,,,0.98,,86.91,Percent of total billed charges,,,0.95,,84.25,Percent of total billed charges,,,0.95,,84.25,Percent of total billed charges,,,0.97,,86.02,Percent of total billed charges,,,0.96,,85.13,Percent of total billed charges,,,0.95,,84.25,Percent of total billed charges,,,,,,,,,0.95,,84.25,Percent of total billed charges,,84.25,86.91,
ALBUTEROL SULFATE HFA 108 (90 BASE) MCG/ACT (ED HOMEPACK) INHAL AERS,RX-74700490,CDM,J3490,HCPCS,637,RC,,inpatient,18,GR,184.37,165.93,,0.95,,175.15,Percent of total billed charges,,,0.98,,180.68,Percent of total billed charges,,,0.95,,175.15,Percent of total billed charges,,,0.97,,178.84,Percent of total billed charges,,,0.97,,178.84,Percent of total billed charges,,,0.96,,177,Percent of total billed charges,,,0.95,,175.15,Percent of total billed charges,,,,,,,,,0.95,,175.15,Percent of total billed charges,,175.15,180.68,
ALBUTEROL SULFATE HFA 108 (90 BASE) MCG/ACT (ED HOMEPACK) INHAL AERS,RX-74700490,CDM,J3490,HCPCS,637,RC,,outpatient,18,GR,184.37,165.93,,0.95,,175.15,Percent of total billed charges,,,0.98,,180.68,Percent of total billed charges,,,0.95,,175.15,Percent of total billed charges,,,0.95,,175.15,Percent of total billed charges,,,0.97,,178.84,Percent of total billed charges,,,0.96,,177,Percent of total billed charges,,,0.95,,175.15,Percent of total billed charges,,,,,,,,,0.95,,175.15,Percent of total billed charges,,175.15,180.68,
AMOXICILLIN 250 MG/5ML (ED HOMEPACK) PO SUSR,RX-74700491,CDM,J3490,HCPCS,637,RC,,inpatient,80,ML,16.77,15.09,,0.95,,15.93,Percent of total billed charges,,,0.98,,16.43,Percent of total billed charges,,,0.95,,15.93,Percent of total billed charges,,,0.97,,16.27,Percent of total billed charges,,,0.97,,16.27,Percent of total billed charges,,,0.96,,16.1,Percent of total billed charges,,,0.95,,15.93,Percent of total billed charges,,,,,,,,,0.95,,15.93,Percent of total billed charges,,15.93,16.43,
AMOXICILLIN 250 MG/5ML (ED HOMEPACK) PO SUSR,RX-74700491,CDM,J3490,HCPCS,637,RC,,outpatient,80,ML,16.77,15.09,,0.95,,15.93,Percent of total billed charges,,,0.98,,16.43,Percent of total billed charges,,,0.95,,15.93,Percent of total billed charges,,,0.95,,15.93,Percent of total billed charges,,,0.97,,16.27,Percent of total billed charges,,,0.96,,16.1,Percent of total billed charges,,,0.95,,15.93,Percent of total billed charges,,,,,,,,,0.95,,15.93,Percent of total billed charges,,15.93,16.43,
AMOXICILLIN-POT CLAVULANATE 400-57 MG/5ML (HOMEPACK) PO SUSR,RX-74700492,CDM,J3490,HCPCS,637,RC,,inpatient,100,ML,174.85,157.37,,0.95,,166.11,Percent of total billed charges,,,0.98,,171.35,Percent of total billed charges,,,0.95,,166.11,Percent of total billed charges,,,0.97,,169.6,Percent of total billed charges,,,0.97,,169.6,Percent of total billed charges,,,0.96,,167.86,Percent of total billed charges,,,0.95,,166.11,Percent of total billed charges,,,,,,,,,0.95,,166.11,Percent of total billed charges,,166.11,171.35,
AMOXICILLIN-POT CLAVULANATE 400-57 MG/5ML (HOMEPACK) PO SUSR,RX-74700492,CDM,J3490,HCPCS,637,RC,,outpatient,100,ML,174.85,157.37,,0.95,,166.11,Percent of total billed charges,,,0.98,,171.35,Percent of total billed charges,,,0.95,,166.11,Percent of total billed charges,,,0.95,,166.11,Percent of total billed charges,,,0.97,,169.6,Percent of total billed charges,,,0.96,,167.86,Percent of total billed charges,,,0.95,,166.11,Percent of total billed charges,,,,,,,,,0.95,,166.11,Percent of total billed charges,,166.11,171.35,
CEPHALEXIN 500 MG (ED HOMEPACK) PO CAPS,RX-74700496,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,25.09,22.58,,0.95,,23.84,Percent of total billed charges,,,0.98,,24.59,Percent of total billed charges,,,0.95,,23.84,Percent of total billed charges,,,0.97,,24.34,Percent of total billed charges,,,0.97,,24.34,Percent of total billed charges,,,0.96,,24.09,Percent of total billed charges,,,0.95,,23.84,Percent of total billed charges,,,,,,,,,0.95,,23.84,Percent of total billed charges,,23.84,24.59,
CEPHALEXIN 500 MG (ED HOMEPACK) PO CAPS,RX-74700496,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,25.09,22.58,,0.95,,23.84,Percent of total billed charges,,,0.98,,24.59,Percent of total billed charges,,,0.95,,23.84,Percent of total billed charges,,,0.95,,23.84,Percent of total billed charges,,,0.97,,24.34,Percent of total billed charges,,,0.96,,24.09,Percent of total billed charges,,,0.95,,23.84,Percent of total billed charges,,,,,,,,,0.95,,23.84,Percent of total billed charges,,23.84,24.59,
CLINDAMYCIN HCL 150 MG (ED HOMEPACK) PO CAPS,RX-74700497,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,48.74,43.87,,0.95,,46.3,Percent of total billed charges,,,0.98,,47.77,Percent of total billed charges,,,0.95,,46.3,Percent of total billed charges,,,0.97,,47.28,Percent of total billed charges,,,0.97,,47.28,Percent of total billed charges,,,0.96,,46.79,Percent of total billed charges,,,0.95,,46.3,Percent of total billed charges,,,,,,,,,0.95,,46.3,Percent of total billed charges,,46.3,47.77,
CLINDAMYCIN HCL 150 MG (ED HOMEPACK) PO CAPS,RX-74700497,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,48.74,43.87,,0.95,,46.3,Percent of total billed charges,,,0.98,,47.77,Percent of total billed charges,,,0.95,,46.3,Percent of total billed charges,,,0.95,,46.3,Percent of total billed charges,,,0.97,,47.28,Percent of total billed charges,,,0.96,,46.79,Percent of total billed charges,,,0.95,,46.3,Percent of total billed charges,,,,,,,,,0.95,,46.3,Percent of total billed charges,,46.3,47.77,
CYCLOBENZAPRINE HCL 10 MG (ED HOMEPACK) PO TABS,RX-74700498,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,23.8,21.42,,0.95,,22.61,Percent of total billed charges,,,0.98,,23.32,Percent of total billed charges,,,0.95,,22.61,Percent of total billed charges,,,0.97,,23.09,Percent of total billed charges,,,0.97,,23.09,Percent of total billed charges,,,0.96,,22.85,Percent of total billed charges,,,0.95,,22.61,Percent of total billed charges,,,,,,,,,0.95,,22.61,Percent of total billed charges,,22.61,23.32,
CYCLOBENZAPRINE HCL 10 MG (ED HOMEPACK) PO TABS,RX-74700498,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,23.8,21.42,,0.95,,22.61,Percent of total billed charges,,,0.98,,23.32,Percent of total billed charges,,,0.95,,22.61,Percent of total billed charges,,,0.95,,22.61,Percent of total billed charges,,,0.97,,23.09,Percent of total billed charges,,,0.96,,22.85,Percent of total billed charges,,,0.95,,22.61,Percent of total billed charges,,,,,,,,,0.95,,22.61,Percent of total billed charges,,22.61,23.32,
DIAZEPAM 5 MG (ED HOMEPACK) PO TABS,RX-74700499,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,25.99,23.39,,0.95,,24.69,Percent of total billed charges,,,0.98,,25.47,Percent of total billed charges,,,0.95,,24.69,Percent of total billed charges,,,0.97,,25.21,Percent of total billed charges,,,0.97,,25.21,Percent of total billed charges,,,0.96,,24.95,Percent of total billed charges,,,0.95,,24.69,Percent of total billed charges,,,,,,,,,0.95,,24.69,Percent of total billed charges,,24.69,25.47,
DIAZEPAM 5 MG (ED HOMEPACK) PO TABS,RX-74700499,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,25.99,23.39,,0.95,,24.69,Percent of total billed charges,,,0.98,,25.47,Percent of total billed charges,,,0.95,,24.69,Percent of total billed charges,,,0.95,,24.69,Percent of total billed charges,,,0.97,,25.21,Percent of total billed charges,,,0.96,,24.95,Percent of total billed charges,,,0.95,,24.69,Percent of total billed charges,,,,,,,,,0.95,,24.69,Percent of total billed charges,,24.69,25.47,
HYDROXYZINE PAMOATE 25 MG  (ED HOMEPACK) PO CAPS,RX-74700504,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,25.77,23.19,,0.95,,24.48,Percent of total billed charges,,,0.98,,25.25,Percent of total billed charges,,,0.95,,24.48,Percent of total billed charges,,,0.97,,25,Percent of total billed charges,,,0.97,,25,Percent of total billed charges,,,0.96,,24.74,Percent of total billed charges,,,0.95,,24.48,Percent of total billed charges,,,,,,,,,0.95,,24.48,Percent of total billed charges,,24.48,25.25,
HYDROXYZINE PAMOATE 25 MG  (ED HOMEPACK) PO CAPS,RX-74700504,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,25.77,23.19,,0.95,,24.48,Percent of total billed charges,,,0.98,,25.25,Percent of total billed charges,,,0.95,,24.48,Percent of total billed charges,,,0.95,,24.48,Percent of total billed charges,,,0.97,,25,Percent of total billed charges,,,0.96,,24.74,Percent of total billed charges,,,0.95,,24.48,Percent of total billed charges,,,,,,,,,0.95,,24.48,Percent of total billed charges,,24.48,25.25,
LORAZEPAM 1 MG (ED HOMEPACK) PO TABS,RX-74700505,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,25.99,23.39,,0.95,,24.69,Percent of total billed charges,,,0.98,,25.47,Percent of total billed charges,,,0.95,,24.69,Percent of total billed charges,,,0.97,,25.21,Percent of total billed charges,,,0.97,,25.21,Percent of total billed charges,,,0.96,,24.95,Percent of total billed charges,,,0.95,,24.69,Percent of total billed charges,,,,,,,,,0.95,,24.69,Percent of total billed charges,,24.69,25.47,
LORAZEPAM 1 MG (ED HOMEPACK) PO TABS,RX-74700505,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,25.99,23.39,,0.95,,24.69,Percent of total billed charges,,,0.98,,25.47,Percent of total billed charges,,,0.95,,24.69,Percent of total billed charges,,,0.95,,24.69,Percent of total billed charges,,,0.97,,25.21,Percent of total billed charges,,,0.96,,24.95,Percent of total billed charges,,,0.95,,24.69,Percent of total billed charges,,,,,,,,,0.95,,24.69,Percent of total billed charges,,24.69,25.47,
ONDANSETRON 4 MG (ED HOMEPACK) PO TBDP,RX-74700509,CDM,J3490,HCPCS,637,RC,,inpatient,2,UN,15.97,14.37,,0.95,,15.17,Percent of total billed charges,,,0.98,,15.65,Percent of total billed charges,,,0.95,,15.17,Percent of total billed charges,,,0.97,,15.49,Percent of total billed charges,,,0.97,,15.49,Percent of total billed charges,,,0.96,,15.33,Percent of total billed charges,,,0.95,,15.17,Percent of total billed charges,,,,,,,,,0.95,,15.17,Percent of total billed charges,,15.17,15.65,
ONDANSETRON 4 MG (ED HOMEPACK) PO TBDP,RX-74700509,CDM,J3490,HCPCS,637,RC,,outpatient,2,UN,15.97,14.37,,0.95,,15.17,Percent of total billed charges,,,0.98,,15.65,Percent of total billed charges,,,0.95,,15.17,Percent of total billed charges,,,0.95,,15.17,Percent of total billed charges,,,0.97,,15.49,Percent of total billed charges,,,0.96,,15.33,Percent of total billed charges,,,0.95,,15.17,Percent of total billed charges,,,,,,,,,0.95,,15.17,Percent of total billed charges,,15.17,15.65,
OXYCODONE HCL 5 MG (ED HOMEPACK) PO TABS,RX-74700510,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,27.65,24.89,,0.95,,26.27,Percent of total billed charges,,,0.98,,27.1,Percent of total billed charges,,,0.95,,26.27,Percent of total billed charges,,,0.97,,26.82,Percent of total billed charges,,,0.97,,26.82,Percent of total billed charges,,,0.96,,26.54,Percent of total billed charges,,,0.95,,26.27,Percent of total billed charges,,,,,,,,,0.95,,26.27,Percent of total billed charges,,26.27,27.1,
OXYCODONE HCL 5 MG (ED HOMEPACK) PO TABS,RX-74700510,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,27.65,24.89,,0.95,,26.27,Percent of total billed charges,,,0.98,,27.1,Percent of total billed charges,,,0.95,,26.27,Percent of total billed charges,,,0.95,,26.27,Percent of total billed charges,,,0.97,,26.82,Percent of total billed charges,,,0.96,,26.54,Percent of total billed charges,,,0.95,,26.27,Percent of total billed charges,,,,,,,,,0.95,,26.27,Percent of total billed charges,,26.27,27.1,
OXYCODONE-ACETAMINOPHEN 5-325 MG (ED HOMEPACK) PO TABS,RX-74700511,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,28.96,26.06,,0.95,,27.51,Percent of total billed charges,,,0.98,,28.38,Percent of total billed charges,,,0.95,,27.51,Percent of total billed charges,,,0.97,,28.09,Percent of total billed charges,,,0.97,,28.09,Percent of total billed charges,,,0.96,,27.8,Percent of total billed charges,,,0.95,,27.51,Percent of total billed charges,,,,,,,,,0.95,,27.51,Percent of total billed charges,,27.51,28.38,
OXYCODONE-ACETAMINOPHEN 5-325 MG (ED HOMEPACK) PO TABS,RX-74700511,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,28.96,26.06,,0.95,,27.51,Percent of total billed charges,,,0.98,,28.38,Percent of total billed charges,,,0.95,,27.51,Percent of total billed charges,,,0.95,,27.51,Percent of total billed charges,,,0.97,,28.09,Percent of total billed charges,,,0.96,,27.8,Percent of total billed charges,,,0.95,,27.51,Percent of total billed charges,,,,,,,,,0.95,,27.51,Percent of total billed charges,,27.51,28.38,
PHENAZOPYRIDINE HCL 100 MG (ED HOMEPACK) PO TABS,RX-74700514,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,39.45,35.51,,0.95,,37.48,Percent of total billed charges,,,0.98,,38.66,Percent of total billed charges,,,0.95,,37.48,Percent of total billed charges,,,0.97,,38.27,Percent of total billed charges,,,0.97,,38.27,Percent of total billed charges,,,0.96,,37.87,Percent of total billed charges,,,0.95,,37.48,Percent of total billed charges,,,,,,,,,0.95,,37.48,Percent of total billed charges,,37.48,38.66,
PHENAZOPYRIDINE HCL 100 MG (ED HOMEPACK) PO TABS,RX-74700514,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,39.45,35.51,,0.95,,37.48,Percent of total billed charges,,,0.98,,38.66,Percent of total billed charges,,,0.95,,37.48,Percent of total billed charges,,,0.95,,37.48,Percent of total billed charges,,,0.97,,38.27,Percent of total billed charges,,,0.96,,37.87,Percent of total billed charges,,,0.95,,37.48,Percent of total billed charges,,,,,,,,,0.95,,37.48,Percent of total billed charges,,37.48,38.66,
PREDNISONE 20 MG (ED HOMEPACK) PO TABS,RX-74700515,CDM,J7512,HCPCS,636,RC,,inpatient,4,UN,26.33,23.7,,0.95,,25.01,Percent of total billed charges,,,0.98,,25.8,Percent of total billed charges,,,0.95,,25.01,Percent of total billed charges,,,0.97,,25.54,Percent of total billed charges,,,0.97,,25.54,Percent of total billed charges,,,0.96,,25.28,Percent of total billed charges,,,0.95,,25.01,Percent of total billed charges,,,,,,,,,0.95,,25.01,Percent of total billed charges,,25.01,25.8,
PREDNISONE 20 MG (ED HOMEPACK) PO TABS,RX-74700515,CDM,J7512,HCPCS,636,RC,,outpatient,4,UN,26.33,23.7,,0.95,,25.01,Percent of total billed charges,,,0.98,,25.8,Percent of total billed charges,,,0.95,,25.01,Percent of total billed charges,,,0.95,,25.01,Percent of total billed charges,,,0.97,,25.54,Percent of total billed charges,,,0.96,,25.28,Percent of total billed charges,,,0.95,,25.01,Percent of total billed charges,,,,,,,,,0.95,,25.01,Percent of total billed charges,,25.01,25.8,
PROMETHAZINE HCL 25 MG (ED HOMEPACK) PO TABS,RX-74700516,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,23.93,21.54,,0.95,,22.73,Percent of total billed charges,,,0.98,,23.45,Percent of total billed charges,,,0.95,,22.73,Percent of total billed charges,,,0.97,,23.21,Percent of total billed charges,,,0.97,,23.21,Percent of total billed charges,,,0.96,,22.97,Percent of total billed charges,,,0.95,,22.73,Percent of total billed charges,,,,,,,,,0.95,,22.73,Percent of total billed charges,,22.73,23.45,
PROMETHAZINE HCL 25 MG (ED HOMEPACK) PO TABS,RX-74700516,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,23.93,21.54,,0.95,,22.73,Percent of total billed charges,,,0.98,,23.45,Percent of total billed charges,,,0.95,,22.73,Percent of total billed charges,,,0.95,,22.73,Percent of total billed charges,,,0.97,,23.21,Percent of total billed charges,,,0.96,,22.97,Percent of total billed charges,,,0.95,,22.73,Percent of total billed charges,,,,,,,,,0.95,,22.73,Percent of total billed charges,,22.73,23.45,
TRAMADOL HCL 50 MG (ED HOMEPACK) PO TABS,RX-74700520,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,26.04,23.44,,0.95,,24.74,Percent of total billed charges,,,0.98,,25.52,Percent of total billed charges,,,0.95,,24.74,Percent of total billed charges,,,0.97,,25.26,Percent of total billed charges,,,0.97,,25.26,Percent of total billed charges,,,0.96,,25,Percent of total billed charges,,,0.95,,24.74,Percent of total billed charges,,,,,,,,,0.95,,24.74,Percent of total billed charges,,24.74,25.52,
TRAMADOL HCL 50 MG (ED HOMEPACK) PO TABS,RX-74700520,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,26.04,23.44,,0.95,,24.74,Percent of total billed charges,,,0.98,,25.52,Percent of total billed charges,,,0.95,,24.74,Percent of total billed charges,,,0.95,,24.74,Percent of total billed charges,,,0.97,,25.26,Percent of total billed charges,,,0.96,,25,Percent of total billed charges,,,0.95,,24.74,Percent of total billed charges,,,,,,,,,0.95,,24.74,Percent of total billed charges,,24.74,25.52,
METHOCARBAMOL 500 MG (ED HOMEPACK) PO TABS,RX-74700916,CDM,J3490,HCPCS,637,RC,,inpatient,2,UN,12.16,10.94,,0.95,,11.55,Percent of total billed charges,,,0.98,,11.92,Percent of total billed charges,,,0.95,,11.55,Percent of total billed charges,,,0.97,,11.8,Percent of total billed charges,,,0.97,,11.8,Percent of total billed charges,,,0.96,,11.67,Percent of total billed charges,,,0.95,,11.55,Percent of total billed charges,,,,,,,,,0.95,,11.55,Percent of total billed charges,,11.55,11.92,
METHOCARBAMOL 500 MG (ED HOMEPACK) PO TABS,RX-74700916,CDM,J3490,HCPCS,637,RC,,outpatient,2,UN,12.16,10.94,,0.95,,11.55,Percent of total billed charges,,,0.98,,11.92,Percent of total billed charges,,,0.95,,11.55,Percent of total billed charges,,,0.95,,11.55,Percent of total billed charges,,,0.97,,11.8,Percent of total billed charges,,,0.96,,11.67,Percent of total billed charges,,,0.95,,11.55,Percent of total billed charges,,,,,,,,,0.95,,11.55,Percent of total billed charges,,11.55,11.92,
AMOXICILLIN 500 MG (ED HOMEPACK) PO CAPS,RX-74700930,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,13.16,11.84,,0.95,,12.5,Percent of total billed charges,,,0.98,,12.9,Percent of total billed charges,,,0.95,,12.5,Percent of total billed charges,,,0.97,,12.77,Percent of total billed charges,,,0.97,,12.77,Percent of total billed charges,,,0.96,,12.63,Percent of total billed charges,,,0.95,,12.5,Percent of total billed charges,,,,,,,,,0.95,,12.5,Percent of total billed charges,,12.5,12.9,
AMOXICILLIN 500 MG (ED HOMEPACK) PO CAPS,RX-74700930,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,13.16,11.84,,0.95,,12.5,Percent of total billed charges,,,0.98,,12.9,Percent of total billed charges,,,0.95,,12.5,Percent of total billed charges,,,0.95,,12.5,Percent of total billed charges,,,0.97,,12.77,Percent of total billed charges,,,0.96,,12.63,Percent of total billed charges,,,0.95,,12.5,Percent of total billed charges,,,,,,,,,0.95,,12.5,Percent of total billed charges,,12.5,12.9,
FENTANYL 10 MCG/ML IN SODIUM CHLORIDE 0.9% INFUSION,RX-74700952,CDM,J3010,HCPCS,636,RC,,inpatient,100,ML,41.46,37.31,,0.95,,39.39,Percent of total billed charges,,,0.98,,40.63,Percent of total billed charges,,,0.95,,39.39,Percent of total billed charges,,,0.97,,40.22,Percent of total billed charges,,,0.97,,40.22,Percent of total billed charges,,,0.96,,39.8,Percent of total billed charges,,,0.95,,39.39,Percent of total billed charges,,,,,,,,,0.95,,39.39,Percent of total billed charges,,39.39,40.63,
FENTANYL 10 MCG/ML IN SODIUM CHLORIDE 0.9% INFUSION,RX-74700952,CDM,J3010,HCPCS,636,RC,,outpatient,100,ML,41.46,37.31,,0.95,,39.39,Percent of total billed charges,,,0.98,,40.63,Percent of total billed charges,,,0.95,,39.39,Percent of total billed charges,,,0.95,,39.39,Percent of total billed charges,,,0.97,,40.22,Percent of total billed charges,,,0.96,,39.8,Percent of total billed charges,,,0.95,,39.39,Percent of total billed charges,,,,,,,,,0.95,,39.39,Percent of total billed charges,,39.39,40.63,
IBUPROFEN 800 MG (ED HOMEPACK) PO TABS,RX-74700965,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,24.25,21.83,,0.95,,23.04,Percent of total billed charges,,,0.98,,23.77,Percent of total billed charges,,,0.95,,23.04,Percent of total billed charges,,,0.97,,23.52,Percent of total billed charges,,,0.97,,23.52,Percent of total billed charges,,,0.96,,23.28,Percent of total billed charges,,,0.95,,23.04,Percent of total billed charges,,,,,,,,,0.95,,23.04,Percent of total billed charges,,23.04,23.77,
IBUPROFEN 800 MG (ED HOMEPACK) PO TABS,RX-74700965,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,24.25,21.83,,0.95,,23.04,Percent of total billed charges,,,0.98,,23.77,Percent of total billed charges,,,0.95,,23.04,Percent of total billed charges,,,0.95,,23.04,Percent of total billed charges,,,0.97,,23.52,Percent of total billed charges,,,0.96,,23.28,Percent of total billed charges,,,0.95,,23.04,Percent of total billed charges,,,,,,,,,0.95,,23.04,Percent of total billed charges,,23.04,23.77,
NITROGLYCERIN 0.4 MG (ED HOMEPACK) SL,RX-74700971,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,185.38,166.84,,0.95,,176.11,Percent of total billed charges,,,0.98,,181.67,Percent of total billed charges,,,0.95,,176.11,Percent of total billed charges,,,0.97,,179.82,Percent of total billed charges,,,0.97,,179.82,Percent of total billed charges,,,0.96,,177.96,Percent of total billed charges,,,0.95,,176.11,Percent of total billed charges,,,,,,,,,0.95,,176.11,Percent of total billed charges,,176.11,181.67,
NITROGLYCERIN 0.4 MG (ED HOMEPACK) SL,RX-74700971,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,185.38,166.84,,0.95,,176.11,Percent of total billed charges,,,0.98,,181.67,Percent of total billed charges,,,0.95,,176.11,Percent of total billed charges,,,0.95,,176.11,Percent of total billed charges,,,0.97,,179.82,Percent of total billed charges,,,0.96,,177.96,Percent of total billed charges,,,0.95,,176.11,Percent of total billed charges,,,,,,,,,0.95,,176.11,Percent of total billed charges,,176.11,181.67,
DOXYCYCLINE HYCLATE 100 MG (ED HOMEPACK) PO TABS,RX-74700972,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,58.9,53.01,,0.95,,55.96,Percent of total billed charges,,,0.98,,57.72,Percent of total billed charges,,,0.95,,55.96,Percent of total billed charges,,,0.97,,57.13,Percent of total billed charges,,,0.97,,57.13,Percent of total billed charges,,,0.96,,56.54,Percent of total billed charges,,,0.95,,55.96,Percent of total billed charges,,,,,,,,,0.95,,55.96,Percent of total billed charges,,55.96,57.72,
DOXYCYCLINE HYCLATE 100 MG (ED HOMEPACK) PO TABS,RX-74700972,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,58.9,53.01,,0.95,,55.96,Percent of total billed charges,,,0.98,,57.72,Percent of total billed charges,,,0.95,,55.96,Percent of total billed charges,,,0.95,,55.96,Percent of total billed charges,,,0.97,,57.13,Percent of total billed charges,,,0.96,,56.54,Percent of total billed charges,,,0.95,,55.96,Percent of total billed charges,,,,,,,,,0.95,,55.96,Percent of total billed charges,,55.96,57.72,
AZITHROMYCIN 250 MG (ED HOMEPACK) PO TABS,RX-74701238,CDM,Q0144,HCPCS,637,RC,,inpatient,2,UN,24.84,22.36,,0.95,,23.6,Percent of total billed charges,,,0.98,,24.34,Percent of total billed charges,,,0.95,,23.6,Percent of total billed charges,,,0.97,,24.09,Percent of total billed charges,,,0.97,,24.09,Percent of total billed charges,,,0.96,,23.85,Percent of total billed charges,,,0.95,,23.6,Percent of total billed charges,,,,,,,,,0.95,,23.6,Percent of total billed charges,,23.6,24.34,
AZITHROMYCIN 250 MG (ED HOMEPACK) PO TABS,RX-74701238,CDM,Q0144,HCPCS,637,RC,,outpatient,2,UN,24.84,22.36,,0.95,,23.6,Percent of total billed charges,,,0.98,,24.34,Percent of total billed charges,,,0.95,,23.6,Percent of total billed charges,,,0.95,,23.6,Percent of total billed charges,,,0.97,,24.09,Percent of total billed charges,,,0.96,,23.85,Percent of total billed charges,,,0.95,,23.6,Percent of total billed charges,,,,,,,,,0.95,,23.6,Percent of total billed charges,,23.6,24.34,
CIPROFLOXACIN HCL 500 MG (ED HOMEPACK) PO TABS,RX-74701239,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,26.81,24.13,,0.95,,25.47,Percent of total billed charges,,,0.98,,26.27,Percent of total billed charges,,,0.95,,25.47,Percent of total billed charges,,,0.97,,26.01,Percent of total billed charges,,,0.97,,26.01,Percent of total billed charges,,,0.96,,25.74,Percent of total billed charges,,,0.95,,25.47,Percent of total billed charges,,,,,,,,,0.95,,25.47,Percent of total billed charges,,25.47,26.27,
CIPROFLOXACIN HCL 500 MG (ED HOMEPACK) PO TABS,RX-74701239,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,26.81,24.13,,0.95,,25.47,Percent of total billed charges,,,0.98,,26.27,Percent of total billed charges,,,0.95,,25.47,Percent of total billed charges,,,0.95,,25.47,Percent of total billed charges,,,0.97,,26.01,Percent of total billed charges,,,0.96,,25.74,Percent of total billed charges,,,0.95,,25.47,Percent of total billed charges,,,,,,,,,0.95,,25.47,Percent of total billed charges,,25.47,26.27,
HYDROCODONE-ACETAMINOPHEN 7.5-325 MG (ED HOMEPACK) PO TAB,RX-74701243,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,27.15,24.44,,0.95,,25.79,Percent of total billed charges,,,0.98,,26.61,Percent of total billed charges,,,0.95,,25.79,Percent of total billed charges,,,0.97,,26.34,Percent of total billed charges,,,0.97,,26.34,Percent of total billed charges,,,0.96,,26.06,Percent of total billed charges,,,0.95,,25.79,Percent of total billed charges,,,,,,,,,0.95,,25.79,Percent of total billed charges,,25.79,26.61,
HYDROCODONE-ACETAMINOPHEN 7.5-325 MG (ED HOMEPACK) PO TAB,RX-74701243,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,27.15,24.44,,0.95,,25.79,Percent of total billed charges,,,0.98,,26.61,Percent of total billed charges,,,0.95,,25.79,Percent of total billed charges,,,0.95,,25.79,Percent of total billed charges,,,0.97,,26.34,Percent of total billed charges,,,0.96,,26.06,Percent of total billed charges,,,0.95,,25.79,Percent of total billed charges,,,,,,,,,0.95,,25.79,Percent of total billed charges,,25.79,26.61,
CIPROFLOXACIN HCL 250 MG (ED HOMEPACK) PO TABS,RX-74701302,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,25.83,23.25,,0.95,,24.54,Percent of total billed charges,,,0.98,,25.31,Percent of total billed charges,,,0.95,,24.54,Percent of total billed charges,,,0.97,,25.06,Percent of total billed charges,,,0.97,,25.06,Percent of total billed charges,,,0.96,,24.8,Percent of total billed charges,,,0.95,,24.54,Percent of total billed charges,,,,,,,,,0.95,,24.54,Percent of total billed charges,,24.54,25.31,
CIPROFLOXACIN HCL 250 MG (ED HOMEPACK) PO TABS,RX-74701302,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,25.83,23.25,,0.95,,24.54,Percent of total billed charges,,,0.98,,25.31,Percent of total billed charges,,,0.95,,24.54,Percent of total billed charges,,,0.95,,24.54,Percent of total billed charges,,,0.97,,25.06,Percent of total billed charges,,,0.96,,24.8,Percent of total billed charges,,,0.95,,24.54,Percent of total billed charges,,,,,,,,,0.95,,24.54,Percent of total billed charges,,24.54,25.31,
METOCLOPRAMIDE HCL 10 MG (ED HOMEPACK) PO TABS,RX-74701304,CDM,J3490,HCPCS,637,RC,,inpatient,2,UN,14.94,13.45,,0.95,,14.19,Percent of total billed charges,,,0.98,,14.64,Percent of total billed charges,,,0.95,,14.19,Percent of total billed charges,,,0.97,,14.49,Percent of total billed charges,,,0.97,,14.49,Percent of total billed charges,,,0.96,,14.34,Percent of total billed charges,,,0.95,,14.19,Percent of total billed charges,,,,,,,,,0.95,,14.19,Percent of total billed charges,,14.19,14.64,
METOCLOPRAMIDE HCL 10 MG (ED HOMEPACK) PO TABS,RX-74701304,CDM,J3490,HCPCS,637,RC,,outpatient,2,UN,14.94,13.45,,0.95,,14.19,Percent of total billed charges,,,0.98,,14.64,Percent of total billed charges,,,0.95,,14.19,Percent of total billed charges,,,0.95,,14.19,Percent of total billed charges,,,0.97,,14.49,Percent of total billed charges,,,0.96,,14.34,Percent of total billed charges,,,0.95,,14.19,Percent of total billed charges,,,,,,,,,0.95,,14.19,Percent of total billed charges,,14.19,14.64,
PANTOPRAZOLE SODIUM 40 MG (ED HOMEPACK) PO TBEC,RX-74701309,CDM,J3490,HCPCS,637,RC,,inpatient,7,UN,48.12,43.31,,0.95,,45.71,Percent of total billed charges,,,0.98,,47.16,Percent of total billed charges,,,0.95,,45.71,Percent of total billed charges,,,0.97,,46.68,Percent of total billed charges,,,0.97,,46.68,Percent of total billed charges,,,0.96,,46.2,Percent of total billed charges,,,0.95,,45.71,Percent of total billed charges,,,,,,,,,0.95,,45.71,Percent of total billed charges,,45.71,47.16,
PANTOPRAZOLE SODIUM 40 MG (ED HOMEPACK) PO TBEC,RX-74701309,CDM,J3490,HCPCS,637,RC,,outpatient,7,UN,48.12,43.31,,0.95,,45.71,Percent of total billed charges,,,0.98,,47.16,Percent of total billed charges,,,0.95,,45.71,Percent of total billed charges,,,0.95,,45.71,Percent of total billed charges,,,0.97,,46.68,Percent of total billed charges,,,0.96,,46.2,Percent of total billed charges,,,0.95,,45.71,Percent of total billed charges,,,,,,,,,0.95,,45.71,Percent of total billed charges,,45.71,47.16,
ACETAMINOPHEN-CODEINE 120-12 MG/5 ML (ED HOMEPACK) PO SOLN,RX-74701320,CDM,J3490,HCPCS,637,RC,,inpatient,60,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
ACETAMINOPHEN-CODEINE 120-12 MG/5 ML (ED HOMEPACK) PO SOLN,RX-74701320,CDM,J3490,HCPCS,637,RC,,outpatient,60,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
ACETAMINOPHEN 160 MG/5ML (ED HOMEPACK) PO SUSP,RX-74701335,CDM,J3490,HCPCS,637,RC,,inpatient,120,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
ACETAMINOPHEN 160 MG/5ML (ED HOMEPACK) PO SUSP,RX-74701335,CDM,J3490,HCPCS,637,RC,,outpatient,120,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
CEPHALEXIN 250 MG (ED HOMEPACK) PO CAPS,RX-74701354,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,24.07,21.66,,0.95,,22.87,Percent of total billed charges,,,0.98,,23.59,Percent of total billed charges,,,0.95,,22.87,Percent of total billed charges,,,0.97,,23.35,Percent of total billed charges,,,0.97,,23.35,Percent of total billed charges,,,0.96,,23.11,Percent of total billed charges,,,0.95,,22.87,Percent of total billed charges,,,,,,,,,0.95,,22.87,Percent of total billed charges,,22.87,23.59,
CEPHALEXIN 250 MG (ED HOMEPACK) PO CAPS,RX-74701354,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,24.07,21.66,,0.95,,22.87,Percent of total billed charges,,,0.98,,23.59,Percent of total billed charges,,,0.95,,22.87,Percent of total billed charges,,,0.95,,22.87,Percent of total billed charges,,,0.97,,23.35,Percent of total billed charges,,,0.96,,23.11,Percent of total billed charges,,,0.95,,22.87,Percent of total billed charges,,,,,,,,,0.95,,22.87,Percent of total billed charges,,22.87,23.59,
FUROSEMIDE 40 MG (ED PREPACK) PO TABS,RX-74701558,CDM,J3490,HCPCS,637,RC,,inpatient,2,UN,11.79,10.61,,0.95,,11.2,Percent of total billed charges,,,0.98,,11.55,Percent of total billed charges,,,0.95,,11.2,Percent of total billed charges,,,0.97,,11.44,Percent of total billed charges,,,0.97,,11.44,Percent of total billed charges,,,0.96,,11.32,Percent of total billed charges,,,0.95,,11.2,Percent of total billed charges,,,,,,,,,0.95,,11.2,Percent of total billed charges,,11.2,11.55,
FUROSEMIDE 40 MG (ED PREPACK) PO TABS,RX-74701558,CDM,J3490,HCPCS,637,RC,,outpatient,2,UN,11.79,10.61,,0.95,,11.2,Percent of total billed charges,,,0.98,,11.55,Percent of total billed charges,,,0.95,,11.2,Percent of total billed charges,,,0.95,,11.2,Percent of total billed charges,,,0.97,,11.44,Percent of total billed charges,,,0.96,,11.32,Percent of total billed charges,,,0.95,,11.2,Percent of total billed charges,,,,,,,,,0.95,,11.2,Percent of total billed charges,,11.2,11.55,
NIFEDIPINE 10 MG (ED HOMEPACK) PO CAPS,RX-74701735,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,33.58,30.22,,0.95,,31.9,Percent of total billed charges,,,0.98,,32.91,Percent of total billed charges,,,0.95,,31.9,Percent of total billed charges,,,0.97,,32.57,Percent of total billed charges,,,0.97,,32.57,Percent of total billed charges,,,0.96,,32.24,Percent of total billed charges,,,0.95,,31.9,Percent of total billed charges,,,,,,,,,0.95,,31.9,Percent of total billed charges,,31.9,32.91,
NIFEDIPINE 10 MG (ED HOMEPACK) PO CAPS,RX-74701735,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,33.58,30.22,,0.95,,31.9,Percent of total billed charges,,,0.98,,32.91,Percent of total billed charges,,,0.95,,31.9,Percent of total billed charges,,,0.95,,31.9,Percent of total billed charges,,,0.97,,32.57,Percent of total billed charges,,,0.96,,32.24,Percent of total billed charges,,,0.95,,31.9,Percent of total billed charges,,,,,,,,,0.95,,31.9,Percent of total billed charges,,31.9,32.91,
AMOXICILLIN-POT CLAVULANATE 250-62.5 MG/5ML (ED HOMEPACK) PO SUSR,RX-74701740,CDM,J3490,HCPCS,637,RC,,inpatient,75,ML,158.99,143.09,,0.95,,151.04,Percent of total billed charges,,,0.98,,155.81,Percent of total billed charges,,,0.95,,151.04,Percent of total billed charges,,,0.97,,154.22,Percent of total billed charges,,,0.97,,154.22,Percent of total billed charges,,,0.96,,152.63,Percent of total billed charges,,,0.95,,151.04,Percent of total billed charges,,,,,,,,,0.95,,151.04,Percent of total billed charges,,151.04,155.81,
AMOXICILLIN-POT CLAVULANATE 250-62.5 MG/5ML (ED HOMEPACK) PO SUSR,RX-74701740,CDM,J3490,HCPCS,637,RC,,outpatient,75,ML,158.99,143.09,,0.95,,151.04,Percent of total billed charges,,,0.98,,155.81,Percent of total billed charges,,,0.95,,151.04,Percent of total billed charges,,,0.95,,151.04,Percent of total billed charges,,,0.97,,154.22,Percent of total billed charges,,,0.96,,152.63,Percent of total billed charges,,,0.95,,151.04,Percent of total billed charges,,,,,,,,,0.95,,151.04,Percent of total billed charges,,151.04,155.81,
AMOXICILLIN-POT CLAVULANATE 250-125 MG (ED HOMEPACK) TAB,RX-74701741,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,85.2,76.68,,0.95,,80.94,Percent of total billed charges,,,0.98,,83.5,Percent of total billed charges,,,0.95,,80.94,Percent of total billed charges,,,0.97,,82.64,Percent of total billed charges,,,0.97,,82.64,Percent of total billed charges,,,0.96,,81.79,Percent of total billed charges,,,0.95,,80.94,Percent of total billed charges,,,,,,,,,0.95,,80.94,Percent of total billed charges,,80.94,83.5,
AMOXICILLIN-POT CLAVULANATE 250-125 MG (ED HOMEPACK) TAB,RX-74701741,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,85.2,76.68,,0.95,,80.94,Percent of total billed charges,,,0.98,,83.5,Percent of total billed charges,,,0.95,,80.94,Percent of total billed charges,,,0.95,,80.94,Percent of total billed charges,,,0.97,,82.64,Percent of total billed charges,,,0.96,,81.79,Percent of total billed charges,,,0.95,,80.94,Percent of total billed charges,,,,,,,,,0.95,,80.94,Percent of total billed charges,,80.94,83.5,
PREDNISONE 10 MG (ED HOMEPACK) PO TABS,RX-74701743,CDM,J7512,HCPCS,636,RC,,inpatient,4,UN,25.15,22.64,,0.95,,23.89,Percent of total billed charges,,,0.98,,24.65,Percent of total billed charges,,,0.95,,23.89,Percent of total billed charges,,,0.97,,24.4,Percent of total billed charges,,,0.97,,24.4,Percent of total billed charges,,,0.96,,24.14,Percent of total billed charges,,,0.95,,23.89,Percent of total billed charges,,,,,,,,,0.95,,23.89,Percent of total billed charges,,23.89,24.65,
PREDNISONE 10 MG (ED HOMEPACK) PO TABS,RX-74701743,CDM,J7512,HCPCS,636,RC,,outpatient,4,UN,25.15,22.64,,0.95,,23.89,Percent of total billed charges,,,0.98,,24.65,Percent of total billed charges,,,0.95,,23.89,Percent of total billed charges,,,0.95,,23.89,Percent of total billed charges,,,0.97,,24.4,Percent of total billed charges,,,0.96,,24.14,Percent of total billed charges,,,0.95,,23.89,Percent of total billed charges,,,,,,,,,0.95,,23.89,Percent of total billed charges,,23.89,24.65,
PROCHLORPERAZINE 5 MG (ED HOMEPACK) PO TABS,RX-74701745,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,36.51,32.86,,0.95,,34.68,Percent of total billed charges,,,0.98,,35.78,Percent of total billed charges,,,0.95,,34.68,Percent of total billed charges,,,0.97,,35.41,Percent of total billed charges,,,0.97,,35.41,Percent of total billed charges,,,0.96,,35.05,Percent of total billed charges,,,0.95,,34.68,Percent of total billed charges,,,,,,,,,0.95,,34.68,Percent of total billed charges,,34.68,35.78,
PROCHLORPERAZINE 5 MG (ED HOMEPACK) PO TABS,RX-74701745,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,36.51,32.86,,0.95,,34.68,Percent of total billed charges,,,0.98,,35.78,Percent of total billed charges,,,0.95,,34.68,Percent of total billed charges,,,0.95,,34.68,Percent of total billed charges,,,0.97,,35.41,Percent of total billed charges,,,0.96,,35.05,Percent of total billed charges,,,0.95,,34.68,Percent of total billed charges,,,,,,,,,0.95,,34.68,Percent of total billed charges,,34.68,35.78,
LORAZEPAM 0.5 MG (ED HOMEPACK) PO TABS,RX-74701746,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,23.75,21.38,,0.95,,22.56,Percent of total billed charges,,,0.98,,23.28,Percent of total billed charges,,,0.95,,22.56,Percent of total billed charges,,,0.97,,23.04,Percent of total billed charges,,,0.97,,23.04,Percent of total billed charges,,,0.96,,22.8,Percent of total billed charges,,,0.95,,22.56,Percent of total billed charges,,,,,,,,,0.95,,22.56,Percent of total billed charges,,22.56,23.28,
LORAZEPAM 0.5 MG (ED HOMEPACK) PO TABS,RX-74701746,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,23.75,21.38,,0.95,,22.56,Percent of total billed charges,,,0.98,,23.28,Percent of total billed charges,,,0.95,,22.56,Percent of total billed charges,,,0.95,,22.56,Percent of total billed charges,,,0.97,,23.04,Percent of total billed charges,,,0.96,,22.8,Percent of total billed charges,,,0.95,,22.56,Percent of total billed charges,,,,,,,,,0.95,,22.56,Percent of total billed charges,,22.56,23.28,
MECLIZINE HCL 12.5 MG (ED HOMEPACK) PO TABS,RX-74701747,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,32.2,28.98,,0.95,,30.59,Percent of total billed charges,,,0.98,,31.56,Percent of total billed charges,,,0.95,,30.59,Percent of total billed charges,,,0.97,,31.23,Percent of total billed charges,,,0.97,,31.23,Percent of total billed charges,,,0.96,,30.91,Percent of total billed charges,,,0.95,,30.59,Percent of total billed charges,,,,,,,,,0.95,,30.59,Percent of total billed charges,,30.59,31.56,
MECLIZINE HCL 12.5 MG (ED HOMEPACK) PO TABS,RX-74701747,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,32.2,28.98,,0.95,,30.59,Percent of total billed charges,,,0.98,,31.56,Percent of total billed charges,,,0.95,,30.59,Percent of total billed charges,,,0.95,,30.59,Percent of total billed charges,,,0.97,,31.23,Percent of total billed charges,,,0.96,,30.91,Percent of total billed charges,,,0.95,,30.59,Percent of total billed charges,,,,,,,,,0.95,,30.59,Percent of total billed charges,,30.59,31.56,
NITROFURANTOIN MACROCRYSTAL 50 MG (ED HOMEPACK) PO CAPS,RX-74701752,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,48.99,44.09,,0.95,,46.54,Percent of total billed charges,,,0.98,,48.01,Percent of total billed charges,,,0.95,,46.54,Percent of total billed charges,,,0.97,,47.52,Percent of total billed charges,,,0.97,,47.52,Percent of total billed charges,,,0.96,,47.03,Percent of total billed charges,,,0.95,,46.54,Percent of total billed charges,,,,,,,,,0.95,,46.54,Percent of total billed charges,,46.54,48.01,
NITROFURANTOIN MACROCRYSTAL 50 MG (ED HOMEPACK) PO CAPS,RX-74701752,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,48.99,44.09,,0.95,,46.54,Percent of total billed charges,,,0.98,,48.01,Percent of total billed charges,,,0.95,,46.54,Percent of total billed charges,,,0.95,,46.54,Percent of total billed charges,,,0.97,,47.52,Percent of total billed charges,,,0.96,,47.03,Percent of total billed charges,,,0.95,,46.54,Percent of total billed charges,,,,,,,,,0.95,,46.54,Percent of total billed charges,,46.54,48.01,
DIPHENHYDRAMINE HCL 25 MG (ED HOMEPACK) PO CAPS,RX-74701757,CDM,J3490,HCPCS,637,RC,,inpatient,8,UN,46.68,42.01,,0.95,,44.35,Percent of total billed charges,,,0.98,,45.75,Percent of total billed charges,,,0.95,,44.35,Percent of total billed charges,,,0.97,,45.28,Percent of total billed charges,,,0.97,,45.28,Percent of total billed charges,,,0.96,,44.81,Percent of total billed charges,,,0.95,,44.35,Percent of total billed charges,,,,,,,,,0.95,,44.35,Percent of total billed charges,,44.35,45.75,
DIPHENHYDRAMINE HCL 25 MG (ED HOMEPACK) PO CAPS,RX-74701757,CDM,J3490,HCPCS,637,RC,,outpatient,8,UN,46.68,42.01,,0.95,,44.35,Percent of total billed charges,,,0.98,,45.75,Percent of total billed charges,,,0.95,,44.35,Percent of total billed charges,,,0.95,,44.35,Percent of total billed charges,,,0.97,,45.28,Percent of total billed charges,,,0.96,,44.81,Percent of total billed charges,,,0.95,,44.35,Percent of total billed charges,,,,,,,,,0.95,,44.35,Percent of total billed charges,,44.35,45.75,
IBUPROFEN 400 MG (ED HOMEPACK) PO TABS,RX-74701758,CDM,J3490,HCPCS,637,RC,,inpatient,6,UN,35.62,32.06,,0.95,,33.84,Percent of total billed charges,,,0.98,,34.91,Percent of total billed charges,,,0.95,,33.84,Percent of total billed charges,,,0.97,,34.55,Percent of total billed charges,,,0.97,,34.55,Percent of total billed charges,,,0.96,,34.2,Percent of total billed charges,,,0.95,,33.84,Percent of total billed charges,,,,,,,,,0.95,,33.84,Percent of total billed charges,,33.84,34.91,
IBUPROFEN 400 MG (ED HOMEPACK) PO TABS,RX-74701758,CDM,J3490,HCPCS,637,RC,,outpatient,6,UN,35.62,32.06,,0.95,,33.84,Percent of total billed charges,,,0.98,,34.91,Percent of total billed charges,,,0.95,,33.84,Percent of total billed charges,,,0.95,,33.84,Percent of total billed charges,,,0.97,,34.55,Percent of total billed charges,,,0.96,,34.2,Percent of total billed charges,,,0.95,,33.84,Percent of total billed charges,,,,,,,,,0.95,,33.84,Percent of total billed charges,,33.84,34.91,
METRONIDAZOLE 250 MG (ED HOMEPACK) PO TABS,RX-74701759,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,30.46,27.41,,0.95,,28.94,Percent of total billed charges,,,0.98,,29.85,Percent of total billed charges,,,0.95,,28.94,Percent of total billed charges,,,0.97,,29.55,Percent of total billed charges,,,0.97,,29.55,Percent of total billed charges,,,0.96,,29.24,Percent of total billed charges,,,0.95,,28.94,Percent of total billed charges,,,,,,,,,0.95,,28.94,Percent of total billed charges,,28.94,29.85,
METRONIDAZOLE 250 MG (ED HOMEPACK) PO TABS,RX-74701759,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,30.46,27.41,,0.95,,28.94,Percent of total billed charges,,,0.98,,29.85,Percent of total billed charges,,,0.95,,28.94,Percent of total billed charges,,,0.95,,28.94,Percent of total billed charges,,,0.97,,29.55,Percent of total billed charges,,,0.96,,29.24,Percent of total billed charges,,,0.95,,28.94,Percent of total billed charges,,,,,,,,,0.95,,28.94,Percent of total billed charges,,28.94,29.85,
NITROFURANTOIN MONOHYD MACRO 100 MG (ED HOMEPACK) PO CAPS,RX-74701935,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,60.57,54.51,,0.95,,57.54,Percent of total billed charges,,,0.98,,59.36,Percent of total billed charges,,,0.95,,57.54,Percent of total billed charges,,,0.97,,58.75,Percent of total billed charges,,,0.97,,58.75,Percent of total billed charges,,,0.96,,58.15,Percent of total billed charges,,,0.95,,57.54,Percent of total billed charges,,,,,,,,,0.95,,57.54,Percent of total billed charges,,57.54,59.36,
NITROFURANTOIN MONOHYD MACRO 100 MG (ED HOMEPACK) PO CAPS,RX-74701935,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,60.57,54.51,,0.95,,57.54,Percent of total billed charges,,,0.98,,59.36,Percent of total billed charges,,,0.95,,57.54,Percent of total billed charges,,,0.95,,57.54,Percent of total billed charges,,,0.97,,58.75,Percent of total billed charges,,,0.96,,58.15,Percent of total billed charges,,,0.95,,57.54,Percent of total billed charges,,,,,,,,,0.95,,57.54,Percent of total billed charges,,57.54,59.36,
BENZONATATE 100 MG (ED PREPACK) PO CAPS,RX-74702032,CDM,J3490,HCPCS,637,RC,,inpatient,6,UN,39.2,35.28,,0.95,,37.24,Percent of total billed charges,,,0.98,,38.42,Percent of total billed charges,,,0.95,,37.24,Percent of total billed charges,,,0.97,,38.02,Percent of total billed charges,,,0.97,,38.02,Percent of total billed charges,,,0.96,,37.63,Percent of total billed charges,,,0.95,,37.24,Percent of total billed charges,,,,,,,,,0.95,,37.24,Percent of total billed charges,,37.24,38.42,
BENZONATATE 100 MG (ED PREPACK) PO CAPS,RX-74702032,CDM,J3490,HCPCS,637,RC,,outpatient,6,UN,39.2,35.28,,0.95,,37.24,Percent of total billed charges,,,0.98,,38.42,Percent of total billed charges,,,0.95,,37.24,Percent of total billed charges,,,0.95,,37.24,Percent of total billed charges,,,0.97,,38.02,Percent of total billed charges,,,0.96,,37.63,Percent of total billed charges,,,0.95,,37.24,Percent of total billed charges,,,,,,,,,0.95,,37.24,Percent of total billed charges,,37.24,38.42,
WARFARIN SODIUM 5 MG (ED PREPACK) PO TABS,RX-74702034,CDM,J3490,HCPCS,637,RC,,inpatient,2,UN,11.79,10.61,,0.95,,11.2,Percent of total billed charges,,,0.98,,11.55,Percent of total billed charges,,,0.95,,11.2,Percent of total billed charges,,,0.97,,11.44,Percent of total billed charges,,,0.97,,11.44,Percent of total billed charges,,,0.96,,11.32,Percent of total billed charges,,,0.95,,11.2,Percent of total billed charges,,,,,,,,,0.95,,11.2,Percent of total billed charges,,11.2,11.55,
WARFARIN SODIUM 5 MG (ED PREPACK) PO TABS,RX-74702034,CDM,J3490,HCPCS,637,RC,,outpatient,2,UN,11.79,10.61,,0.95,,11.2,Percent of total billed charges,,,0.98,,11.55,Percent of total billed charges,,,0.95,,11.2,Percent of total billed charges,,,0.95,,11.2,Percent of total billed charges,,,0.97,,11.44,Percent of total billed charges,,,0.96,,11.32,Percent of total billed charges,,,0.95,,11.2,Percent of total billed charges,,,,,,,,,0.95,,11.2,Percent of total billed charges,,11.2,11.55,
HYDROCODONE-ACETAMINOPHEN 10-325 MG (ED HOMEPACK) PO TABS,RX-74702135,CDM,J3490,HCPCS,637,RC,,inpatient,6,UN,44.77,40.29,,0.95,,42.53,Percent of total billed charges,,,0.98,,43.87,Percent of total billed charges,,,0.95,,42.53,Percent of total billed charges,,,0.97,,43.43,Percent of total billed charges,,,0.97,,43.43,Percent of total billed charges,,,0.96,,42.98,Percent of total billed charges,,,0.95,,42.53,Percent of total billed charges,,,,,,,,,0.95,,42.53,Percent of total billed charges,,42.53,43.87,
HYDROCODONE-ACETAMINOPHEN 10-325 MG (ED HOMEPACK) PO TABS,RX-74702135,CDM,J3490,HCPCS,637,RC,,outpatient,6,UN,44.77,40.29,,0.95,,42.53,Percent of total billed charges,,,0.98,,43.87,Percent of total billed charges,,,0.95,,42.53,Percent of total billed charges,,,0.95,,42.53,Percent of total billed charges,,,0.97,,43.43,Percent of total billed charges,,,0.96,,42.98,Percent of total billed charges,,,0.95,,42.53,Percent of total billed charges,,,,,,,,,0.95,,42.53,Percent of total billed charges,,42.53,43.87,
ALBUTEROL SULFATE (2.5 MG/3ML) 0.083% (ED HOMEPACK) IN NEBU,RX-74702260,CDM,J7613,HCPCS,636,RC,,inpatient,12,ML,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
ALBUTEROL SULFATE (2.5 MG/3ML) 0.083% (ED HOMEPACK) IN NEBU,RX-74702260,CDM,J7613,HCPCS,636,RC,,outpatient,12,ML,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
FAMOTIDINE 20 MG (ED HOMEPACK) PO TABS,RX-74702509,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,23.93,21.54,,0.95,,22.73,Percent of total billed charges,,,0.98,,23.45,Percent of total billed charges,,,0.95,,22.73,Percent of total billed charges,,,0.97,,23.21,Percent of total billed charges,,,0.97,,23.21,Percent of total billed charges,,,0.96,,22.97,Percent of total billed charges,,,0.95,,22.73,Percent of total billed charges,,,,,,,,,0.95,,22.73,Percent of total billed charges,,22.73,23.45,
FAMOTIDINE 20 MG (ED HOMEPACK) PO TABS,RX-74702509,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,23.93,21.54,,0.95,,22.73,Percent of total billed charges,,,0.98,,23.45,Percent of total billed charges,,,0.95,,22.73,Percent of total billed charges,,,0.95,,22.73,Percent of total billed charges,,,0.97,,23.21,Percent of total billed charges,,,0.96,,22.97,Percent of total billed charges,,,0.95,,22.73,Percent of total billed charges,,,,,,,,,0.95,,22.73,Percent of total billed charges,,22.73,23.45,
SODIUM CHLORIDE 0.45 % IV BOLUS,RX-74702735,CDM,J3490,HCPCS,250,RC,,inpatient,250,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
SODIUM CHLORIDE 0.45 % IV BOLUS,RX-74702735,CDM,J3490,HCPCS,250,RC,,outpatient,250,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
SODIUM CHLORIDE 0.45 % IV BOLUS,RX-74702735,CDM,J3490,HCPCS,250,RC,,inpatient,250,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
SODIUM CHLORIDE 0.45 % IV BOLUS,RX-74702735,CDM,J3490,HCPCS,250,RC,,outpatient,250,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
NAPROXEN 250 MG (ED HOMEPACK) PO TABS,RX-74702744,CDM,J3490,HCPCS,637,RC,,inpatient,6,UN,44.22,39.8,,0.95,,42.01,Percent of total billed charges,,,0.98,,43.34,Percent of total billed charges,,,0.95,,42.01,Percent of total billed charges,,,0.97,,42.89,Percent of total billed charges,,,0.97,,42.89,Percent of total billed charges,,,0.96,,42.45,Percent of total billed charges,,,0.95,,42.01,Percent of total billed charges,,,,,,,,,0.95,,42.01,Percent of total billed charges,,42.01,43.34,
NAPROXEN 250 MG (ED HOMEPACK) PO TABS,RX-74702744,CDM,J3490,HCPCS,637,RC,,outpatient,6,UN,44.22,39.8,,0.95,,42.01,Percent of total billed charges,,,0.98,,43.34,Percent of total billed charges,,,0.95,,42.01,Percent of total billed charges,,,0.95,,42.01,Percent of total billed charges,,,0.97,,42.89,Percent of total billed charges,,,0.96,,42.45,Percent of total billed charges,,,0.95,,42.01,Percent of total billed charges,,,,,,,,,0.95,,42.01,Percent of total billed charges,,42.01,43.34,
BUTALBITAL-APAP-CAFFEINE 50-325-40 MG (ED HOMEPACK) PO TABS,RX-74702910,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,39.91,35.92,,0.95,,37.91,Percent of total billed charges,,,0.98,,39.11,Percent of total billed charges,,,0.95,,37.91,Percent of total billed charges,,,0.97,,38.71,Percent of total billed charges,,,0.97,,38.71,Percent of total billed charges,,,0.96,,38.31,Percent of total billed charges,,,0.95,,37.91,Percent of total billed charges,,,,,,,,,0.95,,37.91,Percent of total billed charges,,37.91,39.11,
BUTALBITAL-APAP-CAFFEINE 50-325-40 MG (ED HOMEPACK) PO TABS,RX-74702910,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,39.91,35.92,,0.95,,37.91,Percent of total billed charges,,,0.98,,39.11,Percent of total billed charges,,,0.95,,37.91,Percent of total billed charges,,,0.95,,37.91,Percent of total billed charges,,,0.97,,38.71,Percent of total billed charges,,,0.96,,38.31,Percent of total billed charges,,,0.95,,37.91,Percent of total billed charges,,,,,,,,,0.95,,37.91,Percent of total billed charges,,37.91,39.11,
KETOROLAC 10 MG (ED HOMEPACK) PO TABS,RX-74703241,CDM,J3490,HCPCS,637,RC,,inpatient,3,UN,25.7,23.13,,0.95,,24.42,Percent of total billed charges,,,0.98,,25.19,Percent of total billed charges,,,0.95,,24.42,Percent of total billed charges,,,0.97,,24.93,Percent of total billed charges,,,0.97,,24.93,Percent of total billed charges,,,0.96,,24.67,Percent of total billed charges,,,0.95,,24.42,Percent of total billed charges,,,,,,,,,0.95,,24.42,Percent of total billed charges,,24.42,25.19,
KETOROLAC 10 MG (ED HOMEPACK) PO TABS,RX-74703241,CDM,J3490,HCPCS,637,RC,,outpatient,3,UN,25.7,23.13,,0.95,,24.42,Percent of total billed charges,,,0.98,,25.19,Percent of total billed charges,,,0.95,,24.42,Percent of total billed charges,,,0.95,,24.42,Percent of total billed charges,,,0.97,,24.93,Percent of total billed charges,,,0.96,,24.67,Percent of total billed charges,,,0.95,,24.42,Percent of total billed charges,,,,,,,,,0.95,,24.42,Percent of total billed charges,,24.42,25.19,
ONDANSETRON 8 MG (ED PREPACK) PO TBDP,RX-74703244,CDM,J3490,HCPCS,637,RC,,inpatient,2,UN,119.76,107.78,,0.95,,113.77,Percent of total billed charges,,,0.98,,117.36,Percent of total billed charges,,,0.95,,113.77,Percent of total billed charges,,,0.97,,116.17,Percent of total billed charges,,,0.97,,116.17,Percent of total billed charges,,,0.96,,114.97,Percent of total billed charges,,,0.95,,113.77,Percent of total billed charges,,,,,,,,,0.95,,113.77,Percent of total billed charges,,113.77,117.36,
ONDANSETRON 8 MG (ED PREPACK) PO TBDP,RX-74703244,CDM,J3490,HCPCS,637,RC,,outpatient,2,UN,119.76,107.78,,0.95,,113.77,Percent of total billed charges,,,0.98,,117.36,Percent of total billed charges,,,0.95,,113.77,Percent of total billed charges,,,0.95,,113.77,Percent of total billed charges,,,0.97,,116.17,Percent of total billed charges,,,0.96,,114.97,Percent of total billed charges,,,0.95,,113.77,Percent of total billed charges,,,,,,,,,0.95,,113.77,Percent of total billed charges,,113.77,117.36,
LIDOCAINE-EPINEPHRINE-TETRACAINE GEL (WRAPPER),RX-74703669,CDM,J3490,HCPCS,250,RC,,inpatient,3,ML,51.31,46.18,,0.95,,48.74,Percent of total billed charges,,,0.98,,50.28,Percent of total billed charges,,,0.95,,48.74,Percent of total billed charges,,,0.97,,49.77,Percent of total billed charges,,,0.97,,49.77,Percent of total billed charges,,,0.96,,49.26,Percent of total billed charges,,,0.95,,48.74,Percent of total billed charges,,,,,,,,,0.95,,48.74,Percent of total billed charges,,48.74,50.28,
LIDOCAINE-EPINEPHRINE-TETRACAINE GEL (WRAPPER),RX-74703669,CDM,J3490,HCPCS,250,RC,,outpatient,3,ML,51.31,46.18,,0.95,,48.74,Percent of total billed charges,,,0.98,,50.28,Percent of total billed charges,,,0.95,,48.74,Percent of total billed charges,,,0.95,,48.74,Percent of total billed charges,,,0.97,,49.77,Percent of total billed charges,,,0.96,,49.26,Percent of total billed charges,,,0.95,,48.74,Percent of total billed charges,,,,,,,,,0.95,,48.74,Percent of total billed charges,,48.74,50.28,
AMOXICILLIN 250 MG (ED HOMEPACK) CHEW TAB,RX-74703945,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,28.8,25.92,,0.95,,27.36,Percent of total billed charges,,,0.98,,28.22,Percent of total billed charges,,,0.95,,27.36,Percent of total billed charges,,,0.97,,27.94,Percent of total billed charges,,,0.97,,27.94,Percent of total billed charges,,,0.96,,27.65,Percent of total billed charges,,,0.95,,27.36,Percent of total billed charges,,,,,,,,,0.95,,27.36,Percent of total billed charges,,27.36,28.22,
AMOXICILLIN 250 MG (ED HOMEPACK) CHEW TAB,RX-74703945,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,28.8,25.92,,0.95,,27.36,Percent of total billed charges,,,0.98,,28.22,Percent of total billed charges,,,0.95,,27.36,Percent of total billed charges,,,0.95,,27.36,Percent of total billed charges,,,0.97,,27.94,Percent of total billed charges,,,0.96,,27.65,Percent of total billed charges,,,0.95,,27.36,Percent of total billed charges,,,,,,,,,0.95,,27.36,Percent of total billed charges,,27.36,28.22,
AMOXICILLIN-POT CLAVULANATE 500-125 MG (ED HOMEPACK) TAB,RX-74703946,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,75.84,68.26,,0.95,,72.05,Percent of total billed charges,,,0.98,,74.32,Percent of total billed charges,,,0.95,,72.05,Percent of total billed charges,,,0.97,,73.56,Percent of total billed charges,,,0.97,,73.56,Percent of total billed charges,,,0.96,,72.81,Percent of total billed charges,,,0.95,,72.05,Percent of total billed charges,,,,,,,,,0.95,,72.05,Percent of total billed charges,,72.05,74.32,
AMOXICILLIN-POT CLAVULANATE 500-125 MG (ED HOMEPACK) TAB,RX-74703946,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,75.84,68.26,,0.95,,72.05,Percent of total billed charges,,,0.98,,74.32,Percent of total billed charges,,,0.95,,72.05,Percent of total billed charges,,,0.95,,72.05,Percent of total billed charges,,,0.97,,73.56,Percent of total billed charges,,,0.96,,72.81,Percent of total billed charges,,,0.95,,72.05,Percent of total billed charges,,,,,,,,,0.95,,72.05,Percent of total billed charges,,72.05,74.32,
CLONIDINE HCL 0.1 MG (ED HOMEPACK) TAB,RX-74703947,CDM,J3490,HCPCS,637,RC,,inpatient,4,UN,24.72,22.25,,0.95,,23.48,Percent of total billed charges,,,0.98,,24.23,Percent of total billed charges,,,0.95,,23.48,Percent of total billed charges,,,0.97,,23.98,Percent of total billed charges,,,0.97,,23.98,Percent of total billed charges,,,0.96,,23.73,Percent of total billed charges,,,0.95,,23.48,Percent of total billed charges,,,,,,,,,0.95,,23.48,Percent of total billed charges,,23.48,24.23,
CLONIDINE HCL 0.1 MG (ED HOMEPACK) TAB,RX-74703947,CDM,J3490,HCPCS,637,RC,,outpatient,4,UN,24.72,22.25,,0.95,,23.48,Percent of total billed charges,,,0.98,,24.23,Percent of total billed charges,,,0.95,,23.48,Percent of total billed charges,,,0.95,,23.48,Percent of total billed charges,,,0.97,,23.98,Percent of total billed charges,,,0.96,,23.73,Percent of total billed charges,,,0.95,,23.48,Percent of total billed charges,,,,,,,,,0.95,,23.48,Percent of total billed charges,,23.48,24.23,
DEXAMETHASONE 0.5 MG (ED HOMEPACK) PO TABS,RX-74704056,CDM,J8540,HCPCS,636,RC,,inpatient,4,UN,23.8,21.42,,0.95,,22.61,Percent of total billed charges,,,0.98,,23.32,Percent of total billed charges,,,0.95,,22.61,Percent of total billed charges,,,0.97,,23.09,Percent of total billed charges,,,0.97,,23.09,Percent of total billed charges,,,0.96,,22.85,Percent of total billed charges,,,0.95,,22.61,Percent of total billed charges,,,,,,,,,0.95,,22.61,Percent of total billed charges,,22.61,23.32,
DEXAMETHASONE 0.5 MG (ED HOMEPACK) PO TABS,RX-74704056,CDM,J8540,HCPCS,636,RC,,outpatient,4,UN,23.8,21.42,,0.95,,22.61,Percent of total billed charges,,,0.98,,23.32,Percent of total billed charges,,,0.95,,22.61,Percent of total billed charges,,,0.95,,22.61,Percent of total billed charges,,,0.97,,23.09,Percent of total billed charges,,,0.96,,22.85,Percent of total billed charges,,,0.95,,22.61,Percent of total billed charges,,,,,,,,,0.95,,22.61,Percent of total billed charges,,22.61,23.32,
PANTOPRAZOLE 4 MG/ML IV SYRINGE (PEDIATRIC) (SIMPLE),RX-74704091,CDM,J2470,HCPCS,636,RC,,inpatient,10,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
PANTOPRAZOLE 4 MG/ML IV SYRINGE (PEDIATRIC) (SIMPLE),RX-74704091,CDM,J2470,HCPCS,636,RC,,outpatient,10,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
HYDROMORPHONE HCL (CADD PUMP ENTRY) 2 MG/ML SUBQ SOLN-CC WWM,RX-74704100,CDM,J1171,HCPCS,636,RC,,inpatient,20,ML,70.01,63.01,,0.95,,66.51,Percent of total billed charges,,,0.98,,68.61,Percent of total billed charges,,,0.95,,66.51,Percent of total billed charges,,,0.97,,67.91,Percent of total billed charges,,,0.97,,67.91,Percent of total billed charges,,,0.96,,67.21,Percent of total billed charges,,,0.95,,66.51,Percent of total billed charges,,,,,,,,,0.95,,66.51,Percent of total billed charges,,66.51,68.61,
HYDROMORPHONE HCL (CADD PUMP ENTRY) 2 MG/ML SUBQ SOLN-CC WWM,RX-74704100,CDM,J1171,HCPCS,636,RC,,outpatient,20,ML,70.01,63.01,,0.95,,66.51,Percent of total billed charges,,,0.98,,68.61,Percent of total billed charges,,,0.95,,66.51,Percent of total billed charges,,,0.95,,66.51,Percent of total billed charges,,,0.97,,67.91,Percent of total billed charges,,,0.96,,67.21,Percent of total billed charges,,,0.95,,66.51,Percent of total billed charges,,,,,,,,,0.95,,66.51,Percent of total billed charges,,66.51,68.61,
BALANCED ELECTROLYTES IN WATER IV SOLN WRAPPER,RX-74704105,CDM,J3490,HCPCS,250,RC,,inpatient,1000,ML,24.47,22.02,,0.95,,23.25,Percent of total billed charges,,,0.98,,23.98,Percent of total billed charges,,,0.95,,23.25,Percent of total billed charges,,,0.97,,23.74,Percent of total billed charges,,,0.97,,23.74,Percent of total billed charges,,,0.96,,23.49,Percent of total billed charges,,,0.95,,23.25,Percent of total billed charges,,,,,,,,,0.95,,23.25,Percent of total billed charges,,23.25,23.98,
BALANCED ELECTROLYTES IN WATER IV SOLN WRAPPER,RX-74704105,CDM,J3490,HCPCS,250,RC,,outpatient,1000,ML,24.47,22.02,,0.95,,23.25,Percent of total billed charges,,,0.98,,23.98,Percent of total billed charges,,,0.95,,23.25,Percent of total billed charges,,,0.95,,23.25,Percent of total billed charges,,,0.97,,23.74,Percent of total billed charges,,,0.96,,23.49,Percent of total billed charges,,,0.95,,23.25,Percent of total billed charges,,,,,,,,,0.95,,23.25,Percent of total billed charges,,23.25,23.98,
KCL IN DEXTROSE-NACL 20-5-0.2 MEQ/L-%-% IV SOLN WRAPPER,RX-74704109,CDM,J3490,HCPCS,250,RC,,inpatient,1000,ML,101.72,91.55,,0.95,,96.63,Percent of total billed charges,,,0.98,,99.69,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,0.97,,98.67,Percent of total billed charges,,,0.97,,98.67,Percent of total billed charges,,,0.96,,97.65,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,,,,,,,0.95,,96.63,Percent of total billed charges,,96.63,99.69,
KCL IN DEXTROSE-NACL 20-5-0.2 MEQ/L-%-% IV SOLN WRAPPER,RX-74704109,CDM,J3490,HCPCS,250,RC,,outpatient,1000,ML,101.72,91.55,,0.95,,96.63,Percent of total billed charges,,,0.98,,99.69,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,0.97,,98.67,Percent of total billed charges,,,0.96,,97.65,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,,,,,,,0.95,,96.63,Percent of total billed charges,,96.63,99.69,
DEXTROSE-SODIUM CHLORIDE 5-0.2 % IV SOLN WRAPPER,RX-74704110,CDM,J3490,HCPCS,250,RC,,inpatient,1000,ML,93.99,84.59,,0.95,,89.29,Percent of total billed charges,,,0.98,,92.11,Percent of total billed charges,,,0.95,,89.29,Percent of total billed charges,,,0.97,,91.17,Percent of total billed charges,,,0.97,,91.17,Percent of total billed charges,,,0.96,,90.23,Percent of total billed charges,,,0.95,,89.29,Percent of total billed charges,,,,,,,,,0.95,,89.29,Percent of total billed charges,,89.29,92.11,
DEXTROSE-SODIUM CHLORIDE 5-0.2 % IV SOLN WRAPPER,RX-74704110,CDM,J3490,HCPCS,250,RC,,outpatient,1000,ML,93.99,84.59,,0.95,,89.29,Percent of total billed charges,,,0.98,,92.11,Percent of total billed charges,,,0.95,,89.29,Percent of total billed charges,,,0.95,,89.29,Percent of total billed charges,,,0.97,,91.17,Percent of total billed charges,,,0.96,,90.23,Percent of total billed charges,,,0.95,,89.29,Percent of total billed charges,,,,,,,,,0.95,,89.29,Percent of total billed charges,,89.29,92.11,
LORAZEPAM 2 MG/ML PO CONC (ED HOMEPACK),RX-74704161,CDM,J3490,HCPCS,637,RC,,inpatient,30,ML,36.71,33.04,,0.95,,34.87,Percent of total billed charges,,,0.98,,35.98,Percent of total billed charges,,,0.95,,34.87,Percent of total billed charges,,,0.97,,35.61,Percent of total billed charges,,,0.97,,35.61,Percent of total billed charges,,,0.96,,35.24,Percent of total billed charges,,,0.95,,34.87,Percent of total billed charges,,,,,,,,,0.95,,34.87,Percent of total billed charges,,34.87,35.98,
LORAZEPAM 2 MG/ML PO CONC (ED HOMEPACK),RX-74704161,CDM,J3490,HCPCS,637,RC,,outpatient,30,ML,36.71,33.04,,0.95,,34.87,Percent of total billed charges,,,0.98,,35.98,Percent of total billed charges,,,0.95,,34.87,Percent of total billed charges,,,0.95,,34.87,Percent of total billed charges,,,0.97,,35.61,Percent of total billed charges,,,0.96,,35.24,Percent of total billed charges,,,0.95,,34.87,Percent of total billed charges,,,,,,,,,0.95,,34.87,Percent of total billed charges,,34.87,35.98,
OXYCODONE HCL 100 MG/5ML PO CONC (ED HOMEPACK),RX-74704162,CDM,J3490,HCPCS,637,RC,,inpatient,30,ML,547.92,493.13,,0.95,,520.52,Percent of total billed charges,,,0.98,,536.96,Percent of total billed charges,,,0.95,,520.52,Percent of total billed charges,,,0.97,,531.48,Percent of total billed charges,,,0.97,,531.48,Percent of total billed charges,,,0.96,,526,Percent of total billed charges,,,0.95,,520.52,Percent of total billed charges,,,,,,,,,0.95,,520.52,Percent of total billed charges,,520.52,536.96,
OXYCODONE HCL 100 MG/5ML PO CONC (ED HOMEPACK),RX-74704162,CDM,J3490,HCPCS,637,RC,,outpatient,30,ML,547.92,493.13,,0.95,,520.52,Percent of total billed charges,,,0.98,,536.96,Percent of total billed charges,,,0.95,,520.52,Percent of total billed charges,,,0.95,,520.52,Percent of total billed charges,,,0.97,,531.48,Percent of total billed charges,,,0.96,,526,Percent of total billed charges,,,0.95,,520.52,Percent of total billed charges,,,,,,,,,0.95,,520.52,Percent of total billed charges,,520.52,536.96,
MORPHINE SULFATE (CONCENTRATE) 100 MG/5ML PO SOLN (ED HOMEPACK),RX-74704163,CDM,J3490,HCPCS,637,RC,,inpatient,30,ML,46.17,41.55,,0.95,,43.86,Percent of total billed charges,,,0.98,,45.25,Percent of total billed charges,,,0.95,,43.86,Percent of total billed charges,,,0.97,,44.78,Percent of total billed charges,,,0.97,,44.78,Percent of total billed charges,,,0.96,,44.32,Percent of total billed charges,,,0.95,,43.86,Percent of total billed charges,,,,,,,,,0.95,,43.86,Percent of total billed charges,,43.86,45.25,
MORPHINE SULFATE (CONCENTRATE) 100 MG/5ML PO SOLN (ED HOMEPACK),RX-74704163,CDM,J3490,HCPCS,637,RC,,outpatient,30,ML,46.17,41.55,,0.95,,43.86,Percent of total billed charges,,,0.98,,45.25,Percent of total billed charges,,,0.95,,43.86,Percent of total billed charges,,,0.95,,43.86,Percent of total billed charges,,,0.97,,44.78,Percent of total billed charges,,,0.96,,44.32,Percent of total billed charges,,,0.95,,43.86,Percent of total billed charges,,,,,,,,,0.95,,43.86,Percent of total billed charges,,43.86,45.25,
GLUCOSE 40 % PO GEL (NICU),RX-74704308,CDM,J3490,HCPCS,637,RC,,inpatient,30,ML,6.55,5.9,,0.95,,6.22,Percent of total billed charges,,,0.98,,6.42,Percent of total billed charges,,,0.95,,6.22,Percent of total billed charges,,,0.97,,6.35,Percent of total billed charges,,,0.97,,6.35,Percent of total billed charges,,,0.96,,6.29,Percent of total billed charges,,,0.95,,6.22,Percent of total billed charges,,,,,,,,,0.95,,6.22,Percent of total billed charges,,6.22,6.42,
GLUCOSE 40 % PO GEL (NICU),RX-74704308,CDM,J3490,HCPCS,637,RC,,outpatient,30,ML,6.55,5.9,,0.95,,6.22,Percent of total billed charges,,,0.98,,6.42,Percent of total billed charges,,,0.95,,6.22,Percent of total billed charges,,,0.95,,6.22,Percent of total billed charges,,,0.97,,6.35,Percent of total billed charges,,,0.96,,6.29,Percent of total billed charges,,,0.95,,6.22,Percent of total billed charges,,,,,,,,,0.95,,6.22,Percent of total billed charges,,6.22,6.42,
ATROPINE SULFATE 0.1 MG/ML INJECTION SOLN (WRAPPER),RX-74704356,CDM,J0461,HCPCS,636,RC,,inpatient,4,ML,18.66,16.79,,0.95,,17.73,Percent of total billed charges,,,0.98,,18.29,Percent of total billed charges,,,0.95,,17.73,Percent of total billed charges,,,0.97,,18.1,Percent of total billed charges,,,0.97,,18.1,Percent of total billed charges,,,0.96,,17.91,Percent of total billed charges,,,0.95,,17.73,Percent of total billed charges,,,,,,,,,0.95,,17.73,Percent of total billed charges,,17.73,18.29,
ATROPINE SULFATE 0.1 MG/ML INJECTION SOLN (WRAPPER),RX-74704356,CDM,J0461,HCPCS,636,RC,,outpatient,4,ML,18.66,16.79,,0.95,,17.73,Percent of total billed charges,,,0.98,,18.29,Percent of total billed charges,,,0.95,,17.73,Percent of total billed charges,,,0.95,,17.73,Percent of total billed charges,,,0.97,,18.1,Percent of total billed charges,,,0.96,,17.91,Percent of total billed charges,,,0.95,,17.73,Percent of total billed charges,,,,,,,,,0.95,,17.73,Percent of total billed charges,,17.73,18.29,
METOPROLOL TARTRATE 1 MG/ML IV SOLN (WRAPPER),RX-74704372,CDM,J3490,HCPCS,250,RC,,inpatient,2.5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
METOPROLOL TARTRATE 1 MG/ML IV SOLN (WRAPPER),RX-74704372,CDM,J3490,HCPCS,250,RC,,outpatient,2.5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
SODIUM PHOSPHATE 3 MMOLE/ML IV SOLN (WRAPPER),RX-74704373,CDM,J3490,HCPCS,250,RC,,inpatient,5,ML,69.11,62.2,,0.95,,65.65,Percent of total billed charges,,,0.98,,67.73,Percent of total billed charges,,,0.95,,65.65,Percent of total billed charges,,,0.97,,67.04,Percent of total billed charges,,,0.97,,67.04,Percent of total billed charges,,,0.96,,66.35,Percent of total billed charges,,,0.95,,65.65,Percent of total billed charges,,,,,,,,,0.95,,65.65,Percent of total billed charges,,65.65,67.73,
SODIUM PHOSPHATE 3 MMOLE/ML IV SOLN (WRAPPER),RX-74704373,CDM,J3490,HCPCS,250,RC,,outpatient,5,ML,69.11,62.2,,0.95,,65.65,Percent of total billed charges,,,0.98,,67.73,Percent of total billed charges,,,0.95,,65.65,Percent of total billed charges,,,0.95,,65.65,Percent of total billed charges,,,0.97,,67.04,Percent of total billed charges,,,0.96,,66.35,Percent of total billed charges,,,0.95,,65.65,Percent of total billed charges,,,,,,,,,0.95,,65.65,Percent of total billed charges,,65.65,67.73,
TRASTUZUMAB 150 MG IV SOLR,RX-74704415,CDM,J9355,HCPCS,636,RC,,inpatient,150,ME,3297.3,2967.57,,0.95,,3132.44,Percent of total billed charges,,,0.98,,3231.35,Percent of total billed charges,,,0.95,,3132.44,Percent of total billed charges,,,0.97,,3198.38,Percent of total billed charges,,,0.97,,3198.38,Percent of total billed charges,,,0.96,,3165.41,Percent of total billed charges,,,0.95,,3132.44,Percent of total billed charges,,,,,,,,,0.95,,3132.44,Percent of total billed charges,,3132.44,3231.35,
TRASTUZUMAB 150 MG IV SOLR,RX-74704415,CDM,J9355,HCPCS,636,RC,,outpatient,150,ME,3297.3,2967.57,,0.95,,3132.44,Percent of total billed charges,,,0.98,,3231.35,Percent of total billed charges,,,0.95,,3132.44,Percent of total billed charges,,,0.95,,3132.44,Percent of total billed charges,,,0.97,,3198.38,Percent of total billed charges,,,0.96,,3165.41,Percent of total billed charges,,,0.95,,3132.44,Percent of total billed charges,,,,,,,,,0.95,,3132.44,Percent of total billed charges,,3132.44,3231.35,
EPINEPHRINE 1 MG/ML INJECTION SOLN (WRAPPER),RX-74704545,CDM,J0173,HCPCS,250,RC,,inpatient,0.2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
EPINEPHRINE 1 MG/ML INJECTION SOLN (WRAPPER),RX-74704545,CDM,J0173,HCPCS,250,RC,,outpatient,0.2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
TIZANIDINE HCL 4 MG (ED HOMEPACK) PO TABS,RX-74704564,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.16,7.34,,0.95,,7.75,Percent of total billed charges,,,0.98,,8,Percent of total billed charges,,,0.95,,7.75,Percent of total billed charges,,,0.97,,7.92,Percent of total billed charges,,,0.97,,7.92,Percent of total billed charges,,,0.96,,7.83,Percent of total billed charges,,,0.95,,7.75,Percent of total billed charges,,,,,,,,,0.95,,7.75,Percent of total billed charges,,7.75,8,
TIZANIDINE HCL 4 MG (ED HOMEPACK) PO TABS,RX-74704564,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.16,7.34,,0.95,,7.75,Percent of total billed charges,,,0.98,,8,Percent of total billed charges,,,0.95,,7.75,Percent of total billed charges,,,0.95,,7.75,Percent of total billed charges,,,0.97,,7.92,Percent of total billed charges,,,0.96,,7.83,Percent of total billed charges,,,0.95,,7.75,Percent of total billed charges,,,,,,,,,0.95,,7.75,Percent of total billed charges,,7.75,8,
LABETALOL HCL 5 MG/ML IV SOLN (WRAPPER),RX-74704826,CDM,J1921,HCPCS,636,RC,,inpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
LABETALOL HCL 5 MG/ML IV SOLN (WRAPPER),RX-74704826,CDM,J1921,HCPCS,636,RC,,outpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLN (NARRATOR WRAPPER),RX-74704937,CDM,J0330,HCPCS,636,RC,,inpatient,3,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLN (NARRATOR WRAPPER),RX-74704937,CDM,J0330,HCPCS,636,RC,,outpatient,3,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
ROCURONIUM BROMIDE 10 MG/ML IV SOLN (NARRATOR WRAPPER),RX-74704939,CDM,J3490,HCPCS,250,RC,,inpatient,2,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
ROCURONIUM BROMIDE 10 MG/ML IV SOLN (NARRATOR WRAPPER),RX-74704939,CDM,J3490,HCPCS,250,RC,,outpatient,2,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
AZITHROMYCIN 200 MG/5ML (ED HOMEPACK - 22.5 ML) PO SUSR,RX-74704959,CDM,J3490,HCPCS,637,RC,,inpatient,22.5,ML,343.53,309.18,,0.95,,326.35,Percent of total billed charges,,,0.98,,336.66,Percent of total billed charges,,,0.95,,326.35,Percent of total billed charges,,,0.97,,333.22,Percent of total billed charges,,,0.97,,333.22,Percent of total billed charges,,,0.96,,329.79,Percent of total billed charges,,,0.95,,326.35,Percent of total billed charges,,,,,,,,,0.95,,326.35,Percent of total billed charges,,326.35,336.66,
AZITHROMYCIN 200 MG/5ML (ED HOMEPACK - 22.5 ML) PO SUSR,RX-74704959,CDM,J3490,HCPCS,637,RC,,outpatient,22.5,ML,343.53,309.18,,0.95,,326.35,Percent of total billed charges,,,0.98,,336.66,Percent of total billed charges,,,0.95,,326.35,Percent of total billed charges,,,0.95,,326.35,Percent of total billed charges,,,0.97,,333.22,Percent of total billed charges,,,0.96,,329.79,Percent of total billed charges,,,0.95,,326.35,Percent of total billed charges,,,,,,,,,0.95,,326.35,Percent of total billed charges,,326.35,336.66,
NALOXONE 0.4 MG/ML INJECTION SOLN (NARRATOR WRAPPER),RX-74705040,CDM,J2310,HCPCS,636,RC,,inpatient,1,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
NALOXONE 0.4 MG/ML INJECTION SOLN (NARRATOR WRAPPER),RX-74705040,CDM,J2310,HCPCS,636,RC,,outpatient,1,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
PROPOFOL BOLUS 10 MG/ML IV EMUL (NARRATOR WRAPPER),RX-74705042,CDM,J2704,HCPCS,636,RC,,inpatient,2,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
PROPOFOL BOLUS 10 MG/ML IV EMUL (NARRATOR WRAPPER),RX-74705042,CDM,J2704,HCPCS,636,RC,,outpatient,2,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
MIDAZOLAM 1 MG/ML INJECTION SOLN (WRAPPER),RX-74705043,CDM,J2250,HCPCS,636,RC,,inpatient,0.5,ML,46.35,41.72,,0.95,,44.03,Percent of total billed charges,,,0.98,,45.42,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,0.97,,44.96,Percent of total billed charges,,,0.97,,44.96,Percent of total billed charges,,,0.96,,44.5,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,,,,,,,0.95,,44.03,Percent of total billed charges,,44.03,45.42,
MIDAZOLAM 1 MG/ML INJECTION SOLN (WRAPPER),RX-74705043,CDM,J2250,HCPCS,636,RC,,outpatient,0.5,ML,46.35,41.72,,0.95,,44.03,Percent of total billed charges,,,0.98,,45.42,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,0.97,,44.96,Percent of total billed charges,,,0.96,,44.5,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,,,,,,,0.95,,44.03,Percent of total billed charges,,44.03,45.42,
HYDROMORPHONE HCL 1 MG/ML INJECTION SOLN (NARRATOR WRAPPER),RX-74705053,CDM,J1171,HCPCS,636,RC,,inpatient,0.2,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
HYDROMORPHONE HCL 1 MG/ML INJECTION SOLN (NARRATOR WRAPPER),RX-74705053,CDM,J1171,HCPCS,636,RC,,outpatient,0.2,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
MORPHINE SULFATE 2 MG/ML INJECTION SOLN (NARRATOR WRAPPER),RX-74705056,CDM,J2270,HCPCS,636,RC,,inpatient,1,ML,46.35,41.72,,0.95,,44.03,Percent of total billed charges,,,0.98,,45.42,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,0.97,,44.96,Percent of total billed charges,,,0.97,,44.96,Percent of total billed charges,,,0.96,,44.5,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,,,,,,,0.95,,44.03,Percent of total billed charges,,44.03,45.42,
MORPHINE SULFATE 2 MG/ML INJECTION SOLN (NARRATOR WRAPPER),RX-74705056,CDM,J2270,HCPCS,636,RC,,outpatient,1,ML,46.35,41.72,,0.95,,44.03,Percent of total billed charges,,,0.98,,45.42,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,0.97,,44.96,Percent of total billed charges,,,0.96,,44.5,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,,,,,,,0.95,,44.03,Percent of total billed charges,,44.03,45.42,
MORPHINE SULFATE 4 MG/ML INJECTION SOLN (NARRATOR WRAPPER),RX-74705057,CDM,J2270,HCPCS,636,RC,,inpatient,1,ML,46.35,41.72,,0.95,,44.03,Percent of total billed charges,,,0.98,,45.42,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,0.97,,44.96,Percent of total billed charges,,,0.97,,44.96,Percent of total billed charges,,,0.96,,44.5,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,,,,,,,0.95,,44.03,Percent of total billed charges,,44.03,45.42,
MORPHINE SULFATE 4 MG/ML INJECTION SOLN (NARRATOR WRAPPER),RX-74705057,CDM,J2270,HCPCS,636,RC,,outpatient,1,ML,46.35,41.72,,0.95,,44.03,Percent of total billed charges,,,0.98,,45.42,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,0.97,,44.96,Percent of total billed charges,,,0.96,,44.5,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,,,,,,,0.95,,44.03,Percent of total billed charges,,44.03,45.42,
MIDAZOLAM 5 MG/ML INJECTION SOLN (WRAPPER),RX-74705131,CDM,J2250,HCPCS,636,RC,,inpatient,0.1,ML,46.35,41.72,,0.95,,44.03,Percent of total billed charges,,,0.98,,45.42,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,0.97,,44.96,Percent of total billed charges,,,0.97,,44.96,Percent of total billed charges,,,0.96,,44.5,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,,,,,,,0.95,,44.03,Percent of total billed charges,,44.03,45.42,
MIDAZOLAM 5 MG/ML INJECTION SOLN (WRAPPER),RX-74705131,CDM,J2250,HCPCS,636,RC,,outpatient,0.1,ML,46.35,41.72,,0.95,,44.03,Percent of total billed charges,,,0.98,,45.42,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,0.97,,44.96,Percent of total billed charges,,,0.96,,44.5,Percent of total billed charges,,,0.95,,44.03,Percent of total billed charges,,,,,,,,,0.95,,44.03,Percent of total billed charges,,44.03,45.42,
FENTANYL CITRATE (PF) 50 MCG/ML INJECTION SOLN (NARRATOR WRAPPER),RX-74705132,CDM,J3010,HCPCS,636,RC,,inpatient,2,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
FENTANYL CITRATE (PF) 50 MCG/ML INJECTION SOLN (NARRATOR WRAPPER),RX-74705132,CDM,J3010,HCPCS,636,RC,,outpatient,2,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
LIDOCAINE HCL 4 % TOPICAL SOLN (NARRATOR WRAPPER),RX-74705135,CDM,J3490,HCPCS,637,RC,,inpatient,50,ML,156.56,140.9,,0.95,,148.73,Percent of total billed charges,,,0.98,,153.43,Percent of total billed charges,,,0.95,,148.73,Percent of total billed charges,,,0.97,,151.86,Percent of total billed charges,,,0.97,,151.86,Percent of total billed charges,,,0.96,,150.3,Percent of total billed charges,,,0.95,,148.73,Percent of total billed charges,,,,,,,,,0.95,,148.73,Percent of total billed charges,,148.73,153.43,
LIDOCAINE HCL 4 % TOPICAL SOLN (NARRATOR WRAPPER),RX-74705135,CDM,J3490,HCPCS,637,RC,,outpatient,50,ML,156.56,140.9,,0.95,,148.73,Percent of total billed charges,,,0.98,,153.43,Percent of total billed charges,,,0.95,,148.73,Percent of total billed charges,,,0.95,,148.73,Percent of total billed charges,,,0.97,,151.86,Percent of total billed charges,,,0.96,,150.3,Percent of total billed charges,,,0.95,,148.73,Percent of total billed charges,,,,,,,,,0.95,,148.73,Percent of total billed charges,,148.73,153.43,
LIDOCAINE HCL (CARDIAC) 20 MG/ML IV SOLN (WRAPPER),RX-74705627,CDM,J2003,HCPCS,636,RC,,inpatient,5,ML,28.05,25.25,,0.95,,26.65,Percent of total billed charges,,,0.98,,27.49,Percent of total billed charges,,,0.95,,26.65,Percent of total billed charges,,,0.97,,27.21,Percent of total billed charges,,,0.97,,27.21,Percent of total billed charges,,,0.96,,26.93,Percent of total billed charges,,,0.95,,26.65,Percent of total billed charges,,,,,,,,,0.95,,26.65,Percent of total billed charges,,26.65,27.49,
LIDOCAINE HCL (CARDIAC) 20 MG/ML IV SOLN (WRAPPER),RX-74705627,CDM,J2003,HCPCS,636,RC,,outpatient,5,ML,28.05,25.25,,0.95,,26.65,Percent of total billed charges,,,0.98,,27.49,Percent of total billed charges,,,0.95,,26.65,Percent of total billed charges,,,0.95,,26.65,Percent of total billed charges,,,0.97,,27.21,Percent of total billed charges,,,0.96,,26.93,Percent of total billed charges,,,0.95,,26.65,Percent of total billed charges,,,,,,,,,0.95,,26.65,Percent of total billed charges,,26.65,27.49,
LIDOCAINE HCL URETHRAL/MUCOSAL 2 % EX GEL (WRAPPER),RX-74706101,CDM,J3490,HCPCS,637,RC,,inpatient,11,ML,20.89,18.8,,0.95,,19.85,Percent of total billed charges,,,0.98,,20.47,Percent of total billed charges,,,0.95,,19.85,Percent of total billed charges,,,0.97,,20.26,Percent of total billed charges,,,0.97,,20.26,Percent of total billed charges,,,0.96,,20.05,Percent of total billed charges,,,0.95,,19.85,Percent of total billed charges,,,,,,,,,0.95,,19.85,Percent of total billed charges,,19.85,20.47,
LIDOCAINE HCL URETHRAL/MUCOSAL 2 % EX GEL (WRAPPER),RX-74706101,CDM,J3490,HCPCS,637,RC,,outpatient,11,ML,20.89,18.8,,0.95,,19.85,Percent of total billed charges,,,0.98,,20.47,Percent of total billed charges,,,0.95,,19.85,Percent of total billed charges,,,0.95,,19.85,Percent of total billed charges,,,0.97,,20.26,Percent of total billed charges,,,0.96,,20.05,Percent of total billed charges,,,0.95,,19.85,Percent of total billed charges,,,,,,,,,0.95,,19.85,Percent of total billed charges,,19.85,20.47,
METRONIDAZOLE 500 MG/100ML IV SOLN,RX-74706324,CDM,J1836,HCPCS,636,RC,,inpatient,100,ML,39.14,35.23,,0.95,,37.18,Percent of total billed charges,,,0.98,,38.36,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,0.97,,37.97,Percent of total billed charges,,,0.97,,37.97,Percent of total billed charges,,,0.96,,37.57,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,,,,,,,0.95,,37.18,Percent of total billed charges,,37.18,38.36,
METRONIDAZOLE 500 MG/100ML IV SOLN,RX-74706324,CDM,J1836,HCPCS,636,RC,,outpatient,100,ML,39.14,35.23,,0.95,,37.18,Percent of total billed charges,,,0.98,,38.36,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,0.97,,37.97,Percent of total billed charges,,,0.96,,37.57,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,,,,,,,0.95,,37.18,Percent of total billed charges,,37.18,38.36,
THIAMINE 100 MG PO TABS (WRAPPER),RX-74706877,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.61,5.95,,0.95,,6.28,Percent of total billed charges,,,0.98,,6.48,Percent of total billed charges,,,0.95,,6.28,Percent of total billed charges,,,0.97,,6.41,Percent of total billed charges,,,0.97,,6.41,Percent of total billed charges,,,0.96,,6.35,Percent of total billed charges,,,0.95,,6.28,Percent of total billed charges,,,,,,,,,0.95,,6.28,Percent of total billed charges,,6.28,6.48,
THIAMINE 100 MG PO TABS (WRAPPER),RX-74706877,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.61,5.95,,0.95,,6.28,Percent of total billed charges,,,0.98,,6.48,Percent of total billed charges,,,0.95,,6.28,Percent of total billed charges,,,0.95,,6.28,Percent of total billed charges,,,0.97,,6.41,Percent of total billed charges,,,0.96,,6.35,Percent of total billed charges,,,0.95,,6.28,Percent of total billed charges,,,,,,,,,0.95,,6.28,Percent of total billed charges,,6.28,6.48,
DOCETAXEL 20 MG/ML IV CONC (WRAPPER),RX-74708211,CDM,J9171,HCPCS,636,RC,,inpatient,4,ML,721,648.9,,0.95,,684.95,Percent of total billed charges,,,0.98,,706.58,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,0.97,,699.37,Percent of total billed charges,,,0.97,,699.37,Percent of total billed charges,,,0.96,,692.16,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,,,,,,,0.95,,684.95,Percent of total billed charges,,684.95,706.58,
DOCETAXEL 20 MG/ML IV CONC (WRAPPER),RX-74708211,CDM,J9171,HCPCS,636,RC,,outpatient,4,ML,721,648.9,,0.95,,684.95,Percent of total billed charges,,,0.98,,706.58,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,0.97,,699.37,Percent of total billed charges,,,0.96,,692.16,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,,,,,,,0.95,,684.95,Percent of total billed charges,,684.95,706.58,
AMOXICILLIN 5 MG/ML PO SUSP COMPOUND (DESENSITIZATION),RX-74708283,CDM,J3490,HCPCS,637,RC,,inpatient,1.2,ML,6.96,6.26,,0.95,,6.61,Percent of total billed charges,,,0.98,,6.82,Percent of total billed charges,,,0.95,,6.61,Percent of total billed charges,,,0.97,,6.75,Percent of total billed charges,,,0.97,,6.75,Percent of total billed charges,,,0.96,,6.68,Percent of total billed charges,,,0.95,,6.61,Percent of total billed charges,,,,,,,,,0.95,,6.61,Percent of total billed charges,,6.61,6.82,
AMOXICILLIN 5 MG/ML PO SUSP COMPOUND (DESENSITIZATION),RX-74708283,CDM,J3490,HCPCS,637,RC,,outpatient,1.2,ML,6.96,6.26,,0.95,,6.61,Percent of total billed charges,,,0.98,,6.82,Percent of total billed charges,,,0.95,,6.61,Percent of total billed charges,,,0.95,,6.61,Percent of total billed charges,,,0.97,,6.75,Percent of total billed charges,,,0.96,,6.68,Percent of total billed charges,,,0.95,,6.61,Percent of total billed charges,,,,,,,,,0.95,,6.61,Percent of total billed charges,,6.61,6.82,
AMOXICILLIN 0.5 MG/ML PO SUSP COMPOUND (DESENSITIZATION),RX-74708284,CDM,J3490,HCPCS,637,RC,,inpatient,50,ML,289.74,260.77,,0.95,,275.25,Percent of total billed charges,,,0.98,,283.95,Percent of total billed charges,,,0.95,,275.25,Percent of total billed charges,,,0.97,,281.05,Percent of total billed charges,,,0.97,,281.05,Percent of total billed charges,,,0.96,,278.15,Percent of total billed charges,,,0.95,,275.25,Percent of total billed charges,,,,,,,,,0.95,,275.25,Percent of total billed charges,,275.25,283.95,
AMOXICILLIN 0.5 MG/ML PO SUSP COMPOUND (DESENSITIZATION),RX-74708284,CDM,J3490,HCPCS,637,RC,,outpatient,50,ML,289.74,260.77,,0.95,,275.25,Percent of total billed charges,,,0.98,,283.95,Percent of total billed charges,,,0.95,,275.25,Percent of total billed charges,,,0.95,,275.25,Percent of total billed charges,,,0.97,,281.05,Percent of total billed charges,,,0.96,,278.15,Percent of total billed charges,,,0.95,,275.25,Percent of total billed charges,,,,,,,,,0.95,,275.25,Percent of total billed charges,,275.25,283.95,
PENICILLIN V POTASSIUM 0.0625 MG/ML PO SUSP COMPOUND (DESENSITIZATION),RX-74708299,CDM,J3490,HCPCS,637,RC,,inpatient,64,ML,376.66,338.99,,0.95,,357.83,Percent of total billed charges,,,0.98,,369.13,Percent of total billed charges,,,0.95,,357.83,Percent of total billed charges,,,0.97,,365.36,Percent of total billed charges,,,0.97,,365.36,Percent of total billed charges,,,0.96,,361.59,Percent of total billed charges,,,0.95,,357.83,Percent of total billed charges,,,,,,,,,0.95,,357.83,Percent of total billed charges,,357.83,369.13,
PENICILLIN V POTASSIUM 0.0625 MG/ML PO SUSP COMPOUND (DESENSITIZATION),RX-74708299,CDM,J3490,HCPCS,637,RC,,outpatient,64,ML,376.66,338.99,,0.95,,357.83,Percent of total billed charges,,,0.98,,369.13,Percent of total billed charges,,,0.95,,357.83,Percent of total billed charges,,,0.95,,357.83,Percent of total billed charges,,,0.97,,365.36,Percent of total billed charges,,,0.96,,361.59,Percent of total billed charges,,,0.95,,357.83,Percent of total billed charges,,,,,,,,,0.95,,357.83,Percent of total billed charges,,357.83,369.13,
PENICILLIN V POTASSIUM 0.25 MG/ML PO SUSP COMPOUND (DESENSITIZATION),RX-74708300,CDM,J3490,HCPCS,637,RC,,inpatient,32,ML,188.33,169.5,,0.95,,178.91,Percent of total billed charges,,,0.98,,184.56,Percent of total billed charges,,,0.95,,178.91,Percent of total billed charges,,,0.97,,182.68,Percent of total billed charges,,,0.97,,182.68,Percent of total billed charges,,,0.96,,180.8,Percent of total billed charges,,,0.95,,178.91,Percent of total billed charges,,,,,,,,,0.95,,178.91,Percent of total billed charges,,178.91,184.56,
PENICILLIN V POTASSIUM 0.25 MG/ML PO SUSP COMPOUND (DESENSITIZATION),RX-74708300,CDM,J3490,HCPCS,637,RC,,outpatient,32,ML,188.33,169.5,,0.95,,178.91,Percent of total billed charges,,,0.98,,184.56,Percent of total billed charges,,,0.95,,178.91,Percent of total billed charges,,,0.95,,178.91,Percent of total billed charges,,,0.97,,182.68,Percent of total billed charges,,,0.96,,180.8,Percent of total billed charges,,,0.95,,178.91,Percent of total billed charges,,,,,,,,,0.95,,178.91,Percent of total billed charges,,178.91,184.56,
PENICILLIN V POTASSIUM 4 MG/ML PO SUSP COMPOUND (DESENSITIZATION),RX-74708301,CDM,J3490,HCPCS,637,RC,,inpatient,31.5,ML,367.83,331.05,,0.95,,349.44,Percent of total billed charges,,,0.98,,360.47,Percent of total billed charges,,,0.95,,349.44,Percent of total billed charges,,,0.97,,356.8,Percent of total billed charges,,,0.97,,356.8,Percent of total billed charges,,,0.96,,353.12,Percent of total billed charges,,,0.95,,349.44,Percent of total billed charges,,,,,,,,,0.95,,349.44,Percent of total billed charges,,349.44,360.47,
PENICILLIN V POTASSIUM 4 MG/ML PO SUSP COMPOUND (DESENSITIZATION),RX-74708301,CDM,J3490,HCPCS,637,RC,,outpatient,31.5,ML,367.83,331.05,,0.95,,349.44,Percent of total billed charges,,,0.98,,360.47,Percent of total billed charges,,,0.95,,349.44,Percent of total billed charges,,,0.95,,349.44,Percent of total billed charges,,,0.97,,356.8,Percent of total billed charges,,,0.96,,353.12,Percent of total billed charges,,,0.95,,349.44,Percent of total billed charges,,,,,,,,,0.95,,349.44,Percent of total billed charges,,349.44,360.47,
HEPATITIS B VAC RECOMBINANT 10 MCG/0.5ML INJECTION SUSP/SUSY (WRAPPER),RX-74708468,CDM,90744,HCPCS,636,RC,,inpatient,0.5,ML,96.95,87.26,,0.95,,92.1,Percent of total billed charges,,,0.98,,95.01,Percent of total billed charges,,,0.95,,92.1,Percent of total billed charges,,,0.97,,94.04,Percent of total billed charges,,,0.97,,94.04,Percent of total billed charges,,,0.96,,93.07,Percent of total billed charges,,,0.95,,92.1,Percent of total billed charges,,,,,,,,,0.95,,92.1,Percent of total billed charges,,92.1,95.01,
HEPATITIS B VAC RECOMBINANT 10 MCG/0.5ML INJECTION SUSP/SUSY (WRAPPER),RX-74708468,CDM,90744,HCPCS,636,RC,,outpatient,0.5,ML,96.95,87.26,,0.95,,92.1,Percent of total billed charges,,,0.98,,95.01,Percent of total billed charges,,,0.95,,92.1,Percent of total billed charges,,,0.95,,92.1,Percent of total billed charges,,,0.97,,94.04,Percent of total billed charges,,,0.96,,93.07,Percent of total billed charges,,,0.95,,92.1,Percent of total billed charges,,,,,,,,,0.95,,92.1,Percent of total billed charges,,92.1,95.01,
HEPATITIS B VAC RECOMBINANT 20 MCG/ML INJECTION SUSP/SUSY (WRAPPER),RX-74708469,CDM,90746,HCPCS,636,RC,,inpatient,1,ML,200.77,180.69,,0.95,,190.73,Percent of total billed charges,,,0.98,,196.75,Percent of total billed charges,,,0.95,,190.73,Percent of total billed charges,,,0.97,,194.75,Percent of total billed charges,,,0.97,,194.75,Percent of total billed charges,,,0.96,,192.74,Percent of total billed charges,,,0.95,,190.73,Percent of total billed charges,,,,,,,,,0.95,,190.73,Percent of total billed charges,,190.73,196.75,
HEPATITIS B VAC RECOMBINANT 20 MCG/ML INJECTION SUSP/SUSY (WRAPPER),RX-74708469,CDM,90746,HCPCS,636,RC,,outpatient,1,ML,200.77,180.69,,0.95,,190.73,Percent of total billed charges,,,0.98,,196.75,Percent of total billed charges,,,0.95,,190.73,Percent of total billed charges,,,0.95,,190.73,Percent of total billed charges,,,0.97,,194.75,Percent of total billed charges,,,0.96,,192.74,Percent of total billed charges,,,0.95,,190.73,Percent of total billed charges,,,,,,,,,0.95,,190.73,Percent of total billed charges,,190.73,196.75,
POTASSIUM CHLORIDE IN NACL 20-0.45 MEQ/L-% IV SOLN (WRAPPER),RX-74709094,CDM,J3480,HCPCS,636,RC,,inpatient,1000,ML,97.85,88.07,,0.95,,92.96,Percent of total billed charges,,,0.98,,95.89,Percent of total billed charges,,,0.95,,92.96,Percent of total billed charges,,,0.97,,94.91,Percent of total billed charges,,,0.97,,94.91,Percent of total billed charges,,,0.96,,93.94,Percent of total billed charges,,,0.95,,92.96,Percent of total billed charges,,,,,,,,,0.95,,92.96,Percent of total billed charges,,92.96,95.89,
POTASSIUM CHLORIDE IN NACL 20-0.45 MEQ/L-% IV SOLN (WRAPPER),RX-74709094,CDM,J3480,HCPCS,636,RC,,outpatient,1000,ML,97.85,88.07,,0.95,,92.96,Percent of total billed charges,,,0.98,,95.89,Percent of total billed charges,,,0.95,,92.96,Percent of total billed charges,,,0.95,,92.96,Percent of total billed charges,,,0.97,,94.91,Percent of total billed charges,,,0.96,,93.94,Percent of total billed charges,,,0.95,,92.96,Percent of total billed charges,,,,,,,,,0.95,,92.96,Percent of total billed charges,,92.96,95.89,
POTASSIUM CHLORIDE IN NACL 20-0.9 MEQ/L-% IV SOLN (WRAPPER),RX-74709095,CDM,J3480,HCPCS,636,RC,,inpatient,1000,ML,101.72,91.55,,0.95,,96.63,Percent of total billed charges,,,0.98,,99.69,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,0.97,,98.67,Percent of total billed charges,,,0.97,,98.67,Percent of total billed charges,,,0.96,,97.65,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,,,,,,,0.95,,96.63,Percent of total billed charges,,96.63,99.69,
POTASSIUM CHLORIDE IN NACL 20-0.9 MEQ/L-% IV SOLN (WRAPPER),RX-74709095,CDM,J3480,HCPCS,636,RC,,outpatient,1000,ML,101.72,91.55,,0.95,,96.63,Percent of total billed charges,,,0.98,,99.69,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,0.97,,98.67,Percent of total billed charges,,,0.96,,97.65,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,,,,,,,0.95,,96.63,Percent of total billed charges,,96.63,99.69,
POTASSIUM CHLORIDE IN NACL 40-0.9 MEQ/L-% IV SOLN (WRAPPER),RX-74709096,CDM,J3480,HCPCS,636,RC,,inpatient,1000,ML,101.72,91.55,,0.95,,96.63,Percent of total billed charges,,,0.98,,99.69,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,0.97,,98.67,Percent of total billed charges,,,0.97,,98.67,Percent of total billed charges,,,0.96,,97.65,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,,,,,,,0.95,,96.63,Percent of total billed charges,,96.63,99.69,
POTASSIUM CHLORIDE IN NACL 40-0.9 MEQ/L-% IV SOLN (WRAPPER),RX-74709096,CDM,J3480,HCPCS,636,RC,,outpatient,1000,ML,101.72,91.55,,0.95,,96.63,Percent of total billed charges,,,0.98,,99.69,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,0.97,,98.67,Percent of total billed charges,,,0.96,,97.65,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,,,,,,,0.95,,96.63,Percent of total billed charges,,96.63,99.69,
STERILE WATER FOR INJECTION INJECTION SOLN,RX-7484,CDM,A4217,HCPCS,250,RC,,inpatient,10,ML,19.67,17.7,,0.95,,18.69,Percent of total billed charges,,,0.98,,19.28,Percent of total billed charges,,,0.95,,18.69,Percent of total billed charges,,,0.97,,19.08,Percent of total billed charges,,,0.97,,19.08,Percent of total billed charges,,,0.96,,18.88,Percent of total billed charges,,,0.95,,18.69,Percent of total billed charges,,,,,,,,,0.95,,18.69,Percent of total billed charges,,18.69,19.28,
STERILE WATER FOR INJECTION INJECTION SOLN,RX-7484,CDM,A4217,HCPCS,250,RC,,outpatient,10,ML,19.67,17.7,,0.95,,18.69,Percent of total billed charges,,,0.98,,19.28,Percent of total billed charges,,,0.95,,18.69,Percent of total billed charges,,,0.95,,18.69,Percent of total billed charges,,,0.97,,19.08,Percent of total billed charges,,,0.96,,18.88,Percent of total billed charges,,,0.95,,18.69,Percent of total billed charges,,,,,,,,,0.95,,18.69,Percent of total billed charges,,18.69,19.28,
SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5ML IV SOLN,RX-7556,CDM,J3490,HCPCS,250,RC,,inpatient,30,ML,101.6,91.44,,0.95,,96.52,Percent of total billed charges,,,0.98,,99.57,Percent of total billed charges,,,0.95,,96.52,Percent of total billed charges,,,0.97,,98.55,Percent of total billed charges,,,0.97,,98.55,Percent of total billed charges,,,0.96,,97.54,Percent of total billed charges,,,0.95,,96.52,Percent of total billed charges,,,,,,,,,0.95,,96.52,Percent of total billed charges,,96.52,99.57,
SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5ML IV SOLN,RX-7556,CDM,J3490,HCPCS,250,RC,,outpatient,30,ML,101.6,91.44,,0.95,,96.52,Percent of total billed charges,,,0.98,,99.57,Percent of total billed charges,,,0.95,,96.52,Percent of total billed charges,,,0.95,,96.52,Percent of total billed charges,,,0.97,,98.55,Percent of total billed charges,,,0.96,,97.54,Percent of total billed charges,,,0.95,,96.52,Percent of total billed charges,,,,,,,,,0.95,,96.52,Percent of total billed charges,,96.52,99.57,
SULFASALAZINE 500 MG PO TABS,RX-7562,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.66,5.99,,0.95,,6.33,Percent of total billed charges,,,0.98,,6.53,Percent of total billed charges,,,0.95,,6.33,Percent of total billed charges,,,0.97,,6.46,Percent of total billed charges,,,0.97,,6.46,Percent of total billed charges,,,0.96,,6.39,Percent of total billed charges,,,0.95,,6.33,Percent of total billed charges,,,,,,,,,0.95,,6.33,Percent of total billed charges,,6.33,6.53,
SULFASALAZINE 500 MG PO TABS,RX-7562,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.66,5.99,,0.95,,6.33,Percent of total billed charges,,,0.98,,6.53,Percent of total billed charges,,,0.95,,6.33,Percent of total billed charges,,,0.95,,6.33,Percent of total billed charges,,,0.97,,6.46,Percent of total billed charges,,,0.96,,6.39,Percent of total billed charges,,,0.95,,6.33,Percent of total billed charges,,,,,,,,,0.95,,6.33,Percent of total billed charges,,6.33,6.53,
HYALURONIDASE HUMAN 150 UNIT/ML INJECTION SOLN,RX-76338,CDM,J3471,HCPCS,636,RC,,inpatient,1,ML,152.6,137.34,,0.95,,144.97,Percent of total billed charges,,,0.98,,149.55,Percent of total billed charges,,,0.95,,144.97,Percent of total billed charges,,,0.97,,148.02,Percent of total billed charges,,,0.97,,148.02,Percent of total billed charges,,,0.96,,146.5,Percent of total billed charges,,,0.95,,144.97,Percent of total billed charges,,,,,,,,,0.95,,144.97,Percent of total billed charges,,144.97,149.55,
HYALURONIDASE HUMAN 150 UNIT/ML INJECTION SOLN,RX-76338,CDM,J3471,HCPCS,636,RC,,outpatient,1,ML,152.6,137.34,,0.95,,144.97,Percent of total billed charges,,,0.98,,149.55,Percent of total billed charges,,,0.95,,144.97,Percent of total billed charges,,,0.95,,144.97,Percent of total billed charges,,,0.97,,148.02,Percent of total billed charges,,,0.96,,146.5,Percent of total billed charges,,,0.95,,144.97,Percent of total billed charges,,,,,,,,,0.95,,144.97,Percent of total billed charges,,144.97,149.55,
VARENICLINE TARTRATE 0.5 MG PO TABS,RX-76444,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,23.39,21.05,,0.95,,22.22,Percent of total billed charges,,,0.98,,22.92,Percent of total billed charges,,,0.95,,22.22,Percent of total billed charges,,,0.97,,22.69,Percent of total billed charges,,,0.97,,22.69,Percent of total billed charges,,,0.96,,22.45,Percent of total billed charges,,,0.95,,22.22,Percent of total billed charges,,,,,,,,,0.95,,22.22,Percent of total billed charges,,22.22,22.92,
VARENICLINE TARTRATE 0.5 MG PO TABS,RX-76444,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,23.39,21.05,,0.95,,22.22,Percent of total billed charges,,,0.98,,22.92,Percent of total billed charges,,,0.95,,22.22,Percent of total billed charges,,,0.95,,22.22,Percent of total billed charges,,,0.97,,22.69,Percent of total billed charges,,,0.96,,22.45,Percent of total billed charges,,,0.95,,22.22,Percent of total billed charges,,,,,,,,,0.95,,22.22,Percent of total billed charges,,22.22,22.92,
VANCOMYCIN HCL 1 G/10ML IV (WET SOLR VIAL),RX-767177674,CDM,J3370,HCPCS,636,RC,,inpatient,10,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
VANCOMYCIN HCL 1 G/10ML IV (WET SOLR VIAL),RX-767177674,CDM,J3370,HCPCS,636,RC,,outpatient,10,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
VANCOMYCIN HCL 500 MG/5ML IV (WET SOLR VIAL),RX-7678443,CDM,J3370,HCPCS,636,RC,,inpatient,5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
VANCOMYCIN HCL 500 MG/5ML IV (WET SOLR VIAL),RX-7678443,CDM,J3370,HCPCS,636,RC,,outpatient,5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
VANCOMYCIN HCL 750 MG/7.5ML IV (WET SOLR VIAL),RX-76797371,CDM,J3370,HCPCS,636,RC,,inpatient,7.5,ML,32.36,29.12,,0.95,,30.74,Percent of total billed charges,,,0.98,,31.71,Percent of total billed charges,,,0.95,,30.74,Percent of total billed charges,,,0.97,,31.39,Percent of total billed charges,,,0.97,,31.39,Percent of total billed charges,,,0.96,,31.07,Percent of total billed charges,,,0.95,,30.74,Percent of total billed charges,,,,,,,,,0.95,,30.74,Percent of total billed charges,,30.74,31.71,
VANCOMYCIN HCL 750 MG/7.5ML IV (WET SOLR VIAL),RX-76797371,CDM,J3370,HCPCS,636,RC,,outpatient,7.5,ML,32.36,29.12,,0.95,,30.74,Percent of total billed charges,,,0.98,,31.71,Percent of total billed charges,,,0.95,,30.74,Percent of total billed charges,,,0.95,,30.74,Percent of total billed charges,,,0.97,,31.39,Percent of total billed charges,,,0.96,,31.07,Percent of total billed charges,,,0.95,,30.74,Percent of total billed charges,,,,,,,,,0.95,,30.74,Percent of total billed charges,,30.74,31.71,
CHOLECALCIFEROL 25 MCG (1000 UT) PO TABS,RX-76950,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,5.88,5.29,,0.95,,5.59,Percent of total billed charges,,,0.98,,5.76,Percent of total billed charges,,,0.95,,5.59,Percent of total billed charges,,,0.97,,5.7,Percent of total billed charges,,,0.97,,5.7,Percent of total billed charges,,,0.96,,5.64,Percent of total billed charges,,,0.95,,5.59,Percent of total billed charges,,,,,,,,,0.95,,5.59,Percent of total billed charges,,5.59,5.76,
CHOLECALCIFEROL 25 MCG (1000 UT) PO TABS,RX-76950,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,5.88,5.29,,0.95,,5.59,Percent of total billed charges,,,0.98,,5.76,Percent of total billed charges,,,0.95,,5.59,Percent of total billed charges,,,0.95,,5.59,Percent of total billed charges,,,0.97,,5.7,Percent of total billed charges,,,0.96,,5.64,Percent of total billed charges,,,0.95,,5.59,Percent of total billed charges,,,,,,,,,0.95,,5.59,Percent of total billed charges,,5.59,5.76,
TAMOXIFEN CITRATE 10 MG PO TABS,RX-7711,CDM,J8999,HCPCS,636,RC,,inpatient,2,UN,128.75,115.88,,0.95,,122.31,Percent of total billed charges,,,0.98,,126.18,Percent of total billed charges,,,0.95,,122.31,Percent of total billed charges,,,0.97,,124.89,Percent of total billed charges,,,0.97,,124.89,Percent of total billed charges,,,0.96,,123.6,Percent of total billed charges,,,0.95,,122.31,Percent of total billed charges,,,,,,,,,0.95,,122.31,Percent of total billed charges,,122.31,126.18,
TAMOXIFEN CITRATE 10 MG PO TABS,RX-7711,CDM,J8999,HCPCS,636,RC,,outpatient,2,UN,128.75,115.88,,0.95,,122.31,Percent of total billed charges,,,0.98,,126.18,Percent of total billed charges,,,0.95,,122.31,Percent of total billed charges,,,0.95,,122.31,Percent of total billed charges,,,0.97,,124.89,Percent of total billed charges,,,0.96,,123.6,Percent of total billed charges,,,0.95,,122.31,Percent of total billed charges,,,,,,,,,0.95,,122.31,Percent of total billed charges,,122.31,126.18,
LEVETIRACETAM 500 MG/5ML IV SOLN,RX-77195,CDM,J1953,HCPCS,636,RC,,inpatient,5,ML,206,185.4,,0.95,,195.7,Percent of total billed charges,,,0.98,,201.88,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.96,,197.76,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,,,,,,,0.95,,195.7,Percent of total billed charges,,195.7,201.88,
LEVETIRACETAM 500 MG/5ML IV SOLN,RX-77195,CDM,J1953,HCPCS,636,RC,,outpatient,5,ML,206,185.4,,0.95,,195.7,Percent of total billed charges,,,0.98,,201.88,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,0.97,,199.82,Percent of total billed charges,,,0.96,,197.76,Percent of total billed charges,,,0.95,,195.7,Percent of total billed charges,,,,,,,,,0.95,,195.7,Percent of total billed charges,,195.7,201.88,
MICAFUNGIN SODIUM 100 MG IV SOLR,RX-77685,CDM,J2248,HCPCS,636,RC,,inpatient,5,ML,128.39,115.55,,0.95,,121.97,Percent of total billed charges,,,0.98,,125.82,Percent of total billed charges,,,0.95,,121.97,Percent of total billed charges,,,0.97,,124.54,Percent of total billed charges,,,0.97,,124.54,Percent of total billed charges,,,0.96,,123.25,Percent of total billed charges,,,0.95,,121.97,Percent of total billed charges,,,,,,,,,0.95,,121.97,Percent of total billed charges,,121.97,125.82,
MICAFUNGIN SODIUM 100 MG IV SOLR,RX-77685,CDM,J2248,HCPCS,636,RC,,outpatient,5,ML,128.39,115.55,,0.95,,121.97,Percent of total billed charges,,,0.98,,125.82,Percent of total billed charges,,,0.95,,121.97,Percent of total billed charges,,,0.95,,121.97,Percent of total billed charges,,,0.97,,124.54,Percent of total billed charges,,,0.96,,123.25,Percent of total billed charges,,,0.95,,121.97,Percent of total billed charges,,,,,,,,,0.95,,121.97,Percent of total billed charges,,121.97,125.82,
PRAMOX-PE-GLYCERIN-PETROLATUM 1-0.25-14.4-15 % EX CREA,RX-77868,CDM,J3490,HCPCS,637,RC,,inpatient,51,GR,59.1,53.19,,0.95,,56.15,Percent of total billed charges,,,0.98,,57.92,Percent of total billed charges,,,0.95,,56.15,Percent of total billed charges,,,0.97,,57.33,Percent of total billed charges,,,0.97,,57.33,Percent of total billed charges,,,0.96,,56.74,Percent of total billed charges,,,0.95,,56.15,Percent of total billed charges,,,,,,,,,0.95,,56.15,Percent of total billed charges,,56.15,57.92,
PRAMOX-PE-GLYCERIN-PETROLATUM 1-0.25-14.4-15 % EX CREA,RX-77868,CDM,J3490,HCPCS,637,RC,,outpatient,51,GR,59.1,53.19,,0.95,,56.15,Percent of total billed charges,,,0.98,,57.92,Percent of total billed charges,,,0.95,,56.15,Percent of total billed charges,,,0.95,,56.15,Percent of total billed charges,,,0.97,,57.33,Percent of total billed charges,,,0.96,,56.74,Percent of total billed charges,,,0.95,,56.15,Percent of total billed charges,,,,,,,,,0.95,,56.15,Percent of total billed charges,,56.15,57.92,
TETRACAINE HCL 0.5 % OP SOLN,RX-7795,CDM,J3490,HCPCS,250,RC,,inpatient,15,ML,268.11,241.3,,0.95,,254.7,Percent of total billed charges,,,0.98,,262.75,Percent of total billed charges,,,0.95,,254.7,Percent of total billed charges,,,0.97,,260.07,Percent of total billed charges,,,0.97,,260.07,Percent of total billed charges,,,0.96,,257.39,Percent of total billed charges,,,0.95,,254.7,Percent of total billed charges,,,,,,,,,0.95,,254.7,Percent of total billed charges,,254.7,262.75,
TETRACAINE HCL 0.5 % OP SOLN,RX-7795,CDM,J3490,HCPCS,250,RC,,outpatient,15,ML,268.11,241.3,,0.95,,254.7,Percent of total billed charges,,,0.98,,262.75,Percent of total billed charges,,,0.95,,254.7,Percent of total billed charges,,,0.95,,254.7,Percent of total billed charges,,,0.97,,260.07,Percent of total billed charges,,,0.96,,257.39,Percent of total billed charges,,,0.95,,254.7,Percent of total billed charges,,,,,,,,,0.95,,254.7,Percent of total billed charges,,254.7,262.75,
TETRACYCLINE HCL 250 MG PO CAPS,RX-7796,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,15.54,13.99,,0.95,,14.76,Percent of total billed charges,,,0.98,,15.23,Percent of total billed charges,,,0.95,,14.76,Percent of total billed charges,,,0.97,,15.07,Percent of total billed charges,,,0.97,,15.07,Percent of total billed charges,,,0.96,,14.92,Percent of total billed charges,,,0.95,,14.76,Percent of total billed charges,,,,,,,,,0.95,,14.76,Percent of total billed charges,,14.76,15.23,
TETRACYCLINE HCL 250 MG PO CAPS,RX-7796,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,15.54,13.99,,0.95,,14.76,Percent of total billed charges,,,0.98,,15.23,Percent of total billed charges,,,0.95,,14.76,Percent of total billed charges,,,0.95,,14.76,Percent of total billed charges,,,0.97,,15.07,Percent of total billed charges,,,0.96,,14.92,Percent of total billed charges,,,0.95,,14.76,Percent of total billed charges,,,,,,,,,0.95,,14.76,Percent of total billed charges,,14.76,15.23,
AZACITIDINE 100 MG INJECTION SUSR,RX-78420,CDM,J9025,HCPCS,636,RC,,inpatient,10,ML,721,648.9,,0.95,,684.95,Percent of total billed charges,,,0.98,,706.58,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,0.97,,699.37,Percent of total billed charges,,,0.97,,699.37,Percent of total billed charges,,,0.96,,692.16,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,,,,,,,0.95,,684.95,Percent of total billed charges,,684.95,706.58,
AZACITIDINE 100 MG INJECTION SUSR,RX-78420,CDM,J9025,HCPCS,636,RC,,outpatient,10,ML,721,648.9,,0.95,,684.95,Percent of total billed charges,,,0.98,,706.58,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,0.97,,699.37,Percent of total billed charges,,,0.96,,692.16,Percent of total billed charges,,,0.95,,684.95,Percent of total billed charges,,,,,,,,,0.95,,684.95,Percent of total billed charges,,684.95,706.58,
ESOMEPRAZOLE MAGNESIUM 40 MG PO PACK,RX-78616,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,28.42,25.58,,0.95,,27,Percent of total billed charges,,,0.98,,27.85,Percent of total billed charges,,,0.95,,27,Percent of total billed charges,,,0.97,,27.57,Percent of total billed charges,,,0.97,,27.57,Percent of total billed charges,,,0.96,,27.28,Percent of total billed charges,,,0.95,,27,Percent of total billed charges,,,,,,,,,0.95,,27,Percent of total billed charges,,27,27.85,
ESOMEPRAZOLE MAGNESIUM 40 MG PO PACK,RX-78616,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,28.42,25.58,,0.95,,27,Percent of total billed charges,,,0.98,,27.85,Percent of total billed charges,,,0.95,,27,Percent of total billed charges,,,0.95,,27,Percent of total billed charges,,,0.97,,27.57,Percent of total billed charges,,,0.96,,27.28,Percent of total billed charges,,,0.95,,27,Percent of total billed charges,,,,,,,,,0.95,,27,Percent of total billed charges,,27,27.85,
THERMOTABS PO TABS,RX-7872,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.05,5.45,,0.95,,5.75,Percent of total billed charges,,,0.98,,5.93,Percent of total billed charges,,,0.95,,5.75,Percent of total billed charges,,,0.97,,5.87,Percent of total billed charges,,,0.97,,5.87,Percent of total billed charges,,,0.96,,5.81,Percent of total billed charges,,,0.95,,5.75,Percent of total billed charges,,,,,,,,,0.95,,5.75,Percent of total billed charges,,5.75,5.93,
THERMOTABS PO TABS,RX-7872,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.05,5.45,,0.95,,5.75,Percent of total billed charges,,,0.98,,5.93,Percent of total billed charges,,,0.95,,5.75,Percent of total billed charges,,,0.95,,5.75,Percent of total billed charges,,,0.97,,5.87,Percent of total billed charges,,,0.96,,5.81,Percent of total billed charges,,,0.95,,5.75,Percent of total billed charges,,,,,,,,,0.95,,5.75,Percent of total billed charges,,5.75,5.93,
THIAMINE HCL 100 MG/ML INJECTION SOLN,RX-7876,CDM,J3411,HCPCS,636,RC,,inpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
THIAMINE HCL 100 MG/ML INJECTION SOLN,RX-7876,CDM,J3411,HCPCS,636,RC,,outpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
GUAIFENESIN-CODEINE 100-10 MG/5ML PO SOLN,RX-79088,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
GUAIFENESIN-CODEINE 100-10 MG/5ML PO SOLN,RX-79088,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
THYROID 60 MG PO TABS,RX-7947,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,11.23,10.11,,0.95,,10.67,Percent of total billed charges,,,0.98,,11.01,Percent of total billed charges,,,0.95,,10.67,Percent of total billed charges,,,0.97,,10.89,Percent of total billed charges,,,0.97,,10.89,Percent of total billed charges,,,0.96,,10.78,Percent of total billed charges,,,0.95,,10.67,Percent of total billed charges,,,,,,,,,0.95,,10.67,Percent of total billed charges,,10.67,11.01,
THYROID 60 MG PO TABS,RX-7947,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,11.23,10.11,,0.95,,10.67,Percent of total billed charges,,,0.98,,11.01,Percent of total billed charges,,,0.95,,10.67,Percent of total billed charges,,,0.95,,10.67,Percent of total billed charges,,,0.97,,10.89,Percent of total billed charges,,,0.96,,10.78,Percent of total billed charges,,,0.95,,10.67,Percent of total billed charges,,,,,,,,,0.95,,10.67,Percent of total billed charges,,10.67,11.01,
TOLNAFTATE 1 % EX CREA,RX-8020,CDM,J3490,HCPCS,637,RC,,inpatient,30,GR,15.86,14.27,,0.95,,15.07,Percent of total billed charges,,,0.98,,15.54,Percent of total billed charges,,,0.95,,15.07,Percent of total billed charges,,,0.97,,15.38,Percent of total billed charges,,,0.97,,15.38,Percent of total billed charges,,,0.96,,15.23,Percent of total billed charges,,,0.95,,15.07,Percent of total billed charges,,,,,,,,,0.95,,15.07,Percent of total billed charges,,15.07,15.54,
TOLNAFTATE 1 % EX CREA,RX-8020,CDM,J3490,HCPCS,637,RC,,outpatient,30,GR,15.86,14.27,,0.95,,15.07,Percent of total billed charges,,,0.98,,15.54,Percent of total billed charges,,,0.95,,15.07,Percent of total billed charges,,,0.95,,15.07,Percent of total billed charges,,,0.97,,15.38,Percent of total billed charges,,,0.96,,15.23,Percent of total billed charges,,,0.95,,15.07,Percent of total billed charges,,,,,,,,,0.95,,15.07,Percent of total billed charges,,15.07,15.54,
TRAZODONE HCL 50 MG PO TABS,RX-8085,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.32,5.69,,0.95,,6,Percent of total billed charges,,,0.98,,6.19,Percent of total billed charges,,,0.95,,6,Percent of total billed charges,,,0.97,,6.13,Percent of total billed charges,,,0.97,,6.13,Percent of total billed charges,,,0.96,,6.07,Percent of total billed charges,,,0.95,,6,Percent of total billed charges,,,,,,,,,0.95,,6,Percent of total billed charges,,6,6.19,
TRAZODONE HCL 50 MG PO TABS,RX-8085,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.32,5.69,,0.95,,6,Percent of total billed charges,,,0.98,,6.19,Percent of total billed charges,,,0.95,,6,Percent of total billed charges,,,0.95,,6,Percent of total billed charges,,,0.97,,6.13,Percent of total billed charges,,,0.96,,6.07,Percent of total billed charges,,,0.95,,6,Percent of total billed charges,,,,,,,,,0.95,,6,Percent of total billed charges,,6,6.19,
TRIAMCINOLONE ACETONIDE 0.1 % EX CREA,RX-8113,CDM,J3490,HCPCS,637,RC,,inpatient,15,GR,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
TRIAMCINOLONE ACETONIDE 0.1 % EX CREA,RX-8113,CDM,J3490,HCPCS,637,RC,,outpatient,15,GR,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
TRIAMCINOLONE ACETONIDE 0.1 % EX OINT,RX-8118,CDM,J3490,HCPCS,637,RC,,inpatient,15,GR,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
TRIAMCINOLONE ACETONIDE 0.1 % EX OINT,RX-8118,CDM,J3490,HCPCS,637,RC,,outpatient,15,GR,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
TRIAMCINOLONE ACETONIDE 0.5 % EX OINT,RX-8119,CDM,J3490,HCPCS,637,RC,,inpatient,15,GR,19.16,17.24,,0.95,,18.2,Percent of total billed charges,,,0.98,,18.78,Percent of total billed charges,,,0.95,,18.2,Percent of total billed charges,,,0.97,,18.59,Percent of total billed charges,,,0.97,,18.59,Percent of total billed charges,,,0.96,,18.39,Percent of total billed charges,,,0.95,,18.2,Percent of total billed charges,,,,,,,,,0.95,,18.2,Percent of total billed charges,,18.2,18.78,
TRIAMCINOLONE ACETONIDE 0.5 % EX OINT,RX-8119,CDM,J3490,HCPCS,637,RC,,outpatient,15,GR,19.16,17.24,,0.95,,18.2,Percent of total billed charges,,,0.98,,18.78,Percent of total billed charges,,,0.95,,18.2,Percent of total billed charges,,,0.95,,18.2,Percent of total billed charges,,,0.97,,18.59,Percent of total billed charges,,,0.96,,18.39,Percent of total billed charges,,,0.95,,18.2,Percent of total billed charges,,,,,,,,,0.95,,18.2,Percent of total billed charges,,18.2,18.78,
TRIAMCINOLONE ACETONIDE 40 MG/ML INJECTION SUSP,RX-8120,CDM,J3301,HCPCS,636,RC,,inpatient,0.5,ML,20.99,18.89,,0.95,,19.94,Percent of total billed charges,,,0.98,,20.57,Percent of total billed charges,,,0.95,,19.94,Percent of total billed charges,,,0.97,,20.36,Percent of total billed charges,,,0.97,,20.36,Percent of total billed charges,,,0.96,,20.15,Percent of total billed charges,,,0.95,,19.94,Percent of total billed charges,,,,,,,,,0.95,,19.94,Percent of total billed charges,,19.94,20.57,
TRIAMCINOLONE ACETONIDE 40 MG/ML INJECTION SUSP,RX-8120,CDM,J3301,HCPCS,636,RC,,outpatient,0.5,ML,20.99,18.89,,0.95,,19.94,Percent of total billed charges,,,0.98,,20.57,Percent of total billed charges,,,0.95,,19.94,Percent of total billed charges,,,0.95,,19.94,Percent of total billed charges,,,0.97,,20.36,Percent of total billed charges,,,0.96,,20.15,Percent of total billed charges,,,0.95,,19.94,Percent of total billed charges,,,,,,,,,0.95,,19.94,Percent of total billed charges,,19.94,20.57,
TRIAMCINOLONE ACETONIDE 0.1 % MOUTH/THROAT PSTE,RX-8121,CDM,J3490,HCPCS,637,RC,,inpatient,5,GR,213.82,192.44,,0.95,,203.13,Percent of total billed charges,,,0.98,,209.54,Percent of total billed charges,,,0.95,,203.13,Percent of total billed charges,,,0.97,,207.41,Percent of total billed charges,,,0.97,,207.41,Percent of total billed charges,,,0.96,,205.27,Percent of total billed charges,,,0.95,,203.13,Percent of total billed charges,,,,,,,,,0.95,,203.13,Percent of total billed charges,,203.13,209.54,
TRIAMCINOLONE ACETONIDE 0.1 % MOUTH/THROAT PSTE,RX-8121,CDM,J3490,HCPCS,637,RC,,outpatient,5,GR,213.82,192.44,,0.95,,203.13,Percent of total billed charges,,,0.98,,209.54,Percent of total billed charges,,,0.95,,203.13,Percent of total billed charges,,,0.95,,203.13,Percent of total billed charges,,,0.97,,207.41,Percent of total billed charges,,,0.96,,205.27,Percent of total billed charges,,,0.95,,203.13,Percent of total billed charges,,,,,,,,,0.95,,203.13,Percent of total billed charges,,203.13,209.54,
TRIAMTERENE-HCTZ 37.5-25 MG PO TABS,RX-8132,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,9.91,8.92,,0.95,,9.41,Percent of total billed charges,,,0.98,,9.71,Percent of total billed charges,,,0.95,,9.41,Percent of total billed charges,,,0.97,,9.61,Percent of total billed charges,,,0.97,,9.61,Percent of total billed charges,,,0.96,,9.51,Percent of total billed charges,,,0.95,,9.41,Percent of total billed charges,,,,,,,,,0.95,,9.41,Percent of total billed charges,,9.41,9.71,
TRIAMTERENE-HCTZ 37.5-25 MG PO TABS,RX-8132,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,9.91,8.92,,0.95,,9.41,Percent of total billed charges,,,0.98,,9.71,Percent of total billed charges,,,0.95,,9.41,Percent of total billed charges,,,0.95,,9.41,Percent of total billed charges,,,0.97,,9.61,Percent of total billed charges,,,0.96,,9.51,Percent of total billed charges,,,0.95,,9.41,Percent of total billed charges,,,,,,,,,0.95,,9.41,Percent of total billed charges,,9.41,9.71,
DIVALPROEX SODIUM ER 500 MG PO TB24,RX-81426,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,11.48,10.33,,0.95,,10.91,Percent of total billed charges,,,0.98,,11.25,Percent of total billed charges,,,0.95,,10.91,Percent of total billed charges,,,0.97,,11.14,Percent of total billed charges,,,0.97,,11.14,Percent of total billed charges,,,0.96,,11.02,Percent of total billed charges,,,0.95,,10.91,Percent of total billed charges,,,,,,,,,0.95,,10.91,Percent of total billed charges,,10.91,11.25,
DIVALPROEX SODIUM ER 500 MG PO TB24,RX-81426,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,11.48,10.33,,0.95,,10.91,Percent of total billed charges,,,0.98,,11.25,Percent of total billed charges,,,0.95,,10.91,Percent of total billed charges,,,0.95,,10.91,Percent of total billed charges,,,0.97,,11.14,Percent of total billed charges,,,0.96,,11.02,Percent of total billed charges,,,0.95,,10.91,Percent of total billed charges,,,,,,,,,0.95,,10.91,Percent of total billed charges,,10.91,11.25,
ZOLEDRONIC ACID 5 MG/100ML IV SOLN,RX-81434,CDM,J3489,HCPCS,636,RC,,inpatient,100,ML,106.3,95.67,,0.95,,100.99,Percent of total billed charges,,,0.98,,104.17,Percent of total billed charges,,,0.95,,100.99,Percent of total billed charges,,,0.97,,103.11,Percent of total billed charges,,,0.97,,103.11,Percent of total billed charges,,,0.96,,102.05,Percent of total billed charges,,,0.95,,100.99,Percent of total billed charges,,,,,,,,,0.95,,100.99,Percent of total billed charges,,100.99,104.17,
ZOLEDRONIC ACID 5 MG/100ML IV SOLN,RX-81434,CDM,J3489,HCPCS,636,RC,,outpatient,100,ML,106.3,95.67,,0.95,,100.99,Percent of total billed charges,,,0.98,,104.17,Percent of total billed charges,,,0.95,,100.99,Percent of total billed charges,,,0.95,,100.99,Percent of total billed charges,,,0.97,,103.11,Percent of total billed charges,,,0.96,,102.05,Percent of total billed charges,,,0.95,,100.99,Percent of total billed charges,,,,,,,,,0.95,,100.99,Percent of total billed charges,,100.99,104.17,
BUDESONIDE-FORMOTEROL FUMARATE 80-4.5 MCG/ACT INHAL AERO,RX-81453,CDM,J3490,HCPCS,637,RC,,inpatient,6.9,GR,201.64,181.48,,0.95,,191.56,Percent of total billed charges,,,0.98,,197.61,Percent of total billed charges,,,0.95,,191.56,Percent of total billed charges,,,0.97,,195.59,Percent of total billed charges,,,0.97,,195.59,Percent of total billed charges,,,0.96,,193.57,Percent of total billed charges,,,0.95,,191.56,Percent of total billed charges,,,,,,,,,0.95,,191.56,Percent of total billed charges,,191.56,197.61,
BUDESONIDE-FORMOTEROL FUMARATE 80-4.5 MCG/ACT INHAL AERO,RX-81453,CDM,J3490,HCPCS,637,RC,,outpatient,6.9,GR,201.64,181.48,,0.95,,191.56,Percent of total billed charges,,,0.98,,197.61,Percent of total billed charges,,,0.95,,191.56,Percent of total billed charges,,,0.95,,191.56,Percent of total billed charges,,,0.97,,195.59,Percent of total billed charges,,,0.96,,193.57,Percent of total billed charges,,,0.95,,191.56,Percent of total billed charges,,,,,,,,,0.95,,191.56,Percent of total billed charges,,191.56,197.61,
BUDESONIDE-FORMOTEROL FUMARATE 160-4.5 MCG/ACT INHAL AERO,RX-81454,CDM,J3490,HCPCS,637,RC,,inpatient,6,GR,201.64,181.48,,0.95,,191.56,Percent of total billed charges,,,0.98,,197.61,Percent of total billed charges,,,0.95,,191.56,Percent of total billed charges,,,0.97,,195.59,Percent of total billed charges,,,0.97,,195.59,Percent of total billed charges,,,0.96,,193.57,Percent of total billed charges,,,0.95,,191.56,Percent of total billed charges,,,,,,,,,0.95,,191.56,Percent of total billed charges,,191.56,197.61,
BUDESONIDE-FORMOTEROL FUMARATE 160-4.5 MCG/ACT INHAL AERO,RX-81454,CDM,J3490,HCPCS,637,RC,,outpatient,6,GR,201.64,181.48,,0.95,,191.56,Percent of total billed charges,,,0.98,,197.61,Percent of total billed charges,,,0.95,,191.56,Percent of total billed charges,,,0.95,,191.56,Percent of total billed charges,,,0.97,,195.59,Percent of total billed charges,,,0.96,,193.57,Percent of total billed charges,,,0.95,,191.56,Percent of total billed charges,,,,,,,,,0.95,,191.56,Percent of total billed charges,,191.56,197.61,
TRIHEXYPHENIDYL HCL 2 MG PO TABS,RX-8166,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.47,5.82,,0.95,,6.15,Percent of total billed charges,,,0.98,,6.34,Percent of total billed charges,,,0.95,,6.15,Percent of total billed charges,,,0.97,,6.28,Percent of total billed charges,,,0.97,,6.28,Percent of total billed charges,,,0.96,,6.21,Percent of total billed charges,,,0.95,,6.15,Percent of total billed charges,,,,,,,,,0.95,,6.15,Percent of total billed charges,,6.15,6.34,
TRIHEXYPHENIDYL HCL 2 MG PO TABS,RX-8166,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.47,5.82,,0.95,,6.15,Percent of total billed charges,,,0.98,,6.34,Percent of total billed charges,,,0.95,,6.15,Percent of total billed charges,,,0.95,,6.15,Percent of total billed charges,,,0.97,,6.28,Percent of total billed charges,,,0.96,,6.21,Percent of total billed charges,,,0.95,,6.15,Percent of total billed charges,,,,,,,,,0.95,,6.15,Percent of total billed charges,,6.15,6.34,
GLUCOSE 40 % PO GEL,RX-81823,CDM,J3490,HCPCS,637,RC,,inpatient,15,GR,6.55,5.9,,0.95,,6.22,Percent of total billed charges,,,0.98,,6.42,Percent of total billed charges,,,0.95,,6.22,Percent of total billed charges,,,0.97,,6.35,Percent of total billed charges,,,0.97,,6.35,Percent of total billed charges,,,0.96,,6.29,Percent of total billed charges,,,0.95,,6.22,Percent of total billed charges,,,,,,,,,0.95,,6.22,Percent of total billed charges,,6.22,6.42,
GLUCOSE 40 % PO GEL,RX-81823,CDM,J3490,HCPCS,637,RC,,outpatient,15,GR,6.55,5.9,,0.95,,6.22,Percent of total billed charges,,,0.98,,6.42,Percent of total billed charges,,,0.95,,6.22,Percent of total billed charges,,,0.95,,6.22,Percent of total billed charges,,,0.97,,6.35,Percent of total billed charges,,,0.96,,6.29,Percent of total billed charges,,,0.95,,6.22,Percent of total billed charges,,,,,,,,,0.95,,6.22,Percent of total billed charges,,6.22,6.42,
ESMOLOL HCL 100 MG/10ML IV SOLN,RX-82085,CDM,J1805,HCPCS,636,RC,,inpatient,10,ML,66.89,60.2,,0.95,,63.55,Percent of total billed charges,,,0.98,,65.55,Percent of total billed charges,,,0.95,,63.55,Percent of total billed charges,,,0.97,,64.88,Percent of total billed charges,,,0.97,,64.88,Percent of total billed charges,,,0.96,,64.21,Percent of total billed charges,,,0.95,,63.55,Percent of total billed charges,,,,,,,,,0.95,,63.55,Percent of total billed charges,,63.55,65.55,
ESMOLOL HCL 100 MG/10ML IV SOLN,RX-82085,CDM,J1805,HCPCS,636,RC,,outpatient,10,ML,66.89,60.2,,0.95,,63.55,Percent of total billed charges,,,0.98,,65.55,Percent of total billed charges,,,0.95,,63.55,Percent of total billed charges,,,0.95,,63.55,Percent of total billed charges,,,0.97,,64.88,Percent of total billed charges,,,0.96,,64.21,Percent of total billed charges,,,0.95,,63.55,Percent of total billed charges,,,,,,,,,0.95,,63.55,Percent of total billed charges,,63.55,65.55,
FLUOROURACIL 1 GM/20ML IV SOLN,RX-82204,CDM,J9190,HCPCS,636,RC,,inpatient,20,ML,21.53,19.38,,0.95,,20.45,Percent of total billed charges,,,0.98,,21.1,Percent of total billed charges,,,0.95,,20.45,Percent of total billed charges,,,0.97,,20.88,Percent of total billed charges,,,0.97,,20.88,Percent of total billed charges,,,0.96,,20.67,Percent of total billed charges,,,0.95,,20.45,Percent of total billed charges,,,,,,,,,0.95,,20.45,Percent of total billed charges,,20.45,21.1,
FLUOROURACIL 1 GM/20ML IV SOLN,RX-82204,CDM,J9190,HCPCS,636,RC,,outpatient,20,ML,21.53,19.38,,0.95,,20.45,Percent of total billed charges,,,0.98,,21.1,Percent of total billed charges,,,0.95,,20.45,Percent of total billed charges,,,0.95,,20.45,Percent of total billed charges,,,0.97,,20.88,Percent of total billed charges,,,0.96,,20.67,Percent of total billed charges,,,0.95,,20.45,Percent of total billed charges,,,,,,,,,0.95,,20.45,Percent of total billed charges,,20.45,21.1,
TROPICAMIDE 1 % OP SOLN,RX-8250,CDM,J3490,HCPCS,637,RC,,inpatient,15,ML,117.24,105.52,,0.95,,111.38,Percent of total billed charges,,,0.98,,114.9,Percent of total billed charges,,,0.95,,111.38,Percent of total billed charges,,,0.97,,113.72,Percent of total billed charges,,,0.97,,113.72,Percent of total billed charges,,,0.96,,112.55,Percent of total billed charges,,,0.95,,111.38,Percent of total billed charges,,,,,,,,,0.95,,111.38,Percent of total billed charges,,111.38,114.9,
TROPICAMIDE 1 % OP SOLN,RX-8250,CDM,J3490,HCPCS,637,RC,,outpatient,15,ML,117.24,105.52,,0.95,,111.38,Percent of total billed charges,,,0.98,,114.9,Percent of total billed charges,,,0.95,,111.38,Percent of total billed charges,,,0.95,,111.38,Percent of total billed charges,,,0.97,,113.72,Percent of total billed charges,,,0.96,,112.55,Percent of total billed charges,,,0.95,,111.38,Percent of total billed charges,,,,,,,,,0.95,,111.38,Percent of total billed charges,,111.38,114.9,
TUBERCULIN PPD 5 UNIT/0.1ML ID SOLN,RX-8259,CDM,J3490,HCPCS,250,RC,,inpatient,0.1,ML,31.42,28.28,,0.95,,29.85,Percent of total billed charges,,,0.98,,30.79,Percent of total billed charges,,,0.95,,29.85,Percent of total billed charges,,,0.97,,30.48,Percent of total billed charges,,,0.97,,30.48,Percent of total billed charges,,,0.96,,30.16,Percent of total billed charges,,,0.95,,29.85,Percent of total billed charges,,,,,,,,,0.95,,29.85,Percent of total billed charges,,29.85,30.79,
TUBERCULIN PPD 5 UNIT/0.1ML ID SOLN,RX-8259,CDM,J3490,HCPCS,250,RC,,outpatient,0.1,ML,31.42,28.28,,0.95,,29.85,Percent of total billed charges,,,0.98,,30.79,Percent of total billed charges,,,0.95,,29.85,Percent of total billed charges,,,0.95,,29.85,Percent of total billed charges,,,0.97,,30.48,Percent of total billed charges,,,0.96,,30.16,Percent of total billed charges,,,0.95,,29.85,Percent of total billed charges,,,,,,,,,0.95,,29.85,Percent of total billed charges,,29.85,30.79,
VANCOMYCIN HCL 500 MG IV SOLR,RX-8443,CDM,J3370,HCPCS,636,RC,,inpatient,500,ME,33.74,30.37,,0.95,,32.05,Percent of total billed charges,,,0.98,,33.07,Percent of total billed charges,,,0.95,,32.05,Percent of total billed charges,,,0.97,,32.73,Percent of total billed charges,,,0.97,,32.73,Percent of total billed charges,,,0.96,,32.39,Percent of total billed charges,,,0.95,,32.05,Percent of total billed charges,,,,,,,,,0.95,,32.05,Percent of total billed charges,,32.05,33.07,
VANCOMYCIN HCL 500 MG IV SOLR,RX-8443,CDM,J3370,HCPCS,636,RC,,outpatient,500,ME,33.74,30.37,,0.95,,32.05,Percent of total billed charges,,,0.98,,33.07,Percent of total billed charges,,,0.95,,32.05,Percent of total billed charges,,,0.95,,32.05,Percent of total billed charges,,,0.97,,32.73,Percent of total billed charges,,,0.96,,32.39,Percent of total billed charges,,,0.95,,32.05,Percent of total billed charges,,,,,,,,,0.95,,32.05,Percent of total billed charges,,32.05,33.07,
BACITRACIN 500 UNIT/GM EX OINT,RX-850,CDM,J3490,HCPCS,637,RC,,inpatient,30,GR,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
BACITRACIN 500 UNIT/GM EX OINT,RX-850,CDM,J3490,HCPCS,637,RC,,outpatient,30,GR,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
VERAPAMIL HCL 40 MG PO TABS,RX-8529,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.51,5.86,,0.95,,6.18,Percent of total billed charges,,,0.98,,6.38,Percent of total billed charges,,,0.95,,6.18,Percent of total billed charges,,,0.97,,6.31,Percent of total billed charges,,,0.97,,6.31,Percent of total billed charges,,,0.96,,6.25,Percent of total billed charges,,,0.95,,6.18,Percent of total billed charges,,,,,,,,,0.95,,6.18,Percent of total billed charges,,6.18,6.38,
VERAPAMIL HCL 40 MG PO TABS,RX-8529,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.51,5.86,,0.95,,6.18,Percent of total billed charges,,,0.98,,6.38,Percent of total billed charges,,,0.95,,6.18,Percent of total billed charges,,,0.95,,6.18,Percent of total billed charges,,,0.97,,6.31,Percent of total billed charges,,,0.96,,6.25,Percent of total billed charges,,,0.95,,6.18,Percent of total billed charges,,,,,,,,,0.95,,6.18,Percent of total billed charges,,6.18,6.38,
VINCRISTINE SULFATE 1 MG/ML IV SOLN,RX-8597,CDM,J9370,HCPCS,636,RC,,inpatient,2,ML,160.42,144.38,,0.95,,152.4,Percent of total billed charges,,,0.98,,157.21,Percent of total billed charges,,,0.95,,152.4,Percent of total billed charges,,,0.97,,155.61,Percent of total billed charges,,,0.97,,155.61,Percent of total billed charges,,,0.96,,154,Percent of total billed charges,,,0.95,,152.4,Percent of total billed charges,,,,,,,,,0.95,,152.4,Percent of total billed charges,,152.4,157.21,
VINCRISTINE SULFATE 1 MG/ML IV SOLN,RX-8597,CDM,J9370,HCPCS,636,RC,,outpatient,2,ML,160.42,144.38,,0.95,,152.4,Percent of total billed charges,,,0.98,,157.21,Percent of total billed charges,,,0.95,,152.4,Percent of total billed charges,,,0.95,,152.4,Percent of total billed charges,,,0.97,,155.61,Percent of total billed charges,,,0.96,,154,Percent of total billed charges,,,0.95,,152.4,Percent of total billed charges,,,,,,,,,0.95,,152.4,Percent of total billed charges,,152.4,157.21,
VITAMIN B COMPLEX PO TABS,RX-8646,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,5.79,5.21,,0.95,,5.5,Percent of total billed charges,,,0.98,,5.67,Percent of total billed charges,,,0.95,,5.5,Percent of total billed charges,,,0.97,,5.62,Percent of total billed charges,,,0.97,,5.62,Percent of total billed charges,,,0.96,,5.56,Percent of total billed charges,,,0.95,,5.5,Percent of total billed charges,,,,,,,,,0.95,,5.5,Percent of total billed charges,,5.5,5.67,
VITAMIN B COMPLEX PO TABS,RX-8646,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,5.79,5.21,,0.95,,5.5,Percent of total billed charges,,,0.98,,5.67,Percent of total billed charges,,,0.95,,5.5,Percent of total billed charges,,,0.95,,5.5,Percent of total billed charges,,,0.97,,5.62,Percent of total billed charges,,,0.96,,5.56,Percent of total billed charges,,,0.95,,5.5,Percent of total billed charges,,,,,,,,,0.95,,5.5,Percent of total billed charges,,5.5,5.67,
VITAMIN K1 10 MG/ML INJECTION SOLN,RX-8718,CDM,J3430,HCPCS,636,RC,,inpatient,0.1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
VITAMIN K1 10 MG/ML INJECTION SOLN,RX-8718,CDM,J3430,HCPCS,636,RC,,outpatient,0.1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
WARFARIN SODIUM 2 MG PO TABS,RX-8749,CDM,J3490,HCPCS,637,RC,,inpatient,0.5,UN,5.67,5.1,,0.95,,5.39,Percent of total billed charges,,,0.98,,5.56,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,0.97,,5.5,Percent of total billed charges,,,0.97,,5.5,Percent of total billed charges,,,0.96,,5.44,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,,,,,,,0.95,,5.39,Percent of total billed charges,,5.39,5.56,
WARFARIN SODIUM 2 MG PO TABS,RX-8749,CDM,J3490,HCPCS,637,RC,,outpatient,0.5,UN,5.67,5.1,,0.95,,5.39,Percent of total billed charges,,,0.98,,5.56,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,0.97,,5.5,Percent of total billed charges,,,0.96,,5.44,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,,,,,,,0.95,,5.39,Percent of total billed charges,,5.39,5.56,
WARFARIN SODIUM 2.5 MG PO TABS,RX-8750,CDM,J3490,HCPCS,637,RC,,inpatient,0.5,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
WARFARIN SODIUM 2.5 MG PO TABS,RX-8750,CDM,J3490,HCPCS,637,RC,,outpatient,0.5,UN,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
WARFARIN SODIUM 5 MG PO TABS,RX-8751,CDM,J3490,HCPCS,637,RC,,inpatient,0.5,UN,5.67,5.1,,0.95,,5.39,Percent of total billed charges,,,0.98,,5.56,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,0.97,,5.5,Percent of total billed charges,,,0.97,,5.5,Percent of total billed charges,,,0.96,,5.44,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,,,,,,,0.95,,5.39,Percent of total billed charges,,5.39,5.56,
WARFARIN SODIUM 5 MG PO TABS,RX-8751,CDM,J3490,HCPCS,637,RC,,outpatient,0.5,UN,5.67,5.1,,0.95,,5.39,Percent of total billed charges,,,0.98,,5.56,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,0.97,,5.5,Percent of total billed charges,,,0.96,,5.44,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,,,,,,,0.95,,5.39,Percent of total billed charges,,5.39,5.56,
OXYCODONE HCL 10 MG PO TABS,RX-87795,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,9.56,8.6,,0.95,,9.08,Percent of total billed charges,,,0.98,,9.37,Percent of total billed charges,,,0.95,,9.08,Percent of total billed charges,,,0.97,,9.27,Percent of total billed charges,,,0.97,,9.27,Percent of total billed charges,,,0.96,,9.18,Percent of total billed charges,,,0.95,,9.08,Percent of total billed charges,,,,,,,,,0.95,,9.08,Percent of total billed charges,,9.08,9.37,
OXYCODONE HCL 10 MG PO TABS,RX-87795,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,9.56,8.6,,0.95,,9.08,Percent of total billed charges,,,0.98,,9.37,Percent of total billed charges,,,0.95,,9.08,Percent of total billed charges,,,0.95,,9.08,Percent of total billed charges,,,0.97,,9.27,Percent of total billed charges,,,0.96,,9.18,Percent of total billed charges,,,0.95,,9.08,Percent of total billed charges,,,,,,,,,0.95,,9.08,Percent of total billed charges,,9.08,9.37,
DIAZEPAM 10 MG RECTAL GEL,RX-87867,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,603.43,543.09,,0.95,,573.26,Percent of total billed charges,,,0.98,,591.36,Percent of total billed charges,,,0.95,,573.26,Percent of total billed charges,,,0.97,,585.33,Percent of total billed charges,,,0.97,,585.33,Percent of total billed charges,,,0.96,,579.29,Percent of total billed charges,,,0.95,,573.26,Percent of total billed charges,,,,,,,,,0.95,,573.26,Percent of total billed charges,,573.26,591.36,
DIAZEPAM 10 MG RECTAL GEL,RX-87867,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,603.43,543.09,,0.95,,573.26,Percent of total billed charges,,,0.98,,591.36,Percent of total billed charges,,,0.95,,573.26,Percent of total billed charges,,,0.95,,573.26,Percent of total billed charges,,,0.97,,585.33,Percent of total billed charges,,,0.96,,579.29,Percent of total billed charges,,,0.95,,573.26,Percent of total billed charges,,,,,,,,,0.95,,573.26,Percent of total billed charges,,573.26,591.36,
FOSPHENYTOIN SODIUM 500 MG PE/10ML INJECTION SOLN,RX-88010,CDM,Q2009,HCPCS,636,RC,,inpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
FOSPHENYTOIN SODIUM 500 MG PE/10ML INJECTION SOLN,RX-88010,CDM,Q2009,HCPCS,636,RC,,outpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
METHOTREXATE SODIUM 50 MG/2ML INJECTION SOLN,RX-88042,CDM,J9260,HCPCS,636,RC,,inpatient,2,ML,138.23,124.41,,0.95,,131.32,Percent of total billed charges,,,0.98,,135.47,Percent of total billed charges,,,0.95,,131.32,Percent of total billed charges,,,0.97,,134.08,Percent of total billed charges,,,0.97,,134.08,Percent of total billed charges,,,0.96,,132.7,Percent of total billed charges,,,0.95,,131.32,Percent of total billed charges,,,,,,,,,0.95,,131.32,Percent of total billed charges,,131.32,135.47,
METHOTREXATE SODIUM 50 MG/2ML INJECTION SOLN,RX-88042,CDM,J9260,HCPCS,636,RC,,outpatient,2,ML,138.23,124.41,,0.95,,131.32,Percent of total billed charges,,,0.98,,135.47,Percent of total billed charges,,,0.95,,131.32,Percent of total billed charges,,,0.95,,131.32,Percent of total billed charges,,,0.97,,134.08,Percent of total billed charges,,,0.96,,132.7,Percent of total billed charges,,,0.95,,131.32,Percent of total billed charges,,,,,,,,,0.95,,131.32,Percent of total billed charges,,131.32,135.47,
SINUS RINSE KIT INTRANASAL PACK,RX-88343,CDM,J3490,HCPCS,250,RC,,inpatient,1,UN,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
SINUS RINSE KIT INTRANASAL PACK,RX-88343,CDM,J3490,HCPCS,250,RC,,outpatient,1,UN,15.45,13.91,,0.95,,14.68,Percent of total billed charges,,,0.98,,15.14,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,0.97,,14.99,Percent of total billed charges,,,0.96,,14.83,Percent of total billed charges,,,0.95,,14.68,Percent of total billed charges,,,,,,,,,0.95,,14.68,Percent of total billed charges,,14.68,15.14,
CISPLATIN 50 MG/50ML IV SOLN,RX-88376,CDM,J9060,HCPCS,636,RC,,inpatient,50,ML,190.12,171.11,,0.95,,180.61,Percent of total billed charges,,,0.98,,186.32,Percent of total billed charges,,,0.95,,180.61,Percent of total billed charges,,,0.97,,184.42,Percent of total billed charges,,,0.97,,184.42,Percent of total billed charges,,,0.96,,182.52,Percent of total billed charges,,,0.95,,180.61,Percent of total billed charges,,,,,,,,,0.95,,180.61,Percent of total billed charges,,180.61,186.32,
CISPLATIN 50 MG/50ML IV SOLN,RX-88376,CDM,J9060,HCPCS,636,RC,,outpatient,50,ML,190.12,171.11,,0.95,,180.61,Percent of total billed charges,,,0.98,,186.32,Percent of total billed charges,,,0.95,,180.61,Percent of total billed charges,,,0.95,,180.61,Percent of total billed charges,,,0.97,,184.42,Percent of total billed charges,,,0.96,,182.52,Percent of total billed charges,,,0.95,,180.61,Percent of total billed charges,,,,,,,,,0.95,,180.61,Percent of total billed charges,,180.61,186.32,
CISPLATIN 100 MG/100ML IV SOLN,RX-88377,CDM,J9060,HCPCS,636,RC,,inpatient,100,ML,209.3,188.37,,0.95,,198.84,Percent of total billed charges,,,0.98,,205.11,Percent of total billed charges,,,0.95,,198.84,Percent of total billed charges,,,0.97,,203.02,Percent of total billed charges,,,0.97,,203.02,Percent of total billed charges,,,0.96,,200.93,Percent of total billed charges,,,0.95,,198.84,Percent of total billed charges,,,,,,,,,0.95,,198.84,Percent of total billed charges,,198.84,205.11,
CISPLATIN 100 MG/100ML IV SOLN,RX-88377,CDM,J9060,HCPCS,636,RC,,outpatient,100,ML,209.3,188.37,,0.95,,198.84,Percent of total billed charges,,,0.98,,205.11,Percent of total billed charges,,,0.95,,198.84,Percent of total billed charges,,,0.95,,198.84,Percent of total billed charges,,,0.97,,203.02,Percent of total billed charges,,,0.96,,200.93,Percent of total billed charges,,,0.95,,198.84,Percent of total billed charges,,,,,,,,,0.95,,198.84,Percent of total billed charges,,198.84,205.11,
CISPLATIN 200 MG/200ML IV SOLN,RX-88378,CDM,J9060,HCPCS,636,RC,,inpatient,200,ML,339.7,305.73,,0.95,,322.72,Percent of total billed charges,,,0.98,,332.91,Percent of total billed charges,,,0.95,,322.72,Percent of total billed charges,,,0.97,,329.51,Percent of total billed charges,,,0.97,,329.51,Percent of total billed charges,,,0.96,,326.11,Percent of total billed charges,,,0.95,,322.72,Percent of total billed charges,,,,,,,,,0.95,,322.72,Percent of total billed charges,,322.72,332.91,
CISPLATIN 200 MG/200ML IV SOLN,RX-88378,CDM,J9060,HCPCS,636,RC,,outpatient,200,ML,339.7,305.73,,0.95,,322.72,Percent of total billed charges,,,0.98,,332.91,Percent of total billed charges,,,0.95,,322.72,Percent of total billed charges,,,0.95,,322.72,Percent of total billed charges,,,0.97,,329.51,Percent of total billed charges,,,0.96,,326.11,Percent of total billed charges,,,0.95,,322.72,Percent of total billed charges,,,,,,,,,0.95,,322.72,Percent of total billed charges,,322.72,332.91,
RALTEGRAVIR POTASSIUM 400 MG PO TABS,RX-88608,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,94.28,84.85,,0.95,,89.57,Percent of total billed charges,,,0.98,,92.39,Percent of total billed charges,,,0.95,,89.57,Percent of total billed charges,,,0.97,,91.45,Percent of total billed charges,,,0.97,,91.45,Percent of total billed charges,,,0.96,,90.51,Percent of total billed charges,,,0.95,,89.57,Percent of total billed charges,,,,,,,,,0.95,,89.57,Percent of total billed charges,,89.57,92.39,
RALTEGRAVIR POTASSIUM 400 MG PO TABS,RX-88608,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,94.28,84.85,,0.95,,89.57,Percent of total billed charges,,,0.98,,92.39,Percent of total billed charges,,,0.95,,89.57,Percent of total billed charges,,,0.95,,89.57,Percent of total billed charges,,,0.97,,91.45,Percent of total billed charges,,,0.96,,90.51,Percent of total billed charges,,,0.95,,89.57,Percent of total billed charges,,,,,,,,,0.95,,89.57,Percent of total billed charges,,89.57,92.39,
OSELTAMIVIR PHOSPHATE 30 MG PO CAPS,RX-88704,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,19.37,17.43,,0.95,,18.4,Percent of total billed charges,,,0.98,,18.98,Percent of total billed charges,,,0.95,,18.4,Percent of total billed charges,,,0.97,,18.79,Percent of total billed charges,,,0.97,,18.79,Percent of total billed charges,,,0.96,,18.6,Percent of total billed charges,,,0.95,,18.4,Percent of total billed charges,,,,,,,,,0.95,,18.4,Percent of total billed charges,,18.4,18.98,
OSELTAMIVIR PHOSPHATE 30 MG PO CAPS,RX-88704,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,19.37,17.43,,0.95,,18.4,Percent of total billed charges,,,0.98,,18.98,Percent of total billed charges,,,0.95,,18.4,Percent of total billed charges,,,0.95,,18.4,Percent of total billed charges,,,0.97,,18.79,Percent of total billed charges,,,0.96,,18.6,Percent of total billed charges,,,0.95,,18.4,Percent of total billed charges,,,,,,,,,0.95,,18.4,Percent of total billed charges,,18.4,18.98,
OSELTAMIVIR PHOSPHATE 45 MG PO CAPS,RX-88705,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,12,10.8,,0.95,,11.4,Percent of total billed charges,,,0.98,,11.76,Percent of total billed charges,,,0.95,,11.4,Percent of total billed charges,,,0.97,,11.64,Percent of total billed charges,,,0.97,,11.64,Percent of total billed charges,,,0.96,,11.52,Percent of total billed charges,,,0.95,,11.4,Percent of total billed charges,,,,,,,,,0.95,,11.4,Percent of total billed charges,,11.4,11.76,
OSELTAMIVIR PHOSPHATE 45 MG PO CAPS,RX-88705,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,12,10.8,,0.95,,11.4,Percent of total billed charges,,,0.98,,11.76,Percent of total billed charges,,,0.95,,11.4,Percent of total billed charges,,,0.95,,11.4,Percent of total billed charges,,,0.97,,11.64,Percent of total billed charges,,,0.96,,11.52,Percent of total billed charges,,,0.95,,11.4,Percent of total billed charges,,,,,,,,,0.95,,11.4,Percent of total billed charges,,11.4,11.76,
ZINC SULFATE 220 (50 ZN) MG PO CAPS,RX-8880,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.53,5.88,,0.95,,6.2,Percent of total billed charges,,,0.98,,6.4,Percent of total billed charges,,,0.95,,6.2,Percent of total billed charges,,,0.97,,6.33,Percent of total billed charges,,,0.97,,6.33,Percent of total billed charges,,,0.96,,6.27,Percent of total billed charges,,,0.95,,6.2,Percent of total billed charges,,,,,,,,,0.95,,6.2,Percent of total billed charges,,6.2,6.4,
ZINC SULFATE 220 (50 ZN) MG PO CAPS,RX-8880,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.53,5.88,,0.95,,6.2,Percent of total billed charges,,,0.98,,6.4,Percent of total billed charges,,,0.95,,6.2,Percent of total billed charges,,,0.95,,6.2,Percent of total billed charges,,,0.97,,6.33,Percent of total billed charges,,,0.96,,6.27,Percent of total billed charges,,,0.95,,6.2,Percent of total billed charges,,,,,,,,,0.95,,6.2,Percent of total billed charges,,6.2,6.4,
ACETAMINOPHEN 160 MG/5ML PO SUSP,RX-8943,CDM,J3490,HCPCS,637,RC,,inpatient,118,ML,12.71,11.44,,0.95,,12.07,Percent of total billed charges,,,0.98,,12.46,Percent of total billed charges,,,0.95,,12.07,Percent of total billed charges,,,0.97,,12.33,Percent of total billed charges,,,0.97,,12.33,Percent of total billed charges,,,0.96,,12.2,Percent of total billed charges,,,0.95,,12.07,Percent of total billed charges,,,,,,,,,0.95,,12.07,Percent of total billed charges,,12.07,12.46,
ACETAMINOPHEN 160 MG/5ML PO SUSP,RX-8943,CDM,J3490,HCPCS,637,RC,,outpatient,118,ML,12.71,11.44,,0.95,,12.07,Percent of total billed charges,,,0.98,,12.46,Percent of total billed charges,,,0.95,,12.07,Percent of total billed charges,,,0.95,,12.07,Percent of total billed charges,,,0.97,,12.33,Percent of total billed charges,,,0.96,,12.2,Percent of total billed charges,,,0.95,,12.07,Percent of total billed charges,,,,,,,,,0.95,,12.07,Percent of total billed charges,,12.07,12.46,
BUTALBITAL-APAP-CAFFEINE 50-325-40 MG PO TABS,RX-8958,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,12.01,10.81,,0.95,,11.41,Percent of total billed charges,,,0.98,,11.77,Percent of total billed charges,,,0.95,,11.41,Percent of total billed charges,,,0.97,,11.65,Percent of total billed charges,,,0.97,,11.65,Percent of total billed charges,,,0.96,,11.53,Percent of total billed charges,,,0.95,,11.41,Percent of total billed charges,,,,,,,,,0.95,,11.41,Percent of total billed charges,,11.41,11.77,
BUTALBITAL-APAP-CAFFEINE 50-325-40 MG PO TABS,RX-8958,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,12.01,10.81,,0.95,,11.41,Percent of total billed charges,,,0.98,,11.77,Percent of total billed charges,,,0.95,,11.41,Percent of total billed charges,,,0.95,,11.41,Percent of total billed charges,,,0.97,,11.65,Percent of total billed charges,,,0.96,,11.53,Percent of total billed charges,,,0.95,,11.41,Percent of total billed charges,,,,,,,,,0.95,,11.41,Percent of total billed charges,,11.41,11.77,
ACETIC ACID 0.25 % IRRIG SOLN,RX-8963,CDM,J3490,HCPCS,250,RC,,inpatient,1000,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
ACETIC ACID 0.25 % IRRIG SOLN,RX-8963,CDM,J3490,HCPCS,250,RC,,outpatient,1000,ML,49.44,44.5,,0.95,,46.97,Percent of total billed charges,,,0.98,,48.45,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,0.97,,47.96,Percent of total billed charges,,,0.96,,47.46,Percent of total billed charges,,,0.95,,46.97,Percent of total billed charges,,,,,,,,,0.95,,46.97,Percent of total billed charges,,46.97,48.45,
ACYCLOVIR 200 MG PO CAPS,RX-8969,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.37,5.73,,0.95,,6.05,Percent of total billed charges,,,0.98,,6.24,Percent of total billed charges,,,0.95,,6.05,Percent of total billed charges,,,0.97,,6.18,Percent of total billed charges,,,0.97,,6.18,Percent of total billed charges,,,0.96,,6.12,Percent of total billed charges,,,0.95,,6.05,Percent of total billed charges,,,,,,,,,0.95,,6.05,Percent of total billed charges,,6.05,6.24,
ACYCLOVIR 200 MG PO CAPS,RX-8969,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.37,5.73,,0.95,,6.05,Percent of total billed charges,,,0.98,,6.24,Percent of total billed charges,,,0.95,,6.05,Percent of total billed charges,,,0.95,,6.05,Percent of total billed charges,,,0.97,,6.18,Percent of total billed charges,,,0.96,,6.12,Percent of total billed charges,,,0.95,,6.05,Percent of total billed charges,,,,,,,,,0.95,,6.05,Percent of total billed charges,,6.05,6.24,
ALBUMIN HUMAN 25 % IV SOLN,RX-8981,CDM,P9047,HCPCS,636,RC,,inpatient,50,ML,181.49,163.34,,0.95,,172.42,Percent of total billed charges,,,0.98,,177.86,Percent of total billed charges,,,0.95,,172.42,Percent of total billed charges,,,0.97,,176.05,Percent of total billed charges,,,0.97,,176.05,Percent of total billed charges,,,0.96,,174.23,Percent of total billed charges,,,0.95,,172.42,Percent of total billed charges,,,,,,,,,0.95,,172.42,Percent of total billed charges,,172.42,177.86,
ALBUMIN HUMAN 25 % IV SOLN,RX-8981,CDM,P9047,HCPCS,636,RC,,outpatient,50,ML,181.49,163.34,,0.95,,172.42,Percent of total billed charges,,,0.98,,177.86,Percent of total billed charges,,,0.95,,172.42,Percent of total billed charges,,,0.95,,172.42,Percent of total billed charges,,,0.97,,176.05,Percent of total billed charges,,,0.96,,174.23,Percent of total billed charges,,,0.95,,172.42,Percent of total billed charges,,,,,,,,,0.95,,172.42,Percent of total billed charges,,172.42,177.86,
ALTEPLASE 100 MG IV SOLR,RX-9002,CDM,J2997,HCPCS,636,RC,,inpatient,100,ML,13711.86,12340.67,,0.95,,13026.27,Percent of total billed charges,,,0.98,,13437.62,Percent of total billed charges,,,0.95,,13026.27,Percent of total billed charges,,,0.97,,13300.5,Percent of total billed charges,,,0.97,,13300.5,Percent of total billed charges,,,0.96,,13163.39,Percent of total billed charges,,,0.95,,13026.27,Percent of total billed charges,,,,,,,,,0.95,,13026.27,Percent of total billed charges,,13026.27,13437.62,
ALTEPLASE 100 MG IV SOLR,RX-9002,CDM,J2997,HCPCS,636,RC,,outpatient,100,ML,13711.86,12340.67,,0.95,,13026.27,Percent of total billed charges,,,0.98,,13437.62,Percent of total billed charges,,,0.95,,13026.27,Percent of total billed charges,,,0.95,,13026.27,Percent of total billed charges,,,0.97,,13300.5,Percent of total billed charges,,,0.96,,13163.39,Percent of total billed charges,,,0.95,,13026.27,Percent of total billed charges,,,,,,,,,0.95,,13026.27,Percent of total billed charges,,13026.27,13437.62,
ALUM & MAG HYDROXIDE-SIMETH 200-200-20 MG/5ML PO SUSP,RX-9009,CDM,J3490,HCPCS,637,RC,,inpatient,10,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
ALUM & MAG HYDROXIDE-SIMETH 200-200-20 MG/5ML PO SUSP,RX-9009,CDM,J3490,HCPCS,637,RC,,outpatient,10,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
AMIODARONE HCL 200 MG PO TABS,RX-9066,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.66,5.99,,0.95,,6.33,Percent of total billed charges,,,0.98,,6.53,Percent of total billed charges,,,0.95,,6.33,Percent of total billed charges,,,0.97,,6.46,Percent of total billed charges,,,0.97,,6.46,Percent of total billed charges,,,0.96,,6.39,Percent of total billed charges,,,0.95,,6.33,Percent of total billed charges,,,,,,,,,0.95,,6.33,Percent of total billed charges,,6.33,6.53,
AMIODARONE HCL 200 MG PO TABS,RX-9066,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.66,5.99,,0.95,,6.33,Percent of total billed charges,,,0.98,,6.53,Percent of total billed charges,,,0.95,,6.33,Percent of total billed charges,,,0.95,,6.33,Percent of total billed charges,,,0.97,,6.46,Percent of total billed charges,,,0.96,,6.39,Percent of total billed charges,,,0.95,,6.33,Percent of total billed charges,,,,,,,,,0.95,,6.33,Percent of total billed charges,,6.33,6.53,
AMLODIPINE BESYLATE 5 MG PO TABS,RX-9071,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.42,5.78,,0.95,,6.1,Percent of total billed charges,,,0.98,,6.29,Percent of total billed charges,,,0.95,,6.1,Percent of total billed charges,,,0.97,,6.23,Percent of total billed charges,,,0.97,,6.23,Percent of total billed charges,,,0.96,,6.16,Percent of total billed charges,,,0.95,,6.1,Percent of total billed charges,,,,,,,,,0.95,,6.1,Percent of total billed charges,,6.1,6.29,
AMLODIPINE BESYLATE 5 MG PO TABS,RX-9071,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.42,5.78,,0.95,,6.1,Percent of total billed charges,,,0.98,,6.29,Percent of total billed charges,,,0.95,,6.1,Percent of total billed charges,,,0.95,,6.1,Percent of total billed charges,,,0.97,,6.23,Percent of total billed charges,,,0.96,,6.16,Percent of total billed charges,,,0.95,,6.1,Percent of total billed charges,,,,,,,,,0.95,,6.1,Percent of total billed charges,,6.1,6.29,
AMPICILLIN-SULBACTAM SODIUM 3 (2-1) G INJECTION SOLR,RX-9084,CDM,J0295,HCPCS,636,RC,,inpatient,8,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
AMPICILLIN-SULBACTAM SODIUM 3 (2-1) G INJECTION SOLR,RX-9084,CDM,J0295,HCPCS,636,RC,,outpatient,8,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
PRAMOXINE-CALAMINE 1-3 % EX LOTN,RX-91004,CDM,J3490,HCPCS,637,RC,,inpatient,118,ML,22.52,20.27,,0.95,,21.39,Percent of total billed charges,,,0.98,,22.07,Percent of total billed charges,,,0.95,,21.39,Percent of total billed charges,,,0.97,,21.84,Percent of total billed charges,,,0.97,,21.84,Percent of total billed charges,,,0.96,,21.62,Percent of total billed charges,,,0.95,,21.39,Percent of total billed charges,,,,,,,,,0.95,,21.39,Percent of total billed charges,,21.39,22.07,
PRAMOXINE-CALAMINE 1-3 % EX LOTN,RX-91004,CDM,J3490,HCPCS,637,RC,,outpatient,118,ML,22.52,20.27,,0.95,,21.39,Percent of total billed charges,,,0.98,,22.07,Percent of total billed charges,,,0.95,,21.39,Percent of total billed charges,,,0.95,,21.39,Percent of total billed charges,,,0.97,,21.84,Percent of total billed charges,,,0.96,,21.62,Percent of total billed charges,,,0.95,,21.39,Percent of total billed charges,,,,,,,,,0.95,,21.39,Percent of total billed charges,,21.39,22.07,
IRINOTECAN HCL 100 MG/5ML IV SOLN,RX-91054,CDM,J9206,HCPCS,636,RC,,inpatient,5,ML,205.09,184.58,,0.95,,194.84,Percent of total billed charges,,,0.98,,200.99,Percent of total billed charges,,,0.95,,194.84,Percent of total billed charges,,,0.97,,198.94,Percent of total billed charges,,,0.97,,198.94,Percent of total billed charges,,,0.96,,196.89,Percent of total billed charges,,,0.95,,194.84,Percent of total billed charges,,,,,,,,,0.95,,194.84,Percent of total billed charges,,194.84,200.99,
IRINOTECAN HCL 100 MG/5ML IV SOLN,RX-91054,CDM,J9206,HCPCS,636,RC,,outpatient,5,ML,205.09,184.58,,0.95,,194.84,Percent of total billed charges,,,0.98,,200.99,Percent of total billed charges,,,0.95,,194.84,Percent of total billed charges,,,0.95,,194.84,Percent of total billed charges,,,0.97,,198.94,Percent of total billed charges,,,0.96,,196.89,Percent of total billed charges,,,0.95,,194.84,Percent of total billed charges,,,,,,,,,0.95,,194.84,Percent of total billed charges,,194.84,200.99,
CIPROFLOXACIN IN D5W 400 MG/200ML IV SOLN,RX-91238,CDM,J0744,HCPCS,636,RC,,inpatient,200,ML,46.05,41.45,,0.95,,43.75,Percent of total billed charges,,,0.98,,45.13,Percent of total billed charges,,,0.95,,43.75,Percent of total billed charges,,,0.97,,44.67,Percent of total billed charges,,,0.97,,44.67,Percent of total billed charges,,,0.96,,44.21,Percent of total billed charges,,,0.95,,43.75,Percent of total billed charges,,,,,,,,,0.95,,43.75,Percent of total billed charges,,43.75,45.13,
CIPROFLOXACIN IN D5W 400 MG/200ML IV SOLN,RX-91238,CDM,J0744,HCPCS,636,RC,,outpatient,200,ML,46.05,41.45,,0.95,,43.75,Percent of total billed charges,,,0.98,,45.13,Percent of total billed charges,,,0.95,,43.75,Percent of total billed charges,,,0.95,,43.75,Percent of total billed charges,,,0.97,,44.67,Percent of total billed charges,,,0.96,,44.21,Percent of total billed charges,,,0.95,,43.75,Percent of total billed charges,,,,,,,,,0.95,,43.75,Percent of total billed charges,,43.75,45.13,
OCTREOTIDE ACETATE 200 MCG/ML INJECTION SOLN,RX-91280,CDM,J2354,HCPCS,636,RC,,inpatient,0.5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
OCTREOTIDE ACETATE 200 MCG/ML INJECTION SOLN,RX-91280,CDM,J2354,HCPCS,636,RC,,outpatient,0.5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
ASPIRIN-ACETAMINOPHEN-CAFFEINE 250-250-65 MG PO TABS,RX-9158,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,5.82,5.24,,0.95,,5.53,Percent of total billed charges,,,0.98,,5.7,Percent of total billed charges,,,0.95,,5.53,Percent of total billed charges,,,0.97,,5.65,Percent of total billed charges,,,0.97,,5.65,Percent of total billed charges,,,0.96,,5.59,Percent of total billed charges,,,0.95,,5.53,Percent of total billed charges,,,,,,,,,0.95,,5.53,Percent of total billed charges,,5.53,5.7,
ASPIRIN-ACETAMINOPHEN-CAFFEINE 250-250-65 MG PO TABS,RX-9158,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,5.82,5.24,,0.95,,5.53,Percent of total billed charges,,,0.98,,5.7,Percent of total billed charges,,,0.95,,5.53,Percent of total billed charges,,,0.95,,5.53,Percent of total billed charges,,,0.97,,5.65,Percent of total billed charges,,,0.96,,5.59,Percent of total billed charges,,,0.95,,5.53,Percent of total billed charges,,,,,,,,,0.95,,5.53,Percent of total billed charges,,5.53,5.7,
METHYLNALTREXONE BROMIDE 12 MG/0.6ML SUBQ SOLN,RX-91651,CDM,J2212,HCPCS,637,RC,,inpatient,0.4,ML,328,295.2,,0.95,,311.6,Percent of total billed charges,,,0.98,,321.44,Percent of total billed charges,,,0.95,,311.6,Percent of total billed charges,,,0.97,,318.16,Percent of total billed charges,,,0.97,,318.16,Percent of total billed charges,,,0.96,,314.88,Percent of total billed charges,,,0.95,,311.6,Percent of total billed charges,,,,,,,,,0.95,,311.6,Percent of total billed charges,,311.6,321.44,
METHYLNALTREXONE BROMIDE 12 MG/0.6ML SUBQ SOLN,RX-91651,CDM,J2212,HCPCS,637,RC,,outpatient,0.4,ML,328,295.2,,0.95,,311.6,Percent of total billed charges,,,0.98,,321.44,Percent of total billed charges,,,0.95,,311.6,Percent of total billed charges,,,0.95,,311.6,Percent of total billed charges,,,0.97,,318.16,Percent of total billed charges,,,0.96,,314.88,Percent of total billed charges,,,0.95,,311.6,Percent of total billed charges,,,,,,,,,0.95,,311.6,Percent of total billed charges,,311.6,321.44,
AZATHIOPRINE 50 MG PO TABS,RX-9183,CDM,J7500,HCPCS,636,RC,,inpatient,0.5,UN,5.67,5.1,,0.95,,5.39,Percent of total billed charges,,,0.98,,5.56,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,0.97,,5.5,Percent of total billed charges,,,0.97,,5.5,Percent of total billed charges,,,0.96,,5.44,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,,,,,,,0.95,,5.39,Percent of total billed charges,,5.39,5.56,
AZATHIOPRINE 50 MG PO TABS,RX-9183,CDM,J7500,HCPCS,636,RC,,outpatient,0.5,UN,5.67,5.1,,0.95,,5.39,Percent of total billed charges,,,0.98,,5.56,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,0.97,,5.5,Percent of total billed charges,,,0.96,,5.44,Percent of total billed charges,,,0.95,,5.39,Percent of total billed charges,,,,,,,,,0.95,,5.39,Percent of total billed charges,,5.39,5.56,
AZTREONAM 1 G INJECTION SOLR,RX-9185,CDM,J0457,HCPCS,636,RC,,inpatient,5,ML,63.16,56.84,,0.95,,60,Percent of total billed charges,,,0.98,,61.9,Percent of total billed charges,,,0.95,,60,Percent of total billed charges,,,0.97,,61.27,Percent of total billed charges,,,0.97,,61.27,Percent of total billed charges,,,0.96,,60.63,Percent of total billed charges,,,0.95,,60,Percent of total billed charges,,,,,,,,,0.95,,60,Percent of total billed charges,,60,61.9,
AZTREONAM 1 G INJECTION SOLR,RX-9185,CDM,J0457,HCPCS,636,RC,,outpatient,5,ML,63.16,56.84,,0.95,,60,Percent of total billed charges,,,0.98,,61.9,Percent of total billed charges,,,0.95,,60,Percent of total billed charges,,,0.95,,60,Percent of total billed charges,,,0.97,,61.27,Percent of total billed charges,,,0.96,,60.63,Percent of total billed charges,,,0.95,,60,Percent of total billed charges,,,,,,,,,0.95,,60,Percent of total billed charges,,60,61.9,
AZTREONAM 2 G INJECTION SOLR,RX-9186,CDM,J0457,HCPCS,636,RC,,inpatient,1.5,GR,138.79,124.91,,0.95,,131.85,Percent of total billed charges,,,0.98,,136.01,Percent of total billed charges,,,0.95,,131.85,Percent of total billed charges,,,0.97,,134.63,Percent of total billed charges,,,0.97,,134.63,Percent of total billed charges,,,0.96,,133.24,Percent of total billed charges,,,0.95,,131.85,Percent of total billed charges,,,,,,,,,0.95,,131.85,Percent of total billed charges,,131.85,136.01,
AZTREONAM 2 G INJECTION SOLR,RX-9186,CDM,J0457,HCPCS,636,RC,,outpatient,1.5,GR,138.79,124.91,,0.95,,131.85,Percent of total billed charges,,,0.98,,136.01,Percent of total billed charges,,,0.95,,131.85,Percent of total billed charges,,,0.95,,131.85,Percent of total billed charges,,,0.97,,134.63,Percent of total billed charges,,,0.96,,133.24,Percent of total billed charges,,,0.95,,131.85,Percent of total billed charges,,,,,,,,,0.95,,131.85,Percent of total billed charges,,131.85,136.01,
BENAZEPRIL HCL 10 MG PO TABS,RX-9220,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.2,5.58,,0.95,,5.89,Percent of total billed charges,,,0.98,,6.08,Percent of total billed charges,,,0.95,,5.89,Percent of total billed charges,,,0.97,,6.01,Percent of total billed charges,,,0.97,,6.01,Percent of total billed charges,,,0.96,,5.95,Percent of total billed charges,,,0.95,,5.89,Percent of total billed charges,,,,,,,,,0.95,,5.89,Percent of total billed charges,,5.89,6.08,
BENAZEPRIL HCL 10 MG PO TABS,RX-9220,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.2,5.58,,0.95,,5.89,Percent of total billed charges,,,0.98,,6.08,Percent of total billed charges,,,0.95,,5.89,Percent of total billed charges,,,0.95,,5.89,Percent of total billed charges,,,0.97,,6.01,Percent of total billed charges,,,0.96,,5.95,Percent of total billed charges,,,0.95,,5.89,Percent of total billed charges,,,,,,,,,0.95,,5.89,Percent of total billed charges,,5.89,6.08,
BENZYLPENICILLOYL POLYLYSINE 0.25 ML ID SOLN,RX-9260,CDM,J3490,HCPCS,250,RC,,inpatient,0.01,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
BENZYLPENICILLOYL POLYLYSINE 0.25 ML ID SOLN,RX-9260,CDM,J3490,HCPCS,250,RC,,outpatient,0.01,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
BETAMETHASONE SOD PHOS & ACET 6 (3-3) MG/ML INJECTION SUSP,RX-9266,CDM,J0702,HCPCS,636,RC,,inpatient,1,ML,31.69,28.52,,0.95,,30.11,Percent of total billed charges,,,0.98,,31.06,Percent of total billed charges,,,0.95,,30.11,Percent of total billed charges,,,0.97,,30.74,Percent of total billed charges,,,0.97,,30.74,Percent of total billed charges,,,0.96,,30.42,Percent of total billed charges,,,0.95,,30.11,Percent of total billed charges,,,,,,,,,0.95,,30.11,Percent of total billed charges,,30.11,31.06,
BETAMETHASONE SOD PHOS & ACET 6 (3-3) MG/ML INJECTION SUSP,RX-9266,CDM,J0702,HCPCS,636,RC,,outpatient,1,ML,31.69,28.52,,0.95,,30.11,Percent of total billed charges,,,0.98,,31.06,Percent of total billed charges,,,0.95,,30.11,Percent of total billed charges,,,0.95,,30.11,Percent of total billed charges,,,0.97,,30.74,Percent of total billed charges,,,0.96,,30.42,Percent of total billed charges,,,0.95,,30.11,Percent of total billed charges,,,,,,,,,0.95,,30.11,Percent of total billed charges,,30.11,31.06,
PREDNISOLONE SODIUM PHOSPHATE 6.7 (5 BASE) MG/5ML PO SOLN,RX-92810,CDM,J7510,HCPCS,636,RC,,inpatient,15,ML,32.4,29.16,,0.95,,30.78,Percent of total billed charges,,,0.98,,31.75,Percent of total billed charges,,,0.95,,30.78,Percent of total billed charges,,,0.97,,31.43,Percent of total billed charges,,,0.97,,31.43,Percent of total billed charges,,,0.96,,31.1,Percent of total billed charges,,,0.95,,30.78,Percent of total billed charges,,,,,,,,,0.95,,30.78,Percent of total billed charges,,30.78,31.75,
PREDNISOLONE SODIUM PHOSPHATE 6.7 (5 BASE) MG/5ML PO SOLN,RX-92810,CDM,J7510,HCPCS,636,RC,,outpatient,15,ML,32.4,29.16,,0.95,,30.78,Percent of total billed charges,,,0.98,,31.75,Percent of total billed charges,,,0.95,,30.78,Percent of total billed charges,,,0.95,,30.78,Percent of total billed charges,,,0.97,,31.43,Percent of total billed charges,,,0.96,,31.1,Percent of total billed charges,,,0.95,,30.78,Percent of total billed charges,,,,,,,,,0.95,,30.78,Percent of total billed charges,,30.78,31.75,
ZINC OXIDE 13 % EX CREA,RX-92811,CDM,J3490,HCPCS,637,RC,,inpatient,113,GR,31.43,28.29,,0.95,,29.86,Percent of total billed charges,,,0.98,,30.8,Percent of total billed charges,,,0.95,,29.86,Percent of total billed charges,,,0.97,,30.49,Percent of total billed charges,,,0.97,,30.49,Percent of total billed charges,,,0.96,,30.17,Percent of total billed charges,,,0.95,,29.86,Percent of total billed charges,,,,,,,,,0.95,,29.86,Percent of total billed charges,,29.86,30.8,
ZINC OXIDE 13 % EX CREA,RX-92811,CDM,J3490,HCPCS,637,RC,,outpatient,113,GR,31.43,28.29,,0.95,,29.86,Percent of total billed charges,,,0.98,,30.8,Percent of total billed charges,,,0.95,,29.86,Percent of total billed charges,,,0.95,,29.86,Percent of total billed charges,,,0.97,,30.49,Percent of total billed charges,,,0.96,,30.17,Percent of total billed charges,,,0.95,,29.86,Percent of total billed charges,,,,,,,,,0.95,,29.86,Percent of total billed charges,,29.86,30.8,
AMIODARONE HCL 150 MG/3ML IV SOLN,RX-93084,CDM,J0282,HCPCS,636,RC,,inpatient,3,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
AMIODARONE HCL 150 MG/3ML IV SOLN,RX-93084,CDM,J0282,HCPCS,636,RC,,outpatient,3,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
BUMETANIDE 1 MG PO TABS,RX-9310,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,10.21,9.19,,0.95,,9.7,Percent of total billed charges,,,0.98,,10.01,Percent of total billed charges,,,0.95,,9.7,Percent of total billed charges,,,0.97,,9.9,Percent of total billed charges,,,0.97,,9.9,Percent of total billed charges,,,0.96,,9.8,Percent of total billed charges,,,0.95,,9.7,Percent of total billed charges,,,,,,,,,0.95,,9.7,Percent of total billed charges,,9.7,10.01,
BUMETANIDE 1 MG PO TABS,RX-9310,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,10.21,9.19,,0.95,,9.7,Percent of total billed charges,,,0.98,,10.01,Percent of total billed charges,,,0.95,,9.7,Percent of total billed charges,,,0.95,,9.7,Percent of total billed charges,,,0.97,,9.9,Percent of total billed charges,,,0.96,,9.8,Percent of total billed charges,,,0.95,,9.7,Percent of total billed charges,,,,,,,,,0.95,,9.7,Percent of total billed charges,,9.7,10.01,
BUPIVACAINE-EPINEPHRINE 0.5% -1:200000 INJECTION SOLN,RX-9318,CDM,J3490,HCPCS,250,RC,,inpatient,5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
BUPIVACAINE-EPINEPHRINE 0.5% -1:200000 INJECTION SOLN,RX-9318,CDM,J3490,HCPCS,250,RC,,outpatient,5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
BUPROPION HCL 100 MG PO TABS,RX-9321,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,11.4,10.26,,0.95,,10.83,Percent of total billed charges,,,0.98,,11.17,Percent of total billed charges,,,0.95,,10.83,Percent of total billed charges,,,0.97,,11.06,Percent of total billed charges,,,0.97,,11.06,Percent of total billed charges,,,0.96,,10.94,Percent of total billed charges,,,0.95,,10.83,Percent of total billed charges,,,,,,,,,0.95,,10.83,Percent of total billed charges,,10.83,11.17,
BUPROPION HCL 100 MG PO TABS,RX-9321,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,11.4,10.26,,0.95,,10.83,Percent of total billed charges,,,0.98,,11.17,Percent of total billed charges,,,0.95,,10.83,Percent of total billed charges,,,0.95,,10.83,Percent of total billed charges,,,0.97,,11.06,Percent of total billed charges,,,0.96,,10.94,Percent of total billed charges,,,0.95,,10.83,Percent of total billed charges,,,,,,,,,0.95,,10.83,Percent of total billed charges,,10.83,11.17,
BUSPIRONE HCL 5 MG PO TABS,RX-9324,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,5.96,5.36,,0.95,,5.66,Percent of total billed charges,,,0.98,,5.84,Percent of total billed charges,,,0.95,,5.66,Percent of total billed charges,,,0.97,,5.78,Percent of total billed charges,,,0.97,,5.78,Percent of total billed charges,,,0.96,,5.72,Percent of total billed charges,,,0.95,,5.66,Percent of total billed charges,,,,,,,,,0.95,,5.66,Percent of total billed charges,,5.66,5.84,
BUSPIRONE HCL 5 MG PO TABS,RX-9324,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,5.96,5.36,,0.95,,5.66,Percent of total billed charges,,,0.98,,5.84,Percent of total billed charges,,,0.95,,5.66,Percent of total billed charges,,,0.95,,5.66,Percent of total billed charges,,,0.97,,5.78,Percent of total billed charges,,,0.96,,5.72,Percent of total billed charges,,,0.95,,5.66,Percent of total billed charges,,,,,,,,,0.95,,5.66,Percent of total billed charges,,5.66,5.84,
BUTORPHANOL TARTRATE 1 MG/ML INJECTION SOLN,RX-9333,CDM,J0595,HCPCS,636,RC,,inpatient,1,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
BUTORPHANOL TARTRATE 1 MG/ML INJECTION SOLN,RX-9333,CDM,J0595,HCPCS,636,RC,,outpatient,1,ML,25.75,23.18,,0.95,,24.46,Percent of total billed charges,,,0.98,,25.24,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,0.97,,24.98,Percent of total billed charges,,,0.96,,24.72,Percent of total billed charges,,,0.95,,24.46,Percent of total billed charges,,,,,,,,,0.95,,24.46,Percent of total billed charges,,24.46,25.24,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLN,RX-9347,CDM,J0630,HCPCS,637,RC,,inpatient,0.25,ML,316.49,284.84,,0.95,,300.67,Percent of total billed charges,,,0.98,,310.16,Percent of total billed charges,,,0.95,,300.67,Percent of total billed charges,,,0.97,,307,Percent of total billed charges,,,0.97,,307,Percent of total billed charges,,,0.96,,303.83,Percent of total billed charges,,,0.95,,300.67,Percent of total billed charges,,,,,,,,,0.95,,300.67,Percent of total billed charges,,300.67,310.16,
CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLN,RX-9347,CDM,J0630,HCPCS,637,RC,,outpatient,0.25,ML,316.49,284.84,,0.95,,300.67,Percent of total billed charges,,,0.98,,310.16,Percent of total billed charges,,,0.95,,300.67,Percent of total billed charges,,,0.95,,300.67,Percent of total billed charges,,,0.97,,307,Percent of total billed charges,,,0.96,,303.83,Percent of total billed charges,,,0.95,,300.67,Percent of total billed charges,,,,,,,,,0.95,,300.67,Percent of total billed charges,,300.67,310.16,
CALCITRIOL 0.25 MCG PO CAPS,RX-9350,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,9.43,8.49,,0.95,,8.96,Percent of total billed charges,,,0.98,,9.24,Percent of total billed charges,,,0.95,,8.96,Percent of total billed charges,,,0.97,,9.15,Percent of total billed charges,,,0.97,,9.15,Percent of total billed charges,,,0.96,,9.05,Percent of total billed charges,,,0.95,,8.96,Percent of total billed charges,,,,,,,,,0.95,,8.96,Percent of total billed charges,,8.96,9.24,
CALCITRIOL 0.25 MCG PO CAPS,RX-9350,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,9.43,8.49,,0.95,,8.96,Percent of total billed charges,,,0.98,,9.24,Percent of total billed charges,,,0.95,,8.96,Percent of total billed charges,,,0.95,,8.96,Percent of total billed charges,,,0.97,,9.15,Percent of total billed charges,,,0.96,,9.05,Percent of total billed charges,,,0.95,,8.96,Percent of total billed charges,,,,,,,,,0.95,,8.96,Percent of total billed charges,,8.96,9.24,
SORBITOL 70 % SOLN,RX-93927,CDM,J3490,HCPCS,637,RC,,inpatient,15,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
SORBITOL 70 % SOLN,RX-93927,CDM,J3490,HCPCS,637,RC,,outpatient,15,ML,3914,3522.6,,0.95,,3718.3,Percent of total billed charges,,,0.98,,3835.72,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,0.97,,3796.58,Percent of total billed charges,,,0.96,,3757.44,Percent of total billed charges,,,0.95,,3718.3,Percent of total billed charges,,,,,,,,,0.95,,3718.3,Percent of total billed charges,,3718.3,3835.72,
IPRATROPIUM-ALBUTEROL 0.5-2.5 (3) MG/3ML INHAL SOLN,RX-93931,CDM,J7620,HCPCS,636,RC,,inpatient,3,ML,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
IPRATROPIUM-ALBUTEROL 0.5-2.5 (3) MG/3ML INHAL SOLN,RX-93931,CDM,J7620,HCPCS,636,RC,,outpatient,3,ML,10.3,9.27,,0.95,,9.79,Percent of total billed charges,,,0.98,,10.09,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,0.97,,9.99,Percent of total billed charges,,,0.96,,9.89,Percent of total billed charges,,,0.95,,9.79,Percent of total billed charges,,,,,,,,,0.95,,9.79,Percent of total billed charges,,9.79,10.09,
CAPSAICIN 0.075 % EX CREA,RX-9399,CDM,J3490,HCPCS,637,RC,,inpatient,57,GR,20.36,18.32,,0.95,,19.34,Percent of total billed charges,,,0.98,,19.95,Percent of total billed charges,,,0.95,,19.34,Percent of total billed charges,,,0.97,,19.75,Percent of total billed charges,,,0.97,,19.75,Percent of total billed charges,,,0.96,,19.55,Percent of total billed charges,,,0.95,,19.34,Percent of total billed charges,,,,,,,,,0.95,,19.34,Percent of total billed charges,,19.34,19.95,
CAPSAICIN 0.075 % EX CREA,RX-9399,CDM,J3490,HCPCS,637,RC,,outpatient,57,GR,20.36,18.32,,0.95,,19.34,Percent of total billed charges,,,0.98,,19.95,Percent of total billed charges,,,0.95,,19.34,Percent of total billed charges,,,0.95,,19.34,Percent of total billed charges,,,0.97,,19.75,Percent of total billed charges,,,0.96,,19.55,Percent of total billed charges,,,0.95,,19.34,Percent of total billed charges,,,,,,,,,0.95,,19.34,Percent of total billed charges,,19.34,19.95,
CAPTOPRIL 12.5 MG PO TABS,RX-9401,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,9.83,8.85,,0.95,,9.34,Percent of total billed charges,,,0.98,,9.63,Percent of total billed charges,,,0.95,,9.34,Percent of total billed charges,,,0.97,,9.54,Percent of total billed charges,,,0.97,,9.54,Percent of total billed charges,,,0.96,,9.44,Percent of total billed charges,,,0.95,,9.34,Percent of total billed charges,,,,,,,,,0.95,,9.34,Percent of total billed charges,,9.34,9.63,
CAPTOPRIL 12.5 MG PO TABS,RX-9401,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,9.83,8.85,,0.95,,9.34,Percent of total billed charges,,,0.98,,9.63,Percent of total billed charges,,,0.95,,9.34,Percent of total billed charges,,,0.95,,9.34,Percent of total billed charges,,,0.97,,9.54,Percent of total billed charges,,,0.96,,9.44,Percent of total billed charges,,,0.95,,9.34,Percent of total billed charges,,,,,,,,,0.95,,9.34,Percent of total billed charges,,9.34,9.63,
CARBIDOPA-LEVODOPA 10-100 MG PO TABS,RX-9406,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.83,6.15,,0.95,,6.49,Percent of total billed charges,,,0.98,,6.69,Percent of total billed charges,,,0.95,,6.49,Percent of total billed charges,,,0.97,,6.63,Percent of total billed charges,,,0.97,,6.63,Percent of total billed charges,,,0.96,,6.56,Percent of total billed charges,,,0.95,,6.49,Percent of total billed charges,,,,,,,,,0.95,,6.49,Percent of total billed charges,,6.49,6.69,
CARBIDOPA-LEVODOPA 10-100 MG PO TABS,RX-9406,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.83,6.15,,0.95,,6.49,Percent of total billed charges,,,0.98,,6.69,Percent of total billed charges,,,0.95,,6.49,Percent of total billed charges,,,0.95,,6.49,Percent of total billed charges,,,0.97,,6.63,Percent of total billed charges,,,0.96,,6.56,Percent of total billed charges,,,0.95,,6.49,Percent of total billed charges,,,,,,,,,0.95,,6.49,Percent of total billed charges,,6.49,6.69,
CARBIDOPA-LEVODOPA 25-100 MG PO TABS,RX-9407,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.73,6.06,,0.95,,6.39,Percent of total billed charges,,,0.98,,6.6,Percent of total billed charges,,,0.95,,6.39,Percent of total billed charges,,,0.97,,6.53,Percent of total billed charges,,,0.97,,6.53,Percent of total billed charges,,,0.96,,6.46,Percent of total billed charges,,,0.95,,6.39,Percent of total billed charges,,,,,,,,,0.95,,6.39,Percent of total billed charges,,6.39,6.6,
CARBIDOPA-LEVODOPA 25-100 MG PO TABS,RX-9407,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.73,6.06,,0.95,,6.39,Percent of total billed charges,,,0.98,,6.6,Percent of total billed charges,,,0.95,,6.39,Percent of total billed charges,,,0.95,,6.39,Percent of total billed charges,,,0.97,,6.53,Percent of total billed charges,,,0.96,,6.46,Percent of total billed charges,,,0.95,,6.39,Percent of total billed charges,,,,,,,,,0.95,,6.39,Percent of total billed charges,,6.39,6.6,
ONDANSETRON HCL 4 MG/2ML INJECTION SOLN,RX-94096,CDM,J2405,HCPCS,636,RC,,inpatient,2,ML,39.14,35.23,,0.95,,37.18,Percent of total billed charges,,,0.98,,38.36,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,0.97,,37.97,Percent of total billed charges,,,0.97,,37.97,Percent of total billed charges,,,0.96,,37.57,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,,,,,,,0.95,,37.18,Percent of total billed charges,,37.18,38.36,
ONDANSETRON HCL 4 MG/2ML INJECTION SOLN,RX-94096,CDM,J2405,HCPCS,636,RC,,outpatient,2,ML,39.14,35.23,,0.95,,37.18,Percent of total billed charges,,,0.98,,38.36,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,0.97,,37.97,Percent of total billed charges,,,0.96,,37.57,Percent of total billed charges,,,0.95,,37.18,Percent of total billed charges,,,,,,,,,0.95,,37.18,Percent of total billed charges,,37.18,38.36,
CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN,RX-9413,CDM,J3490,HCPCS,250,RC,,inpatient,0.5,ML,494.92,445.43,,0.95,,470.17,Percent of total billed charges,,,0.98,,485.02,Percent of total billed charges,,,0.95,,470.17,Percent of total billed charges,,,0.97,,480.07,Percent of total billed charges,,,0.97,,480.07,Percent of total billed charges,,,0.96,,475.12,Percent of total billed charges,,,0.95,,470.17,Percent of total billed charges,,,,,,,,,0.95,,470.17,Percent of total billed charges,,470.17,485.02,
CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN,RX-9413,CDM,J3490,HCPCS,250,RC,,outpatient,0.5,ML,494.92,445.43,,0.95,,470.17,Percent of total billed charges,,,0.98,,485.02,Percent of total billed charges,,,0.95,,470.17,Percent of total billed charges,,,0.95,,470.17,Percent of total billed charges,,,0.97,,480.07,Percent of total billed charges,,,0.96,,475.12,Percent of total billed charges,,,0.95,,470.17,Percent of total billed charges,,,,,,,,,0.95,,470.17,Percent of total billed charges,,470.17,485.02,
BENZOCAINE-MENTHOL 15-3.6 MG MOUTH/THROAT LOZG,RX-94141,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.5,5.85,,0.95,,6.18,Percent of total billed charges,,,0.98,,6.37,Percent of total billed charges,,,0.95,,6.18,Percent of total billed charges,,,0.97,,6.31,Percent of total billed charges,,,0.97,,6.31,Percent of total billed charges,,,0.96,,6.24,Percent of total billed charges,,,0.95,,6.18,Percent of total billed charges,,,,,,,,,0.95,,6.18,Percent of total billed charges,,6.18,6.37,
BENZOCAINE-MENTHOL 15-3.6 MG MOUTH/THROAT LOZG,RX-94141,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.5,5.85,,0.95,,6.18,Percent of total billed charges,,,0.98,,6.37,Percent of total billed charges,,,0.95,,6.18,Percent of total billed charges,,,0.95,,6.18,Percent of total billed charges,,,0.97,,6.31,Percent of total billed charges,,,0.96,,6.24,Percent of total billed charges,,,0.95,,6.18,Percent of total billed charges,,,,,,,,,0.95,,6.18,Percent of total billed charges,,6.18,6.37,
NICARDIPINE HCL IN NACL 40-0.83 MG/200ML-% IV SOLN,RX-94576,CDM,J2404,HCPCS,636,RC,,inpatient,200,ML,259.15,233.24,,0.95,,246.19,Percent of total billed charges,,,0.98,,253.97,Percent of total billed charges,,,0.95,,246.19,Percent of total billed charges,,,0.97,,251.38,Percent of total billed charges,,,0.97,,251.38,Percent of total billed charges,,,0.96,,248.78,Percent of total billed charges,,,0.95,,246.19,Percent of total billed charges,,,,,,,,,0.95,,246.19,Percent of total billed charges,,246.19,253.97,
NICARDIPINE HCL IN NACL 40-0.83 MG/200ML-% IV SOLN,RX-94576,CDM,J2404,HCPCS,636,RC,,outpatient,200,ML,259.15,233.24,,0.95,,246.19,Percent of total billed charges,,,0.98,,253.97,Percent of total billed charges,,,0.95,,246.19,Percent of total billed charges,,,0.95,,246.19,Percent of total billed charges,,,0.97,,251.38,Percent of total billed charges,,,0.96,,248.78,Percent of total billed charges,,,0.95,,246.19,Percent of total billed charges,,,,,,,,,0.95,,246.19,Percent of total billed charges,,246.19,253.97,
CEFOTETAN DISODIUM 1 G INJECTION SOLR,RX-9458,CDM,J3490,HCPCS,250,RC,,inpatient,0.25,GR,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
CEFOTETAN DISODIUM 1 G INJECTION SOLR,RX-9458,CDM,J3490,HCPCS,250,RC,,outpatient,0.25,GR,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
CEFOXITIN SODIUM 1 G IV SOLR,RX-9461,CDM,J0694,HCPCS,636,RC,,inpatient,1,GR,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
CEFOXITIN SODIUM 1 G IV SOLR,RX-9461,CDM,J0694,HCPCS,636,RC,,outpatient,1,GR,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
CEFOXITIN SODIUM 2 G IV SOLR,RX-9463,CDM,J0694,HCPCS,636,RC,,inpatient,2,GR,30.17,27.15,,0.95,,28.66,Percent of total billed charges,,,0.98,,29.57,Percent of total billed charges,,,0.95,,28.66,Percent of total billed charges,,,0.97,,29.26,Percent of total billed charges,,,0.97,,29.26,Percent of total billed charges,,,0.96,,28.96,Percent of total billed charges,,,0.95,,28.66,Percent of total billed charges,,,,,,,,,0.95,,28.66,Percent of total billed charges,,28.66,29.57,
CEFOXITIN SODIUM 2 G IV SOLR,RX-9463,CDM,J0694,HCPCS,636,RC,,outpatient,2,GR,30.17,27.15,,0.95,,28.66,Percent of total billed charges,,,0.98,,29.57,Percent of total billed charges,,,0.95,,28.66,Percent of total billed charges,,,0.95,,28.66,Percent of total billed charges,,,0.97,,29.26,Percent of total billed charges,,,0.96,,28.96,Percent of total billed charges,,,0.95,,28.66,Percent of total billed charges,,,,,,,,,0.95,,28.66,Percent of total billed charges,,28.66,29.57,
CEFPODOXIME PROXETIL 100 MG/5ML PO SUSR,RX-9466,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,39.94,35.95,,0.95,,37.94,Percent of total billed charges,,,0.98,,39.14,Percent of total billed charges,,,0.95,,37.94,Percent of total billed charges,,,0.97,,38.74,Percent of total billed charges,,,0.97,,38.74,Percent of total billed charges,,,0.96,,38.34,Percent of total billed charges,,,0.95,,37.94,Percent of total billed charges,,,,,,,,,0.95,,37.94,Percent of total billed charges,,37.94,39.14,
CEFPODOXIME PROXETIL 100 MG/5ML PO SUSR,RX-9466,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,39.94,35.95,,0.95,,37.94,Percent of total billed charges,,,0.98,,39.14,Percent of total billed charges,,,0.95,,37.94,Percent of total billed charges,,,0.95,,37.94,Percent of total billed charges,,,0.97,,38.74,Percent of total billed charges,,,0.96,,38.34,Percent of total billed charges,,,0.95,,37.94,Percent of total billed charges,,,,,,,,,0.95,,37.94,Percent of total billed charges,,37.94,39.14,
CEFPODOXIME PROXETIL 200 MG PO TABS,RX-9469,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,22.57,20.31,,0.95,,21.44,Percent of total billed charges,,,0.98,,22.12,Percent of total billed charges,,,0.95,,21.44,Percent of total billed charges,,,0.97,,21.89,Percent of total billed charges,,,0.97,,21.89,Percent of total billed charges,,,0.96,,21.67,Percent of total billed charges,,,0.95,,21.44,Percent of total billed charges,,,,,,,,,0.95,,21.44,Percent of total billed charges,,21.44,22.12,
CEFPODOXIME PROXETIL 200 MG PO TABS,RX-9469,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,22.57,20.31,,0.95,,21.44,Percent of total billed charges,,,0.98,,22.12,Percent of total billed charges,,,0.95,,21.44,Percent of total billed charges,,,0.95,,21.44,Percent of total billed charges,,,0.97,,21.89,Percent of total billed charges,,,0.96,,21.67,Percent of total billed charges,,,0.95,,21.44,Percent of total billed charges,,,,,,,,,0.95,,21.44,Percent of total billed charges,,21.44,22.12,
CEFTAZIDIME 1 G INJECTION SOLR,RX-9474,CDM,J0713,HCPCS,636,RC,,inpatient,1,GR,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
CEFTAZIDIME 1 G INJECTION SOLR,RX-9474,CDM,J0713,HCPCS,636,RC,,outpatient,1,GR,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
CEFTRIAXONE SODIUM 1 G INJECTION SOLR,RX-9487,CDM,J0696,HCPCS,636,RC,,inpatient,1,GR,89.46,80.51,,0.95,,84.99,Percent of total billed charges,,,0.98,,87.67,Percent of total billed charges,,,0.95,,84.99,Percent of total billed charges,,,0.97,,86.78,Percent of total billed charges,,,0.97,,86.78,Percent of total billed charges,,,0.96,,85.88,Percent of total billed charges,,,0.95,,84.99,Percent of total billed charges,,,,,,,,,0.95,,84.99,Percent of total billed charges,,84.99,87.67,
CEFTRIAXONE SODIUM 1 G INJECTION SOLR,RX-9487,CDM,J0696,HCPCS,636,RC,,outpatient,1,GR,89.46,80.51,,0.95,,84.99,Percent of total billed charges,,,0.98,,87.67,Percent of total billed charges,,,0.95,,84.99,Percent of total billed charges,,,0.95,,84.99,Percent of total billed charges,,,0.97,,86.78,Percent of total billed charges,,,0.96,,85.88,Percent of total billed charges,,,0.95,,84.99,Percent of total billed charges,,,,,,,,,0.95,,84.99,Percent of total billed charges,,84.99,87.67,
CEFTRIAXONE SODIUM 250 MG INJECTION SOLR,RX-9489,CDM,J0696,HCPCS,636,RC,,inpatient,250,ME,89.33,80.4,,0.95,,84.86,Percent of total billed charges,,,0.98,,87.54,Percent of total billed charges,,,0.95,,84.86,Percent of total billed charges,,,0.97,,86.65,Percent of total billed charges,,,0.97,,86.65,Percent of total billed charges,,,0.96,,85.76,Percent of total billed charges,,,0.95,,84.86,Percent of total billed charges,,,,,,,,,0.95,,84.86,Percent of total billed charges,,84.86,87.54,
CEFTRIAXONE SODIUM 250 MG INJECTION SOLR,RX-9489,CDM,J0696,HCPCS,636,RC,,outpatient,250,ME,89.33,80.4,,0.95,,84.86,Percent of total billed charges,,,0.98,,87.54,Percent of total billed charges,,,0.95,,84.86,Percent of total billed charges,,,0.95,,84.86,Percent of total billed charges,,,0.97,,86.65,Percent of total billed charges,,,0.96,,85.76,Percent of total billed charges,,,0.95,,84.86,Percent of total billed charges,,,,,,,,,0.95,,84.86,Percent of total billed charges,,84.86,87.54,
CEFTRIAXONE SODIUM 500 MG INJECTION SOLR,RX-9490,CDM,J0696,HCPCS,636,RC,,inpatient,500,ME,119.74,107.77,,0.95,,113.75,Percent of total billed charges,,,0.98,,117.35,Percent of total billed charges,,,0.95,,113.75,Percent of total billed charges,,,0.97,,116.15,Percent of total billed charges,,,0.97,,116.15,Percent of total billed charges,,,0.96,,114.95,Percent of total billed charges,,,0.95,,113.75,Percent of total billed charges,,,,,,,,,0.95,,113.75,Percent of total billed charges,,113.75,117.35,
CEFTRIAXONE SODIUM 500 MG INJECTION SOLR,RX-9490,CDM,J0696,HCPCS,636,RC,,outpatient,500,ME,119.74,107.77,,0.95,,113.75,Percent of total billed charges,,,0.98,,117.35,Percent of total billed charges,,,0.95,,113.75,Percent of total billed charges,,,0.95,,113.75,Percent of total billed charges,,,0.97,,116.15,Percent of total billed charges,,,0.96,,114.95,Percent of total billed charges,,,0.95,,113.75,Percent of total billed charges,,,,,,,,,0.95,,113.75,Percent of total billed charges,,113.75,117.35,
CEFUROXIME AXETIL 250 MG PO TABS,RX-9495,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,22.6,20.34,,0.95,,21.47,Percent of total billed charges,,,0.98,,22.15,Percent of total billed charges,,,0.95,,21.47,Percent of total billed charges,,,0.97,,21.92,Percent of total billed charges,,,0.97,,21.92,Percent of total billed charges,,,0.96,,21.7,Percent of total billed charges,,,0.95,,21.47,Percent of total billed charges,,,,,,,,,0.95,,21.47,Percent of total billed charges,,21.47,22.15,
CEFUROXIME AXETIL 250 MG PO TABS,RX-9495,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,22.6,20.34,,0.95,,21.47,Percent of total billed charges,,,0.98,,22.15,Percent of total billed charges,,,0.95,,21.47,Percent of total billed charges,,,0.95,,21.47,Percent of total billed charges,,,0.97,,21.92,Percent of total billed charges,,,0.96,,21.7,Percent of total billed charges,,,0.95,,21.47,Percent of total billed charges,,,,,,,,,0.95,,21.47,Percent of total billed charges,,21.47,22.15,
CEPHALEXIN 250 MG PO CAPS,RX-9499,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.3,6.57,,0.95,,6.94,Percent of total billed charges,,,0.98,,7.15,Percent of total billed charges,,,0.95,,6.94,Percent of total billed charges,,,0.97,,7.08,Percent of total billed charges,,,0.97,,7.08,Percent of total billed charges,,,0.96,,7.01,Percent of total billed charges,,,0.95,,6.94,Percent of total billed charges,,,,,,,,,0.95,,6.94,Percent of total billed charges,,6.94,7.15,
CEPHALEXIN 250 MG PO CAPS,RX-9499,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.3,6.57,,0.95,,6.94,Percent of total billed charges,,,0.98,,7.15,Percent of total billed charges,,,0.95,,6.94,Percent of total billed charges,,,0.95,,6.94,Percent of total billed charges,,,0.97,,7.08,Percent of total billed charges,,,0.96,,7.01,Percent of total billed charges,,,0.95,,6.94,Percent of total billed charges,,,,,,,,,0.95,,6.94,Percent of total billed charges,,6.94,7.15,
CEPHALEXIN 500 MG PO CAPS,RX-9500,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.03,6.33,,0.95,,6.68,Percent of total billed charges,,,0.98,,6.89,Percent of total billed charges,,,0.95,,6.68,Percent of total billed charges,,,0.97,,6.82,Percent of total billed charges,,,0.97,,6.82,Percent of total billed charges,,,0.96,,6.75,Percent of total billed charges,,,0.95,,6.68,Percent of total billed charges,,,,,,,,,0.95,,6.68,Percent of total billed charges,,6.68,6.89,
CEPHALEXIN 500 MG PO CAPS,RX-9500,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.03,6.33,,0.95,,6.68,Percent of total billed charges,,,0.98,,6.89,Percent of total billed charges,,,0.95,,6.68,Percent of total billed charges,,,0.95,,6.68,Percent of total billed charges,,,0.97,,6.82,Percent of total billed charges,,,0.96,,6.75,Percent of total billed charges,,,0.95,,6.68,Percent of total billed charges,,,,,,,,,0.95,,6.68,Percent of total billed charges,,6.68,6.89,
CEPHALEXIN 125 MG/5ML PO SUSR,RX-9501,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
CEPHALEXIN 125 MG/5ML PO SUSR,RX-9501,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
CEPHALEXIN 250 MG/5ML PO SUSR,RX-9502,CDM,J3490,HCPCS,637,RC,,inpatient,5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
CEPHALEXIN 250 MG/5ML PO SUSR,RX-9502,CDM,J3490,HCPCS,637,RC,,outpatient,5,ML,6.18,5.56,,0.95,,5.87,Percent of total billed charges,,,0.98,,6.06,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,0.97,,5.99,Percent of total billed charges,,,0.96,,5.93,Percent of total billed charges,,,0.95,,5.87,Percent of total billed charges,,,,,,,,,0.95,,5.87,Percent of total billed charges,,5.87,6.06,
CETIRIZINE HCL 10 MG PO TABS,RX-9506,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.26,5.63,,0.95,,5.95,Percent of total billed charges,,,0.98,,6.13,Percent of total billed charges,,,0.95,,5.95,Percent of total billed charges,,,0.97,,6.07,Percent of total billed charges,,,0.97,,6.07,Percent of total billed charges,,,0.96,,6.01,Percent of total billed charges,,,0.95,,5.95,Percent of total billed charges,,,,,,,,,0.95,,5.95,Percent of total billed charges,,5.95,6.13,
CETIRIZINE HCL 10 MG PO TABS,RX-9506,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.26,5.63,,0.95,,5.95,Percent of total billed charges,,,0.98,,6.13,Percent of total billed charges,,,0.95,,5.95,Percent of total billed charges,,,0.95,,5.95,Percent of total billed charges,,,0.97,,6.07,Percent of total billed charges,,,0.96,,6.01,Percent of total billed charges,,,0.95,,5.95,Percent of total billed charges,,,,,,,,,0.95,,5.95,Percent of total billed charges,,5.95,6.13,
CHLORHEXIDINE GLUCONATE 0.12 % MOUTH/THROAT SOLN,RX-9516,CDM,J3490,HCPCS,637,RC,,inpatient,473,ML,16.08,14.47,,0.95,,15.28,Percent of total billed charges,,,0.98,,15.76,Percent of total billed charges,,,0.95,,15.28,Percent of total billed charges,,,0.97,,15.6,Percent of total billed charges,,,0.97,,15.6,Percent of total billed charges,,,0.96,,15.44,Percent of total billed charges,,,0.95,,15.28,Percent of total billed charges,,,,,,,,,0.95,,15.28,Percent of total billed charges,,15.28,15.76,
CHLORHEXIDINE GLUCONATE 0.12 % MOUTH/THROAT SOLN,RX-9516,CDM,J3490,HCPCS,637,RC,,outpatient,473,ML,16.08,14.47,,0.95,,15.28,Percent of total billed charges,,,0.98,,15.76,Percent of total billed charges,,,0.95,,15.28,Percent of total billed charges,,,0.95,,15.28,Percent of total billed charges,,,0.97,,15.6,Percent of total billed charges,,,0.96,,15.44,Percent of total billed charges,,,0.95,,15.28,Percent of total billed charges,,,,,,,,,0.95,,15.28,Percent of total billed charges,,15.28,15.76,
DIMETHICONE 1.3 % EX LOTN,RX-95747,CDM,J3490,HCPCS,637,RC,,inpatient,227,GR,24.2,21.78,,0.95,,22.99,Percent of total billed charges,,,0.98,,23.72,Percent of total billed charges,,,0.95,,22.99,Percent of total billed charges,,,0.97,,23.47,Percent of total billed charges,,,0.97,,23.47,Percent of total billed charges,,,0.96,,23.23,Percent of total billed charges,,,0.95,,22.99,Percent of total billed charges,,,,,,,,,0.95,,22.99,Percent of total billed charges,,22.99,23.72,
DIMETHICONE 1.3 % EX LOTN,RX-95747,CDM,J3490,HCPCS,637,RC,,outpatient,227,GR,24.2,21.78,,0.95,,22.99,Percent of total billed charges,,,0.98,,23.72,Percent of total billed charges,,,0.95,,22.99,Percent of total billed charges,,,0.95,,22.99,Percent of total billed charges,,,0.97,,23.47,Percent of total billed charges,,,0.96,,23.23,Percent of total billed charges,,,0.95,,22.99,Percent of total billed charges,,,,,,,,,0.95,,22.99,Percent of total billed charges,,22.99,23.72,
ROCURONIUM BROMIDE 50 MG/5ML IV SOLN,RX-95811,CDM,J7999,HCPCS,250,RC,,inpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
ROCURONIUM BROMIDE 50 MG/5ML IV SOLN,RX-95811,CDM,J7999,HCPCS,250,RC,,outpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
ROCURONIUM BROMIDE 100 MG/10ML IV SOLN,RX-95812,CDM,J7999,HCPCS,250,RC,,inpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
ROCURONIUM BROMIDE 100 MG/10ML IV SOLN,RX-95812,CDM,J7999,HCPCS,250,RC,,outpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
CIPROFLOXACIN HCL 0.3 % OP SOLN,RX-9610,CDM,J3490,HCPCS,637,RC,,inpatient,3,ML,43.67,39.3,,0.95,,41.49,Percent of total billed charges,,,0.98,,42.8,Percent of total billed charges,,,0.95,,41.49,Percent of total billed charges,,,0.97,,42.36,Percent of total billed charges,,,0.97,,42.36,Percent of total billed charges,,,0.96,,41.92,Percent of total billed charges,,,0.95,,41.49,Percent of total billed charges,,,,,,,,,0.95,,41.49,Percent of total billed charges,,41.49,42.8,
CIPROFLOXACIN HCL 0.3 % OP SOLN,RX-9610,CDM,J3490,HCPCS,637,RC,,outpatient,3,ML,43.67,39.3,,0.95,,41.49,Percent of total billed charges,,,0.98,,42.8,Percent of total billed charges,,,0.95,,41.49,Percent of total billed charges,,,0.95,,41.49,Percent of total billed charges,,,0.97,,42.36,Percent of total billed charges,,,0.96,,41.92,Percent of total billed charges,,,0.95,,41.49,Percent of total billed charges,,,,,,,,,0.95,,41.49,Percent of total billed charges,,41.49,42.8,
CLINDAMYCIN PHOSPHATE IN D5W 600 MG/50ML IV SOLN,RX-9626,CDM,J0736,HCPCS,636,RC,,inpatient,50,ML,64.95,58.46,,0.95,,61.7,Percent of total billed charges,,,0.98,,63.65,Percent of total billed charges,,,0.95,,61.7,Percent of total billed charges,,,0.97,,63,Percent of total billed charges,,,0.97,,63,Percent of total billed charges,,,0.96,,62.35,Percent of total billed charges,,,0.95,,61.7,Percent of total billed charges,,,,,,,,,0.95,,61.7,Percent of total billed charges,,61.7,63.65,
CLINDAMYCIN PHOSPHATE IN D5W 600 MG/50ML IV SOLN,RX-9626,CDM,J0736,HCPCS,636,RC,,outpatient,50,ML,64.95,58.46,,0.95,,61.7,Percent of total billed charges,,,0.98,,63.65,Percent of total billed charges,,,0.95,,61.7,Percent of total billed charges,,,0.95,,61.7,Percent of total billed charges,,,0.97,,63,Percent of total billed charges,,,0.96,,62.35,Percent of total billed charges,,,0.95,,61.7,Percent of total billed charges,,,,,,,,,0.95,,61.7,Percent of total billed charges,,61.7,63.65,
CLINDAMYCIN PHOSPHATE IN D5W 900 MG/50ML IV SOLN,RX-9627,CDM,J0736,HCPCS,636,RC,,inpatient,50,ML,53.41,48.07,,0.95,,50.74,Percent of total billed charges,,,0.98,,52.34,Percent of total billed charges,,,0.95,,50.74,Percent of total billed charges,,,0.97,,51.81,Percent of total billed charges,,,0.97,,51.81,Percent of total billed charges,,,0.96,,51.27,Percent of total billed charges,,,0.95,,50.74,Percent of total billed charges,,,,,,,,,0.95,,50.74,Percent of total billed charges,,50.74,52.34,
CLINDAMYCIN PHOSPHATE IN D5W 900 MG/50ML IV SOLN,RX-9627,CDM,J0736,HCPCS,636,RC,,outpatient,50,ML,53.41,48.07,,0.95,,50.74,Percent of total billed charges,,,0.98,,52.34,Percent of total billed charges,,,0.95,,50.74,Percent of total billed charges,,,0.95,,50.74,Percent of total billed charges,,,0.97,,51.81,Percent of total billed charges,,,0.96,,51.27,Percent of total billed charges,,,0.95,,50.74,Percent of total billed charges,,,,,,,,,0.95,,50.74,Percent of total billed charges,,50.74,52.34,
CLOBETASOL PROPIONATE 0.05 % EX CREA,RX-9630,CDM,J3490,HCPCS,637,RC,,inpatient,30,GR,38.24,34.42,,0.95,,36.33,Percent of total billed charges,,,0.98,,37.48,Percent of total billed charges,,,0.95,,36.33,Percent of total billed charges,,,0.97,,37.09,Percent of total billed charges,,,0.97,,37.09,Percent of total billed charges,,,0.96,,36.71,Percent of total billed charges,,,0.95,,36.33,Percent of total billed charges,,,,,,,,,0.95,,36.33,Percent of total billed charges,,36.33,37.48,
CLOBETASOL PROPIONATE 0.05 % EX CREA,RX-9630,CDM,J3490,HCPCS,637,RC,,outpatient,30,GR,38.24,34.42,,0.95,,36.33,Percent of total billed charges,,,0.98,,37.48,Percent of total billed charges,,,0.95,,36.33,Percent of total billed charges,,,0.95,,36.33,Percent of total billed charges,,,0.97,,37.09,Percent of total billed charges,,,0.96,,36.71,Percent of total billed charges,,,0.95,,36.33,Percent of total billed charges,,,,,,,,,0.95,,36.33,Percent of total billed charges,,36.33,37.48,
CLOBETASOL PROPIONATE 0.05 % EX OINT,RX-9631,CDM,J3490,HCPCS,637,RC,,inpatient,30,GR,42.14,37.93,,0.95,,40.03,Percent of total billed charges,,,0.98,,41.3,Percent of total billed charges,,,0.95,,40.03,Percent of total billed charges,,,0.97,,40.88,Percent of total billed charges,,,0.97,,40.88,Percent of total billed charges,,,0.96,,40.45,Percent of total billed charges,,,0.95,,40.03,Percent of total billed charges,,,,,,,,,0.95,,40.03,Percent of total billed charges,,40.03,41.3,
CLOBETASOL PROPIONATE 0.05 % EX OINT,RX-9631,CDM,J3490,HCPCS,637,RC,,outpatient,30,GR,42.14,37.93,,0.95,,40.03,Percent of total billed charges,,,0.98,,41.3,Percent of total billed charges,,,0.95,,40.03,Percent of total billed charges,,,0.95,,40.03,Percent of total billed charges,,,0.97,,40.88,Percent of total billed charges,,,0.96,,40.45,Percent of total billed charges,,,0.95,,40.03,Percent of total billed charges,,,,,,,,,0.95,,40.03,Percent of total billed charges,,40.03,41.3,
COLLAGENASE 250 UNIT/GM EX OINT,RX-9682,CDM,J3490,HCPCS,637,RC,,inpatient,30,GR,866.97,780.27,,0.95,,823.62,Percent of total billed charges,,,0.98,,849.63,Percent of total billed charges,,,0.95,,823.62,Percent of total billed charges,,,0.97,,840.96,Percent of total billed charges,,,0.97,,840.96,Percent of total billed charges,,,0.96,,832.29,Percent of total billed charges,,,0.95,,823.62,Percent of total billed charges,,,,,,,,,0.95,,823.62,Percent of total billed charges,,823.62,849.63,
COLLAGENASE 250 UNIT/GM EX OINT,RX-9682,CDM,J3490,HCPCS,637,RC,,outpatient,30,GR,866.97,780.27,,0.95,,823.62,Percent of total billed charges,,,0.98,,849.63,Percent of total billed charges,,,0.95,,823.62,Percent of total billed charges,,,0.95,,823.62,Percent of total billed charges,,,0.97,,840.96,Percent of total billed charges,,,0.96,,832.29,Percent of total billed charges,,,0.95,,823.62,Percent of total billed charges,,,,,,,,,0.95,,823.62,Percent of total billed charges,,823.62,849.63,
COSYNTROPIN 0.25 MG INJECTION SOLR,RX-9686,CDM,J0834,HCPCS,636,RC,,inpatient,1,ML,84.99,76.49,,0.95,,80.74,Percent of total billed charges,,,0.98,,83.29,Percent of total billed charges,,,0.95,,80.74,Percent of total billed charges,,,0.97,,82.44,Percent of total billed charges,,,0.97,,82.44,Percent of total billed charges,,,0.96,,81.59,Percent of total billed charges,,,0.95,,80.74,Percent of total billed charges,,,,,,,,,0.95,,80.74,Percent of total billed charges,,80.74,83.29,
COSYNTROPIN 0.25 MG INJECTION SOLR,RX-9686,CDM,J0834,HCPCS,636,RC,,outpatient,1,ML,84.99,76.49,,0.95,,80.74,Percent of total billed charges,,,0.98,,83.29,Percent of total billed charges,,,0.95,,80.74,Percent of total billed charges,,,0.95,,80.74,Percent of total billed charges,,,0.97,,82.44,Percent of total billed charges,,,0.96,,81.59,Percent of total billed charges,,,0.95,,80.74,Percent of total billed charges,,,,,,,,,0.95,,80.74,Percent of total billed charges,,80.74,83.29,
BUDESONIDE 90 MCG/ACT INHAL AEPB,RX-96976,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,517.99,466.19,,0.95,,492.09,Percent of total billed charges,,,0.98,,507.63,Percent of total billed charges,,,0.95,,492.09,Percent of total billed charges,,,0.97,,502.45,Percent of total billed charges,,,0.97,,502.45,Percent of total billed charges,,,0.96,,497.27,Percent of total billed charges,,,0.95,,492.09,Percent of total billed charges,,,,,,,,,0.95,,492.09,Percent of total billed charges,,492.09,507.63,
BUDESONIDE 90 MCG/ACT INHAL AEPB,RX-96976,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,517.99,466.19,,0.95,,492.09,Percent of total billed charges,,,0.98,,507.63,Percent of total billed charges,,,0.95,,492.09,Percent of total billed charges,,,0.95,,492.09,Percent of total billed charges,,,0.97,,502.45,Percent of total billed charges,,,0.96,,497.27,Percent of total billed charges,,,0.95,,492.09,Percent of total billed charges,,,,,,,,,0.95,,492.09,Percent of total billed charges,,492.09,507.63,
DANTROLENE SODIUM 25 MG PO CAPS,RX-9718,CDM,J3490,HCPCS,637,RC,,inpatient,2,UN,25.84,23.26,,0.95,,24.55,Percent of total billed charges,,,0.98,,25.32,Percent of total billed charges,,,0.95,,24.55,Percent of total billed charges,,,0.97,,25.06,Percent of total billed charges,,,0.97,,25.06,Percent of total billed charges,,,0.96,,24.81,Percent of total billed charges,,,0.95,,24.55,Percent of total billed charges,,,,,,,,,0.95,,24.55,Percent of total billed charges,,24.55,25.32,
DANTROLENE SODIUM 25 MG PO CAPS,RX-9718,CDM,J3490,HCPCS,637,RC,,outpatient,2,UN,25.84,23.26,,0.95,,24.55,Percent of total billed charges,,,0.98,,25.32,Percent of total billed charges,,,0.95,,24.55,Percent of total billed charges,,,0.95,,24.55,Percent of total billed charges,,,0.97,,25.06,Percent of total billed charges,,,0.96,,24.81,Percent of total billed charges,,,0.95,,24.55,Percent of total billed charges,,,,,,,,,0.95,,24.55,Percent of total billed charges,,24.55,25.32,
DEFEROXAMINE MESYLATE 500 MG INJECTION SOLR,RX-9723,CDM,J0895,HCPCS,636,RC,,inpatient,5.275,ML,54.98,49.48,,0.95,,52.23,Percent of total billed charges,,,0.98,,53.88,Percent of total billed charges,,,0.95,,52.23,Percent of total billed charges,,,0.97,,53.33,Percent of total billed charges,,,0.97,,53.33,Percent of total billed charges,,,0.96,,52.78,Percent of total billed charges,,,0.95,,52.23,Percent of total billed charges,,,,,,,,,0.95,,52.23,Percent of total billed charges,,52.23,53.88,
DEFEROXAMINE MESYLATE 500 MG INJECTION SOLR,RX-9723,CDM,J0895,HCPCS,636,RC,,outpatient,5.275,ML,54.98,49.48,,0.95,,52.23,Percent of total billed charges,,,0.98,,53.88,Percent of total billed charges,,,0.95,,52.23,Percent of total billed charges,,,0.95,,52.23,Percent of total billed charges,,,0.97,,53.33,Percent of total billed charges,,,0.96,,52.78,Percent of total billed charges,,,0.95,,52.23,Percent of total billed charges,,,,,,,,,0.95,,52.23,Percent of total billed charges,,52.23,53.88,
DILTIAZEM HCL 25 MG/5ML IV SOLN,RX-97252,CDM,J3490,HCPCS,636,RC,,inpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
DILTIAZEM HCL 25 MG/5ML IV SOLN,RX-97252,CDM,J3490,HCPCS,636,RC,,outpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
DILTIAZEM HCL 125 MG/25ML IV SOLN,RX-97253,CDM,J7999,HCPCS,250,RC,,inpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
DILTIAZEM HCL 125 MG/25ML IV SOLN,RX-97253,CDM,J7999,HCPCS,250,RC,,outpatient,2,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
SUMATRIPTAN SUCCINATE 6 MG/0.5ML SUBQ SOLN,RX-97343,CDM,J3030,HCPCS,637,RC,,inpatient,0.5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
SUMATRIPTAN SUCCINATE 6 MG/0.5ML SUBQ SOLN,RX-97343,CDM,J3030,HCPCS,637,RC,,outpatient,0.5,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
VANCOMYCIN HCL 750 MG IV SOLR,RX-97371,CDM,J3370,HCPCS,636,RC,,inpatient,750,ME,32.36,29.12,,0.95,,30.74,Percent of total billed charges,,,0.98,,31.71,Percent of total billed charges,,,0.95,,30.74,Percent of total billed charges,,,0.97,,31.39,Percent of total billed charges,,,0.97,,31.39,Percent of total billed charges,,,0.96,,31.07,Percent of total billed charges,,,0.95,,30.74,Percent of total billed charges,,,,,,,,,0.95,,30.74,Percent of total billed charges,,30.74,31.71,
VANCOMYCIN HCL 750 MG IV SOLR,RX-97371,CDM,J3370,HCPCS,636,RC,,outpatient,750,ME,32.36,29.12,,0.95,,30.74,Percent of total billed charges,,,0.98,,31.71,Percent of total billed charges,,,0.95,,30.74,Percent of total billed charges,,,0.95,,30.74,Percent of total billed charges,,,0.97,,31.39,Percent of total billed charges,,,0.96,,31.07,Percent of total billed charges,,,0.95,,30.74,Percent of total billed charges,,,,,,,,,0.95,,30.74,Percent of total billed charges,,30.74,31.71,
DESMOPRESSIN ACETATE 4 MCG/ML INJECTION SOLN,RX-9748,CDM,J2597,HCPCS,636,RC,,inpatient,0.25,ML,19.2,17.28,,0.95,,18.24,Percent of total billed charges,,,0.98,,18.82,Percent of total billed charges,,,0.95,,18.24,Percent of total billed charges,,,0.97,,18.62,Percent of total billed charges,,,0.97,,18.62,Percent of total billed charges,,,0.96,,18.43,Percent of total billed charges,,,0.95,,18.24,Percent of total billed charges,,,,,,,,,0.95,,18.24,Percent of total billed charges,,18.24,18.82,
DESMOPRESSIN ACETATE 4 MCG/ML INJECTION SOLN,RX-9748,CDM,J2597,HCPCS,636,RC,,outpatient,0.25,ML,19.2,17.28,,0.95,,18.24,Percent of total billed charges,,,0.98,,18.82,Percent of total billed charges,,,0.95,,18.24,Percent of total billed charges,,,0.95,,18.24,Percent of total billed charges,,,0.97,,18.62,Percent of total billed charges,,,0.96,,18.43,Percent of total billed charges,,,0.95,,18.24,Percent of total billed charges,,,,,,,,,0.95,,18.24,Percent of total billed charges,,18.24,18.82,
BIOTENE ORALBALANCE DRY MOUTH MOUTH/THROAT GEL,RX-97660,CDM,J3490,HCPCS,637,RC,,inpatient,42,GR,33.1,29.79,,0.95,,31.45,Percent of total billed charges,,,0.98,,32.44,Percent of total billed charges,,,0.95,,31.45,Percent of total billed charges,,,0.97,,32.11,Percent of total billed charges,,,0.97,,32.11,Percent of total billed charges,,,0.96,,31.78,Percent of total billed charges,,,0.95,,31.45,Percent of total billed charges,,,,,,,,,0.95,,31.45,Percent of total billed charges,,31.45,32.44,
BIOTENE ORALBALANCE DRY MOUTH MOUTH/THROAT GEL,RX-97660,CDM,J3490,HCPCS,637,RC,,outpatient,42,GR,33.1,29.79,,0.95,,31.45,Percent of total billed charges,,,0.98,,32.44,Percent of total billed charges,,,0.95,,31.45,Percent of total billed charges,,,0.95,,31.45,Percent of total billed charges,,,0.97,,32.11,Percent of total billed charges,,,0.96,,31.78,Percent of total billed charges,,,0.95,,31.45,Percent of total billed charges,,,,,,,,,0.95,,31.45,Percent of total billed charges,,31.45,32.44,
AMIODARONE HCL 450 MG/9ML IV SOLN,RX-97692,CDM,J0282,HCPCS,636,RC,,inpatient,3,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
AMIODARONE HCL 450 MG/9ML IV SOLN,RX-97692,CDM,J0282,HCPCS,636,RC,,outpatient,3,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
AMIODARONE HCL 900 MG/18ML IV SOLN,RX-97694,CDM,J0282,HCPCS,636,RC,,inpatient,3,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
AMIODARONE HCL 900 MG/18ML IV SOLN,RX-97694,CDM,J0282,HCPCS,636,RC,,outpatient,3,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
DEXTROSE IN LACTATED RINGERS 5 % IV SOLN,RX-9788,CDM,J7121,HCPCS,636,RC,,inpatient,1000,ML,101.72,91.55,,0.95,,96.63,Percent of total billed charges,,,0.98,,99.69,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,0.97,,98.67,Percent of total billed charges,,,0.97,,98.67,Percent of total billed charges,,,0.96,,97.65,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,,,,,,,0.95,,96.63,Percent of total billed charges,,96.63,99.69,
DEXTROSE IN LACTATED RINGERS 5 % IV SOLN,RX-9788,CDM,J7121,HCPCS,636,RC,,outpatient,1000,ML,101.72,91.55,,0.95,,96.63,Percent of total billed charges,,,0.98,,99.69,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,0.97,,98.67,Percent of total billed charges,,,0.96,,97.65,Percent of total billed charges,,,0.95,,96.63,Percent of total billed charges,,,,,,,,,0.95,,96.63,Percent of total billed charges,,96.63,99.69,
FLUOROURACIL 5 GM/100ML IV SOLN,RX-98249,CDM,J9190,HCPCS,636,RC,,inpatient,100,ML,192.07,172.86,,0.95,,182.47,Percent of total billed charges,,,0.98,,188.23,Percent of total billed charges,,,0.95,,182.47,Percent of total billed charges,,,0.97,,186.31,Percent of total billed charges,,,0.97,,186.31,Percent of total billed charges,,,0.96,,184.39,Percent of total billed charges,,,0.95,,182.47,Percent of total billed charges,,,,,,,,,0.95,,182.47,Percent of total billed charges,,182.47,188.23,
FLUOROURACIL 5 GM/100ML IV SOLN,RX-98249,CDM,J9190,HCPCS,636,RC,,outpatient,100,ML,192.07,172.86,,0.95,,182.47,Percent of total billed charges,,,0.98,,188.23,Percent of total billed charges,,,0.95,,182.47,Percent of total billed charges,,,0.95,,182.47,Percent of total billed charges,,,0.97,,186.31,Percent of total billed charges,,,0.96,,184.39,Percent of total billed charges,,,0.95,,182.47,Percent of total billed charges,,,,,,,,,0.95,,182.47,Percent of total billed charges,,182.47,188.23,
SE-NATAL 19 29-1 MG PO CHEW,RX-98285,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.77,7.89,,0.95,,8.33,Percent of total billed charges,,,0.98,,8.59,Percent of total billed charges,,,0.95,,8.33,Percent of total billed charges,,,0.97,,8.51,Percent of total billed charges,,,0.97,,8.51,Percent of total billed charges,,,0.96,,8.42,Percent of total billed charges,,,0.95,,8.33,Percent of total billed charges,,,,,,,,,0.95,,8.33,Percent of total billed charges,,8.33,8.59,
SE-NATAL 19 29-1 MG PO CHEW,RX-98285,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.77,7.89,,0.95,,8.33,Percent of total billed charges,,,0.98,,8.59,Percent of total billed charges,,,0.95,,8.33,Percent of total billed charges,,,0.95,,8.33,Percent of total billed charges,,,0.97,,8.51,Percent of total billed charges,,,0.96,,8.42,Percent of total billed charges,,,0.95,,8.33,Percent of total billed charges,,,,,,,,,0.95,,8.33,Percent of total billed charges,,8.33,8.59,
FERUMOXYTOL 510 MG/17ML IV SOLN,RX-98312,CDM,Q0138,HCPCS,636,RC,,inpatient,17,ML,451.74,406.57,,0.95,,429.15,Percent of total billed charges,,,0.98,,442.71,Percent of total billed charges,,,0.95,,429.15,Percent of total billed charges,,,0.97,,438.19,Percent of total billed charges,,,0.97,,438.19,Percent of total billed charges,,,0.96,,433.67,Percent of total billed charges,,,0.95,,429.15,Percent of total billed charges,,,,,,,,,0.95,,429.15,Percent of total billed charges,,429.15,442.71,
FERUMOXYTOL 510 MG/17ML IV SOLN,RX-98312,CDM,Q0138,HCPCS,636,RC,,outpatient,17,ML,451.74,406.57,,0.95,,429.15,Percent of total billed charges,,,0.98,,442.71,Percent of total billed charges,,,0.95,,429.15,Percent of total billed charges,,,0.95,,429.15,Percent of total billed charges,,,0.97,,438.19,Percent of total billed charges,,,0.96,,433.67,Percent of total billed charges,,,0.95,,429.15,Percent of total billed charges,,,,,,,,,0.95,,429.15,Percent of total billed charges,,429.15,442.71,
PRASUGREL HCL 10 MG PO TABS,RX-98373,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,9.1,8.19,,0.95,,8.65,Percent of total billed charges,,,0.98,,8.92,Percent of total billed charges,,,0.95,,8.65,Percent of total billed charges,,,0.97,,8.83,Percent of total billed charges,,,0.97,,8.83,Percent of total billed charges,,,0.96,,8.74,Percent of total billed charges,,,0.95,,8.65,Percent of total billed charges,,,,,,,,,0.95,,8.65,Percent of total billed charges,,8.65,8.92,
PRASUGREL HCL 10 MG PO TABS,RX-98373,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,9.1,8.19,,0.95,,8.65,Percent of total billed charges,,,0.98,,8.92,Percent of total billed charges,,,0.95,,8.65,Percent of total billed charges,,,0.95,,8.65,Percent of total billed charges,,,0.97,,8.83,Percent of total billed charges,,,0.96,,8.74,Percent of total billed charges,,,0.95,,8.65,Percent of total billed charges,,,,,,,,,0.95,,8.65,Percent of total billed charges,,8.65,8.92,
DIHYDROERGOTAMINE MESYLATE 1 MG/ML INJECTION SOLN,RX-9859,CDM,J1110,HCPCS,636,RC,,inpatient,0.25,ML,46.38,41.74,,0.95,,44.06,Percent of total billed charges,,,0.98,,45.45,Percent of total billed charges,,,0.95,,44.06,Percent of total billed charges,,,0.97,,44.99,Percent of total billed charges,,,0.97,,44.99,Percent of total billed charges,,,0.96,,44.52,Percent of total billed charges,,,0.95,,44.06,Percent of total billed charges,,,,,,,,,0.95,,44.06,Percent of total billed charges,,44.06,45.45,
DIHYDROERGOTAMINE MESYLATE 1 MG/ML INJECTION SOLN,RX-9859,CDM,J1110,HCPCS,636,RC,,outpatient,0.25,ML,46.38,41.74,,0.95,,44.06,Percent of total billed charges,,,0.98,,45.45,Percent of total billed charges,,,0.95,,44.06,Percent of total billed charges,,,0.95,,44.06,Percent of total billed charges,,,0.97,,44.99,Percent of total billed charges,,,0.96,,44.52,Percent of total billed charges,,,0.95,,44.06,Percent of total billed charges,,,,,,,,,0.95,,44.06,Percent of total billed charges,,44.06,45.45,
BENZONATATE 100 MG PO CAPS,RX-988,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,7.49,6.74,,0.95,,7.12,Percent of total billed charges,,,0.98,,7.34,Percent of total billed charges,,,0.95,,7.12,Percent of total billed charges,,,0.97,,7.27,Percent of total billed charges,,,0.97,,7.27,Percent of total billed charges,,,0.96,,7.19,Percent of total billed charges,,,0.95,,7.12,Percent of total billed charges,,,,,,,,,0.95,,7.12,Percent of total billed charges,,7.12,7.34,
BENZONATATE 100 MG PO CAPS,RX-988,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,7.49,6.74,,0.95,,7.12,Percent of total billed charges,,,0.98,,7.34,Percent of total billed charges,,,0.95,,7.12,Percent of total billed charges,,,0.95,,7.12,Percent of total billed charges,,,0.97,,7.27,Percent of total billed charges,,,0.96,,7.19,Percent of total billed charges,,,0.95,,7.12,Percent of total billed charges,,,,,,,,,0.95,,7.12,Percent of total billed charges,,7.12,7.34,
DOXAZOSIN MESYLATE 2 MG PO TABS,RX-9895,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.47,7.62,,0.95,,8.05,Percent of total billed charges,,,0.98,,8.3,Percent of total billed charges,,,0.95,,8.05,Percent of total billed charges,,,0.97,,8.22,Percent of total billed charges,,,0.97,,8.22,Percent of total billed charges,,,0.96,,8.13,Percent of total billed charges,,,0.95,,8.05,Percent of total billed charges,,,,,,,,,0.95,,8.05,Percent of total billed charges,,8.05,8.3,
DOXAZOSIN MESYLATE 2 MG PO TABS,RX-9895,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.47,7.62,,0.95,,8.05,Percent of total billed charges,,,0.98,,8.3,Percent of total billed charges,,,0.95,,8.05,Percent of total billed charges,,,0.95,,8.05,Percent of total billed charges,,,0.97,,8.22,Percent of total billed charges,,,0.96,,8.13,Percent of total billed charges,,,0.95,,8.05,Percent of total billed charges,,,,,,,,,0.95,,8.05,Percent of total billed charges,,8.05,8.3,
ENALAPRIL MALEATE 5 MG PO TABS,RX-9927,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,6.16,5.54,,0.95,,5.85,Percent of total billed charges,,,0.98,,6.04,Percent of total billed charges,,,0.95,,5.85,Percent of total billed charges,,,0.97,,5.98,Percent of total billed charges,,,0.97,,5.98,Percent of total billed charges,,,0.96,,5.91,Percent of total billed charges,,,0.95,,5.85,Percent of total billed charges,,,,,,,,,0.95,,5.85,Percent of total billed charges,,5.85,6.04,
ENALAPRIL MALEATE 5 MG PO TABS,RX-9927,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,6.16,5.54,,0.95,,5.85,Percent of total billed charges,,,0.98,,6.04,Percent of total billed charges,,,0.95,,5.85,Percent of total billed charges,,,0.95,,5.85,Percent of total billed charges,,,0.97,,5.98,Percent of total billed charges,,,0.96,,5.91,Percent of total billed charges,,,0.95,,5.85,Percent of total billed charges,,,,,,,,,0.95,,5.85,Percent of total billed charges,,5.85,6.04,
ENALAPRILAT 1.25 MG/ML IV SOLN,RX-9929,CDM,J3490,HCPCS,636,RC,,inpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
ENALAPRILAT 1.25 MG/ML IV SOLN,RX-9929,CDM,J3490,HCPCS,636,RC,,outpatient,1,ML,18.54,16.69,,0.95,,17.61,Percent of total billed charges,,,0.98,,18.17,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,0.97,,17.98,Percent of total billed charges,,,0.96,,17.8,Percent of total billed charges,,,0.95,,17.61,Percent of total billed charges,,,,,,,,,0.95,,17.61,Percent of total billed charges,,17.61,18.17,
EPOETIN ALFA 10000 UNIT/ML INJECTION SOLN,RX-9938,CDM,J0885,HCPCS,636,RC,,inpatient,1,ML,579.98,521.98,,0.95,,550.98,Percent of total billed charges,,,0.98,,568.38,Percent of total billed charges,,,0.95,,550.98,Percent of total billed charges,,,0.97,,562.58,Percent of total billed charges,,,0.97,,562.58,Percent of total billed charges,,,0.96,,556.78,Percent of total billed charges,,,0.95,,550.98,Percent of total billed charges,,,,,,,,,0.95,,550.98,Percent of total billed charges,,550.98,568.38,
EPOETIN ALFA 10000 UNIT/ML INJECTION SOLN,RX-9938,CDM,J0885,HCPCS,636,RC,,outpatient,1,ML,579.98,521.98,,0.95,,550.98,Percent of total billed charges,,,0.98,,568.38,Percent of total billed charges,,,0.95,,550.98,Percent of total billed charges,,,0.95,,550.98,Percent of total billed charges,,,0.97,,562.58,Percent of total billed charges,,,0.96,,556.78,Percent of total billed charges,,,0.95,,550.98,Percent of total billed charges,,,,,,,,,0.95,,550.98,Percent of total billed charges,,550.98,568.38,
ESTROGENS CONJUGATED 25 MG INJECTION SOLR,RX-9972,CDM,J1410,HCPCS,636,RC,,inpatient,5,ML,1129.55,1016.6,,0.95,,1073.07,Percent of total billed charges,,,0.98,,1106.96,Percent of total billed charges,,,0.95,,1073.07,Percent of total billed charges,,,0.97,,1095.66,Percent of total billed charges,,,0.97,,1095.66,Percent of total billed charges,,,0.96,,1084.37,Percent of total billed charges,,,0.95,,1073.07,Percent of total billed charges,,,,,,,,,0.95,,1073.07,Percent of total billed charges,,1073.07,1106.96,
ESTROGENS CONJUGATED 25 MG INJECTION SOLR,RX-9972,CDM,J1410,HCPCS,636,RC,,outpatient,5,ML,1129.55,1016.6,,0.95,,1073.07,Percent of total billed charges,,,0.98,,1106.96,Percent of total billed charges,,,0.95,,1073.07,Percent of total billed charges,,,0.95,,1073.07,Percent of total billed charges,,,0.97,,1095.66,Percent of total billed charges,,,0.96,,1084.37,Percent of total billed charges,,,0.95,,1073.07,Percent of total billed charges,,,,,,,,,0.95,,1073.07,Percent of total billed charges,,1073.07,1106.96,
BENZTROPINE MESYLATE 1 MG PO TABS,RX-999,CDM,J3490,HCPCS,637,RC,,inpatient,1,UN,8.21,7.39,,0.95,,7.8,Percent of total billed charges,,,0.98,,8.05,Percent of total billed charges,,,0.95,,7.8,Percent of total billed charges,,,0.97,,7.96,Percent of total billed charges,,,0.97,,7.96,Percent of total billed charges,,,0.96,,7.88,Percent of total billed charges,,,0.95,,7.8,Percent of total billed charges,,,,,,,,,0.95,,7.8,Percent of total billed charges,,7.8,8.05,
BENZTROPINE MESYLATE 1 MG PO TABS,RX-999,CDM,J3490,HCPCS,637,RC,,outpatient,1,UN,8.21,7.39,,0.95,,7.8,Percent of total billed charges,,,0.98,,8.05,Percent of total billed charges,,,0.95,,7.8,Percent of total billed charges,,,0.95,,7.8,Percent of total billed charges,,,0.97,,7.96,Percent of total billed charges,,,0.96,,7.88,Percent of total billed charges,,,0.95,,7.8,Percent of total billed charges,,,,,,,,,0.95,,7.8,Percent of total billed charges,,7.8,8.05,
OR SO ACTIS COLLARED STD SIZE 3,SUP-101011030,CDM,27810126,LOCAL,278,RC,,inpatient,,,15858,14272.2,,0.95,,15065.1,Percent of total billed charges,,,0.98,,15540.84,Percent of total billed charges,,,0.95,,15065.1,Percent of total billed charges,,,0.97,,15382.26,Percent of total billed charges,,,0.97,,15382.26,Percent of total billed charges,,,0.96,,15223.68,Percent of total billed charges,,,0.95,,15065.1,Percent of total billed charges,,,,,,,,,0.95,,15065.1,Percent of total billed charges,,15065.1,15540.84,
OR SO ACTIS COLLARED STD SIZE 3,SUP-101011030,CDM,27810126,LOCAL,278,RC,,outpatient,,,15858,14272.2,,0.95,,15065.1,Percent of total billed charges,,,0.98,,15540.84,Percent of total billed charges,,,0.95,,15065.1,Percent of total billed charges,,,0.95,,15065.1,Percent of total billed charges,,,0.97,,15382.26,Percent of total billed charges,,,0.96,,15223.68,Percent of total billed charges,,,0.95,,15065.1,Percent of total billed charges,,,,,,,,,0.95,,15065.1,Percent of total billed charges,,15065.1,15540.84,
OR SO 3.5 LCP PERIARTIC PROX HUM PL 4H/127/RT,SUP-02.123.022,CDM,27810126,LOCAL,278,RC,,inpatient,,,6684,6015.6,,0.95,,6349.8,Percent of total billed charges,,,0.98,,6550.32,Percent of total billed charges,,,0.95,,6349.8,Percent of total billed charges,,,0.97,,6483.48,Percent of total billed charges,,,0.97,,6483.48,Percent of total billed charges,,,0.96,,6416.64,Percent of total billed charges,,,0.95,,6349.8,Percent of total billed charges,,,,,,,,,0.95,,6349.8,Percent of total billed charges,,6349.8,6550.32,
OR SO 3.5 LCP PERIARTIC PROX HUM PL 4H/127/RT,SUP-02.123.022,CDM,27810126,LOCAL,278,RC,,outpatient,,,6684,6015.6,,0.95,,6349.8,Percent of total billed charges,,,0.98,,6550.32,Percent of total billed charges,,,0.95,,6349.8,Percent of total billed charges,,,0.95,,6349.8,Percent of total billed charges,,,0.97,,6483.48,Percent of total billed charges,,,0.96,,6416.64,Percent of total billed charges,,,0.95,,6349.8,Percent of total billed charges,,,,,,,,,0.95,,6349.8,Percent of total billed charges,,6349.8,6550.32,
OR SO 3.5MM CORTEX SCREW  SELF-TAPPING 26MM,SUP-204.826,CDM,27810126,LOCAL,278,RC,,inpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
OR SO 3.5MM CORTEX SCREW  SELF-TAPPING 26MM,SUP-204.826,CDM,27810126,LOCAL,278,RC,,outpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
OR SO 3.5MM CORTEX SCREW SELF-TAPPING 45MM,SUP-204.845,CDM,27810126,LOCAL,278,RC,,inpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
OR SO 3.5MM CORTEX SCREW SELF-TAPPING 45MM,SUP-204.845,CDM,27810126,LOCAL,278,RC,,outpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
OR SO 3.5 LCKNG SCREW SLF-TPNG W/SD REC 30,SUP-212.111,CDM,27810126,LOCAL,278,RC,,inpatient,,,620,558,,0.95,,589,Percent of total billed charges,,,0.98,,607.6,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.96,,595.2,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,,,,,,,0.95,,589,Percent of total billed charges,,589,607.6,
OR SO 3.5 LCKNG SCREW SLF-TPNG W/SD REC 30,SUP-212.111,CDM,27810126,LOCAL,278,RC,,outpatient,,,620,558,,0.95,,589,Percent of total billed charges,,,0.98,,607.6,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.96,,595.2,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,,,,,,,0.95,,589,Percent of total billed charges,,589,607.6,
OR SO 3.5 LCKNG SCREW SLF-TPNG W/SD REC 50,SUP-212.121,CDM,27810126,LOCAL,278,RC,,inpatient,,,620,558,,0.95,,589,Percent of total billed charges,,,0.98,,607.6,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.96,,595.2,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,,,,,,,0.95,,589,Percent of total billed charges,,589,607.6,
OR SO 3.5 LCKNG SCREW SLF-TPNG W/SD REC 50,SUP-212.121,CDM,27810126,LOCAL,278,RC,,outpatient,,,620,558,,0.95,,589,Percent of total billed charges,,,0.98,,607.6,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.96,,595.2,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,,,,,,,0.95,,589,Percent of total billed charges,,589,607.6,
OR SO 3.5 LCKNG SCREW SLF-TPNG W/SD REC 55,SUP-212.123,CDM,27810126,LOCAL,278,RC,,inpatient,,,620,558,,0.95,,589,Percent of total billed charges,,,0.98,,607.6,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.96,,595.2,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,,,,,,,0.95,,589,Percent of total billed charges,,589,607.6,
OR SO 3.5 LCKNG SCREW SLF-TPNG W/SD REC 55,SUP-212.123,CDM,27810126,LOCAL,278,RC,,outpatient,,,620,558,,0.95,,589,Percent of total billed charges,,,0.98,,607.6,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.96,,595.2,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,,,,,,,0.95,,589,Percent of total billed charges,,589,607.6,
OR SO BIO-COMOP-SITE P-LCK 2.9X15.5MM,SUP-AR-1923BC,CDM,27810126,LOCAL,278,RC,,inpatient,,,840,756,,0.95,,798,Percent of total billed charges,,,0.98,,823.2,Percent of total billed charges,,,0.95,,798,Percent of total billed charges,,,0.97,,814.8,Percent of total billed charges,,,0.97,,814.8,Percent of total billed charges,,,0.96,,806.4,Percent of total billed charges,,,0.95,,798,Percent of total billed charges,,,,,,,,,0.95,,798,Percent of total billed charges,,798,823.2,
OR SO BIO-COMOP-SITE P-LCK 2.9X15.5MM,SUP-AR-1923BC,CDM,27810126,LOCAL,278,RC,,outpatient,,,840,756,,0.95,,798,Percent of total billed charges,,,0.98,,823.2,Percent of total billed charges,,,0.95,,798,Percent of total billed charges,,,0.95,,798,Percent of total billed charges,,,0.97,,814.8,Percent of total billed charges,,,0.96,,806.4,Percent of total billed charges,,,0.95,,798,Percent of total billed charges,,,,,,,,,0.95,,798,Percent of total billed charges,,798,823.2,
OR SO PERC INSERT KIT FOR 2.9MM P-LCK,SUP-AR-1923PK,CDM,27010242,LOCAL,270,RC,,inpatient,,,578,520.2,,0.95,,549.1,Percent of total billed charges,,,0.98,,566.44,Percent of total billed charges,,,0.95,,549.1,Percent of total billed charges,,,0.97,,560.66,Percent of total billed charges,,,0.97,,560.66,Percent of total billed charges,,,0.96,,554.88,Percent of total billed charges,,,0.95,,549.1,Percent of total billed charges,,,,,,,,,0.95,,549.1,Percent of total billed charges,,549.1,566.44,
OR SO PERC INSERT KIT FOR 2.9MM P-LCK,SUP-AR-1923PK,CDM,27010242,LOCAL,270,RC,,outpatient,,,578,520.2,,0.95,,549.1,Percent of total billed charges,,,0.98,,566.44,Percent of total billed charges,,,0.95,,549.1,Percent of total billed charges,,,0.95,,549.1,Percent of total billed charges,,,0.97,,560.66,Percent of total billed charges,,,0.96,,554.88,Percent of total billed charges,,,0.95,,549.1,Percent of total billed charges,,,,,,,,,0.95,,549.1,Percent of total billed charges,,549.1,566.44,
OR SO GUIDEWIRE FOR BIO-COMPRESSION SCREW,SUP-AR-5025K,CDM,27010242,LOCAL,270,RC,,inpatient,,,37,33.3,,0.95,,35.15,Percent of total billed charges,,,0.98,,36.26,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.96,,35.52,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,,,,,,,0.95,,35.15,Percent of total billed charges,,35.15,36.26,
OR SO GUIDEWIRE FOR BIO-COMPRESSION SCREW,SUP-AR-5025K,CDM,27010242,LOCAL,270,RC,,outpatient,,,37,33.3,,0.95,,35.15,Percent of total billed charges,,,0.98,,36.26,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,0.97,,35.89,Percent of total billed charges,,,0.96,,35.52,Percent of total billed charges,,,0.95,,35.15,Percent of total billed charges,,,,,,,,,0.95,,35.15,Percent of total billed charges,,35.15,36.26,
OR SO BIO-COMPRESSION SCREW 3X26MM,SUP-AR-5025B-26,CDM,27810126,LOCAL,278,RC,,inpatient,,,830,747,,0.95,,788.5,Percent of total billed charges,,,0.98,,813.4,Percent of total billed charges,,,0.95,,788.5,Percent of total billed charges,,,0.97,,805.1,Percent of total billed charges,,,0.97,,805.1,Percent of total billed charges,,,0.96,,796.8,Percent of total billed charges,,,0.95,,788.5,Percent of total billed charges,,,,,,,,,0.95,,788.5,Percent of total billed charges,,788.5,813.4,
OR SO BIO-COMPRESSION SCREW 3X26MM,SUP-AR-5025B-26,CDM,27810126,LOCAL,278,RC,,outpatient,,,830,747,,0.95,,788.5,Percent of total billed charges,,,0.98,,813.4,Percent of total billed charges,,,0.95,,788.5,Percent of total billed charges,,,0.95,,788.5,Percent of total billed charges,,,0.97,,805.1,Percent of total billed charges,,,0.96,,796.8,Percent of total billed charges,,,0.95,,788.5,Percent of total billed charges,,,,,,,,,0.95,,788.5,Percent of total billed charges,,788.5,813.4,
"OR SO IMPLANT DELIVERY SYSTEM, BIOCOMPOSITE DISTAL BICEPS REPAIR",SUP-AR-2260BC,CDM,27810126,LOCAL,278,RC,,inpatient,,,1733,1559.7,,0.95,,1646.35,Percent of total billed charges,,,0.98,,1698.34,Percent of total billed charges,,,0.95,,1646.35,Percent of total billed charges,,,0.97,,1681.01,Percent of total billed charges,,,0.97,,1681.01,Percent of total billed charges,,,0.96,,1663.68,Percent of total billed charges,,,0.95,,1646.35,Percent of total billed charges,,,,,,,,,0.95,,1646.35,Percent of total billed charges,,1646.35,1698.34,
"OR SO IMPLANT DELIVERY SYSTEM, BIOCOMPOSITE DISTAL BICEPS REPAIR",SUP-AR-2260BC,CDM,27810126,LOCAL,278,RC,,outpatient,,,1733,1559.7,,0.95,,1646.35,Percent of total billed charges,,,0.98,,1698.34,Percent of total billed charges,,,0.95,,1646.35,Percent of total billed charges,,,0.95,,1646.35,Percent of total billed charges,,,0.97,,1681.01,Percent of total billed charges,,,0.96,,1663.68,Percent of total billed charges,,,0.95,,1646.35,Percent of total billed charges,,,,,,,,,0.95,,1646.35,Percent of total billed charges,,1646.35,1698.34,
OR SMARTSET GMV BONE CEMENT,SUP-3254605,CDM,27810126,LOCAL,278,RC,,inpatient,,,827,744.3,,0.95,,785.65,Percent of total billed charges,,,0.98,,810.46,Percent of total billed charges,,,0.95,,785.65,Percent of total billed charges,,,0.97,,802.19,Percent of total billed charges,,,0.97,,802.19,Percent of total billed charges,,,0.96,,793.92,Percent of total billed charges,,,0.95,,785.65,Percent of total billed charges,,,,,,,,,0.95,,785.65,Percent of total billed charges,,785.65,810.46,
OR SMARTSET GMV BONE CEMENT,SUP-3254605,CDM,27810126,LOCAL,278,RC,,outpatient,,,827,744.3,,0.95,,785.65,Percent of total billed charges,,,0.98,,810.46,Percent of total billed charges,,,0.95,,785.65,Percent of total billed charges,,,0.95,,785.65,Percent of total billed charges,,,0.97,,802.19,Percent of total billed charges,,,0.96,,793.92,Percent of total billed charges,,,0.95,,785.65,Percent of total billed charges,,,,,,,,,0.95,,785.65,Percent of total billed charges,,785.65,810.46,
OR SO REVISION CRS FEMORAL SIZE 6 LEFT CEMENTED,SUP-1504-40-106,CDM,27810126,LOCAL,278,RC,,inpatient,,,17656,15890.4,,0.95,,16773.2,Percent of total billed charges,,,0.98,,17302.88,Percent of total billed charges,,,0.95,,16773.2,Percent of total billed charges,,,0.97,,17126.32,Percent of total billed charges,,,0.97,,17126.32,Percent of total billed charges,,,0.96,,16949.76,Percent of total billed charges,,,0.95,,16773.2,Percent of total billed charges,,,,,,,,,0.95,,16773.2,Percent of total billed charges,,16773.2,17302.88,
OR SO REVISION CRS FEMORAL SIZE 6 LEFT CEMENTED,SUP-1504-40-106,CDM,27810126,LOCAL,278,RC,,outpatient,,,17656,15890.4,,0.95,,16773.2,Percent of total billed charges,,,0.98,,17302.88,Percent of total billed charges,,,0.95,,16773.2,Percent of total billed charges,,,0.95,,16773.2,Percent of total billed charges,,,0.97,,17126.32,Percent of total billed charges,,,0.96,,16949.76,Percent of total billed charges,,,0.95,,16773.2,Percent of total billed charges,,,,,,,,,0.95,,16773.2,Percent of total billed charges,,16773.2,17302.88,
OR SO REVISION TIBIAL BASE ROTATING PLATFORM SIZE 5 CEMENTED,SUP-1506-60-005,CDM,27810126,LOCAL,278,RC,,inpatient,,,12815,11533.5,,0.95,,12174.25,Percent of total billed charges,,,0.98,,12558.7,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,0.97,,12430.55,Percent of total billed charges,,,0.97,,12430.55,Percent of total billed charges,,,0.96,,12302.4,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,,,,,,,0.95,,12174.25,Percent of total billed charges,,12174.25,12558.7,
OR SO REVISION TIBIAL BASE ROTATING PLATFORM SIZE 5 CEMENTED,SUP-1506-60-005,CDM,27810126,LOCAL,278,RC,,outpatient,,,12815,11533.5,,0.95,,12174.25,Percent of total billed charges,,,0.98,,12558.7,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,0.97,,12430.55,Percent of total billed charges,,,0.96,,12302.4,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,,,,,,,0.95,,12174.25,Percent of total billed charges,,12174.25,12558.7,
OR SO REVISION CEMENTED STEM 14MMX50MM CEMENTED,SUP-1512-14-050,CDM,27810126,LOCAL,278,RC,,inpatient,,,2732,2458.8,,0.95,,2595.4,Percent of total billed charges,,,0.98,,2677.36,Percent of total billed charges,,,0.95,,2595.4,Percent of total billed charges,,,0.97,,2650.04,Percent of total billed charges,,,0.97,,2650.04,Percent of total billed charges,,,0.96,,2622.72,Percent of total billed charges,,,0.95,,2595.4,Percent of total billed charges,,,,,,,,,0.95,,2595.4,Percent of total billed charges,,2595.4,2677.36,
OR SO REVISION CEMENTED STEM 14MMX50MM CEMENTED,SUP-1512-14-050,CDM,27810126,LOCAL,278,RC,,outpatient,,,2732,2458.8,,0.95,,2595.4,Percent of total billed charges,,,0.98,,2677.36,Percent of total billed charges,,,0.95,,2595.4,Percent of total billed charges,,,0.95,,2595.4,Percent of total billed charges,,,0.97,,2650.04,Percent of total billed charges,,,0.96,,2622.72,Percent of total billed charges,,,0.95,,2595.4,Percent of total billed charges,,,,,,,,,0.95,,2595.4,Percent of total billed charges,,2595.4,2677.36,
OR SO PATELLA MEDIALIZED ANATOMIC 35MM CEMENTED AOX,SUP-1518-10-035,CDM,27810126,LOCAL,278,RC,,inpatient,,,2506,2255.4,,0.95,,2380.7,Percent of total billed charges,,,0.98,,2455.88,Percent of total billed charges,,,0.95,,2380.7,Percent of total billed charges,,,0.97,,2430.82,Percent of total billed charges,,,0.97,,2430.82,Percent of total billed charges,,,0.96,,2405.76,Percent of total billed charges,,,0.95,,2380.7,Percent of total billed charges,,,,,,,,,0.95,,2380.7,Percent of total billed charges,,2380.7,2455.88,
OR SO PATELLA MEDIALIZED ANATOMIC 35MM CEMENTED AOX,SUP-1518-10-035,CDM,27810126,LOCAL,278,RC,,outpatient,,,2506,2255.4,,0.95,,2380.7,Percent of total billed charges,,,0.98,,2455.88,Percent of total billed charges,,,0.95,,2380.7,Percent of total billed charges,,,0.95,,2380.7,Percent of total billed charges,,,0.97,,2430.82,Percent of total billed charges,,,0.96,,2405.76,Percent of total billed charges,,,0.95,,2380.7,Percent of total billed charges,,,,,,,,,0.95,,2380.7,Percent of total billed charges,,2380.7,2455.88,
OR SO REVISION CRS ROTATING PLATFORM INSERT SIZE 6 10MM AOX,SUP-1517-10-610,CDM,27810126,LOCAL,278,RC,,inpatient,,,7649,6884.1,,0.95,,7266.55,Percent of total billed charges,,,0.98,,7496.02,Percent of total billed charges,,,0.95,,7266.55,Percent of total billed charges,,,0.97,,7419.53,Percent of total billed charges,,,0.97,,7419.53,Percent of total billed charges,,,0.96,,7343.04,Percent of total billed charges,,,0.95,,7266.55,Percent of total billed charges,,,,,,,,,0.95,,7266.55,Percent of total billed charges,,7266.55,7496.02,
OR SO REVISION CRS ROTATING PLATFORM INSERT SIZE 6 10MM AOX,SUP-1517-10-610,CDM,27810126,LOCAL,278,RC,,outpatient,,,7649,6884.1,,0.95,,7266.55,Percent of total billed charges,,,0.98,,7496.02,Percent of total billed charges,,,0.95,,7266.55,Percent of total billed charges,,,0.95,,7266.55,Percent of total billed charges,,,0.97,,7419.53,Percent of total billed charges,,,0.96,,7343.04,Percent of total billed charges,,,0.95,,7266.55,Percent of total billed charges,,,,,,,,,0.95,,7266.55,Percent of total billed charges,,7266.55,7496.02,
OR SO PINNING SYSTEM,SUP-2544-00-111,CDM,27010242,LOCAL,270,RC,,inpatient,,,969,872.1,,0.95,,920.55,Percent of total billed charges,,,0.98,,949.62,Percent of total billed charges,,,0.95,,920.55,Percent of total billed charges,,,0.97,,939.93,Percent of total billed charges,,,0.97,,939.93,Percent of total billed charges,,,0.96,,930.24,Percent of total billed charges,,,0.95,,920.55,Percent of total billed charges,,,,,,,,,0.95,,920.55,Percent of total billed charges,,920.55,949.62,
OR SO PINNING SYSTEM,SUP-2544-00-111,CDM,27010242,LOCAL,270,RC,,outpatient,,,969,872.1,,0.95,,920.55,Percent of total billed charges,,,0.98,,949.62,Percent of total billed charges,,,0.95,,920.55,Percent of total billed charges,,,0.95,,920.55,Percent of total billed charges,,,0.97,,939.93,Percent of total billed charges,,,0.96,,930.24,Percent of total billed charges,,,0.95,,920.55,Percent of total billed charges,,,,,,,,,0.95,,920.55,Percent of total billed charges,,920.55,949.62,
OR SO PRISM II CART W/BRKOFF NOZZLE,SUP-5401-33-500,CDM,27010242,LOCAL,270,RC,,inpatient,,,494,444.6,,0.95,,469.3,Percent of total billed charges,,,0.98,,484.12,Percent of total billed charges,,,0.95,,469.3,Percent of total billed charges,,,0.97,,479.18,Percent of total billed charges,,,0.97,,479.18,Percent of total billed charges,,,0.96,,474.24,Percent of total billed charges,,,0.95,,469.3,Percent of total billed charges,,,,,,,,,0.95,,469.3,Percent of total billed charges,,469.3,484.12,
OR SO PRISM II CART W/BRKOFF NOZZLE,SUP-5401-33-500,CDM,27010242,LOCAL,270,RC,,outpatient,,,494,444.6,,0.95,,469.3,Percent of total billed charges,,,0.98,,484.12,Percent of total billed charges,,,0.95,,469.3,Percent of total billed charges,,,0.95,,469.3,Percent of total billed charges,,,0.97,,479.18,Percent of total billed charges,,,0.96,,474.24,Percent of total billed charges,,,0.95,,469.3,Percent of total billed charges,,,,,,,,,0.95,,469.3,Percent of total billed charges,,469.3,484.12,
AMBU BAG,SUP-3254070,CDM,27010242,LOCAL,270,RC,,inpatient,,,87,78.3,,0.95,,82.65,Percent of total billed charges,,,0.98,,85.26,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.96,,83.52,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,,,,,,,0.95,,82.65,Percent of total billed charges,,82.65,85.26,
AMBU BAG,SUP-3254070,CDM,27010242,LOCAL,270,RC,,outpatient,,,87,78.3,,0.95,,82.65,Percent of total billed charges,,,0.98,,85.26,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,0.97,,84.39,Percent of total billed charges,,,0.96,,83.52,Percent of total billed charges,,,0.95,,82.65,Percent of total billed charges,,,,,,,,,0.95,,82.65,Percent of total billed charges,,82.65,85.26,
OR SO KNOTLESS 2.6 FIBERTAK RC (BLACK/BLUE),SUP-AR-3653TTSP,CDM,27810126,LOCAL,278,RC,,inpatient,,,974,876.6,,0.95,,925.3,Percent of total billed charges,,,0.98,,954.52,Percent of total billed charges,,,0.95,,925.3,Percent of total billed charges,,,0.97,,944.78,Percent of total billed charges,,,0.97,,944.78,Percent of total billed charges,,,0.96,,935.04,Percent of total billed charges,,,0.95,,925.3,Percent of total billed charges,,,,,,,,,0.95,,925.3,Percent of total billed charges,,925.3,954.52,
OR SO KNOTLESS 2.6 FIBERTAK RC (BLACK/BLUE),SUP-AR-3653TTSP,CDM,27810126,LOCAL,278,RC,,outpatient,,,974,876.6,,0.95,,925.3,Percent of total billed charges,,,0.98,,954.52,Percent of total billed charges,,,0.95,,925.3,Percent of total billed charges,,,0.95,,925.3,Percent of total billed charges,,,0.97,,944.78,Percent of total billed charges,,,0.96,,935.04,Percent of total billed charges,,,0.95,,925.3,Percent of total billed charges,,,,,,,,,0.95,,925.3,Percent of total billed charges,,925.3,954.52,
OR SO KNOTLESS 2.6 FIBERTAK RC (WHITE/BLACK),SUP-AR-3653SP,CDM,27810126,LOCAL,278,RC,,inpatient,,,974,876.6,,0.95,,925.3,Percent of total billed charges,,,0.98,,954.52,Percent of total billed charges,,,0.95,,925.3,Percent of total billed charges,,,0.97,,944.78,Percent of total billed charges,,,0.97,,944.78,Percent of total billed charges,,,0.96,,935.04,Percent of total billed charges,,,0.95,,925.3,Percent of total billed charges,,,,,,,,,0.95,,925.3,Percent of total billed charges,,925.3,954.52,
OR SO KNOTLESS 2.6 FIBERTAK RC (WHITE/BLACK),SUP-AR-3653SP,CDM,27810126,LOCAL,278,RC,,outpatient,,,974,876.6,,0.95,,925.3,Percent of total billed charges,,,0.98,,954.52,Percent of total billed charges,,,0.95,,925.3,Percent of total billed charges,,,0.95,,925.3,Percent of total billed charges,,,0.97,,944.78,Percent of total billed charges,,,0.96,,935.04,Percent of total billed charges,,,0.95,,925.3,Percent of total billed charges,,,,,,,,,0.95,,925.3,Percent of total billed charges,,925.3,954.52,
OR SO ATTUNE SOLO PINNING SYSTEM,SUP-254400111,CDM,27010242,LOCAL,270,RC,,inpatient,,,969,872.1,,0.95,,920.55,Percent of total billed charges,,,0.98,,949.62,Percent of total billed charges,,,0.95,,920.55,Percent of total billed charges,,,0.97,,939.93,Percent of total billed charges,,,0.97,,939.93,Percent of total billed charges,,,0.96,,930.24,Percent of total billed charges,,,0.95,,920.55,Percent of total billed charges,,,,,,,,,0.95,,920.55,Percent of total billed charges,,920.55,949.62,
OR SO ATTUNE SOLO PINNING SYSTEM,SUP-254400111,CDM,27010242,LOCAL,270,RC,,outpatient,,,969,872.1,,0.95,,920.55,Percent of total billed charges,,,0.98,,949.62,Percent of total billed charges,,,0.95,,920.55,Percent of total billed charges,,,0.95,,920.55,Percent of total billed charges,,,0.97,,939.93,Percent of total billed charges,,,0.96,,930.24,Percent of total billed charges,,,0.95,,920.55,Percent of total billed charges,,,,,,,,,0.95,,920.55,Percent of total billed charges,,920.55,949.62,
OR SO ATTUNE MEDIAL ANAT PAT 35MM,SUP-151810035,CDM,27810126,LOCAL,278,RC,,inpatient,,,2506,2255.4,,0.95,,2380.7,Percent of total billed charges,,,0.98,,2455.88,Percent of total billed charges,,,0.95,,2380.7,Percent of total billed charges,,,0.97,,2430.82,Percent of total billed charges,,,0.97,,2430.82,Percent of total billed charges,,,0.96,,2405.76,Percent of total billed charges,,,0.95,,2380.7,Percent of total billed charges,,,,,,,,,0.95,,2380.7,Percent of total billed charges,,2380.7,2455.88,
OR SO ATTUNE MEDIAL ANAT PAT 35MM,SUP-151810035,CDM,27810126,LOCAL,278,RC,,outpatient,,,2506,2255.4,,0.95,,2380.7,Percent of total billed charges,,,0.98,,2455.88,Percent of total billed charges,,,0.95,,2380.7,Percent of total billed charges,,,0.95,,2380.7,Percent of total billed charges,,,0.97,,2430.82,Percent of total billed charges,,,0.96,,2405.76,Percent of total billed charges,,,0.95,,2380.7,Percent of total billed charges,,,,,,,,,0.95,,2380.7,Percent of total billed charges,,2380.7,2455.88,
OR SO ATTUNE CEMENTED STEM 14X50MM,SUP-151214050,CDM,27810126,LOCAL,278,RC,,inpatient,,,2732,2458.8,,0.95,,2595.4,Percent of total billed charges,,,0.98,,2677.36,Percent of total billed charges,,,0.95,,2595.4,Percent of total billed charges,,,0.97,,2650.04,Percent of total billed charges,,,0.97,,2650.04,Percent of total billed charges,,,0.96,,2622.72,Percent of total billed charges,,,0.95,,2595.4,Percent of total billed charges,,,,,,,,,0.95,,2595.4,Percent of total billed charges,,2595.4,2677.36,
OR SO ATTUNE CEMENTED STEM 14X50MM,SUP-151214050,CDM,27810126,LOCAL,278,RC,,outpatient,,,2732,2458.8,,0.95,,2595.4,Percent of total billed charges,,,0.98,,2677.36,Percent of total billed charges,,,0.95,,2595.4,Percent of total billed charges,,,0.95,,2595.4,Percent of total billed charges,,,0.97,,2650.04,Percent of total billed charges,,,0.96,,2622.72,Percent of total billed charges,,,0.95,,2595.4,Percent of total billed charges,,,,,,,,,0.95,,2595.4,Percent of total billed charges,,2595.4,2677.36,
OR SO ATTUNE CRS FEMORAL RT SZ 5 CEM,SUP-150440205,CDM,27810126,LOCAL,278,RC,,inpatient,,,17656,15890.4,,0.95,,16773.2,Percent of total billed charges,,,0.98,,17302.88,Percent of total billed charges,,,0.95,,16773.2,Percent of total billed charges,,,0.97,,17126.32,Percent of total billed charges,,,0.97,,17126.32,Percent of total billed charges,,,0.96,,16949.76,Percent of total billed charges,,,0.95,,16773.2,Percent of total billed charges,,,,,,,,,0.95,,16773.2,Percent of total billed charges,,16773.2,17302.88,
OR SO ATTUNE CRS FEMORAL RT SZ 5 CEM,SUP-150440205,CDM,27810126,LOCAL,278,RC,,outpatient,,,17656,15890.4,,0.95,,16773.2,Percent of total billed charges,,,0.98,,17302.88,Percent of total billed charges,,,0.95,,16773.2,Percent of total billed charges,,,0.95,,16773.2,Percent of total billed charges,,,0.97,,17126.32,Percent of total billed charges,,,0.96,,16949.76,Percent of total billed charges,,,0.95,,16773.2,Percent of total billed charges,,,,,,,,,0.95,,16773.2,Percent of total billed charges,,16773.2,17302.88,
OR SO ATUNE REV RP TIB BASE SZ 4 CEM,SUP-150660004,CDM,27810126,LOCAL,278,RC,,inpatient,,,12815,11533.5,,0.95,,12174.25,Percent of total billed charges,,,0.98,,12558.7,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,0.97,,12430.55,Percent of total billed charges,,,0.97,,12430.55,Percent of total billed charges,,,0.96,,12302.4,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,,,,,,,0.95,,12174.25,Percent of total billed charges,,12174.25,12558.7,
OR SO ATUNE REV RP TIB BASE SZ 4 CEM,SUP-150660004,CDM,27810126,LOCAL,278,RC,,outpatient,,,12815,11533.5,,0.95,,12174.25,Percent of total billed charges,,,0.98,,12558.7,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,0.97,,12430.55,Percent of total billed charges,,,0.96,,12302.4,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,,,,,,,0.95,,12174.25,Percent of total billed charges,,12174.25,12558.7,
OR SO ATTUNE CRS RP INSRT SZ 5 6MM,SUP-151710506,CDM,27810126,LOCAL,278,RC,,inpatient,,,7649,6884.1,,0.95,,7266.55,Percent of total billed charges,,,0.98,,7496.02,Percent of total billed charges,,,0.95,,7266.55,Percent of total billed charges,,,0.97,,7419.53,Percent of total billed charges,,,0.97,,7419.53,Percent of total billed charges,,,0.96,,7343.04,Percent of total billed charges,,,0.95,,7266.55,Percent of total billed charges,,,,,,,,,0.95,,7266.55,Percent of total billed charges,,7266.55,7496.02,
OR SO ATTUNE CRS RP INSRT SZ 5 6MM,SUP-151710506,CDM,27810126,LOCAL,278,RC,,outpatient,,,7649,6884.1,,0.95,,7266.55,Percent of total billed charges,,,0.98,,7496.02,Percent of total billed charges,,,0.95,,7266.55,Percent of total billed charges,,,0.95,,7266.55,Percent of total billed charges,,,0.97,,7419.53,Percent of total billed charges,,,0.96,,7343.04,Percent of total billed charges,,,0.95,,7266.55,Percent of total billed charges,,,,,,,,,0.95,,7266.55,Percent of total billed charges,,7266.55,7496.02,
"OR SO IMPL DELIVERY SYS, DISTAL BICEPS REPR",SUP-AR-2260,CDM,27810126,LOCAL,278,RC,,inpatient,,,1339,1205.1,,0.95,,1272.05,Percent of total billed charges,,,0.98,,1312.22,Percent of total billed charges,,,0.95,,1272.05,Percent of total billed charges,,,0.97,,1298.83,Percent of total billed charges,,,0.97,,1298.83,Percent of total billed charges,,,0.96,,1285.44,Percent of total billed charges,,,0.95,,1272.05,Percent of total billed charges,,,,,,,,,0.95,,1272.05,Percent of total billed charges,,1272.05,1312.22,
"OR SO IMPL DELIVERY SYS, DISTAL BICEPS REPR",SUP-AR-2260,CDM,27810126,LOCAL,278,RC,,outpatient,,,1339,1205.1,,0.95,,1272.05,Percent of total billed charges,,,0.98,,1312.22,Percent of total billed charges,,,0.95,,1272.05,Percent of total billed charges,,,0.95,,1272.05,Percent of total billed charges,,,0.97,,1298.83,Percent of total billed charges,,,0.96,,1285.44,Percent of total billed charges,,,0.95,,1272.05,Percent of total billed charges,,,,,,,,,0.95,,1272.05,Percent of total billed charges,,1272.05,1312.22,
OR SO TORIC OPTIBLUE LENS,SUP-DXW225U2050,CDM,27810126,LOCAL,278,RC,,inpatient,,,1493,1343.7,,0.95,,1418.35,Percent of total billed charges,,,0.98,,1463.14,Percent of total billed charges,,,0.95,,1418.35,Percent of total billed charges,,,0.97,,1448.21,Percent of total billed charges,,,0.97,,1448.21,Percent of total billed charges,,,0.96,,1433.28,Percent of total billed charges,,,0.95,,1418.35,Percent of total billed charges,,,,,,,,,0.95,,1418.35,Percent of total billed charges,,1418.35,1463.14,
OR SO TORIC OPTIBLUE LENS,SUP-DXW225U2050,CDM,27810126,LOCAL,278,RC,,outpatient,,,1493,1343.7,,0.95,,1418.35,Percent of total billed charges,,,0.98,,1463.14,Percent of total billed charges,,,0.95,,1418.35,Percent of total billed charges,,,0.95,,1418.35,Percent of total billed charges,,,0.97,,1448.21,Percent of total billed charges,,,0.96,,1433.28,Percent of total billed charges,,,0.95,,1418.35,Percent of total billed charges,,,,,,,,,0.95,,1418.35,Percent of total billed charges,,1418.35,1463.14,
OR SO TORIC II LENS,SUP-DIU150U1950,CDM,27810126,LOCAL,278,RC,,inpatient,,,1041,936.9,,0.95,,988.95,Percent of total billed charges,,,0.98,,1020.18,Percent of total billed charges,,,0.95,,988.95,Percent of total billed charges,,,0.97,,1009.77,Percent of total billed charges,,,0.97,,1009.77,Percent of total billed charges,,,0.96,,999.36,Percent of total billed charges,,,0.95,,988.95,Percent of total billed charges,,,,,,,,,0.95,,988.95,Percent of total billed charges,,988.95,1020.18,
OR SO TORIC II LENS,SUP-DIU150U1950,CDM,27810126,LOCAL,278,RC,,outpatient,,,1041,936.9,,0.95,,988.95,Percent of total billed charges,,,0.98,,1020.18,Percent of total billed charges,,,0.95,,988.95,Percent of total billed charges,,,0.95,,988.95,Percent of total billed charges,,,0.97,,1009.77,Percent of total billed charges,,,0.96,,999.36,Percent of total billed charges,,,0.95,,988.95,Percent of total billed charges,,,,,,,,,0.95,,988.95,Percent of total billed charges,,988.95,1020.18,
OR SO ATTUNE MEDIAL ANAT PAT 38MM,SUP-151810038,CDM,27810126,LOCAL,278,RC,,inpatient,,,2506,2255.4,,0.95,,2380.7,Percent of total billed charges,,,0.98,,2455.88,Percent of total billed charges,,,0.95,,2380.7,Percent of total billed charges,,,0.97,,2430.82,Percent of total billed charges,,,0.97,,2430.82,Percent of total billed charges,,,0.96,,2405.76,Percent of total billed charges,,,0.95,,2380.7,Percent of total billed charges,,,,,,,,,0.95,,2380.7,Percent of total billed charges,,2380.7,2455.88,
OR SO ATTUNE MEDIAL ANAT PAT 38MM,SUP-151810038,CDM,27810126,LOCAL,278,RC,,outpatient,,,2506,2255.4,,0.95,,2380.7,Percent of total billed charges,,,0.98,,2455.88,Percent of total billed charges,,,0.95,,2380.7,Percent of total billed charges,,,0.95,,2380.7,Percent of total billed charges,,,0.97,,2430.82,Percent of total billed charges,,,0.96,,2405.76,Percent of total billed charges,,,0.95,,2380.7,Percent of total billed charges,,,,,,,,,0.95,,2380.7,Percent of total billed charges,,2380.7,2455.88,
OR SO ATTUNE CR FEM LT SZ 7 CEM,SUP-150400107,CDM,27810126,LOCAL,278,RC,,inpatient,,,8840,7956,,0.95,,8398,Percent of total billed charges,,,0.98,,8663.2,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,0.97,,8574.8,Percent of total billed charges,,,0.97,,8574.8,Percent of total billed charges,,,0.96,,8486.4,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,,,,,,,0.95,,8398,Percent of total billed charges,,8398,8663.2,
OR SO ATTUNE CR FEM LT SZ 7 CEM,SUP-150400107,CDM,27810126,LOCAL,278,RC,,outpatient,,,8840,7956,,0.95,,8398,Percent of total billed charges,,,0.98,,8663.2,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,0.97,,8574.8,Percent of total billed charges,,,0.96,,8486.4,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,,,,,,,0.95,,8398,Percent of total billed charges,,8398,8663.2,
OR SO ATTUNE RP TIB BASE SZ 7 CEM,SUP-150680007,CDM,27810126,LOCAL,278,RC,,inpatient,,,6209,5588.1,,0.95,,5898.55,Percent of total billed charges,,,0.98,,6084.82,Percent of total billed charges,,,0.95,,5898.55,Percent of total billed charges,,,0.97,,6022.73,Percent of total billed charges,,,0.97,,6022.73,Percent of total billed charges,,,0.96,,5960.64,Percent of total billed charges,,,0.95,,5898.55,Percent of total billed charges,,,,,,,,,0.95,,5898.55,Percent of total billed charges,,5898.55,6084.82,
OR SO ATTUNE RP TIB BASE SZ 7 CEM,SUP-150680007,CDM,27810126,LOCAL,278,RC,,outpatient,,,6209,5588.1,,0.95,,5898.55,Percent of total billed charges,,,0.98,,6084.82,Percent of total billed charges,,,0.95,,5898.55,Percent of total billed charges,,,0.95,,5898.55,Percent of total billed charges,,,0.97,,6022.73,Percent of total billed charges,,,0.96,,5960.64,Percent of total billed charges,,,0.95,,5898.55,Percent of total billed charges,,,,,,,,,0.95,,5898.55,Percent of total billed charges,,5898.55,6084.82,
OR SO ATTUNE CR RP INSRT SZ7 MM,SUP-151630707,CDM,27810126,LOCAL,278,RC,,inpatient,,,4803,4322.7,,0.95,,4562.85,Percent of total billed charges,,,0.98,,4706.94,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.96,,4610.88,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,,,,,,,0.95,,4562.85,Percent of total billed charges,,4562.85,4706.94,
OR SO ATTUNE CR RP INSRT SZ7 MM,SUP-151630707,CDM,27810126,LOCAL,278,RC,,outpatient,,,4803,4322.7,,0.95,,4562.85,Percent of total billed charges,,,0.98,,4706.94,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.96,,4610.88,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,,,,,,,0.95,,4562.85,Percent of total billed charges,,4562.85,4706.94,
OR SO SMARTMIX TOWER CARTRIDGE,SUP-540198000,CDM,27010242,LOCAL,270,RC,,inpatient,,,529,476.1,,0.95,,502.55,Percent of total billed charges,,,0.98,,518.42,Percent of total billed charges,,,0.95,,502.55,Percent of total billed charges,,,0.97,,513.13,Percent of total billed charges,,,0.97,,513.13,Percent of total billed charges,,,0.96,,507.84,Percent of total billed charges,,,0.95,,502.55,Percent of total billed charges,,,,,,,,,0.95,,502.55,Percent of total billed charges,,502.55,518.42,
OR SO SMARTMIX TOWER CARTRIDGE,SUP-540198000,CDM,27010242,LOCAL,270,RC,,outpatient,,,529,476.1,,0.95,,502.55,Percent of total billed charges,,,0.98,,518.42,Percent of total billed charges,,,0.95,,502.55,Percent of total billed charges,,,0.95,,502.55,Percent of total billed charges,,,0.97,,513.13,Percent of total billed charges,,,0.96,,507.84,Percent of total billed charges,,,0.95,,502.55,Percent of total billed charges,,,,,,,,,0.95,,502.55,Percent of total billed charges,,502.55,518.42,
OR SO ATTUNE MEDIAL ANAT PAT 41MM,SUP-151810041,CDM,27810126,LOCAL,278,RC,,inpatient,,,2506,2255.4,,0.95,,2380.7,Percent of total billed charges,,,0.98,,2455.88,Percent of total billed charges,,,0.95,,2380.7,Percent of total billed charges,,,0.97,,2430.82,Percent of total billed charges,,,0.97,,2430.82,Percent of total billed charges,,,0.96,,2405.76,Percent of total billed charges,,,0.95,,2380.7,Percent of total billed charges,,,,,,,,,0.95,,2380.7,Percent of total billed charges,,2380.7,2455.88,
OR SO ATTUNE MEDIAL ANAT PAT 41MM,SUP-151810041,CDM,27810126,LOCAL,278,RC,,outpatient,,,2506,2255.4,,0.95,,2380.7,Percent of total billed charges,,,0.98,,2455.88,Percent of total billed charges,,,0.95,,2380.7,Percent of total billed charges,,,0.95,,2380.7,Percent of total billed charges,,,0.97,,2430.82,Percent of total billed charges,,,0.96,,2405.76,Percent of total billed charges,,,0.95,,2380.7,Percent of total billed charges,,,,,,,,,0.95,,2380.7,Percent of total billed charges,,2380.7,2455.88,
OR SO ATUNE REV RP TIB BASE SZ 6,SUP-150660006,CDM,27810126,LOCAL,278,RC,,inpatient,,,12815,11533.5,,0.95,,12174.25,Percent of total billed charges,,,0.98,,12558.7,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,0.97,,12430.55,Percent of total billed charges,,,0.97,,12430.55,Percent of total billed charges,,,0.96,,12302.4,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,,,,,,,0.95,,12174.25,Percent of total billed charges,,12174.25,12558.7,
OR SO ATUNE REV RP TIB BASE SZ 6,SUP-150660006,CDM,27810126,LOCAL,278,RC,,outpatient,,,12815,11533.5,,0.95,,12174.25,Percent of total billed charges,,,0.98,,12558.7,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,0.97,,12430.55,Percent of total billed charges,,,0.96,,12302.4,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,,,,,,,0.95,,12174.25,Percent of total billed charges,,12174.25,12558.7,
OR SO ATTUNE CRS FEMORAL LT SZ 7,SUP-150440107,CDM,27810126,LOCAL,278,RC,,inpatient,,,17656,15890.4,,0.95,,16773.2,Percent of total billed charges,,,0.98,,17302.88,Percent of total billed charges,,,0.95,,16773.2,Percent of total billed charges,,,0.97,,17126.32,Percent of total billed charges,,,0.97,,17126.32,Percent of total billed charges,,,0.96,,16949.76,Percent of total billed charges,,,0.95,,16773.2,Percent of total billed charges,,,,,,,,,0.95,,16773.2,Percent of total billed charges,,16773.2,17302.88,
OR SO ATTUNE CRS FEMORAL LT SZ 7,SUP-150440107,CDM,27810126,LOCAL,278,RC,,outpatient,,,17656,15890.4,,0.95,,16773.2,Percent of total billed charges,,,0.98,,17302.88,Percent of total billed charges,,,0.95,,16773.2,Percent of total billed charges,,,0.95,,16773.2,Percent of total billed charges,,,0.97,,17126.32,Percent of total billed charges,,,0.96,,16949.76,Percent of total billed charges,,,0.95,,16773.2,Percent of total billed charges,,,,,,,,,0.95,,16773.2,Percent of total billed charges,,16773.2,17302.88,
OR SO ATTUNE CEMENTED STEM 14X30MM,SUP-151214030,CDM,27810126,LOCAL,278,RC,,inpatient,,,2732,2458.8,,0.95,,2595.4,Percent of total billed charges,,,0.98,,2677.36,Percent of total billed charges,,,0.95,,2595.4,Percent of total billed charges,,,0.97,,2650.04,Percent of total billed charges,,,0.97,,2650.04,Percent of total billed charges,,,0.96,,2622.72,Percent of total billed charges,,,0.95,,2595.4,Percent of total billed charges,,,,,,,,,0.95,,2595.4,Percent of total billed charges,,2595.4,2677.36,
OR SO ATTUNE CEMENTED STEM 14X30MM,SUP-151214030,CDM,27810126,LOCAL,278,RC,,outpatient,,,2732,2458.8,,0.95,,2595.4,Percent of total billed charges,,,0.98,,2677.36,Percent of total billed charges,,,0.95,,2595.4,Percent of total billed charges,,,0.95,,2595.4,Percent of total billed charges,,,0.97,,2650.04,Percent of total billed charges,,,0.96,,2622.72,Percent of total billed charges,,,0.95,,2595.4,Percent of total billed charges,,,,,,,,,0.95,,2595.4,Percent of total billed charges,,2595.4,2677.36,
OR SO ATTUNE CRS RP INSRT SZ 7 6MM,SUP-151710706,CDM,27810126,LOCAL,278,RC,,inpatient,,,7649,6884.1,,0.95,,7266.55,Percent of total billed charges,,,0.98,,7496.02,Percent of total billed charges,,,0.95,,7266.55,Percent of total billed charges,,,0.97,,7419.53,Percent of total billed charges,,,0.97,,7419.53,Percent of total billed charges,,,0.96,,7343.04,Percent of total billed charges,,,0.95,,7266.55,Percent of total billed charges,,,,,,,,,0.95,,7266.55,Percent of total billed charges,,7266.55,7496.02,
OR SO ATTUNE CRS RP INSRT SZ 7 6MM,SUP-151710706,CDM,27810126,LOCAL,278,RC,,outpatient,,,7649,6884.1,,0.95,,7266.55,Percent of total billed charges,,,0.98,,7496.02,Percent of total billed charges,,,0.95,,7266.55,Percent of total billed charges,,,0.95,,7266.55,Percent of total billed charges,,,0.97,,7419.53,Percent of total billed charges,,,0.96,,7343.04,Percent of total billed charges,,,0.95,,7266.55,Percent of total billed charges,,,,,,,,,0.95,,7266.55,Percent of total billed charges,,7266.55,7496.02,
OR SO DELTA CER HEAD 12/14 28MM +1.5,SUP-136528310,CDM,27810126,LOCAL,278,RC,,inpatient,,,4283,3854.7,,0.95,,4068.85,Percent of total billed charges,,,0.98,,4197.34,Percent of total billed charges,,,0.95,,4068.85,Percent of total billed charges,,,0.97,,4154.51,Percent of total billed charges,,,0.97,,4154.51,Percent of total billed charges,,,0.96,,4111.68,Percent of total billed charges,,,0.95,,4068.85,Percent of total billed charges,,,,,,,,,0.95,,4068.85,Percent of total billed charges,,4068.85,4197.34,
OR SO DELTA CER HEAD 12/14 28MM +1.5,SUP-136528310,CDM,27810126,LOCAL,278,RC,,outpatient,,,4283,3854.7,,0.95,,4068.85,Percent of total billed charges,,,0.98,,4197.34,Percent of total billed charges,,,0.95,,4068.85,Percent of total billed charges,,,0.95,,4068.85,Percent of total billed charges,,,0.97,,4154.51,Percent of total billed charges,,,0.96,,4111.68,Percent of total billed charges,,,0.95,,4068.85,Percent of total billed charges,,,,,,,,,0.95,,4068.85,Percent of total billed charges,,4068.85,4197.34,
OR SO SELF CENT HIP 45X28 GRY,SUP-103545000,CDM,27810126,LOCAL,278,RC,,inpatient,,,2226,2003.4,,0.95,,2114.7,Percent of total billed charges,,,0.98,,2181.48,Percent of total billed charges,,,0.95,,2114.7,Percent of total billed charges,,,0.97,,2159.22,Percent of total billed charges,,,0.97,,2159.22,Percent of total billed charges,,,0.96,,2136.96,Percent of total billed charges,,,0.95,,2114.7,Percent of total billed charges,,,,,,,,,0.95,,2114.7,Percent of total billed charges,,2114.7,2181.48,
OR SO SELF CENT HIP 45X28 GRY,SUP-103545000,CDM,27810126,LOCAL,278,RC,,outpatient,,,2226,2003.4,,0.95,,2114.7,Percent of total billed charges,,,0.98,,2181.48,Percent of total billed charges,,,0.95,,2114.7,Percent of total billed charges,,,0.95,,2114.7,Percent of total billed charges,,,0.97,,2159.22,Percent of total billed charges,,,0.96,,2136.96,Percent of total billed charges,,,0.95,,2114.7,Percent of total billed charges,,,,,,,,,0.95,,2114.7,Percent of total billed charges,,2114.7,2181.48,
OR SO ATTUNE PS FEM LT SZ 7 CEM,SUP-150410107,CDM,27810126,LOCAL,278,RC,,inpatient,,,8840,7956,,0.95,,8398,Percent of total billed charges,,,0.98,,8663.2,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,0.97,,8574.8,Percent of total billed charges,,,0.97,,8574.8,Percent of total billed charges,,,0.96,,8486.4,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,,,,,,,0.95,,8398,Percent of total billed charges,,8398,8663.2,
OR SO ATTUNE PS FEM LT SZ 7 CEM,SUP-150410107,CDM,27810126,LOCAL,278,RC,,outpatient,,,8840,7956,,0.95,,8398,Percent of total billed charges,,,0.98,,8663.2,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,0.97,,8574.8,Percent of total billed charges,,,0.96,,8486.4,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,,,,,,,0.95,,8398,Percent of total billed charges,,8398,8663.2,
OR SO ATTUNE RP TIB BASE SZ 5 CEM,SUP-150680005,CDM,27810126,LOCAL,278,RC,,inpatient,,,6202,5581.8,,0.95,,5891.9,Percent of total billed charges,,,0.98,,6077.96,Percent of total billed charges,,,0.95,,5891.9,Percent of total billed charges,,,0.97,,6015.94,Percent of total billed charges,,,0.97,,6015.94,Percent of total billed charges,,,0.96,,5953.92,Percent of total billed charges,,,0.95,,5891.9,Percent of total billed charges,,,,,,,,,0.95,,5891.9,Percent of total billed charges,,5891.9,6077.96,
OR SO ATTUNE RP TIB BASE SZ 5 CEM,SUP-150680005,CDM,27810126,LOCAL,278,RC,,outpatient,,,6202,5581.8,,0.95,,5891.9,Percent of total billed charges,,,0.98,,6077.96,Percent of total billed charges,,,0.95,,5891.9,Percent of total billed charges,,,0.95,,5891.9,Percent of total billed charges,,,0.97,,6015.94,Percent of total billed charges,,,0.96,,5953.92,Percent of total billed charges,,,0.95,,5891.9,Percent of total billed charges,,,,,,,,,0.95,,5891.9,Percent of total billed charges,,5891.9,6077.96,
OR SO ATTUNE PS RP INSRT SZ7 6MM,SUP-151650706,CDM,27810126,LOCAL,278,RC,,inpatient,,,4803,4322.7,,0.95,,4562.85,Percent of total billed charges,,,0.98,,4706.94,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.96,,4610.88,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,,,,,,,0.95,,4562.85,Percent of total billed charges,,4562.85,4706.94,
OR SO ATTUNE PS RP INSRT SZ7 6MM,SUP-151650706,CDM,27810126,LOCAL,278,RC,,outpatient,,,4803,4322.7,,0.95,,4562.85,Percent of total billed charges,,,0.98,,4706.94,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.96,,4610.88,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,,,,,,,0.95,,4562.85,Percent of total billed charges,,4562.85,4706.94,
OR FIBERTAK 2.6 SP SOFT ANCHOR,SUP-3254615,CDM,27810126,LOCAL,278,RC,,inpatient,,,861,774.9,,0.95,,817.95,Percent of total billed charges,,,0.98,,843.78,Percent of total billed charges,,,0.95,,817.95,Percent of total billed charges,,,0.97,,835.17,Percent of total billed charges,,,0.97,,835.17,Percent of total billed charges,,,0.96,,826.56,Percent of total billed charges,,,0.95,,817.95,Percent of total billed charges,,,,,,,,,0.95,,817.95,Percent of total billed charges,,817.95,843.78,
OR FIBERTAK 2.6 SP SOFT ANCHOR,SUP-3254615,CDM,27810126,LOCAL,278,RC,,outpatient,,,861,774.9,,0.95,,817.95,Percent of total billed charges,,,0.98,,843.78,Percent of total billed charges,,,0.95,,817.95,Percent of total billed charges,,,0.95,,817.95,Percent of total billed charges,,,0.97,,835.17,Percent of total billed charges,,,0.96,,826.56,Percent of total billed charges,,,0.95,,817.95,Percent of total billed charges,,,,,,,,,0.95,,817.95,Percent of total billed charges,,817.95,843.78,
OR SO ATTUNE PS FEM LT SZ 9 CEM,SUP-150410109,CDM,27810126,LOCAL,278,RC,,inpatient,,,8840,7956,,0.95,,8398,Percent of total billed charges,,,0.98,,8663.2,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,0.97,,8574.8,Percent of total billed charges,,,0.97,,8574.8,Percent of total billed charges,,,0.96,,8486.4,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,,,,,,,0.95,,8398,Percent of total billed charges,,8398,8663.2,
OR SO ATTUNE PS FEM LT SZ 9 CEM,SUP-150410109,CDM,27810126,LOCAL,278,RC,,outpatient,,,8840,7956,,0.95,,8398,Percent of total billed charges,,,0.98,,8663.2,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,0.97,,8574.8,Percent of total billed charges,,,0.96,,8486.4,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,,,,,,,0.95,,8398,Percent of total billed charges,,8398,8663.2,
OR SO ATTUNE RP TIB BASE SZ 8 CEM,SUP-150680008,CDM,27810126,LOCAL,278,RC,,inpatient,,,6209,5588.1,,0.95,,5898.55,Percent of total billed charges,,,0.98,,6084.82,Percent of total billed charges,,,0.95,,5898.55,Percent of total billed charges,,,0.97,,6022.73,Percent of total billed charges,,,0.97,,6022.73,Percent of total billed charges,,,0.96,,5960.64,Percent of total billed charges,,,0.95,,5898.55,Percent of total billed charges,,,,,,,,,0.95,,5898.55,Percent of total billed charges,,5898.55,6084.82,
OR SO ATTUNE RP TIB BASE SZ 8 CEM,SUP-150680008,CDM,27810126,LOCAL,278,RC,,outpatient,,,6209,5588.1,,0.95,,5898.55,Percent of total billed charges,,,0.98,,6084.82,Percent of total billed charges,,,0.95,,5898.55,Percent of total billed charges,,,0.95,,5898.55,Percent of total billed charges,,,0.97,,6022.73,Percent of total billed charges,,,0.96,,5960.64,Percent of total billed charges,,,0.95,,5898.55,Percent of total billed charges,,,,,,,,,0.95,,5898.55,Percent of total billed charges,,5898.55,6084.82,
OR SO ATTUNE PS RP INSRT SZ 9 7MM,SUP-151650907,CDM,27810126,LOCAL,278,RC,,inpatient,,,4803,4322.7,,0.95,,4562.85,Percent of total billed charges,,,0.98,,4706.94,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.96,,4610.88,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,,,,,,,0.95,,4562.85,Percent of total billed charges,,4562.85,4706.94,
OR SO ATTUNE PS RP INSRT SZ 9 7MM,SUP-151650907,CDM,27810126,LOCAL,278,RC,,outpatient,,,4803,4322.7,,0.95,,4562.85,Percent of total billed charges,,,0.98,,4706.94,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.96,,4610.88,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,,,,,,,0.95,,4562.85,Percent of total billed charges,,4562.85,4706.94,
"OR SO 3.5MM X 5"" QUICK RELEASE DRILL",SUP-MS-DC35,CDM,27010242,LOCAL,270,RC,,inpatient,,,480,432,,0.95,,456,Percent of total billed charges,,,0.98,,470.4,Percent of total billed charges,,,0.95,,456,Percent of total billed charges,,,0.97,,465.6,Percent of total billed charges,,,0.97,,465.6,Percent of total billed charges,,,0.96,,460.8,Percent of total billed charges,,,0.95,,456,Percent of total billed charges,,,,,,,,,0.95,,456,Percent of total billed charges,,456,470.4,
"OR SO 3.5MM X 5"" QUICK RELEASE DRILL",SUP-MS-DC35,CDM,27010242,LOCAL,270,RC,,outpatient,,,480,432,,0.95,,456,Percent of total billed charges,,,0.98,,470.4,Percent of total billed charges,,,0.95,,456,Percent of total billed charges,,,0.95,,456,Percent of total billed charges,,,0.97,,465.6,Percent of total billed charges,,,0.96,,460.8,Percent of total billed charges,,,0.95,,456,Percent of total billed charges,,,,,,,,,0.95,,456,Percent of total billed charges,,456,470.4,
"OR SO 2.8MM X 5"" QUICK RELEASE DRILL",SUP-MS-DC28,CDM,27010242,LOCAL,270,RC,,inpatient,,,480,432,,0.95,,456,Percent of total billed charges,,,0.98,,470.4,Percent of total billed charges,,,0.95,,456,Percent of total billed charges,,,0.97,,465.6,Percent of total billed charges,,,0.97,,465.6,Percent of total billed charges,,,0.96,,460.8,Percent of total billed charges,,,0.95,,456,Percent of total billed charges,,,,,,,,,0.95,,456,Percent of total billed charges,,456,470.4,
"OR SO 2.8MM X 5"" QUICK RELEASE DRILL",SUP-MS-DC28,CDM,27010242,LOCAL,270,RC,,outpatient,,,480,432,,0.95,,456,Percent of total billed charges,,,0.98,,470.4,Percent of total billed charges,,,0.95,,456,Percent of total billed charges,,,0.95,,456,Percent of total billed charges,,,0.97,,465.6,Percent of total billed charges,,,0.96,,460.8,Percent of total billed charges,,,0.95,,456,Percent of total billed charges,,,,,,,,,0.95,,456,Percent of total billed charges,,456,470.4,
OR SO 6 HOLE ULNA SHORTENING PLATE,SUP-PL-UL06,CDM,27810126,LOCAL,278,RC,,inpatient,,,3858,3472.2,,0.95,,3665.1,Percent of total billed charges,,,0.98,,3780.84,Percent of total billed charges,,,0.95,,3665.1,Percent of total billed charges,,,0.97,,3742.26,Percent of total billed charges,,,0.97,,3742.26,Percent of total billed charges,,,0.96,,3703.68,Percent of total billed charges,,,0.95,,3665.1,Percent of total billed charges,,,,,,,,,0.95,,3665.1,Percent of total billed charges,,3665.1,3780.84,
OR SO 6 HOLE ULNA SHORTENING PLATE,SUP-PL-UL06,CDM,27810126,LOCAL,278,RC,,outpatient,,,3858,3472.2,,0.95,,3665.1,Percent of total billed charges,,,0.98,,3780.84,Percent of total billed charges,,,0.95,,3665.1,Percent of total billed charges,,,0.95,,3665.1,Percent of total billed charges,,,0.97,,3742.26,Percent of total billed charges,,,0.96,,3703.68,Percent of total billed charges,,,0.95,,3665.1,Percent of total billed charges,,,,,,,,,0.95,,3665.1,Percent of total billed charges,,3665.1,3780.84,
"OR SO .045"" X 6"" ST GUIDE WIRE",SUP-WS-1106ST,CDM,27010242,LOCAL,270,RC,,inpatient,,,144,129.6,,0.95,,136.8,Percent of total billed charges,,,0.98,,141.12,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,0.97,,139.68,Percent of total billed charges,,,0.97,,139.68,Percent of total billed charges,,,0.96,,138.24,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,,,,,,,0.95,,136.8,Percent of total billed charges,,136.8,141.12,
"OR SO .045"" X 6"" ST GUIDE WIRE",SUP-WS-1106ST,CDM,27010242,LOCAL,270,RC,,outpatient,,,144,129.6,,0.95,,136.8,Percent of total billed charges,,,0.98,,141.12,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,0.97,,139.68,Percent of total billed charges,,,0.96,,138.24,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,,,,,,,0.95,,136.8,Percent of total billed charges,,136.8,141.12,
OR SO PLATE TACK,SUP-PL-PTACK,CDM,27010242,LOCAL,270,RC,,inpatient,,,323,290.7,,0.95,,306.85,Percent of total billed charges,,,0.98,,316.54,Percent of total billed charges,,,0.95,,306.85,Percent of total billed charges,,,0.97,,313.31,Percent of total billed charges,,,0.97,,313.31,Percent of total billed charges,,,0.96,,310.08,Percent of total billed charges,,,0.95,,306.85,Percent of total billed charges,,,,,,,,,0.95,,306.85,Percent of total billed charges,,306.85,316.54,
OR SO PLATE TACK,SUP-PL-PTACK,CDM,27010242,LOCAL,270,RC,,outpatient,,,323,290.7,,0.95,,306.85,Percent of total billed charges,,,0.98,,316.54,Percent of total billed charges,,,0.95,,306.85,Percent of total billed charges,,,0.95,,306.85,Percent of total billed charges,,,0.97,,313.31,Percent of total billed charges,,,0.96,,310.08,Percent of total billed charges,,,0.95,,306.85,Percent of total billed charges,,,,,,,,,0.95,,306.85,Percent of total billed charges,,306.85,316.54,
OR SO 3.5MM X 16MM NON-LOCKING HEXALOBE SCREW,SUP-30-0259,CDM,27810126,LOCAL,278,RC,,inpatient,,,400,360,,0.95,,380,Percent of total billed charges,,,0.98,,392,Percent of total billed charges,,,0.95,,380,Percent of total billed charges,,,0.97,,388,Percent of total billed charges,,,0.97,,388,Percent of total billed charges,,,0.96,,384,Percent of total billed charges,,,0.95,,380,Percent of total billed charges,,,,,,,,,0.95,,380,Percent of total billed charges,,380,392,
OR SO 3.5MM X 16MM NON-LOCKING HEXALOBE SCREW,SUP-30-0259,CDM,27810126,LOCAL,278,RC,,outpatient,,,400,360,,0.95,,380,Percent of total billed charges,,,0.98,,392,Percent of total billed charges,,,0.95,,380,Percent of total billed charges,,,0.95,,380,Percent of total billed charges,,,0.97,,388,Percent of total billed charges,,,0.96,,384,Percent of total billed charges,,,0.95,,380,Percent of total billed charges,,,,,,,,,0.95,,380,Percent of total billed charges,,380,392,
OR SO 3.5MM X 14MM NON-LOCKING HEXALOBE SCREW,SUP-30-0258,CDM,27810126,LOCAL,278,RC,,inpatient,,,400,360,,0.95,,380,Percent of total billed charges,,,0.98,,392,Percent of total billed charges,,,0.95,,380,Percent of total billed charges,,,0.97,,388,Percent of total billed charges,,,0.97,,388,Percent of total billed charges,,,0.96,,384,Percent of total billed charges,,,0.95,,380,Percent of total billed charges,,,,,,,,,0.95,,380,Percent of total billed charges,,380,392,
OR SO 3.5MM X 14MM NON-LOCKING HEXALOBE SCREW,SUP-30-0258,CDM,27810126,LOCAL,278,RC,,outpatient,,,400,360,,0.95,,380,Percent of total billed charges,,,0.98,,392,Percent of total billed charges,,,0.95,,380,Percent of total billed charges,,,0.95,,380,Percent of total billed charges,,,0.97,,388,Percent of total billed charges,,,0.96,,384,Percent of total billed charges,,,0.95,,380,Percent of total billed charges,,,,,,,,,0.95,,380,Percent of total billed charges,,380,392,
OR SO 3.5MM X 18MM NON-LOCKING HEXALOBE SCREW,SUP-30-0260,CDM,27810126,LOCAL,278,RC,,inpatient,,,400,360,,0.95,,380,Percent of total billed charges,,,0.98,,392,Percent of total billed charges,,,0.95,,380,Percent of total billed charges,,,0.97,,388,Percent of total billed charges,,,0.97,,388,Percent of total billed charges,,,0.96,,384,Percent of total billed charges,,,0.95,,380,Percent of total billed charges,,,,,,,,,0.95,,380,Percent of total billed charges,,380,392,
OR SO 3.5MM X 18MM NON-LOCKING HEXALOBE SCREW,SUP-30-0260,CDM,27810126,LOCAL,278,RC,,outpatient,,,400,360,,0.95,,380,Percent of total billed charges,,,0.98,,392,Percent of total billed charges,,,0.95,,380,Percent of total billed charges,,,0.95,,380,Percent of total billed charges,,,0.97,,388,Percent of total billed charges,,,0.96,,384,Percent of total billed charges,,,0.95,,380,Percent of total billed charges,,,,,,,,,0.95,,380,Percent of total billed charges,,380,392,
OR SO FLIPCUTTER III,SUP-AR-1204FF,CDM,27010242,LOCAL,270,RC,,inpatient,,,872,784.8,,0.95,,828.4,Percent of total billed charges,,,0.98,,854.56,Percent of total billed charges,,,0.95,,828.4,Percent of total billed charges,,,0.97,,845.84,Percent of total billed charges,,,0.97,,845.84,Percent of total billed charges,,,0.96,,837.12,Percent of total billed charges,,,0.95,,828.4,Percent of total billed charges,,,,,,,,,0.95,,828.4,Percent of total billed charges,,828.4,854.56,
OR SO FLIPCUTTER III,SUP-AR-1204FF,CDM,27010242,LOCAL,270,RC,,outpatient,,,872,784.8,,0.95,,828.4,Percent of total billed charges,,,0.98,,854.56,Percent of total billed charges,,,0.95,,828.4,Percent of total billed charges,,,0.95,,828.4,Percent of total billed charges,,,0.97,,845.84,Percent of total billed charges,,,0.96,,837.12,Percent of total billed charges,,,0.95,,828.4,Percent of total billed charges,,,,,,,,,0.95,,828.4,Percent of total billed charges,,828.4,854.56,
OR SO DRILL TIP GUIDE PIN 3.5MM X 311MM,SUP-AR-1250FS,CDM,27010242,LOCAL,270,RC,,inpatient,,,345,310.5,,0.95,,327.75,Percent of total billed charges,,,0.98,,338.1,Percent of total billed charges,,,0.95,,327.75,Percent of total billed charges,,,0.97,,334.65,Percent of total billed charges,,,0.97,,334.65,Percent of total billed charges,,,0.96,,331.2,Percent of total billed charges,,,0.95,,327.75,Percent of total billed charges,,,,,,,,,0.95,,327.75,Percent of total billed charges,,327.75,338.1,
OR SO DRILL TIP GUIDE PIN 3.5MM X 311MM,SUP-AR-1250FS,CDM,27010242,LOCAL,270,RC,,outpatient,,,345,310.5,,0.95,,327.75,Percent of total billed charges,,,0.98,,338.1,Percent of total billed charges,,,0.95,,327.75,Percent of total billed charges,,,0.95,,327.75,Percent of total billed charges,,,0.97,,334.65,Percent of total billed charges,,,0.96,,331.2,Percent of total billed charges,,,0.95,,327.75,Percent of total billed charges,,,,,,,,,0.95,,327.75,Percent of total billed charges,,327.75,338.1,
OR SO TIGHTROPE ABS 3 HOLE BUTTON 11MM CONCAVE,SUP-AR-1588TB-31B,CDM,27810126,LOCAL,278,RC,,inpatient,,,722,649.8,,0.95,,685.9,Percent of total billed charges,,,0.98,,707.56,Percent of total billed charges,,,0.95,,685.9,Percent of total billed charges,,,0.97,,700.34,Percent of total billed charges,,,0.97,,700.34,Percent of total billed charges,,,0.96,,693.12,Percent of total billed charges,,,0.95,,685.9,Percent of total billed charges,,,,,,,,,0.95,,685.9,Percent of total billed charges,,685.9,707.56,
OR SO TIGHTROPE ABS 3 HOLE BUTTON 11MM CONCAVE,SUP-AR-1588TB-31B,CDM,27810126,LOCAL,278,RC,,outpatient,,,722,649.8,,0.95,,685.9,Percent of total billed charges,,,0.98,,707.56,Percent of total billed charges,,,0.95,,685.9,Percent of total billed charges,,,0.95,,685.9,Percent of total billed charges,,,0.97,,700.34,Percent of total billed charges,,,0.96,,693.12,Percent of total billed charges,,,0.95,,685.9,Percent of total billed charges,,,,,,,,,0.95,,685.9,Percent of total billed charges,,685.9,707.56,
"OR SO TRAPEZIECTOMY TOOL, STERILE",SUP-AR-8919-01S,CDM,27010242,LOCAL,270,RC,,inpatient,,,656,590.4,,0.95,,623.2,Percent of total billed charges,,,0.98,,642.88,Percent of total billed charges,,,0.95,,623.2,Percent of total billed charges,,,0.97,,636.32,Percent of total billed charges,,,0.97,,636.32,Percent of total billed charges,,,0.96,,629.76,Percent of total billed charges,,,0.95,,623.2,Percent of total billed charges,,,,,,,,,0.95,,623.2,Percent of total billed charges,,623.2,642.88,
"OR SO TRAPEZIECTOMY TOOL, STERILE",SUP-AR-8919-01S,CDM,27010242,LOCAL,270,RC,,outpatient,,,656,590.4,,0.95,,623.2,Percent of total billed charges,,,0.98,,642.88,Percent of total billed charges,,,0.95,,623.2,Percent of total billed charges,,,0.95,,623.2,Percent of total billed charges,,,0.97,,636.32,Percent of total billed charges,,,0.96,,629.76,Percent of total billed charges,,,0.95,,623.2,Percent of total billed charges,,,,,,,,,0.95,,623.2,Percent of total billed charges,,623.2,642.88,
OR SO H/W INTERNALBRACE LGMNT AUGMNT REPR KIT,SUP-AR-8978-CP,CDM,27810126,LOCAL,278,RC,,inpatient,,,2355,2119.5,,0.95,,2237.25,Percent of total billed charges,,,0.98,,2307.9,Percent of total billed charges,,,0.95,,2237.25,Percent of total billed charges,,,0.97,,2284.35,Percent of total billed charges,,,0.97,,2284.35,Percent of total billed charges,,,0.96,,2260.8,Percent of total billed charges,,,0.95,,2237.25,Percent of total billed charges,,,,,,,,,0.95,,2237.25,Percent of total billed charges,,2237.25,2307.9,
OR SO H/W INTERNALBRACE LGMNT AUGMNT REPR KIT,SUP-AR-8978-CP,CDM,27810126,LOCAL,278,RC,,outpatient,,,2355,2119.5,,0.95,,2237.25,Percent of total billed charges,,,0.98,,2307.9,Percent of total billed charges,,,0.95,,2237.25,Percent of total billed charges,,,0.95,,2237.25,Percent of total billed charges,,,0.97,,2284.35,Percent of total billed charges,,,0.96,,2260.8,Percent of total billed charges,,,0.95,,2237.25,Percent of total billed charges,,,,,,,,,0.95,,2237.25,Percent of total billed charges,,2237.25,2307.9,
OR SO 11/130 DEG TI CANN TFNA 380/RIGHT-SILE,SUP-04.037.158S,CDM,27810126,LOCAL,278,RC,,inpatient,,,8610,7749,,0.95,,8179.5,Percent of total billed charges,,,0.98,,8437.8,Percent of total billed charges,,,0.95,,8179.5,Percent of total billed charges,,,0.97,,8351.7,Percent of total billed charges,,,0.97,,8351.7,Percent of total billed charges,,,0.96,,8265.6,Percent of total billed charges,,,0.95,,8179.5,Percent of total billed charges,,,,,,,,,0.95,,8179.5,Percent of total billed charges,,8179.5,8437.8,
OR SO 11/130 DEG TI CANN TFNA 380/RIGHT-SILE,SUP-04.037.158S,CDM,27810126,LOCAL,278,RC,,outpatient,,,8610,7749,,0.95,,8179.5,Percent of total billed charges,,,0.98,,8437.8,Percent of total billed charges,,,0.95,,8179.5,Percent of total billed charges,,,0.95,,8179.5,Percent of total billed charges,,,0.97,,8351.7,Percent of total billed charges,,,0.96,,8265.6,Percent of total billed charges,,,0.95,,8179.5,Percent of total billed charges,,,,,,,,,0.95,,8179.5,Percent of total billed charges,,8179.5,8437.8,
OR SO TFNA FENESTRATED SCREW 100MM-STERILE,SUP-04.038.200S,CDM,27810126,LOCAL,278,RC,,inpatient,,,2747,2472.3,,0.95,,2609.65,Percent of total billed charges,,,0.98,,2692.06,Percent of total billed charges,,,0.95,,2609.65,Percent of total billed charges,,,0.97,,2664.59,Percent of total billed charges,,,0.97,,2664.59,Percent of total billed charges,,,0.96,,2637.12,Percent of total billed charges,,,0.95,,2609.65,Percent of total billed charges,,,,,,,,,0.95,,2609.65,Percent of total billed charges,,2609.65,2692.06,
OR SO TFNA FENESTRATED SCREW 100MM-STERILE,SUP-04.038.200S,CDM,27810126,LOCAL,278,RC,,outpatient,,,2747,2472.3,,0.95,,2609.65,Percent of total billed charges,,,0.98,,2692.06,Percent of total billed charges,,,0.95,,2609.65,Percent of total billed charges,,,0.95,,2609.65,Percent of total billed charges,,,0.97,,2664.59,Percent of total billed charges,,,0.96,,2637.12,Percent of total billed charges,,,0.95,,2609.65,Percent of total billed charges,,,,,,,,,0.95,,2609.65,Percent of total billed charges,,2609.65,2692.06,
OR SO ATUNE REV RP TIB BASE SZ 7 CEM,SUP-150660007,CDM,27810126,LOCAL,278,RC,,inpatient,,,12815,11533.5,,0.95,,12174.25,Percent of total billed charges,,,0.98,,12558.7,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,0.97,,12430.55,Percent of total billed charges,,,0.97,,12430.55,Percent of total billed charges,,,0.96,,12302.4,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,,,,,,,0.95,,12174.25,Percent of total billed charges,,12174.25,12558.7,
OR SO ATUNE REV RP TIB BASE SZ 7 CEM,SUP-150660007,CDM,27810126,LOCAL,278,RC,,outpatient,,,12815,11533.5,,0.95,,12174.25,Percent of total billed charges,,,0.98,,12558.7,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,0.97,,12430.55,Percent of total billed charges,,,0.96,,12302.4,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,,,,,,,0.95,,12174.25,Percent of total billed charges,,12174.25,12558.7,
OR SO ATTUNE PS FEM RT SZ 8 CEM,SUP-150410208,CDM,27810126,LOCAL,278,RC,,inpatient,,,8840,7956,,0.95,,8398,Percent of total billed charges,,,0.98,,8663.2,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,0.97,,8574.8,Percent of total billed charges,,,0.97,,8574.8,Percent of total billed charges,,,0.96,,8486.4,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,,,,,,,0.95,,8398,Percent of total billed charges,,8398,8663.2,
OR SO ATTUNE PS FEM RT SZ 8 CEM,SUP-150410208,CDM,27810126,LOCAL,278,RC,,outpatient,,,8840,7956,,0.95,,8398,Percent of total billed charges,,,0.98,,8663.2,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,0.97,,8574.8,Percent of total billed charges,,,0.96,,8486.4,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,,,,,,,0.95,,8398,Percent of total billed charges,,8398,8663.2,
OR SO ATTUNE PS RP INSRT SZ8 6MM,SUP-151650806,CDM,27810126,LOCAL,278,RC,,inpatient,,,4803,4322.7,,0.95,,4562.85,Percent of total billed charges,,,0.98,,4706.94,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.96,,4610.88,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,,,,,,,0.95,,4562.85,Percent of total billed charges,,4562.85,4706.94,
OR SO ATTUNE PS RP INSRT SZ8 6MM,SUP-151650806,CDM,27810126,LOCAL,278,RC,,outpatient,,,4803,4322.7,,0.95,,4562.85,Percent of total billed charges,,,0.98,,4706.94,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.96,,4610.88,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,,,,,,,0.95,,4562.85,Percent of total billed charges,,4562.85,4706.94,
OR FIBERTAK KNOTLESS 2.6 W/B/BL,SUP-3254620,CDM,27810126,LOCAL,278,RC,,inpatient,,,974,876.6,,0.95,,925.3,Percent of total billed charges,,,0.98,,954.52,Percent of total billed charges,,,0.95,,925.3,Percent of total billed charges,,,0.97,,944.78,Percent of total billed charges,,,0.97,,944.78,Percent of total billed charges,,,0.96,,935.04,Percent of total billed charges,,,0.95,,925.3,Percent of total billed charges,,,,,,,,,0.95,,925.3,Percent of total billed charges,,925.3,954.52,
OR FIBERTAK KNOTLESS 2.6 W/B/BL,SUP-3254620,CDM,27810126,LOCAL,278,RC,,outpatient,,,974,876.6,,0.95,,925.3,Percent of total billed charges,,,0.98,,954.52,Percent of total billed charges,,,0.95,,925.3,Percent of total billed charges,,,0.95,,925.3,Percent of total billed charges,,,0.97,,944.78,Percent of total billed charges,,,0.96,,935.04,Percent of total billed charges,,,0.95,,925.3,Percent of total billed charges,,,,,,,,,0.95,,925.3,Percent of total billed charges,,925.3,954.52,
OR FIBERTAK KNOTLESS 2.6 W/B,SUP-3254621,CDM,27810126,LOCAL,278,RC,,inpatient,,,974,876.6,,0.95,,925.3,Percent of total billed charges,,,0.98,,954.52,Percent of total billed charges,,,0.95,,925.3,Percent of total billed charges,,,0.97,,944.78,Percent of total billed charges,,,0.97,,944.78,Percent of total billed charges,,,0.96,,935.04,Percent of total billed charges,,,0.95,,925.3,Percent of total billed charges,,,,,,,,,0.95,,925.3,Percent of total billed charges,,925.3,954.52,
OR FIBERTAK KNOTLESS 2.6 W/B,SUP-3254621,CDM,27810126,LOCAL,278,RC,,outpatient,,,974,876.6,,0.95,,925.3,Percent of total billed charges,,,0.98,,954.52,Percent of total billed charges,,,0.95,,925.3,Percent of total billed charges,,,0.95,,925.3,Percent of total billed charges,,,0.97,,944.78,Percent of total billed charges,,,0.96,,935.04,Percent of total billed charges,,,0.95,,925.3,Percent of total billed charges,,,,,,,,,0.95,,925.3,Percent of total billed charges,,925.3,954.52,
OR FIBERTAK KNOTLESS 2.6 B/BL,SUP-3254622,CDM,27810126,LOCAL,278,RC,,inpatient,,,974,876.6,,0.95,,925.3,Percent of total billed charges,,,0.98,,954.52,Percent of total billed charges,,,0.95,,925.3,Percent of total billed charges,,,0.97,,944.78,Percent of total billed charges,,,0.97,,944.78,Percent of total billed charges,,,0.96,,935.04,Percent of total billed charges,,,0.95,,925.3,Percent of total billed charges,,,,,,,,,0.95,,925.3,Percent of total billed charges,,925.3,954.52,
OR FIBERTAK KNOTLESS 2.6 B/BL,SUP-3254622,CDM,27810126,LOCAL,278,RC,,outpatient,,,974,876.6,,0.95,,925.3,Percent of total billed charges,,,0.98,,954.52,Percent of total billed charges,,,0.95,,925.3,Percent of total billed charges,,,0.95,,925.3,Percent of total billed charges,,,0.97,,944.78,Percent of total billed charges,,,0.96,,935.04,Percent of total billed charges,,,0.95,,925.3,Percent of total billed charges,,,,,,,,,0.95,,925.3,Percent of total billed charges,,925.3,954.52,
OR DRAPE C-SECTION CLEAR,SUP-3254623,CDM,27010242,LOCAL,270,RC,,inpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
OR DRAPE C-SECTION CLEAR,SUP-3254623,CDM,27010242,LOCAL,270,RC,,outpatient,,,91,81.9,,0.95,,86.45,Percent of total billed charges,,,0.98,,89.18,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,0.97,,88.27,Percent of total billed charges,,,0.96,,87.36,Percent of total billed charges,,,0.95,,86.45,Percent of total billed charges,,,,,,,,,0.95,,86.45,Percent of total billed charges,,86.45,89.18,
OR SO ATUNE REV RP TIB BASE SZ 8 CEM,SUP-150660008,CDM,27810126,LOCAL,278,RC,,inpatient,,,12815,11533.5,,0.95,,12174.25,Percent of total billed charges,,,0.98,,12558.7,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,0.97,,12430.55,Percent of total billed charges,,,0.97,,12430.55,Percent of total billed charges,,,0.96,,12302.4,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,,,,,,,0.95,,12174.25,Percent of total billed charges,,12174.25,12558.7,
OR SO ATUNE REV RP TIB BASE SZ 8 CEM,SUP-150660008,CDM,27810126,LOCAL,278,RC,,outpatient,,,12815,11533.5,,0.95,,12174.25,Percent of total billed charges,,,0.98,,12558.7,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,0.97,,12430.55,Percent of total billed charges,,,0.96,,12302.4,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,,,,,,,0.95,,12174.25,Percent of total billed charges,,12174.25,12558.7,
OR SO ATTUNE CRS FEMORAL RT SZ 8 CEM,SUP-150440208,CDM,27810126,LOCAL,278,RC,,inpatient,,,17656,15890.4,,0.95,,16773.2,Percent of total billed charges,,,0.98,,17302.88,Percent of total billed charges,,,0.95,,16773.2,Percent of total billed charges,,,0.97,,17126.32,Percent of total billed charges,,,0.97,,17126.32,Percent of total billed charges,,,0.96,,16949.76,Percent of total billed charges,,,0.95,,16773.2,Percent of total billed charges,,,,,,,,,0.95,,16773.2,Percent of total billed charges,,16773.2,17302.88,
OR SO ATTUNE CRS FEMORAL RT SZ 8 CEM,SUP-150440208,CDM,27810126,LOCAL,278,RC,,outpatient,,,17656,15890.4,,0.95,,16773.2,Percent of total billed charges,,,0.98,,17302.88,Percent of total billed charges,,,0.95,,16773.2,Percent of total billed charges,,,0.95,,16773.2,Percent of total billed charges,,,0.97,,17126.32,Percent of total billed charges,,,0.96,,16949.76,Percent of total billed charges,,,0.95,,16773.2,Percent of total billed charges,,,,,,,,,0.95,,16773.2,Percent of total billed charges,,16773.2,17302.88,
OR SO ATTUNE CRS RP INSRT SZ 8 8MM,SUP-151710808,CDM,27810126,LOCAL,278,RC,,inpatient,,,7649,6884.1,,0.95,,7266.55,Percent of total billed charges,,,0.98,,7496.02,Percent of total billed charges,,,0.95,,7266.55,Percent of total billed charges,,,0.97,,7419.53,Percent of total billed charges,,,0.97,,7419.53,Percent of total billed charges,,,0.96,,7343.04,Percent of total billed charges,,,0.95,,7266.55,Percent of total billed charges,,,,,,,,,0.95,,7266.55,Percent of total billed charges,,7266.55,7496.02,
OR SO ATTUNE CRS RP INSRT SZ 8 8MM,SUP-151710808,CDM,27810126,LOCAL,278,RC,,outpatient,,,7649,6884.1,,0.95,,7266.55,Percent of total billed charges,,,0.98,,7496.02,Percent of total billed charges,,,0.95,,7266.55,Percent of total billed charges,,,0.95,,7266.55,Percent of total billed charges,,,0.97,,7419.53,Percent of total billed charges,,,0.96,,7343.04,Percent of total billed charges,,,0.95,,7266.55,Percent of total billed charges,,,,,,,,,0.95,,7266.55,Percent of total billed charges,,7266.55,7496.02,
"OR SO 7X20 MM BC IF SCRW, VENTED",SUP-AR-4020C-07,CDM,27810126,LOCAL,278,RC,,inpatient,,,620,558,,0.95,,589,Percent of total billed charges,,,0.98,,607.6,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.96,,595.2,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,,,,,,,0.95,,589,Percent of total billed charges,,589,607.6,
"OR SO 7X20 MM BC IF SCRW, VENTED",SUP-AR-4020C-07,CDM,27810126,LOCAL,278,RC,,outpatient,,,620,558,,0.95,,589,Percent of total billed charges,,,0.98,,607.6,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.96,,595.2,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,,,,,,,0.95,,589,Percent of total billed charges,,589,607.6,
OR SO ATTUNE PS RP INSRT SZ 9 8MM,SUP-151650908,CDM,27810126,LOCAL,278,RC,,inpatient,,,4803,4322.7,,0.95,,4562.85,Percent of total billed charges,,,0.98,,4706.94,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.96,,4610.88,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,,,,,,,0.95,,4562.85,Percent of total billed charges,,4562.85,4706.94,
OR SO ATTUNE PS RP INSRT SZ 9 8MM,SUP-151650908,CDM,27810126,LOCAL,278,RC,,outpatient,,,4803,4322.7,,0.95,,4562.85,Percent of total billed charges,,,0.98,,4706.94,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.96,,4610.88,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,,,,,,,0.95,,4562.85,Percent of total billed charges,,4562.85,4706.94,
OR SO ATTUNE RP TIB BASE SZ 9 CEM,SUP-150680009,CDM,27810126,LOCAL,278,RC,,inpatient,,,6209,5588.1,,0.95,,5898.55,Percent of total billed charges,,,0.98,,6084.82,Percent of total billed charges,,,0.95,,5898.55,Percent of total billed charges,,,0.97,,6022.73,Percent of total billed charges,,,0.97,,6022.73,Percent of total billed charges,,,0.96,,5960.64,Percent of total billed charges,,,0.95,,5898.55,Percent of total billed charges,,,,,,,,,0.95,,5898.55,Percent of total billed charges,,5898.55,6084.82,
OR SO ATTUNE RP TIB BASE SZ 9 CEM,SUP-150680009,CDM,27810126,LOCAL,278,RC,,outpatient,,,6209,5588.1,,0.95,,5898.55,Percent of total billed charges,,,0.98,,6084.82,Percent of total billed charges,,,0.95,,5898.55,Percent of total billed charges,,,0.95,,5898.55,Percent of total billed charges,,,0.97,,6022.73,Percent of total billed charges,,,0.96,,5960.64,Percent of total billed charges,,,0.95,,5898.55,Percent of total billed charges,,,,,,,,,0.95,,5898.55,Percent of total billed charges,,5898.55,6084.82,
OR SO ATTUNE PS FEM RT SZ 9 CEM,SUP-150410209,CDM,27810126,LOCAL,278,RC,,inpatient,,,8840,7956,,0.95,,8398,Percent of total billed charges,,,0.98,,8663.2,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,0.97,,8574.8,Percent of total billed charges,,,0.97,,8574.8,Percent of total billed charges,,,0.96,,8486.4,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,,,,,,,0.95,,8398,Percent of total billed charges,,8398,8663.2,
OR SO ATTUNE PS FEM RT SZ 9 CEM,SUP-150410209,CDM,27810126,LOCAL,278,RC,,outpatient,,,8840,7956,,0.95,,8398,Percent of total billed charges,,,0.98,,8663.2,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,0.97,,8574.8,Percent of total billed charges,,,0.96,,8486.4,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,,,,,,,0.95,,8398,Percent of total billed charges,,8398,8663.2,
OR SO HP STRL THREADED PINS HEADED,SUP-950502303,CDM,27010242,LOCAL,270,RC,,inpatient,,,969,872.1,,0.95,,920.55,Percent of total billed charges,,,0.98,,949.62,Percent of total billed charges,,,0.95,,920.55,Percent of total billed charges,,,0.97,,939.93,Percent of total billed charges,,,0.97,,939.93,Percent of total billed charges,,,0.96,,930.24,Percent of total billed charges,,,0.95,,920.55,Percent of total billed charges,,,,,,,,,0.95,,920.55,Percent of total billed charges,,920.55,949.62,
OR SO HP STRL THREADED PINS HEADED,SUP-950502303,CDM,27010242,LOCAL,270,RC,,outpatient,,,969,872.1,,0.95,,920.55,Percent of total billed charges,,,0.98,,949.62,Percent of total billed charges,,,0.95,,920.55,Percent of total billed charges,,,0.95,,920.55,Percent of total billed charges,,,0.97,,939.93,Percent of total billed charges,,,0.96,,930.24,Percent of total billed charges,,,0.95,,920.55,Percent of total billed charges,,,,,,,,,0.95,,920.55,Percent of total billed charges,,920.55,949.62,
OR BONESYNC 5ML,SUP-ABS-3105,CDM,27010242,LOCAL,270,RC,,inpatient,,,2475,2227.5,,0.95,,2351.25,Percent of total billed charges,,,0.98,,2425.5,Percent of total billed charges,,,0.95,,2351.25,Percent of total billed charges,,,0.97,,2400.75,Percent of total billed charges,,,0.97,,2400.75,Percent of total billed charges,,,0.96,,2376,Percent of total billed charges,,,0.95,,2351.25,Percent of total billed charges,,,,,,,,,0.95,,2351.25,Percent of total billed charges,,2351.25,2425.5,
OR BONESYNC 5ML,SUP-ABS-3105,CDM,27010242,LOCAL,270,RC,,outpatient,,,2475,2227.5,,0.95,,2351.25,Percent of total billed charges,,,0.98,,2425.5,Percent of total billed charges,,,0.95,,2351.25,Percent of total billed charges,,,0.95,,2351.25,Percent of total billed charges,,,0.97,,2400.75,Percent of total billed charges,,,0.96,,2376,Percent of total billed charges,,,0.95,,2351.25,Percent of total billed charges,,,,,,,,,0.95,,2351.25,Percent of total billed charges,,2351.25,2425.5,
OR SU TENSIONER/CUTTER,SUP-3254626,CDM,27010242,LOCAL,270,RC,,inpatient,,,459,413.1,,0.95,,436.05,Percent of total billed charges,,,0.98,,449.82,Percent of total billed charges,,,0.95,,436.05,Percent of total billed charges,,,0.97,,445.23,Percent of total billed charges,,,0.97,,445.23,Percent of total billed charges,,,0.96,,440.64,Percent of total billed charges,,,0.95,,436.05,Percent of total billed charges,,,,,,,,,0.95,,436.05,Percent of total billed charges,,436.05,449.82,
OR SU TENSIONER/CUTTER,SUP-3254626,CDM,27010242,LOCAL,270,RC,,outpatient,,,459,413.1,,0.95,,436.05,Percent of total billed charges,,,0.98,,449.82,Percent of total billed charges,,,0.95,,436.05,Percent of total billed charges,,,0.95,,436.05,Percent of total billed charges,,,0.97,,445.23,Percent of total billed charges,,,0.96,,440.64,Percent of total billed charges,,,0.95,,436.05,Percent of total billed charges,,,,,,,,,0.95,,436.05,Percent of total billed charges,,436.05,449.82,
OR SO ATTUNE PS RP INSRT SZ8 5MM,SUP-151650805,CDM,27810126,LOCAL,278,RC,,inpatient,,,4803,4322.7,,0.95,,4562.85,Percent of total billed charges,,,0.98,,4706.94,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.96,,4610.88,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,,,,,,,0.95,,4562.85,Percent of total billed charges,,4562.85,4706.94,
OR SO ATTUNE PS RP INSRT SZ8 5MM,SUP-151650805,CDM,27810126,LOCAL,278,RC,,outpatient,,,4803,4322.7,,0.95,,4562.85,Percent of total billed charges,,,0.98,,4706.94,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.96,,4610.88,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,,,,,,,0.95,,4562.85,Percent of total billed charges,,4562.85,4706.94,
OR SO ACTIS COLLARED STD SIZE 5,SUP-101011050,CDM,27810126,LOCAL,278,RC,,inpatient,,,11656,10490.4,,0.95,,11073.2,Percent of total billed charges,,,0.98,,11422.88,Percent of total billed charges,,,0.95,,11073.2,Percent of total billed charges,,,0.97,,11306.32,Percent of total billed charges,,,0.97,,11306.32,Percent of total billed charges,,,0.96,,11189.76,Percent of total billed charges,,,0.95,,11073.2,Percent of total billed charges,,,,,,,,,0.95,,11073.2,Percent of total billed charges,,11073.2,11422.88,
OR SO ACTIS COLLARED STD SIZE 5,SUP-101011050,CDM,27810126,LOCAL,278,RC,,outpatient,,,11656,10490.4,,0.95,,11073.2,Percent of total billed charges,,,0.98,,11422.88,Percent of total billed charges,,,0.95,,11073.2,Percent of total billed charges,,,0.95,,11073.2,Percent of total billed charges,,,0.97,,11306.32,Percent of total billed charges,,,0.96,,11189.76,Percent of total billed charges,,,0.95,,11073.2,Percent of total billed charges,,,,,,,,,0.95,,11073.2,Percent of total billed charges,,11073.2,11422.88,
OR SO DLT TS CER HD 12/14 28MM +5.0,SUP-136528720,CDM,27810126,LOCAL,278,RC,,inpatient,,,6964,6267.6,,0.95,,6615.8,Percent of total billed charges,,,0.98,,6824.72,Percent of total billed charges,,,0.95,,6615.8,Percent of total billed charges,,,0.97,,6755.08,Percent of total billed charges,,,0.97,,6755.08,Percent of total billed charges,,,0.96,,6685.44,Percent of total billed charges,,,0.95,,6615.8,Percent of total billed charges,,,,,,,,,0.95,,6615.8,Percent of total billed charges,,6615.8,6824.72,
OR SO DLT TS CER HD 12/14 28MM +5.0,SUP-136528720,CDM,27810126,LOCAL,278,RC,,outpatient,,,6964,6267.6,,0.95,,6615.8,Percent of total billed charges,,,0.98,,6824.72,Percent of total billed charges,,,0.95,,6615.8,Percent of total billed charges,,,0.95,,6615.8,Percent of total billed charges,,,0.97,,6755.08,Percent of total billed charges,,,0.96,,6685.44,Percent of total billed charges,,,0.95,,6615.8,Percent of total billed charges,,,,,,,,,0.95,,6615.8,Percent of total billed charges,,6615.8,6824.72,
OR SO SELF CENT HIP 50X28 BRN,SUP-103550000,CDM,27810126,LOCAL,278,RC,,inpatient,,,2226,2003.4,,0.95,,2114.7,Percent of total billed charges,,,0.98,,2181.48,Percent of total billed charges,,,0.95,,2114.7,Percent of total billed charges,,,0.97,,2159.22,Percent of total billed charges,,,0.97,,2159.22,Percent of total billed charges,,,0.96,,2136.96,Percent of total billed charges,,,0.95,,2114.7,Percent of total billed charges,,,,,,,,,0.95,,2114.7,Percent of total billed charges,,2114.7,2181.48,
OR SO SELF CENT HIP 50X28 BRN,SUP-103550000,CDM,27810126,LOCAL,278,RC,,outpatient,,,2226,2003.4,,0.95,,2114.7,Percent of total billed charges,,,0.98,,2181.48,Percent of total billed charges,,,0.95,,2114.7,Percent of total billed charges,,,0.95,,2114.7,Percent of total billed charges,,,0.97,,2159.22,Percent of total billed charges,,,0.96,,2136.96,Percent of total billed charges,,,0.95,,2114.7,Percent of total billed charges,,,,,,,,,0.95,,2114.7,Percent of total billed charges,,2114.7,2181.48,
OR SO ATTUNE CR FEM RT SZ 8 CEM,SUP-150400208,CDM,27810126,LOCAL,278,RC,,inpatient,,,8840,7956,,0.95,,8398,Percent of total billed charges,,,0.98,,8663.2,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,0.97,,8574.8,Percent of total billed charges,,,0.97,,8574.8,Percent of total billed charges,,,0.96,,8486.4,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,,,,,,,0.95,,8398,Percent of total billed charges,,8398,8663.2,
OR SO ATTUNE CR FEM RT SZ 8 CEM,SUP-150400208,CDM,27810126,LOCAL,278,RC,,outpatient,,,8840,7956,,0.95,,8398,Percent of total billed charges,,,0.98,,8663.2,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,0.97,,8574.8,Percent of total billed charges,,,0.96,,8486.4,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,,,,,,,0.95,,8398,Percent of total billed charges,,8398,8663.2,
OR SO ATTUNE CR RP INSRT SZ 8 7MM,SUP-151630807,CDM,27810126,LOCAL,278,RC,,inpatient,,,4803,4322.7,,0.95,,4562.85,Percent of total billed charges,,,0.98,,4706.94,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.96,,4610.88,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,,,,,,,0.95,,4562.85,Percent of total billed charges,,4562.85,4706.94,
OR SO ATTUNE CR RP INSRT SZ 8 7MM,SUP-151630807,CDM,27810126,LOCAL,278,RC,,outpatient,,,4803,4322.7,,0.95,,4562.85,Percent of total billed charges,,,0.98,,4706.94,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.96,,4610.88,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,,,,,,,0.95,,4562.85,Percent of total billed charges,,4562.85,4706.94,
OR SO 5 GM SURGICAL POWDER CELLERATE,SUP-WCI-05-SACRXP,CDM,27010242,LOCAL,270,RC,,inpatient,,,2025,1822.5,,0.95,,1923.75,Percent of total billed charges,,,0.98,,1984.5,Percent of total billed charges,,,0.95,,1923.75,Percent of total billed charges,,,0.97,,1964.25,Percent of total billed charges,,,0.97,,1964.25,Percent of total billed charges,,,0.96,,1944,Percent of total billed charges,,,0.95,,1923.75,Percent of total billed charges,,,,,,,,,0.95,,1923.75,Percent of total billed charges,,1923.75,1984.5,
OR SO 5 GM SURGICAL POWDER CELLERATE,SUP-WCI-05-SACRXP,CDM,27010242,LOCAL,270,RC,,outpatient,,,2025,1822.5,,0.95,,1923.75,Percent of total billed charges,,,0.98,,1984.5,Percent of total billed charges,,,0.95,,1923.75,Percent of total billed charges,,,0.95,,1923.75,Percent of total billed charges,,,0.97,,1964.25,Percent of total billed charges,,,0.96,,1944,Percent of total billed charges,,,0.95,,1923.75,Percent of total billed charges,,,,,,,,,0.95,,1923.75,Percent of total billed charges,,1923.75,1984.5,
OR UTERINE ASP TUBE SUB,SUP-3254636,CDM,27010242,LOCAL,270,RC,,inpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
OR UTERINE ASP TUBE SUB,SUP-3254636,CDM,27010242,LOCAL,270,RC,,outpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
OR SO ATTUNE MEDIAL ANAT PAT 32MM,SUP-151810032,CDM,27810126,LOCAL,278,RC,,inpatient,,,2506,2255.4,,0.95,,2380.7,Percent of total billed charges,,,0.98,,2455.88,Percent of total billed charges,,,0.95,,2380.7,Percent of total billed charges,,,0.97,,2430.82,Percent of total billed charges,,,0.97,,2430.82,Percent of total billed charges,,,0.96,,2405.76,Percent of total billed charges,,,0.95,,2380.7,Percent of total billed charges,,,,,,,,,0.95,,2380.7,Percent of total billed charges,,2380.7,2455.88,
OR SO ATTUNE MEDIAL ANAT PAT 32MM,SUP-151810032,CDM,27810126,LOCAL,278,RC,,outpatient,,,2506,2255.4,,0.95,,2380.7,Percent of total billed charges,,,0.98,,2455.88,Percent of total billed charges,,,0.95,,2380.7,Percent of total billed charges,,,0.95,,2380.7,Percent of total billed charges,,,0.97,,2430.82,Percent of total billed charges,,,0.96,,2405.76,Percent of total billed charges,,,0.95,,2380.7,Percent of total billed charges,,,,,,,,,0.95,,2380.7,Percent of total billed charges,,2380.7,2455.88,
OR SO ATTUNE CRS FEMORAL LT SZ 4 CEM,SUP-150440104,CDM,27810126,LOCAL,278,RC,,inpatient,,,17656,15890.4,,0.95,,16773.2,Percent of total billed charges,,,0.98,,17302.88,Percent of total billed charges,,,0.95,,16773.2,Percent of total billed charges,,,0.97,,17126.32,Percent of total billed charges,,,0.97,,17126.32,Percent of total billed charges,,,0.96,,16949.76,Percent of total billed charges,,,0.95,,16773.2,Percent of total billed charges,,,,,,,,,0.95,,16773.2,Percent of total billed charges,,16773.2,17302.88,
OR SO ATTUNE CRS FEMORAL LT SZ 4 CEM,SUP-150440104,CDM,27810126,LOCAL,278,RC,,outpatient,,,17656,15890.4,,0.95,,16773.2,Percent of total billed charges,,,0.98,,17302.88,Percent of total billed charges,,,0.95,,16773.2,Percent of total billed charges,,,0.95,,16773.2,Percent of total billed charges,,,0.97,,17126.32,Percent of total billed charges,,,0.96,,16949.76,Percent of total billed charges,,,0.95,,16773.2,Percent of total billed charges,,,,,,,,,0.95,,16773.2,Percent of total billed charges,,16773.2,17302.88,
OR SO ATUNE REV RP TIB BASE SZ 3,SUP-150660003,CDM,27810126,LOCAL,278,RC,,inpatient,,,12815,11533.5,,0.95,,12174.25,Percent of total billed charges,,,0.98,,12558.7,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,0.97,,12430.55,Percent of total billed charges,,,0.97,,12430.55,Percent of total billed charges,,,0.96,,12302.4,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,,,,,,,0.95,,12174.25,Percent of total billed charges,,12174.25,12558.7,
OR SO ATUNE REV RP TIB BASE SZ 3,SUP-150660003,CDM,27810126,LOCAL,278,RC,,outpatient,,,12815,11533.5,,0.95,,12174.25,Percent of total billed charges,,,0.98,,12558.7,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,0.97,,12430.55,Percent of total billed charges,,,0.96,,12302.4,Percent of total billed charges,,,0.95,,12174.25,Percent of total billed charges,,,,,,,,,0.95,,12174.25,Percent of total billed charges,,12174.25,12558.7,
OR SO ATTUNE PS RP INSRT SZ 4 6MM,SUP-151650406,CDM,27810126,LOCAL,278,RC,,inpatient,,,4803,4322.7,,0.95,,4562.85,Percent of total billed charges,,,0.98,,4706.94,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.96,,4610.88,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,,,,,,,0.95,,4562.85,Percent of total billed charges,,4562.85,4706.94,
OR SO ATTUNE PS RP INSRT SZ 4 6MM,SUP-151650406,CDM,27810126,LOCAL,278,RC,,outpatient,,,4803,4322.7,,0.95,,4562.85,Percent of total billed charges,,,0.98,,4706.94,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.96,,4610.88,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,,,,,,,0.95,,4562.85,Percent of total billed charges,,4562.85,4706.94,
OR SO 3.0MM TI ELASTIC NAIL 440MM,SUP-475.930,CDM,27810126,LOCAL,278,RC,,inpatient,,,1322,1189.8,,0.95,,1255.9,Percent of total billed charges,,,0.98,,1295.56,Percent of total billed charges,,,0.95,,1255.9,Percent of total billed charges,,,0.97,,1282.34,Percent of total billed charges,,,0.97,,1282.34,Percent of total billed charges,,,0.96,,1269.12,Percent of total billed charges,,,0.95,,1255.9,Percent of total billed charges,,,,,,,,,0.95,,1255.9,Percent of total billed charges,,1255.9,1295.56,
OR SO 3.0MM TI ELASTIC NAIL 440MM,SUP-475.930,CDM,27810126,LOCAL,278,RC,,outpatient,,,1322,1189.8,,0.95,,1255.9,Percent of total billed charges,,,0.98,,1295.56,Percent of total billed charges,,,0.95,,1255.9,Percent of total billed charges,,,0.95,,1255.9,Percent of total billed charges,,,0.97,,1282.34,Percent of total billed charges,,,0.96,,1269.12,Percent of total billed charges,,,0.95,,1255.9,Percent of total billed charges,,,,,,,,,0.95,,1255.9,Percent of total billed charges,,1255.9,1295.56,
OR SO 3.2MM THREE-FLUTED DRILL BIT QC/195MM,SUP-315.29,CDM,27010242,LOCAL,270,RC,,inpatient,,,832,748.8,,0.95,,790.4,Percent of total billed charges,,,0.98,,815.36,Percent of total billed charges,,,0.95,,790.4,Percent of total billed charges,,,0.97,,807.04,Percent of total billed charges,,,0.97,,807.04,Percent of total billed charges,,,0.96,,798.72,Percent of total billed charges,,,0.95,,790.4,Percent of total billed charges,,,,,,,,,0.95,,790.4,Percent of total billed charges,,790.4,815.36,
OR SO 3.2MM THREE-FLUTED DRILL BIT QC/195MM,SUP-315.29,CDM,27010242,LOCAL,270,RC,,outpatient,,,832,748.8,,0.95,,790.4,Percent of total billed charges,,,0.98,,815.36,Percent of total billed charges,,,0.95,,790.4,Percent of total billed charges,,,0.95,,790.4,Percent of total billed charges,,,0.97,,807.04,Percent of total billed charges,,,0.96,,798.72,Percent of total billed charges,,,0.95,,790.4,Percent of total billed charges,,,,,,,,,0.95,,790.4,Percent of total billed charges,,790.4,815.36,
OR SPHERE INFLATION DEVICE,SUP-3254644,CDM,27010242,LOCAL,270,RC,,inpatient,,,158,142.2,,0.95,,150.1,Percent of total billed charges,,,0.98,,154.84,Percent of total billed charges,,,0.95,,150.1,Percent of total billed charges,,,0.97,,153.26,Percent of total billed charges,,,0.97,,153.26,Percent of total billed charges,,,0.96,,151.68,Percent of total billed charges,,,0.95,,150.1,Percent of total billed charges,,,,,,,,,0.95,,150.1,Percent of total billed charges,,150.1,154.84,
OR SPHERE INFLATION DEVICE,SUP-3254644,CDM,27010242,LOCAL,270,RC,,outpatient,,,158,142.2,,0.95,,150.1,Percent of total billed charges,,,0.98,,154.84,Percent of total billed charges,,,0.95,,150.1,Percent of total billed charges,,,0.95,,150.1,Percent of total billed charges,,,0.97,,153.26,Percent of total billed charges,,,0.96,,151.68,Percent of total billed charges,,,0.95,,150.1,Percent of total billed charges,,,,,,,,,0.95,,150.1,Percent of total billed charges,,150.1,154.84,
OR SO 11/130 DEG TI CANN TFNA 380/LEFT-SILE,SUP-04.037.159S,CDM,27810126,LOCAL,278,RC,,inpatient,,,9213,8291.7,,0.95,,8752.35,Percent of total billed charges,,,0.98,,9028.74,Percent of total billed charges,,,0.95,,8752.35,Percent of total billed charges,,,0.97,,8936.61,Percent of total billed charges,,,0.97,,8936.61,Percent of total billed charges,,,0.96,,8844.48,Percent of total billed charges,,,0.95,,8752.35,Percent of total billed charges,,,,,,,,,0.95,,8752.35,Percent of total billed charges,,8752.35,9028.74,
OR SO 11/130 DEG TI CANN TFNA 380/LEFT-SILE,SUP-04.037.159S,CDM,27810126,LOCAL,278,RC,,outpatient,,,9213,8291.7,,0.95,,8752.35,Percent of total billed charges,,,0.98,,9028.74,Percent of total billed charges,,,0.95,,8752.35,Percent of total billed charges,,,0.95,,8752.35,Percent of total billed charges,,,0.97,,8936.61,Percent of total billed charges,,,0.96,,8844.48,Percent of total billed charges,,,0.95,,8752.35,Percent of total billed charges,,,,,,,,,0.95,,8752.35,Percent of total billed charges,,8752.35,9028.74,
OR SO ACTIS COLLARED STD SIZE 6,SUP-101011060,CDM,27810126,LOCAL,278,RC,,inpatient,,,11656,10490.4,,0.95,,11073.2,Percent of total billed charges,,,0.98,,11422.88,Percent of total billed charges,,,0.95,,11073.2,Percent of total billed charges,,,0.97,,11306.32,Percent of total billed charges,,,0.97,,11306.32,Percent of total billed charges,,,0.96,,11189.76,Percent of total billed charges,,,0.95,,11073.2,Percent of total billed charges,,,,,,,,,0.95,,11073.2,Percent of total billed charges,,11073.2,11422.88,
OR SO ACTIS COLLARED STD SIZE 6,SUP-101011060,CDM,27810126,LOCAL,278,RC,,outpatient,,,11656,10490.4,,0.95,,11073.2,Percent of total billed charges,,,0.98,,11422.88,Percent of total billed charges,,,0.95,,11073.2,Percent of total billed charges,,,0.95,,11073.2,Percent of total billed charges,,,0.97,,11306.32,Percent of total billed charges,,,0.96,,11189.76,Percent of total billed charges,,,0.95,,11073.2,Percent of total billed charges,,,,,,,,,0.95,,11073.2,Percent of total billed charges,,11073.2,11422.88,
OR SO DLT TS CER HD 12/14 28MM +1.5,SUP-136528710,CDM,27810126,LOCAL,278,RC,,inpatient,,,6964,6267.6,,0.95,,6615.8,Percent of total billed charges,,,0.98,,6824.72,Percent of total billed charges,,,0.95,,6615.8,Percent of total billed charges,,,0.97,,6755.08,Percent of total billed charges,,,0.97,,6755.08,Percent of total billed charges,,,0.96,,6685.44,Percent of total billed charges,,,0.95,,6615.8,Percent of total billed charges,,,,,,,,,0.95,,6615.8,Percent of total billed charges,,6615.8,6824.72,
OR SO DLT TS CER HD 12/14 28MM +1.5,SUP-136528710,CDM,27810126,LOCAL,278,RC,,outpatient,,,6964,6267.6,,0.95,,6615.8,Percent of total billed charges,,,0.98,,6824.72,Percent of total billed charges,,,0.95,,6615.8,Percent of total billed charges,,,0.95,,6615.8,Percent of total billed charges,,,0.97,,6755.08,Percent of total billed charges,,,0.96,,6685.44,Percent of total billed charges,,,0.95,,6615.8,Percent of total billed charges,,,,,,,,,0.95,,6615.8,Percent of total billed charges,,6615.8,6824.72,
OR SCREW LP LOCK 2.7X30MM,SUP-3254645,CDM,27810126,LOCAL,278,RC,,inpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,,,,,,,0.95,,286.9,Percent of total billed charges,,286.9,295.96,
OR SCREW LP LOCK 2.7X30MM,SUP-3254645,CDM,27810126,LOCAL,278,RC,,outpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,,,,,,,0.95,,286.9,Percent of total billed charges,,286.9,295.96,
OR SCREW LP LOCK 2.7X34MM,SUP-3254646,CDM,27810126,LOCAL,278,RC,,inpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,,,,,,,0.95,,286.9,Percent of total billed charges,,286.9,295.96,
OR SCREW LP LOCK 2.7X34MM,SUP-3254646,CDM,27810126,LOCAL,278,RC,,outpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,,,,,,,0.95,,286.9,Percent of total billed charges,,286.9,295.96,
OR SCREW LP LOCK 2.7X38mm,SUP-3254647,CDM,27810126,LOCAL,278,RC,,inpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,,,,,,,0.95,,286.9,Percent of total billed charges,,286.9,295.96,
OR SCREW LP LOCK 2.7X38mm,SUP-3254647,CDM,27810126,LOCAL,278,RC,,outpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,,,,,,,0.95,,286.9,Percent of total billed charges,,286.9,295.96,
OR SCREW LP LOCK 2.7X40mm,SUP-3254648,CDM,27810126,LOCAL,278,RC,,inpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,,,,,,,0.95,,286.9,Percent of total billed charges,,286.9,295.96,
OR SCREW LP LOCK 2.7X40mm,SUP-3254648,CDM,27810126,LOCAL,278,RC,,outpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,,,,,,,0.95,,286.9,Percent of total billed charges,,286.9,295.96,
OR SCREW LP LOCK 2.7X44MM,SUP-3254649,CDM,27810126,LOCAL,278,RC,,inpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,,,,,,,0.95,,286.9,Percent of total billed charges,,286.9,295.96,
OR SCREW LP LOCK 2.7X44MM,SUP-3254649,CDM,27810126,LOCAL,278,RC,,outpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,,,,,,,0.95,,286.9,Percent of total billed charges,,286.9,295.96,
OR SCREW LP LOCK 2.7X48MM,SUP-3254650,CDM,27810126,LOCAL,278,RC,,inpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,,,,,,,0.95,,286.9,Percent of total billed charges,,286.9,295.96,
OR SCREW LP LOCK 2.7X48MM,SUP-3254650,CDM,27810126,LOCAL,278,RC,,outpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,,,,,,,0.95,,286.9,Percent of total billed charges,,286.9,295.96,
OR SCREW LP LOCK 2.7X50MM,SUP-3254651,CDM,27810126,LOCAL,278,RC,,inpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,,,,,,,0.95,,286.9,Percent of total billed charges,,286.9,295.96,
OR SCREW LP LOCK 2.7X50MM,SUP-3254651,CDM,27810126,LOCAL,278,RC,,outpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,,,,,,,0.95,,286.9,Percent of total billed charges,,286.9,295.96,
OR SCREW LP LOCK 2.7X54MM,SUP-3254652,CDM,27810126,LOCAL,278,RC,,inpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,,,,,,,0.95,,286.9,Percent of total billed charges,,286.9,295.96,
OR SCREW LP LOCK 2.7X54MM,SUP-3254652,CDM,27810126,LOCAL,278,RC,,outpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,,,,,,,0.95,,286.9,Percent of total billed charges,,286.9,295.96,
OR SCREW LP LOCK 2.7X28MM,SUP-3254653,CDM,27810126,LOCAL,278,RC,,inpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,,,,,,,0.95,,286.9,Percent of total billed charges,,286.9,295.96,
OR SCREW LP LOCK 2.7X28MM,SUP-3254653,CDM,27810126,LOCAL,278,RC,,outpatient,,,302,271.8,,0.95,,286.9,Percent of total billed charges,,,0.98,,295.96,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,0.97,,292.94,Percent of total billed charges,,,0.96,,289.92,Percent of total billed charges,,,0.95,,286.9,Percent of total billed charges,,,,,,,,,0.95,,286.9,Percent of total billed charges,,286.9,295.96,
OR SO ATTUNE PS FEM LT SZ 8 CEM,SUP-150410108,CDM,27810126,LOCAL,278,RC,,inpatient,,,8840,7956,,0.95,,8398,Percent of total billed charges,,,0.98,,8663.2,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,0.97,,8574.8,Percent of total billed charges,,,0.97,,8574.8,Percent of total billed charges,,,0.96,,8486.4,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,,,,,,,0.95,,8398,Percent of total billed charges,,8398,8663.2,
OR SO ATTUNE PS FEM LT SZ 8 CEM,SUP-150410108,CDM,27810126,LOCAL,278,RC,,outpatient,,,8840,7956,,0.95,,8398,Percent of total billed charges,,,0.98,,8663.2,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,0.97,,8574.8,Percent of total billed charges,,,0.96,,8486.4,Percent of total billed charges,,,0.95,,8398,Percent of total billed charges,,,,,,,,,0.95,,8398,Percent of total billed charges,,8398,8663.2,
OR SO ATTUNE PS RP INSRT SZ 8 7MM,SUP-151650807,CDM,27810126,LOCAL,278,RC,,inpatient,,,4803,4322.7,,0.95,,4562.85,Percent of total billed charges,,,0.98,,4706.94,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.96,,4610.88,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,,,,,,,0.95,,4562.85,Percent of total billed charges,,4562.85,4706.94,
OR SO ATTUNE PS RP INSRT SZ 8 7MM,SUP-151650807,CDM,27810126,LOCAL,278,RC,,outpatient,,,4803,4322.7,,0.95,,4562.85,Percent of total billed charges,,,0.98,,4706.94,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,0.97,,4658.91,Percent of total billed charges,,,0.96,,4610.88,Percent of total billed charges,,,0.95,,4562.85,Percent of total billed charges,,,,,,,,,0.95,,4562.85,Percent of total billed charges,,4562.85,4706.94,
ARM SLING LARGE,SUP-3250305,CDM,3250305WWM,LOCAL,270,RC,,inpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
ARM SLING LARGE,SUP-3250305,CDM,3250305WWM,LOCAL,270,RC,,outpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
SPLINT W/F M/L,SUP-3250329,CDM,27010242,LOCAL,270,RC,,inpatient,,,31.5,28.35,,0.95,,29.93,Percent of total billed charges,,,0.98,,30.87,Percent of total billed charges,,,0.95,,29.93,Percent of total billed charges,,,0.97,,30.56,Percent of total billed charges,,,0.97,,30.56,Percent of total billed charges,,,0.96,,30.24,Percent of total billed charges,,,0.95,,29.93,Percent of total billed charges,,,,,,,,,0.95,,29.93,Percent of total billed charges,,29.93,30.87,
SPLINT W/F M/L,SUP-3250329,CDM,27010242,LOCAL,270,RC,,outpatient,,,31.5,28.35,,0.95,,29.93,Percent of total billed charges,,,0.98,,30.87,Percent of total billed charges,,,0.95,,29.93,Percent of total billed charges,,,0.95,,29.93,Percent of total billed charges,,,0.97,,30.56,Percent of total billed charges,,,0.96,,30.24,Percent of total billed charges,,,0.95,,29.93,Percent of total billed charges,,,,,,,,,0.95,,29.93,Percent of total billed charges,,29.93,30.87,
SPLINT W/F M/R #10273,SUP-3250330,CDM,27010242,LOCAL,270,RC,,inpatient,,,58.5,52.65,,0.95,,55.58,Percent of total billed charges,,,0.98,,57.33,Percent of total billed charges,,,0.95,,55.58,Percent of total billed charges,,,0.97,,56.75,Percent of total billed charges,,,0.97,,56.75,Percent of total billed charges,,,0.96,,56.16,Percent of total billed charges,,,0.95,,55.58,Percent of total billed charges,,,,,,,,,0.95,,55.58,Percent of total billed charges,,55.58,57.33,
SPLINT W/F M/R #10273,SUP-3250330,CDM,27010242,LOCAL,270,RC,,outpatient,,,58.5,52.65,,0.95,,55.58,Percent of total billed charges,,,0.98,,57.33,Percent of total billed charges,,,0.95,,55.58,Percent of total billed charges,,,0.95,,55.58,Percent of total billed charges,,,0.97,,56.75,Percent of total billed charges,,,0.96,,56.16,Percent of total billed charges,,,0.95,,55.58,Percent of total billed charges,,,,,,,,,0.95,,55.58,Percent of total billed charges,,55.58,57.33,
SPLINT W/F LG/L,SUP-3250331,CDM,27010242,LOCAL,270,RC,,inpatient,,,31.5,28.35,,0.95,,29.93,Percent of total billed charges,,,0.98,,30.87,Percent of total billed charges,,,0.95,,29.93,Percent of total billed charges,,,0.97,,30.56,Percent of total billed charges,,,0.97,,30.56,Percent of total billed charges,,,0.96,,30.24,Percent of total billed charges,,,0.95,,29.93,Percent of total billed charges,,,,,,,,,0.95,,29.93,Percent of total billed charges,,29.93,30.87,
SPLINT W/F LG/L,SUP-3250331,CDM,27010242,LOCAL,270,RC,,outpatient,,,31.5,28.35,,0.95,,29.93,Percent of total billed charges,,,0.98,,30.87,Percent of total billed charges,,,0.95,,29.93,Percent of total billed charges,,,0.95,,29.93,Percent of total billed charges,,,0.97,,30.56,Percent of total billed charges,,,0.96,,30.24,Percent of total billed charges,,,0.95,,29.93,Percent of total billed charges,,,,,,,,,0.95,,29.93,Percent of total billed charges,,29.93,30.87,
SPLINT W/F LG/R,SUP-3250332,CDM,3250332WWM,LOCAL,270,RC,,inpatient,,,31.5,28.35,,0.95,,29.93,Percent of total billed charges,,,0.98,,30.87,Percent of total billed charges,,,0.95,,29.93,Percent of total billed charges,,,0.97,,30.56,Percent of total billed charges,,,0.97,,30.56,Percent of total billed charges,,,0.96,,30.24,Percent of total billed charges,,,0.95,,29.93,Percent of total billed charges,,,,,,,,,0.95,,29.93,Percent of total billed charges,,29.93,30.87,
SPLINT W/F LG/R,SUP-3250332,CDM,3250332WWM,LOCAL,270,RC,,outpatient,,,31.5,28.35,,0.95,,29.93,Percent of total billed charges,,,0.98,,30.87,Percent of total billed charges,,,0.95,,29.93,Percent of total billed charges,,,0.95,,29.93,Percent of total billed charges,,,0.97,,30.56,Percent of total billed charges,,,0.96,,30.24,Percent of total billed charges,,,0.95,,29.93,Percent of total billed charges,,,,,,,,,0.95,,29.93,Percent of total billed charges,,29.93,30.87,
BONE WAX 2 31G,SUP-3250425,CDM,3250425WWM,LOCAL,270,RC,,inpatient,,,29.4,26.46,,0.95,,27.93,Percent of total billed charges,,,0.98,,28.81,Percent of total billed charges,,,0.95,,27.93,Percent of total billed charges,,,0.97,,28.52,Percent of total billed charges,,,0.97,,28.52,Percent of total billed charges,,,0.96,,28.22,Percent of total billed charges,,,0.95,,27.93,Percent of total billed charges,,,,,,,,,0.95,,27.93,Percent of total billed charges,,27.93,28.81,
BONE WAX 2 31G,SUP-3250425,CDM,3250425WWM,LOCAL,270,RC,,outpatient,,,29.4,26.46,,0.95,,27.93,Percent of total billed charges,,,0.98,,28.81,Percent of total billed charges,,,0.95,,27.93,Percent of total billed charges,,,0.95,,27.93,Percent of total billed charges,,,0.97,,28.52,Percent of total billed charges,,,0.96,,28.22,Percent of total billed charges,,,0.95,,27.93,Percent of total billed charges,,,,,,,,,0.95,,27.93,Percent of total billed charges,,27.93,28.81,
HOT SNARE ROTATE,SUP-3250583,CDM,3250583WWM,LOCAL,270,RC,,inpatient,,,255.69,230.12,,0.95,,242.91,Percent of total billed charges,,,0.98,,250.58,Percent of total billed charges,,,0.95,,242.91,Percent of total billed charges,,,0.97,,248.02,Percent of total billed charges,,,0.97,,248.02,Percent of total billed charges,,,0.96,,245.46,Percent of total billed charges,,,0.95,,242.91,Percent of total billed charges,,,,,,,,,0.95,,242.91,Percent of total billed charges,,242.91,250.58,
HOT SNARE ROTATE,SUP-3250583,CDM,3250583WWM,LOCAL,270,RC,,outpatient,,,255.69,230.12,,0.95,,242.91,Percent of total billed charges,,,0.98,,250.58,Percent of total billed charges,,,0.95,,242.91,Percent of total billed charges,,,0.95,,242.91,Percent of total billed charges,,,0.97,,248.02,Percent of total billed charges,,,0.96,,245.46,Percent of total billed charges,,,0.95,,242.91,Percent of total billed charges,,,,,,,,,0.95,,242.91,Percent of total billed charges,,242.91,250.58,
PURSE STRING,SUP-3252522,CDM,3252522WWM,LOCAL,270,RC,,inpatient,,,619.96,557.96,,0.95,,588.96,Percent of total billed charges,,,0.98,,607.56,Percent of total billed charges,,,0.95,,588.96,Percent of total billed charges,,,0.97,,601.36,Percent of total billed charges,,,0.97,,601.36,Percent of total billed charges,,,0.96,,595.16,Percent of total billed charges,,,0.95,,588.96,Percent of total billed charges,,,,,,,,,0.95,,588.96,Percent of total billed charges,,588.96,607.56,
PURSE STRING,SUP-3252522,CDM,3252522WWM,LOCAL,270,RC,,outpatient,,,619.96,557.96,,0.95,,588.96,Percent of total billed charges,,,0.98,,607.56,Percent of total billed charges,,,0.95,,588.96,Percent of total billed charges,,,0.95,,588.96,Percent of total billed charges,,,0.97,,601.36,Percent of total billed charges,,,0.96,,595.16,Percent of total billed charges,,,0.95,,588.96,Percent of total billed charges,,,,,,,,,0.95,,588.96,Percent of total billed charges,,588.96,607.56,
SURGICELL ABS/HEM#1963,SUP-3252536,CDM,3252536WWM,LOCAL,270,RC,,inpatient,,,718.62,646.76,,0.95,,682.69,Percent of total billed charges,,,0.98,,704.25,Percent of total billed charges,,,0.95,,682.69,Percent of total billed charges,,,0.97,,697.06,Percent of total billed charges,,,0.97,,697.06,Percent of total billed charges,,,0.96,,689.88,Percent of total billed charges,,,0.95,,682.69,Percent of total billed charges,,,,,,,,,0.95,,682.69,Percent of total billed charges,,682.69,704.25,
SURGICELL ABS/HEM#1963,SUP-3252536,CDM,3252536WWM,LOCAL,270,RC,,outpatient,,,718.62,646.76,,0.95,,682.69,Percent of total billed charges,,,0.98,,704.25,Percent of total billed charges,,,0.95,,682.69,Percent of total billed charges,,,0.95,,682.69,Percent of total billed charges,,,0.97,,697.06,Percent of total billed charges,,,0.96,,689.88,Percent of total billed charges,,,0.95,,682.69,Percent of total billed charges,,,,,,,,,0.95,,682.69,Percent of total billed charges,,682.69,704.25,
FORCEP COLON - HOT,SUP-3252547,CDM,3252547WWM,LOCAL,270,RC,,inpatient,,,116.7,105.03,,0.95,,110.87,Percent of total billed charges,,,0.98,,114.37,Percent of total billed charges,,,0.95,,110.87,Percent of total billed charges,,,0.97,,113.2,Percent of total billed charges,,,0.97,,113.2,Percent of total billed charges,,,0.96,,112.03,Percent of total billed charges,,,0.95,,110.87,Percent of total billed charges,,,,,,,,,0.95,,110.87,Percent of total billed charges,,110.87,114.37,
FORCEP COLON - HOT,SUP-3252547,CDM,3252547WWM,LOCAL,270,RC,,outpatient,,,116.7,105.03,,0.95,,110.87,Percent of total billed charges,,,0.98,,114.37,Percent of total billed charges,,,0.95,,110.87,Percent of total billed charges,,,0.95,,110.87,Percent of total billed charges,,,0.97,,113.2,Percent of total billed charges,,,0.96,,112.03,Percent of total billed charges,,,0.95,,110.87,Percent of total billed charges,,,,,,,,,0.95,,110.87,Percent of total billed charges,,110.87,114.37,
SU VICRYL ENDO LOOP#EJ10G,SUP-3252548,CDM,27010242,LOCAL,270,RC,,inpatient,,,192.05,172.85,,0.95,,182.45,Percent of total billed charges,,,0.98,,188.21,Percent of total billed charges,,,0.95,,182.45,Percent of total billed charges,,,0.97,,186.29,Percent of total billed charges,,,0.97,,186.29,Percent of total billed charges,,,0.96,,184.37,Percent of total billed charges,,,0.95,,182.45,Percent of total billed charges,,,,,,,,,0.95,,182.45,Percent of total billed charges,,182.45,188.21,
SU VICRYL ENDO LOOP#EJ10G,SUP-3252548,CDM,27010242,LOCAL,270,RC,,outpatient,,,192.05,172.85,,0.95,,182.45,Percent of total billed charges,,,0.98,,188.21,Percent of total billed charges,,,0.95,,182.45,Percent of total billed charges,,,0.95,,182.45,Percent of total billed charges,,,0.97,,186.29,Percent of total billed charges,,,0.96,,184.37,Percent of total billed charges,,,0.95,,182.45,Percent of total billed charges,,,,,,,,,0.95,,182.45,Percent of total billed charges,,182.45,188.21,
RECTAL TUBE 30FR,SUP-3252549,CDM,3252549WWM,LOCAL,270,RC,,inpatient,,,26.88,24.19,,0.95,,25.54,Percent of total billed charges,,,0.98,,26.34,Percent of total billed charges,,,0.95,,25.54,Percent of total billed charges,,,0.97,,26.07,Percent of total billed charges,,,0.97,,26.07,Percent of total billed charges,,,0.96,,25.8,Percent of total billed charges,,,0.95,,25.54,Percent of total billed charges,,,,,,,,,0.95,,25.54,Percent of total billed charges,,25.54,26.34,
RECTAL TUBE 30FR,SUP-3252549,CDM,3252549WWM,LOCAL,270,RC,,outpatient,,,26.88,24.19,,0.95,,25.54,Percent of total billed charges,,,0.98,,26.34,Percent of total billed charges,,,0.95,,25.54,Percent of total billed charges,,,0.95,,25.54,Percent of total billed charges,,,0.97,,26.07,Percent of total billed charges,,,0.96,,25.8,Percent of total billed charges,,,0.95,,25.54,Percent of total billed charges,,,,,,,,,0.95,,25.54,Percent of total billed charges,,25.54,26.34,
SUCT IRRIGATOR,SUP-3252559,CDM,3252559WWM,LOCAL,270,RC,,inpatient,,,243.36,219.02,,0.95,,231.19,Percent of total billed charges,,,0.98,,238.49,Percent of total billed charges,,,0.95,,231.19,Percent of total billed charges,,,0.97,,236.06,Percent of total billed charges,,,0.97,,236.06,Percent of total billed charges,,,0.96,,233.63,Percent of total billed charges,,,0.95,,231.19,Percent of total billed charges,,,,,,,,,0.95,,231.19,Percent of total billed charges,,231.19,238.49,
SUCT IRRIGATOR,SUP-3252559,CDM,3252559WWM,LOCAL,270,RC,,outpatient,,,243.36,219.02,,0.95,,231.19,Percent of total billed charges,,,0.98,,238.49,Percent of total billed charges,,,0.95,,231.19,Percent of total billed charges,,,0.95,,231.19,Percent of total billed charges,,,0.97,,236.06,Percent of total billed charges,,,0.96,,233.63,Percent of total billed charges,,,0.95,,231.19,Percent of total billed charges,,,,,,,,,0.95,,231.19,Percent of total billed charges,,231.19,238.49,
BLADE AGEE CTR,SUP-3252601,CDM,3252601WWM,LOCAL,270,RC,,inpatient,,,700,630,,0.95,,665,Percent of total billed charges,,,0.98,,686,Percent of total billed charges,,,0.95,,665,Percent of total billed charges,,,0.97,,679,Percent of total billed charges,,,0.97,,679,Percent of total billed charges,,,0.96,,672,Percent of total billed charges,,,0.95,,665,Percent of total billed charges,,,,,,,,,0.95,,665,Percent of total billed charges,,665,686,
BLADE AGEE CTR,SUP-3252601,CDM,3252601WWM,LOCAL,270,RC,,outpatient,,,700,630,,0.95,,665,Percent of total billed charges,,,0.98,,686,Percent of total billed charges,,,0.95,,665,Percent of total billed charges,,,0.95,,665,Percent of total billed charges,,,0.97,,679,Percent of total billed charges,,,0.96,,672,Percent of total billed charges,,,0.95,,665,Percent of total billed charges,,,,,,,,,0.95,,665,Percent of total billed charges,,665,686,
WIRE K 062X5 #5050-249,SUP-3252618,CDM,3252618WWM,LOCAL,278,RC,,inpatient,,,44.22,39.8,,0.95,,42.01,Percent of total billed charges,,,0.98,,43.34,Percent of total billed charges,,,0.95,,42.01,Percent of total billed charges,,,0.97,,42.89,Percent of total billed charges,,,0.97,,42.89,Percent of total billed charges,,,0.96,,42.45,Percent of total billed charges,,,0.95,,42.01,Percent of total billed charges,,,,,,,,,0.95,,42.01,Percent of total billed charges,,42.01,43.34,
WIRE K 062X5 #5050-249,SUP-3252618,CDM,3252618WWM,LOCAL,278,RC,,outpatient,,,44.22,39.8,,0.95,,42.01,Percent of total billed charges,,,0.98,,43.34,Percent of total billed charges,,,0.95,,42.01,Percent of total billed charges,,,0.95,,42.01,Percent of total billed charges,,,0.97,,42.89,Percent of total billed charges,,,0.96,,42.45,Percent of total billed charges,,,0.95,,42.01,Percent of total billed charges,,,,,,,,,0.95,,42.01,Percent of total billed charges,,42.01,43.34,
WIRE K 045X5#5050-248,SUP-3252619,CDM,3252619WWM,LOCAL,278,RC,,inpatient,,,49.2,44.28,,0.95,,46.74,Percent of total billed charges,,,0.98,,48.22,Percent of total billed charges,,,0.95,,46.74,Percent of total billed charges,,,0.97,,47.72,Percent of total billed charges,,,0.97,,47.72,Percent of total billed charges,,,0.96,,47.23,Percent of total billed charges,,,0.95,,46.74,Percent of total billed charges,,,,,,,,,0.95,,46.74,Percent of total billed charges,,46.74,48.22,
WIRE K 045X5#5050-248,SUP-3252619,CDM,3252619WWM,LOCAL,278,RC,,outpatient,,,49.2,44.28,,0.95,,46.74,Percent of total billed charges,,,0.98,,48.22,Percent of total billed charges,,,0.95,,46.74,Percent of total billed charges,,,0.95,,46.74,Percent of total billed charges,,,0.97,,47.72,Percent of total billed charges,,,0.96,,47.23,Percent of total billed charges,,,0.95,,46.74,Percent of total billed charges,,,,,,,,,0.95,,46.74,Percent of total billed charges,,46.74,48.22,
SUCT TUBE 10',SUP-3252633,CDM,3252633WWM,LOCAL,270,RC,,inpatient,,,13.12,11.81,,0.95,,12.46,Percent of total billed charges,,,0.98,,12.86,Percent of total billed charges,,,0.95,,12.46,Percent of total billed charges,,,0.97,,12.73,Percent of total billed charges,,,0.97,,12.73,Percent of total billed charges,,,0.96,,12.6,Percent of total billed charges,,,0.95,,12.46,Percent of total billed charges,,,,,,,,,0.95,,12.46,Percent of total billed charges,,12.46,12.86,
SUCT TUBE 10',SUP-3252633,CDM,3252633WWM,LOCAL,270,RC,,outpatient,,,13.12,11.81,,0.95,,12.46,Percent of total billed charges,,,0.98,,12.86,Percent of total billed charges,,,0.95,,12.46,Percent of total billed charges,,,0.95,,12.46,Percent of total billed charges,,,0.97,,12.73,Percent of total billed charges,,,0.96,,12.6,Percent of total billed charges,,,0.95,,12.46,Percent of total billed charges,,,,,,,,,0.95,,12.46,Percent of total billed charges,,12.46,12.86,
ARM SLING X LARGE,SUP-3252691,CDM,3252691WWM,LOCAL,270,RC,,inpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
ARM SLING X LARGE,SUP-3252691,CDM,3252691WWM,LOCAL,270,RC,,outpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
ARM SLING MEDIUM,SUP-3252693,CDM,3252693WWM,LOCAL,270,RC,,inpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
ARM SLING MEDIUM,SUP-3252693,CDM,3252693WWM,LOCAL,270,RC,,outpatient,,,34,30.6,,0.95,,32.3,Percent of total billed charges,,,0.98,,33.32,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,0.97,,32.98,Percent of total billed charges,,,0.96,,32.64,Percent of total billed charges,,,0.95,,32.3,Percent of total billed charges,,,,,,,,,0.95,,32.3,Percent of total billed charges,,32.3,33.32,
CUTTER LIN 55MM #TLC55,SUP-3252709,CDM,3252709WWM,LOCAL,270,RC,,inpatient,,,400.01,360.01,,0.95,,380.01,Percent of total billed charges,,,0.98,,392.01,Percent of total billed charges,,,0.95,,380.01,Percent of total billed charges,,,0.97,,388.01,Percent of total billed charges,,,0.97,,388.01,Percent of total billed charges,,,0.96,,384.01,Percent of total billed charges,,,0.95,,380.01,Percent of total billed charges,,,,,,,,,0.95,,380.01,Percent of total billed charges,,380.01,392.01,
CUTTER LIN 55MM #TLC55,SUP-3252709,CDM,3252709WWM,LOCAL,270,RC,,outpatient,,,400.01,360.01,,0.95,,380.01,Percent of total billed charges,,,0.98,,392.01,Percent of total billed charges,,,0.95,,380.01,Percent of total billed charges,,,0.95,,380.01,Percent of total billed charges,,,0.97,,388.01,Percent of total billed charges,,,0.96,,384.01,Percent of total billed charges,,,0.95,,380.01,Percent of total billed charges,,,,,,,,,0.95,,380.01,Percent of total billed charges,,380.01,392.01,
CUTTER LIN RELOAD TCR55,SUP-3252710,CDM,3252710WWM,LOCAL,270,RC,,inpatient,,,214.38,192.94,,0.95,,203.66,Percent of total billed charges,,,0.98,,210.09,Percent of total billed charges,,,0.95,,203.66,Percent of total billed charges,,,0.97,,207.95,Percent of total billed charges,,,0.97,,207.95,Percent of total billed charges,,,0.96,,205.8,Percent of total billed charges,,,0.95,,203.66,Percent of total billed charges,,,,,,,,,0.95,,203.66,Percent of total billed charges,,203.66,210.09,
CUTTER LIN RELOAD TCR55,SUP-3252710,CDM,3252710WWM,LOCAL,270,RC,,outpatient,,,214.38,192.94,,0.95,,203.66,Percent of total billed charges,,,0.98,,210.09,Percent of total billed charges,,,0.95,,203.66,Percent of total billed charges,,,0.95,,203.66,Percent of total billed charges,,,0.97,,207.95,Percent of total billed charges,,,0.96,,205.8,Percent of total billed charges,,,0.95,,203.66,Percent of total billed charges,,,,,,,,,0.95,,203.66,Percent of total billed charges,,203.66,210.09,
LIGA CLIP EX #LT400,SUP-3252716,CDM,3252716WWM,LOCAL,278,RC,,inpatient,,,35,31.5,,0.95,,33.25,Percent of total billed charges,,,0.98,,34.3,Percent of total billed charges,,,0.95,,33.25,Percent of total billed charges,,,0.97,,33.95,Percent of total billed charges,,,0.97,,33.95,Percent of total billed charges,,,0.96,,33.6,Percent of total billed charges,,,0.95,,33.25,Percent of total billed charges,,,,,,,,,0.95,,33.25,Percent of total billed charges,,33.25,34.3,
LIGA CLIP EX #LT400,SUP-3252716,CDM,3252716WWM,LOCAL,278,RC,,outpatient,,,35,31.5,,0.95,,33.25,Percent of total billed charges,,,0.98,,34.3,Percent of total billed charges,,,0.95,,33.25,Percent of total billed charges,,,0.95,,33.25,Percent of total billed charges,,,0.97,,33.95,Percent of total billed charges,,,0.96,,33.6,Percent of total billed charges,,,0.95,,33.25,Percent of total billed charges,,,,,,,,,0.95,,33.25,Percent of total billed charges,,33.25,34.3,
DRAIN TLS 7FR #6640,SUP-3252785,CDM,27010242,LOCAL,270,RC,,inpatient,,,310.28,279.25,,0.95,,294.77,Percent of total billed charges,,,0.98,,304.07,Percent of total billed charges,,,0.95,,294.77,Percent of total billed charges,,,0.97,,300.97,Percent of total billed charges,,,0.97,,300.97,Percent of total billed charges,,,0.96,,297.87,Percent of total billed charges,,,0.95,,294.77,Percent of total billed charges,,,,,,,,,0.95,,294.77,Percent of total billed charges,,294.77,304.07,
DRAIN TLS 7FR #6640,SUP-3252785,CDM,27010242,LOCAL,270,RC,,outpatient,,,310.28,279.25,,0.95,,294.77,Percent of total billed charges,,,0.98,,304.07,Percent of total billed charges,,,0.95,,294.77,Percent of total billed charges,,,0.95,,294.77,Percent of total billed charges,,,0.97,,300.97,Percent of total billed charges,,,0.96,,297.87,Percent of total billed charges,,,0.95,,294.77,Percent of total billed charges,,,,,,,,,0.95,,294.77,Percent of total billed charges,,294.77,304.07,
SUCT POOLE TIP,SUP-3252787,CDM,3252787WWM,LOCAL,270,RC,,inpatient,,,14.72,13.25,,0.95,,13.98,Percent of total billed charges,,,0.98,,14.43,Percent of total billed charges,,,0.95,,13.98,Percent of total billed charges,,,0.97,,14.28,Percent of total billed charges,,,0.97,,14.28,Percent of total billed charges,,,0.96,,14.13,Percent of total billed charges,,,0.95,,13.98,Percent of total billed charges,,,,,,,,,0.95,,13.98,Percent of total billed charges,,13.98,14.43,
SUCT POOLE TIP,SUP-3252787,CDM,3252787WWM,LOCAL,270,RC,,outpatient,,,14.72,13.25,,0.95,,13.98,Percent of total billed charges,,,0.98,,14.43,Percent of total billed charges,,,0.95,,13.98,Percent of total billed charges,,,0.95,,13.98,Percent of total billed charges,,,0.97,,14.28,Percent of total billed charges,,,0.96,,14.13,Percent of total billed charges,,,0.95,,13.98,Percent of total billed charges,,,,,,,,,0.95,,13.98,Percent of total billed charges,,13.98,14.43,
JP RESVR    #SU1301305,SUP-3252789,CDM,3252789WWM,LOCAL,270,RC,,inpatient,,,25.2,22.68,,0.95,,23.94,Percent of total billed charges,,,0.98,,24.7,Percent of total billed charges,,,0.95,,23.94,Percent of total billed charges,,,0.97,,24.44,Percent of total billed charges,,,0.97,,24.44,Percent of total billed charges,,,0.96,,24.19,Percent of total billed charges,,,0.95,,23.94,Percent of total billed charges,,,,,,,,,0.95,,23.94,Percent of total billed charges,,23.94,24.7,
JP RESVR    #SU1301305,SUP-3252789,CDM,3252789WWM,LOCAL,270,RC,,outpatient,,,25.2,22.68,,0.95,,23.94,Percent of total billed charges,,,0.98,,24.7,Percent of total billed charges,,,0.95,,23.94,Percent of total billed charges,,,0.95,,23.94,Percent of total billed charges,,,0.97,,24.44,Percent of total billed charges,,,0.96,,24.19,Percent of total billed charges,,,0.95,,23.94,Percent of total billed charges,,,,,,,,,0.95,,23.94,Percent of total billed charges,,23.94,24.7,
COLON HOT SNARE,SUP-3252815,CDM,3252815WWM,LOCAL,270,RC,,inpatient,,,637.74,573.97,,0.95,,605.85,Percent of total billed charges,,,0.98,,624.99,Percent of total billed charges,,,0.95,,605.85,Percent of total billed charges,,,0.97,,618.61,Percent of total billed charges,,,0.97,,618.61,Percent of total billed charges,,,0.96,,612.23,Percent of total billed charges,,,0.95,,605.85,Percent of total billed charges,,,,,,,,,0.95,,605.85,Percent of total billed charges,,605.85,624.99,
COLON HOT SNARE,SUP-3252815,CDM,3252815WWM,LOCAL,270,RC,,outpatient,,,637.74,573.97,,0.95,,605.85,Percent of total billed charges,,,0.98,,624.99,Percent of total billed charges,,,0.95,,605.85,Percent of total billed charges,,,0.95,,605.85,Percent of total billed charges,,,0.97,,618.61,Percent of total billed charges,,,0.96,,612.23,Percent of total billed charges,,,0.95,,605.85,Percent of total billed charges,,,,,,,,,0.95,,605.85,Percent of total billed charges,,605.85,624.99,
ENDOPOUCH RETRV,SUP-3252840,CDM,3252840WWM,LOCAL,270,RC,,inpatient,,,234,210.6,,0.95,,222.3,Percent of total billed charges,,,0.98,,229.32,Percent of total billed charges,,,0.95,,222.3,Percent of total billed charges,,,0.97,,226.98,Percent of total billed charges,,,0.97,,226.98,Percent of total billed charges,,,0.96,,224.64,Percent of total billed charges,,,0.95,,222.3,Percent of total billed charges,,,,,,,,,0.95,,222.3,Percent of total billed charges,,222.3,229.32,
ENDOPOUCH RETRV,SUP-3252840,CDM,3252840WWM,LOCAL,270,RC,,outpatient,,,234,210.6,,0.95,,222.3,Percent of total billed charges,,,0.98,,229.32,Percent of total billed charges,,,0.95,,222.3,Percent of total billed charges,,,0.95,,222.3,Percent of total billed charges,,,0.97,,226.98,Percent of total billed charges,,,0.96,,224.64,Percent of total billed charges,,,0.95,,222.3,Percent of total billed charges,,,,,,,,,0.95,,222.3,Percent of total billed charges,,222.3,229.32,
SIGMOID SUCTION,SUP-3252892,CDM,3252892WWM,LOCAL,270,RC,,inpatient,,,19.12,17.21,,0.95,,18.16,Percent of total billed charges,,,0.98,,18.74,Percent of total billed charges,,,0.95,,18.16,Percent of total billed charges,,,0.97,,18.55,Percent of total billed charges,,,0.97,,18.55,Percent of total billed charges,,,0.96,,18.36,Percent of total billed charges,,,0.95,,18.16,Percent of total billed charges,,,,,,,,,0.95,,18.16,Percent of total billed charges,,18.16,18.74,
SIGMOID SUCTION,SUP-3252892,CDM,3252892WWM,LOCAL,270,RC,,outpatient,,,19.12,17.21,,0.95,,18.16,Percent of total billed charges,,,0.98,,18.74,Percent of total billed charges,,,0.95,,18.16,Percent of total billed charges,,,0.95,,18.16,Percent of total billed charges,,,0.97,,18.55,Percent of total billed charges,,,0.96,,18.36,Percent of total billed charges,,,0.95,,18.16,Percent of total billed charges,,,,,,,,,0.95,,18.16,Percent of total billed charges,,18.16,18.74,
STAPLER PROX #PRW35,SUP-3252909,CDM,3252909WWM,LOCAL,270,RC,,inpatient,,,120,108,,0.95,,114,Percent of total billed charges,,,0.98,,117.6,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.96,,115.2,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,,,,,,,0.95,,114,Percent of total billed charges,,114,117.6,
STAPLER PROX #PRW35,SUP-3252909,CDM,3252909WWM,LOCAL,270,RC,,outpatient,,,120,108,,0.95,,114,Percent of total billed charges,,,0.98,,117.6,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,0.97,,116.4,Percent of total billed charges,,,0.96,,115.2,Percent of total billed charges,,,0.95,,114,Percent of total billed charges,,,,,,,,,0.95,,114,Percent of total billed charges,,114,117.6,
FOLEY CATHETER,SUP-3252939,CDM,3252939WWM,LOCAL,270,RC,,inpatient,,,64.74,58.27,,0.95,,61.5,Percent of total billed charges,,,0.98,,63.45,Percent of total billed charges,,,0.95,,61.5,Percent of total billed charges,,,0.97,,62.8,Percent of total billed charges,,,0.97,,62.8,Percent of total billed charges,,,0.96,,62.15,Percent of total billed charges,,,0.95,,61.5,Percent of total billed charges,,,,,,,,,0.95,,61.5,Percent of total billed charges,,61.5,63.45,
FOLEY CATHETER,SUP-3252939,CDM,3252939WWM,LOCAL,270,RC,,outpatient,,,64.74,58.27,,0.95,,61.5,Percent of total billed charges,,,0.98,,63.45,Percent of total billed charges,,,0.95,,61.5,Percent of total billed charges,,,0.95,,61.5,Percent of total billed charges,,,0.97,,62.8,Percent of total billed charges,,,0.96,,62.15,Percent of total billed charges,,,0.95,,61.5,Percent of total billed charges,,,,,,,,,0.95,,61.5,Percent of total billed charges,,61.5,63.45,
CURETTE CVD 8MM,SUP-3252973,CDM,3252973WWM,LOCAL,270,RC,,inpatient,,,18.56,16.7,,0.95,,17.63,Percent of total billed charges,,,0.98,,18.19,Percent of total billed charges,,,0.95,,17.63,Percent of total billed charges,,,0.97,,18,Percent of total billed charges,,,0.97,,18,Percent of total billed charges,,,0.96,,17.82,Percent of total billed charges,,,0.95,,17.63,Percent of total billed charges,,,,,,,,,0.95,,17.63,Percent of total billed charges,,17.63,18.19,
CURETTE CVD 8MM,SUP-3252973,CDM,3252973WWM,LOCAL,270,RC,,outpatient,,,18.56,16.7,,0.95,,17.63,Percent of total billed charges,,,0.98,,18.19,Percent of total billed charges,,,0.95,,17.63,Percent of total billed charges,,,0.95,,17.63,Percent of total billed charges,,,0.97,,18,Percent of total billed charges,,,0.96,,17.82,Percent of total billed charges,,,0.95,,17.63,Percent of total billed charges,,,,,,,,,0.95,,17.63,Percent of total billed charges,,17.63,18.19,
CURETTE CVD 9MM,SUP-3252974,CDM,3252974WWM,LOCAL,270,RC,,inpatient,,,18.56,16.7,,0.95,,17.63,Percent of total billed charges,,,0.98,,18.19,Percent of total billed charges,,,0.95,,17.63,Percent of total billed charges,,,0.97,,18,Percent of total billed charges,,,0.97,,18,Percent of total billed charges,,,0.96,,17.82,Percent of total billed charges,,,0.95,,17.63,Percent of total billed charges,,,,,,,,,0.95,,17.63,Percent of total billed charges,,17.63,18.19,
CURETTE CVD 9MM,SUP-3252974,CDM,3252974WWM,LOCAL,270,RC,,outpatient,,,18.56,16.7,,0.95,,17.63,Percent of total billed charges,,,0.98,,18.19,Percent of total billed charges,,,0.95,,17.63,Percent of total billed charges,,,0.95,,17.63,Percent of total billed charges,,,0.97,,18,Percent of total billed charges,,,0.96,,17.82,Percent of total billed charges,,,0.95,,17.63,Percent of total billed charges,,,,,,,,,0.95,,17.63,Percent of total billed charges,,17.63,18.19,
CURETTE CVD 7MM,SUP-3252975,CDM,3252975WWM,LOCAL,270,RC,,inpatient,,,30.24,27.22,,0.95,,28.73,Percent of total billed charges,,,0.98,,29.64,Percent of total billed charges,,,0.95,,28.73,Percent of total billed charges,,,0.97,,29.33,Percent of total billed charges,,,0.97,,29.33,Percent of total billed charges,,,0.96,,29.03,Percent of total billed charges,,,0.95,,28.73,Percent of total billed charges,,,,,,,,,0.95,,28.73,Percent of total billed charges,,28.73,29.64,
CURETTE CVD 7MM,SUP-3252975,CDM,3252975WWM,LOCAL,270,RC,,outpatient,,,30.24,27.22,,0.95,,28.73,Percent of total billed charges,,,0.98,,29.64,Percent of total billed charges,,,0.95,,28.73,Percent of total billed charges,,,0.95,,28.73,Percent of total billed charges,,,0.97,,29.33,Percent of total billed charges,,,0.96,,29.03,Percent of total billed charges,,,0.95,,28.73,Percent of total billed charges,,,,,,,,,0.95,,28.73,Percent of total billed charges,,28.73,29.64,
VENAFLOW CALF CUFF ELITE,SUP-3254202,CDM,3253029WWM,LOCAL,270,RC,,inpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
VENAFLOW CALF CUFF ELITE,SUP-3254202,CDM,3253029WWM,LOCAL,270,RC,,outpatient,,,71,63.9,,0.95,,67.45,Percent of total billed charges,,,0.98,,69.58,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,0.97,,68.87,Percent of total billed charges,,,0.96,,68.16,Percent of total billed charges,,,0.95,,67.45,Percent of total billed charges,,,,,,,,,0.95,,67.45,Percent of total billed charges,,67.45,69.58,
FIBERWIRE #2    #AR-7200,SUP-3254220,CDM,27810126,LOCAL,278,RC,,inpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
FIBERWIRE #2    #AR-7200,SUP-3254220,CDM,27810126,LOCAL,278,RC,,outpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
BX INSTR 14GX16CM,SUP-3253113,CDM,3253113WWM,LOCAL,270,RC,,inpatient,,,247.5,222.75,,0.95,,235.13,Percent of total billed charges,,,0.98,,242.55,Percent of total billed charges,,,0.95,,235.13,Percent of total billed charges,,,0.97,,240.08,Percent of total billed charges,,,0.97,,240.08,Percent of total billed charges,,,0.96,,237.6,Percent of total billed charges,,,0.95,,235.13,Percent of total billed charges,,,,,,,,,0.95,,235.13,Percent of total billed charges,,235.13,242.55,
BX INSTR 14GX16CM,SUP-3253113,CDM,3253113WWM,LOCAL,270,RC,,outpatient,,,247.5,222.75,,0.95,,235.13,Percent of total billed charges,,,0.98,,242.55,Percent of total billed charges,,,0.95,,235.13,Percent of total billed charges,,,0.95,,235.13,Percent of total billed charges,,,0.97,,240.08,Percent of total billed charges,,,0.96,,237.6,Percent of total billed charges,,,0.95,,235.13,Percent of total billed charges,,,,,,,,,0.95,,235.13,Percent of total billed charges,,235.13,242.55,
STAPLER CURV #CS40B,SUP-3253143,CDM,3253143WWM,LOCAL,270,RC,,inpatient,,,1122,1009.8,,0.95,,1065.9,Percent of total billed charges,,,0.98,,1099.56,Percent of total billed charges,,,0.95,,1065.9,Percent of total billed charges,,,0.97,,1088.34,Percent of total billed charges,,,0.97,,1088.34,Percent of total billed charges,,,0.96,,1077.12,Percent of total billed charges,,,0.95,,1065.9,Percent of total billed charges,,,,,,,,,0.95,,1065.9,Percent of total billed charges,,1065.9,1099.56,
STAPLER CURV #CS40B,SUP-3253143,CDM,3253143WWM,LOCAL,270,RC,,outpatient,,,1122,1009.8,,0.95,,1065.9,Percent of total billed charges,,,0.98,,1099.56,Percent of total billed charges,,,0.95,,1065.9,Percent of total billed charges,,,0.95,,1065.9,Percent of total billed charges,,,0.97,,1088.34,Percent of total billed charges,,,0.96,,1077.12,Percent of total billed charges,,,0.95,,1065.9,Percent of total billed charges,,,,,,,,,0.95,,1065.9,Percent of total billed charges,,1065.9,1099.56,
STAPLER CURV REL#CR40B,SUP-3253144,CDM,3253144WWM,LOCAL,270,RC,,inpatient,,,676.62,608.96,,0.95,,642.79,Percent of total billed charges,,,0.98,,663.09,Percent of total billed charges,,,0.95,,642.79,Percent of total billed charges,,,0.97,,656.32,Percent of total billed charges,,,0.97,,656.32,Percent of total billed charges,,,0.96,,649.56,Percent of total billed charges,,,0.95,,642.79,Percent of total billed charges,,,,,,,,,0.95,,642.79,Percent of total billed charges,,642.79,663.09,
STAPLER CURV REL#CR40B,SUP-3253144,CDM,3253144WWM,LOCAL,270,RC,,outpatient,,,676.62,608.96,,0.95,,642.79,Percent of total billed charges,,,0.98,,663.09,Percent of total billed charges,,,0.95,,642.79,Percent of total billed charges,,,0.95,,642.79,Percent of total billed charges,,,0.97,,656.32,Percent of total billed charges,,,0.96,,649.56,Percent of total billed charges,,,0.95,,642.79,Percent of total billed charges,,,,,,,,,0.95,,642.79,Percent of total billed charges,,642.79,663.09,
EGD BIOPSY FORCEPS,SUP-3253145,CDM,3253145WWM,LOCAL,270,RC,,inpatient,,,58.2,52.38,,0.95,,55.29,Percent of total billed charges,,,0.98,,57.04,Percent of total billed charges,,,0.95,,55.29,Percent of total billed charges,,,0.97,,56.45,Percent of total billed charges,,,0.97,,56.45,Percent of total billed charges,,,0.96,,55.87,Percent of total billed charges,,,0.95,,55.29,Percent of total billed charges,,,,,,,,,0.95,,55.29,Percent of total billed charges,,55.29,57.04,
EGD BIOPSY FORCEPS,SUP-3253145,CDM,3253145WWM,LOCAL,270,RC,,outpatient,,,58.2,52.38,,0.95,,55.29,Percent of total billed charges,,,0.98,,57.04,Percent of total billed charges,,,0.95,,55.29,Percent of total billed charges,,,0.95,,55.29,Percent of total billed charges,,,0.97,,56.45,Percent of total billed charges,,,0.96,,55.87,Percent of total billed charges,,,0.95,,55.29,Percent of total billed charges,,,,,,,,,0.95,,55.29,Percent of total billed charges,,55.29,57.04,
FORCEP COLON,SUP-3253146,CDM,3253146WWM,LOCAL,270,RC,,inpatient,,,58.2,52.38,,0.95,,55.29,Percent of total billed charges,,,0.98,,57.04,Percent of total billed charges,,,0.95,,55.29,Percent of total billed charges,,,0.97,,56.45,Percent of total billed charges,,,0.97,,56.45,Percent of total billed charges,,,0.96,,55.87,Percent of total billed charges,,,0.95,,55.29,Percent of total billed charges,,,,,,,,,0.95,,55.29,Percent of total billed charges,,55.29,57.04,
FORCEP COLON,SUP-3253146,CDM,3253146WWM,LOCAL,270,RC,,outpatient,,,58.2,52.38,,0.95,,55.29,Percent of total billed charges,,,0.98,,57.04,Percent of total billed charges,,,0.95,,55.29,Percent of total billed charges,,,0.95,,55.29,Percent of total billed charges,,,0.97,,56.45,Percent of total billed charges,,,0.96,,55.87,Percent of total billed charges,,,0.95,,55.29,Percent of total billed charges,,,,,,,,,0.95,,55.29,Percent of total billed charges,,55.29,57.04,
MINI FRAG SCREW 1.5X6 #200.006,SUP-3253200,CDM,3253200WWM,LOCAL,278,RC,,inpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
MINI FRAG SCREW 1.5X6 #200.006,SUP-3253200,CDM,3253200WWM,LOCAL,278,RC,,outpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
MINI FRAG SCREW 1.5X8 #200.008,SUP-3253201,CDM,3253201WWM,LOCAL,278,RC,,inpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
MINI FRAG SCREW 1.5X8 #200.008,SUP-3253201,CDM,3253201WWM,LOCAL,278,RC,,outpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
MINI FRAG SCREW 1.5X10 #200.010,SUP-3253202,CDM,3253202WWM,LOCAL,278,RC,,inpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
MINI FRAG SCREW 1.5X10 #200.010,SUP-3253202,CDM,3253202WWM,LOCAL,278,RC,,outpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
MINI FRAG SCREW 1.5X12 #200.012,SUP-3253203,CDM,3253203WWM,LOCAL,278,RC,,inpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
MINI FRAG SCREW 1.5X12 #200.012,SUP-3253203,CDM,3253203WWM,LOCAL,278,RC,,outpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
MINI FRAG SCREW 1.5X14 #200.014,SUP-3253204,CDM,3253204WWM,LOCAL,278,RC,,inpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
MINI FRAG SCREW 1.5X14 #200.014,SUP-3253204,CDM,3253204WWM,LOCAL,278,RC,,outpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
MINI FRAG  SCREW 1.5X16 #200.016,SUP-3253205,CDM,3253205WWM,LOCAL,278,RC,,inpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
MINI FRAG  SCREW 1.5X16 #200.016,SUP-3253205,CDM,3253205WWM,LOCAL,278,RC,,outpatient,,,102,91.8,,0.95,,96.9,Percent of total billed charges,,,0.98,,99.96,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,0.97,,98.94,Percent of total billed charges,,,0.96,,97.92,Percent of total billed charges,,,0.95,,96.9,Percent of total billed charges,,,,,,,,,0.95,,96.9,Percent of total billed charges,,96.9,99.96,
MINI FRAG SCREW 2.0X6 #201.006,SUP-3253206,CDM,3253206WWM,LOCAL,278,RC,,inpatient,,,94.5,85.05,,0.95,,89.78,Percent of total billed charges,,,0.98,,92.61,Percent of total billed charges,,,0.95,,89.78,Percent of total billed charges,,,0.97,,91.67,Percent of total billed charges,,,0.97,,91.67,Percent of total billed charges,,,0.96,,90.72,Percent of total billed charges,,,0.95,,89.78,Percent of total billed charges,,,,,,,,,0.95,,89.78,Percent of total billed charges,,89.78,92.61,
MINI FRAG SCREW 2.0X6 #201.006,SUP-3253206,CDM,3253206WWM,LOCAL,278,RC,,outpatient,,,94.5,85.05,,0.95,,89.78,Percent of total billed charges,,,0.98,,92.61,Percent of total billed charges,,,0.95,,89.78,Percent of total billed charges,,,0.95,,89.78,Percent of total billed charges,,,0.97,,91.67,Percent of total billed charges,,,0.96,,90.72,Percent of total billed charges,,,0.95,,89.78,Percent of total billed charges,,,,,,,,,0.95,,89.78,Percent of total billed charges,,89.78,92.61,
MINI FRAG SCREW 2.0X8 #201.008,SUP-3253207,CDM,3253207WWM,LOCAL,278,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
MINI FRAG SCREW 2.0X8 #201.008,SUP-3253207,CDM,3253207WWM,LOCAL,278,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
MINI FRAG SCREW 2.0X10 #201.010,SUP-3253208,CDM,3253208WWM,LOCAL,278,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
MINI FRAG SCREW 2.0X10 #201.010,SUP-3253208,CDM,3253208WWM,LOCAL,278,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
MINI FRAG SCREW 2.0X12 #201.012,SUP-3253209,CDM,3253209WWM,LOCAL,278,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
MINI FRAG SCREW 2.0X12 #201.012,SUP-3253209,CDM,3253209WWM,LOCAL,278,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
MINI FRAG SCREW 2.0X14 #201.014,SUP-3253210,CDM,3253210WWM,LOCAL,278,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
MINI FRAG SCREW 2.0X14 #201.014,SUP-3253210,CDM,3253210WWM,LOCAL,278,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
MINI FRAG SCREW 2.0X16 #201.016,SUP-3253211,CDM,3253211WWM,LOCAL,278,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
MINI FRAG SCREW 2.0X16 #201.016,SUP-3253211,CDM,3253211WWM,LOCAL,278,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
MINI FRAG SCREW 2.0X18 #201.018,SUP-3253212,CDM,3253212WWM,LOCAL,278,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
MINI FRAG SCREW 2.0X18 #201.018,SUP-3253212,CDM,3253212WWM,LOCAL,278,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
MINI FRAG SCREW 2.0X20 #201.020,SUP-3253213,CDM,3253213WWM,LOCAL,278,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
MINI FRAG SCREW 2.0X20 #201.020,SUP-3253213,CDM,3253213WWM,LOCAL,278,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
MINI FRAG SCREW 2.7X6 #202.006,SUP-3253214,CDM,3253214WWM,LOCAL,278,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
MINI FRAG SCREW 2.7X6 #202.006,SUP-3253214,CDM,3253214WWM,LOCAL,278,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
MINI FRAG SCREW 2.7X8 #202.008,SUP-3253215,CDM,3253215WWM,LOCAL,278,RC,,inpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
MINI FRAG SCREW 2.7X8 #202.008,SUP-3253215,CDM,3253215WWM,LOCAL,278,RC,,outpatient,,,99,89.1,,0.95,,94.05,Percent of total billed charges,,,0.98,,97.02,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,0.97,,96.03,Percent of total billed charges,,,0.96,,95.04,Percent of total billed charges,,,0.95,,94.05,Percent of total billed charges,,,,,,,,,0.95,,94.05,Percent of total billed charges,,94.05,97.02,
MINI FRAG SCREW 2.7X10 #202.010,SUP-3253216,CDM,3253216WWM,LOCAL,278,RC,,inpatient,,,103.5,93.15,,0.95,,98.33,Percent of total billed charges,,,0.98,,101.43,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,0.97,,100.4,Percent of total billed charges,,,0.97,,100.4,Percent of total billed charges,,,0.96,,99.36,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,,,,,,,0.95,,98.33,Percent of total billed charges,,98.33,101.43,
MINI FRAG SCREW 2.7X10 #202.010,SUP-3253216,CDM,3253216WWM,LOCAL,278,RC,,outpatient,,,103.5,93.15,,0.95,,98.33,Percent of total billed charges,,,0.98,,101.43,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,0.97,,100.4,Percent of total billed charges,,,0.96,,99.36,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,,,,,,,0.95,,98.33,Percent of total billed charges,,98.33,101.43,
MINI FRAG SCREW 2.7X12 #202.012,SUP-3253217,CDM,3253217WWM,LOCAL,278,RC,,inpatient,,,103.5,93.15,,0.95,,98.33,Percent of total billed charges,,,0.98,,101.43,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,0.97,,100.4,Percent of total billed charges,,,0.97,,100.4,Percent of total billed charges,,,0.96,,99.36,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,,,,,,,0.95,,98.33,Percent of total billed charges,,98.33,101.43,
MINI FRAG SCREW 2.7X12 #202.012,SUP-3253217,CDM,3253217WWM,LOCAL,278,RC,,outpatient,,,103.5,93.15,,0.95,,98.33,Percent of total billed charges,,,0.98,,101.43,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,0.97,,100.4,Percent of total billed charges,,,0.96,,99.36,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,,,,,,,0.95,,98.33,Percent of total billed charges,,98.33,101.43,
MINI FRAG SCREW 2.7X14 #202.014,SUP-3253218,CDM,3253218WWM,LOCAL,278,RC,,inpatient,,,103.5,93.15,,0.95,,98.33,Percent of total billed charges,,,0.98,,101.43,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,0.97,,100.4,Percent of total billed charges,,,0.97,,100.4,Percent of total billed charges,,,0.96,,99.36,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,,,,,,,0.95,,98.33,Percent of total billed charges,,98.33,101.43,
MINI FRAG SCREW 2.7X14 #202.014,SUP-3253218,CDM,3253218WWM,LOCAL,278,RC,,outpatient,,,103.5,93.15,,0.95,,98.33,Percent of total billed charges,,,0.98,,101.43,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,0.97,,100.4,Percent of total billed charges,,,0.96,,99.36,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,,,,,,,0.95,,98.33,Percent of total billed charges,,98.33,101.43,
MINI FRAG SCREW 2.7X16 #202.016,SUP-3253219,CDM,3253219WWM,LOCAL,278,RC,,inpatient,,,103.5,93.15,,0.95,,98.33,Percent of total billed charges,,,0.98,,101.43,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,0.97,,100.4,Percent of total billed charges,,,0.97,,100.4,Percent of total billed charges,,,0.96,,99.36,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,,,,,,,0.95,,98.33,Percent of total billed charges,,98.33,101.43,
MINI FRAG SCREW 2.7X16 #202.016,SUP-3253219,CDM,3253219WWM,LOCAL,278,RC,,outpatient,,,103.5,93.15,,0.95,,98.33,Percent of total billed charges,,,0.98,,101.43,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,0.97,,100.4,Percent of total billed charges,,,0.96,,99.36,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,,,,,,,0.95,,98.33,Percent of total billed charges,,98.33,101.43,
MINI FRAG SCREW 2.7X18 #202.018,SUP-3253220,CDM,3253220WWM,LOCAL,278,RC,,inpatient,,,103.5,93.15,,0.95,,98.33,Percent of total billed charges,,,0.98,,101.43,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,0.97,,100.4,Percent of total billed charges,,,0.97,,100.4,Percent of total billed charges,,,0.96,,99.36,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,,,,,,,0.95,,98.33,Percent of total billed charges,,98.33,101.43,
MINI FRAG SCREW 2.7X18 #202.018,SUP-3253220,CDM,3253220WWM,LOCAL,278,RC,,outpatient,,,103.5,93.15,,0.95,,98.33,Percent of total billed charges,,,0.98,,101.43,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,0.97,,100.4,Percent of total billed charges,,,0.96,,99.36,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,,,,,,,0.95,,98.33,Percent of total billed charges,,98.33,101.43,
MINI FRAG SCREW 2.7X20 #202.020,SUP-3253221,CDM,3253221WWM,LOCAL,278,RC,,inpatient,,,103.5,93.15,,0.95,,98.33,Percent of total billed charges,,,0.98,,101.43,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,0.97,,100.4,Percent of total billed charges,,,0.97,,100.4,Percent of total billed charges,,,0.96,,99.36,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,,,,,,,0.95,,98.33,Percent of total billed charges,,98.33,101.43,
MINI FRAG SCREW 2.7X20 #202.020,SUP-3253221,CDM,3253221WWM,LOCAL,278,RC,,outpatient,,,103.5,93.15,,0.95,,98.33,Percent of total billed charges,,,0.98,,101.43,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,0.97,,100.4,Percent of total billed charges,,,0.96,,99.36,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,,,,,,,0.95,,98.33,Percent of total billed charges,,98.33,101.43,
MINI FRAG SCREW 2.7X22 #202.022,SUP-3253222,CDM,3253222WWM,LOCAL,278,RC,,inpatient,,,103.5,93.15,,0.95,,98.33,Percent of total billed charges,,,0.98,,101.43,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,0.97,,100.4,Percent of total billed charges,,,0.97,,100.4,Percent of total billed charges,,,0.96,,99.36,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,,,,,,,0.95,,98.33,Percent of total billed charges,,98.33,101.43,
MINI FRAG SCREW 2.7X22 #202.022,SUP-3253222,CDM,3253222WWM,LOCAL,278,RC,,outpatient,,,103.5,93.15,,0.95,,98.33,Percent of total billed charges,,,0.98,,101.43,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,0.97,,100.4,Percent of total billed charges,,,0.96,,99.36,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,,,,,,,0.95,,98.33,Percent of total billed charges,,98.33,101.43,
MINI FRAG SCREW 2.7X24 #202.024,SUP-3253223,CDM,3253223WWM,LOCAL,278,RC,,inpatient,,,103.5,93.15,,0.95,,98.33,Percent of total billed charges,,,0.98,,101.43,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,0.97,,100.4,Percent of total billed charges,,,0.97,,100.4,Percent of total billed charges,,,0.96,,99.36,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,,,,,,,0.95,,98.33,Percent of total billed charges,,98.33,101.43,
MINI FRAG SCREW 2.7X24 #202.024,SUP-3253223,CDM,3253223WWM,LOCAL,278,RC,,outpatient,,,103.5,93.15,,0.95,,98.33,Percent of total billed charges,,,0.98,,101.43,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,0.97,,100.4,Percent of total billed charges,,,0.96,,99.36,Percent of total billed charges,,,0.95,,98.33,Percent of total billed charges,,,,,,,,,0.95,,98.33,Percent of total billed charges,,98.33,101.43,
TROCAR 5MM #B5LT,SUP-3253248,CDM,3253248WWM,LOCAL,270,RC,,inpatient,,,206.51,185.86,,0.95,,196.18,Percent of total billed charges,,,0.98,,202.38,Percent of total billed charges,,,0.95,,196.18,Percent of total billed charges,,,0.97,,200.31,Percent of total billed charges,,,0.97,,200.31,Percent of total billed charges,,,0.96,,198.25,Percent of total billed charges,,,0.95,,196.18,Percent of total billed charges,,,,,,,,,0.95,,196.18,Percent of total billed charges,,196.18,202.38,
TROCAR 5MM #B5LT,SUP-3253248,CDM,3253248WWM,LOCAL,270,RC,,outpatient,,,206.51,185.86,,0.95,,196.18,Percent of total billed charges,,,0.98,,202.38,Percent of total billed charges,,,0.95,,196.18,Percent of total billed charges,,,0.95,,196.18,Percent of total billed charges,,,0.97,,200.31,Percent of total billed charges,,,0.96,,198.25,Percent of total billed charges,,,0.95,,196.18,Percent of total billed charges,,,,,,,,,0.95,,196.18,Percent of total billed charges,,196.18,202.38,
TROCAR SLEEVE 5MM#CB5LT,SUP-3253249,CDM,3253249WWM,LOCAL,270,RC,,inpatient,,,134,120.6,,0.95,,127.3,Percent of total billed charges,,,0.98,,131.32,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,0.97,,129.98,Percent of total billed charges,,,0.97,,129.98,Percent of total billed charges,,,0.96,,128.64,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,,,,,,,0.95,,127.3,Percent of total billed charges,,127.3,131.32,
TROCAR SLEEVE 5MM#CB5LT,SUP-3253249,CDM,3253249WWM,LOCAL,270,RC,,outpatient,,,134,120.6,,0.95,,127.3,Percent of total billed charges,,,0.98,,131.32,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,0.97,,129.98,Percent of total billed charges,,,0.96,,128.64,Percent of total billed charges,,,0.95,,127.3,Percent of total billed charges,,,,,,,,,0.95,,127.3,Percent of total billed charges,,127.3,131.32,
TROCAR 12MM #B12LT,SUP-3253250,CDM,3253250WWM,LOCAL,270,RC,,inpatient,,,271.62,244.46,,0.95,,258.04,Percent of total billed charges,,,0.98,,266.19,Percent of total billed charges,,,0.95,,258.04,Percent of total billed charges,,,0.97,,263.47,Percent of total billed charges,,,0.97,,263.47,Percent of total billed charges,,,0.96,,260.76,Percent of total billed charges,,,0.95,,258.04,Percent of total billed charges,,,,,,,,,0.95,,258.04,Percent of total billed charges,,258.04,266.19,
TROCAR 12MM #B12LT,SUP-3253250,CDM,3253250WWM,LOCAL,270,RC,,outpatient,,,271.62,244.46,,0.95,,258.04,Percent of total billed charges,,,0.98,,266.19,Percent of total billed charges,,,0.95,,258.04,Percent of total billed charges,,,0.95,,258.04,Percent of total billed charges,,,0.97,,263.47,Percent of total billed charges,,,0.96,,260.76,Percent of total billed charges,,,0.95,,258.04,Percent of total billed charges,,,,,,,,,0.95,,258.04,Percent of total billed charges,,258.04,266.19,
TROCAR SLEEVE 12MM#CB12LT,SUP-3253251,CDM,3253251WWM,LOCAL,270,RC,,inpatient,,,173.2,155.88,,0.95,,164.54,Percent of total billed charges,,,0.98,,169.74,Percent of total billed charges,,,0.95,,164.54,Percent of total billed charges,,,0.97,,168,Percent of total billed charges,,,0.97,,168,Percent of total billed charges,,,0.96,,166.27,Percent of total billed charges,,,0.95,,164.54,Percent of total billed charges,,,,,,,,,0.95,,164.54,Percent of total billed charges,,164.54,169.74,
TROCAR SLEEVE 12MM#CB12LT,SUP-3253251,CDM,3253251WWM,LOCAL,270,RC,,outpatient,,,173.2,155.88,,0.95,,164.54,Percent of total billed charges,,,0.98,,169.74,Percent of total billed charges,,,0.95,,164.54,Percent of total billed charges,,,0.95,,164.54,Percent of total billed charges,,,0.97,,168,Percent of total billed charges,,,0.96,,166.27,Percent of total billed charges,,,0.95,,164.54,Percent of total billed charges,,,,,,,,,0.95,,164.54,Percent of total billed charges,,164.54,169.74,
MESH VENTRALEX LG,SUP-3253277,CDM,3253277WWM,LOCAL,278,RC,,inpatient,,,1589.5,1430.55,,0.95,,1510.03,Percent of total billed charges,,,0.98,,1557.71,Percent of total billed charges,,,0.95,,1510.03,Percent of total billed charges,,,0.97,,1541.82,Percent of total billed charges,,,0.97,,1541.82,Percent of total billed charges,,,0.96,,1525.92,Percent of total billed charges,,,0.95,,1510.03,Percent of total billed charges,,,,,,,,,0.95,,1510.03,Percent of total billed charges,,1510.03,1557.71,
MESH VENTRALEX LG,SUP-3253277,CDM,3253277WWM,LOCAL,278,RC,,outpatient,,,1589.5,1430.55,,0.95,,1510.03,Percent of total billed charges,,,0.98,,1557.71,Percent of total billed charges,,,0.95,,1510.03,Percent of total billed charges,,,0.95,,1510.03,Percent of total billed charges,,,0.97,,1541.82,Percent of total billed charges,,,0.96,,1525.92,Percent of total billed charges,,,0.95,,1510.03,Percent of total billed charges,,,,,,,,,0.95,,1510.03,Percent of total billed charges,,1510.03,1557.71,
MINI FRAG SCREW 2.7X20 #202.820,SUP-3253300,CDM,3253300WWM,LOCAL,278,RC,,inpatient,,,115,103.5,,0.95,,109.25,Percent of total billed charges,,,0.98,,112.7,Percent of total billed charges,,,0.95,,109.25,Percent of total billed charges,,,0.97,,111.55,Percent of total billed charges,,,0.97,,111.55,Percent of total billed charges,,,0.96,,110.4,Percent of total billed charges,,,0.95,,109.25,Percent of total billed charges,,,,,,,,,0.95,,109.25,Percent of total billed charges,,109.25,112.7,
MINI FRAG SCREW 2.7X20 #202.820,SUP-3253300,CDM,3253300WWM,LOCAL,278,RC,,outpatient,,,115,103.5,,0.95,,109.25,Percent of total billed charges,,,0.98,,112.7,Percent of total billed charges,,,0.95,,109.25,Percent of total billed charges,,,0.95,,109.25,Percent of total billed charges,,,0.97,,111.55,Percent of total billed charges,,,0.96,,110.4,Percent of total billed charges,,,0.95,,109.25,Percent of total billed charges,,,,,,,,,0.95,,109.25,Percent of total billed charges,,109.25,112.7,
MINI FRAG SCREW 2.7X16 #202.816,SUP-3253301,CDM,3253301WWM,LOCAL,278,RC,,inpatient,,,115,103.5,,0.95,,109.25,Percent of total billed charges,,,0.98,,112.7,Percent of total billed charges,,,0.95,,109.25,Percent of total billed charges,,,0.97,,111.55,Percent of total billed charges,,,0.97,,111.55,Percent of total billed charges,,,0.96,,110.4,Percent of total billed charges,,,0.95,,109.25,Percent of total billed charges,,,,,,,,,0.95,,109.25,Percent of total billed charges,,109.25,112.7,
MINI FRAG SCREW 2.7X16 #202.816,SUP-3253301,CDM,3253301WWM,LOCAL,278,RC,,outpatient,,,115,103.5,,0.95,,109.25,Percent of total billed charges,,,0.98,,112.7,Percent of total billed charges,,,0.95,,109.25,Percent of total billed charges,,,0.95,,109.25,Percent of total billed charges,,,0.97,,111.55,Percent of total billed charges,,,0.96,,110.4,Percent of total billed charges,,,0.95,,109.25,Percent of total billed charges,,,,,,,,,0.95,,109.25,Percent of total billed charges,,109.25,112.7,
MINI FRAG SCREW 2.7X18 #202.818,SUP-3253302,CDM,3253302WWM,LOCAL,278,RC,,inpatient,,,102.45,92.21,,0.95,,97.33,Percent of total billed charges,,,0.98,,100.4,Percent of total billed charges,,,0.95,,97.33,Percent of total billed charges,,,0.97,,99.38,Percent of total billed charges,,,0.97,,99.38,Percent of total billed charges,,,0.96,,98.35,Percent of total billed charges,,,0.95,,97.33,Percent of total billed charges,,,,,,,,,0.95,,97.33,Percent of total billed charges,,97.33,100.4,
MINI FRAG SCREW 2.7X18 #202.818,SUP-3253302,CDM,3253302WWM,LOCAL,278,RC,,outpatient,,,102.45,92.21,,0.95,,97.33,Percent of total billed charges,,,0.98,,100.4,Percent of total billed charges,,,0.95,,97.33,Percent of total billed charges,,,0.95,,97.33,Percent of total billed charges,,,0.97,,99.38,Percent of total billed charges,,,0.96,,98.35,Percent of total billed charges,,,0.95,,97.33,Percent of total billed charges,,,,,,,,,0.95,,97.33,Percent of total billed charges,,97.33,100.4,
ILS CRVD #CDH25,SUP-3253329,CDM,3253329WWM,LOCAL,270,RC,,inpatient,,,906.21,815.59,,0.95,,860.9,Percent of total billed charges,,,0.98,,888.09,Percent of total billed charges,,,0.95,,860.9,Percent of total billed charges,,,0.97,,879.02,Percent of total billed charges,,,0.97,,879.02,Percent of total billed charges,,,0.96,,869.96,Percent of total billed charges,,,0.95,,860.9,Percent of total billed charges,,,,,,,,,0.95,,860.9,Percent of total billed charges,,860.9,888.09,
ILS CRVD #CDH25,SUP-3253329,CDM,3253329WWM,LOCAL,270,RC,,outpatient,,,906.21,815.59,,0.95,,860.9,Percent of total billed charges,,,0.98,,888.09,Percent of total billed charges,,,0.95,,860.9,Percent of total billed charges,,,0.95,,860.9,Percent of total billed charges,,,0.97,,879.02,Percent of total billed charges,,,0.96,,869.96,Percent of total billed charges,,,0.95,,860.9,Percent of total billed charges,,,,,,,,,0.95,,860.9,Percent of total billed charges,,860.9,888.09,
ILS CRVD #CDH29,SUP-3253330,CDM,3253330WWM,LOCAL,270,RC,,inpatient,,,871.71,784.54,,0.95,,828.12,Percent of total billed charges,,,0.98,,854.28,Percent of total billed charges,,,0.95,,828.12,Percent of total billed charges,,,0.97,,845.56,Percent of total billed charges,,,0.97,,845.56,Percent of total billed charges,,,0.96,,836.84,Percent of total billed charges,,,0.95,,828.12,Percent of total billed charges,,,,,,,,,0.95,,828.12,Percent of total billed charges,,828.12,854.28,
ILS CRVD #CDH29,SUP-3253330,CDM,3253330WWM,LOCAL,270,RC,,outpatient,,,871.71,784.54,,0.95,,828.12,Percent of total billed charges,,,0.98,,854.28,Percent of total billed charges,,,0.95,,828.12,Percent of total billed charges,,,0.95,,828.12,Percent of total billed charges,,,0.97,,845.56,Percent of total billed charges,,,0.96,,836.84,Percent of total billed charges,,,0.95,,828.12,Percent of total billed charges,,,,,,,,,0.95,,828.12,Percent of total billed charges,,828.12,854.28,
ILS CRVD #CDH33,SUP-3253331,CDM,3253331WWM,LOCAL,270,RC,,inpatient,,,906.21,815.59,,0.95,,860.9,Percent of total billed charges,,,0.98,,888.09,Percent of total billed charges,,,0.95,,860.9,Percent of total billed charges,,,0.97,,879.02,Percent of total billed charges,,,0.97,,879.02,Percent of total billed charges,,,0.96,,869.96,Percent of total billed charges,,,0.95,,860.9,Percent of total billed charges,,,,,,,,,0.95,,860.9,Percent of total billed charges,,860.9,888.09,
ILS CRVD #CDH33,SUP-3253331,CDM,3253331WWM,LOCAL,270,RC,,outpatient,,,906.21,815.59,,0.95,,860.9,Percent of total billed charges,,,0.98,,888.09,Percent of total billed charges,,,0.95,,860.9,Percent of total billed charges,,,0.95,,860.9,Percent of total billed charges,,,0.97,,879.02,Percent of total billed charges,,,0.96,,869.96,Percent of total billed charges,,,0.95,,860.9,Percent of total billed charges,,,,,,,,,0.95,,860.9,Percent of total billed charges,,860.9,888.09,
CATH CHOLAN #2401-50,SUP-3253351,CDM,3253351WWM,LOCAL,270,RC,,inpatient,,,437.33,393.6,,0.95,,415.46,Percent of total billed charges,,,0.98,,428.58,Percent of total billed charges,,,0.95,,415.46,Percent of total billed charges,,,0.97,,424.21,Percent of total billed charges,,,0.97,,424.21,Percent of total billed charges,,,0.96,,419.84,Percent of total billed charges,,,0.95,,415.46,Percent of total billed charges,,,,,,,,,0.95,,415.46,Percent of total billed charges,,415.46,428.58,
CATH CHOLAN #2401-50,SUP-3253351,CDM,3253351WWM,LOCAL,270,RC,,outpatient,,,437.33,393.6,,0.95,,415.46,Percent of total billed charges,,,0.98,,428.58,Percent of total billed charges,,,0.95,,415.46,Percent of total billed charges,,,0.95,,415.46,Percent of total billed charges,,,0.97,,424.21,Percent of total billed charges,,,0.96,,419.84,Percent of total billed charges,,,0.95,,415.46,Percent of total billed charges,,,,,,,,,0.95,,415.46,Percent of total billed charges,,415.46,428.58,
MESH VENTRALEX MD,SUP-3253363,CDM,3253363WWM,LOCAL,278,RC,,inpatient,,,1398,1258.2,,0.95,,1328.1,Percent of total billed charges,,,0.98,,1370.04,Percent of total billed charges,,,0.95,,1328.1,Percent of total billed charges,,,0.97,,1356.06,Percent of total billed charges,,,0.97,,1356.06,Percent of total billed charges,,,0.96,,1342.08,Percent of total billed charges,,,0.95,,1328.1,Percent of total billed charges,,,,,,,,,0.95,,1328.1,Percent of total billed charges,,1328.1,1370.04,
MESH VENTRALEX MD,SUP-3253363,CDM,3253363WWM,LOCAL,278,RC,,outpatient,,,1398,1258.2,,0.95,,1328.1,Percent of total billed charges,,,0.98,,1370.04,Percent of total billed charges,,,0.95,,1328.1,Percent of total billed charges,,,0.95,,1328.1,Percent of total billed charges,,,0.97,,1356.06,Percent of total billed charges,,,0.96,,1342.08,Percent of total billed charges,,,0.95,,1328.1,Percent of total billed charges,,,,,,,,,0.95,,1328.1,Percent of total billed charges,,1328.1,1370.04,
SUCT IRRIGATOR / PULSED,SUP-3253380,CDM,3253380WWM,LOCAL,270,RC,,inpatient,,,195.85,176.27,,0.95,,186.06,Percent of total billed charges,,,0.98,,191.93,Percent of total billed charges,,,0.95,,186.06,Percent of total billed charges,,,0.97,,189.97,Percent of total billed charges,,,0.97,,189.97,Percent of total billed charges,,,0.96,,188.02,Percent of total billed charges,,,0.95,,186.06,Percent of total billed charges,,,,,,,,,0.95,,186.06,Percent of total billed charges,,186.06,191.93,
SUCT IRRIGATOR / PULSED,SUP-3253380,CDM,3253380WWM,LOCAL,270,RC,,outpatient,,,195.85,176.27,,0.95,,186.06,Percent of total billed charges,,,0.98,,191.93,Percent of total billed charges,,,0.95,,186.06,Percent of total billed charges,,,0.95,,186.06,Percent of total billed charges,,,0.97,,189.97,Percent of total billed charges,,,0.96,,188.02,Percent of total billed charges,,,0.95,,186.06,Percent of total billed charges,,,,,,,,,0.95,,186.06,Percent of total billed charges,,186.06,191.93,
TROCAR XL 5MM#B5XT,SUP-3253399,CDM,3253399WWM,LOCAL,270,RC,,inpatient,,,238.05,214.25,,0.95,,226.15,Percent of total billed charges,,,0.98,,233.29,Percent of total billed charges,,,0.95,,226.15,Percent of total billed charges,,,0.97,,230.91,Percent of total billed charges,,,0.97,,230.91,Percent of total billed charges,,,0.96,,228.53,Percent of total billed charges,,,0.95,,226.15,Percent of total billed charges,,,,,,,,,0.95,,226.15,Percent of total billed charges,,226.15,233.29,
TROCAR XL 5MM#B5XT,SUP-3253399,CDM,3253399WWM,LOCAL,270,RC,,outpatient,,,238.05,214.25,,0.95,,226.15,Percent of total billed charges,,,0.98,,233.29,Percent of total billed charges,,,0.95,,226.15,Percent of total billed charges,,,0.95,,226.15,Percent of total billed charges,,,0.97,,230.91,Percent of total billed charges,,,0.96,,228.53,Percent of total billed charges,,,0.95,,226.15,Percent of total billed charges,,,,,,,,,0.95,,226.15,Percent of total billed charges,,226.15,233.29,
TROCAR XL 12MM#B12XT,SUP-3253400,CDM,3253400WWM,LOCAL,270,RC,,inpatient,,,315.05,283.55,,0.95,,299.3,Percent of total billed charges,,,0.98,,308.75,Percent of total billed charges,,,0.95,,299.3,Percent of total billed charges,,,0.97,,305.6,Percent of total billed charges,,,0.97,,305.6,Percent of total billed charges,,,0.96,,302.45,Percent of total billed charges,,,0.95,,299.3,Percent of total billed charges,,,,,,,,,0.95,,299.3,Percent of total billed charges,,299.3,308.75,
TROCAR XL 12MM#B12XT,SUP-3253400,CDM,3253400WWM,LOCAL,270,RC,,outpatient,,,315.05,283.55,,0.95,,299.3,Percent of total billed charges,,,0.98,,308.75,Percent of total billed charges,,,0.95,,299.3,Percent of total billed charges,,,0.95,,299.3,Percent of total billed charges,,,0.97,,305.6,Percent of total billed charges,,,0.96,,302.45,Percent of total billed charges,,,0.95,,299.3,Percent of total billed charges,,,,,,,,,0.95,,299.3,Percent of total billed charges,,299.3,308.75,
CANNULA TWISTIN 8.25X7,SUP-3253538,CDM,3253538WWM,LOCAL,270,RC,,inpatient,,,125,112.5,,0.95,,118.75,Percent of total billed charges,,,0.98,,122.5,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.96,,120,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,,,,,,,0.95,,118.75,Percent of total billed charges,,118.75,122.5,
CANNULA TWISTIN 8.25X7,SUP-3253538,CDM,3253538WWM,LOCAL,270,RC,,outpatient,,,125,112.5,,0.95,,118.75,Percent of total billed charges,,,0.98,,122.5,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.96,,120,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,,,,,,,0.95,,118.75,Percent of total billed charges,,118.75,122.5,
IMPERV STOCKINETTE,SUP-3253541,CDM,3253541WWM,LOCAL,270,RC,,inpatient,,,32.52,29.27,,0.95,,30.89,Percent of total billed charges,,,0.98,,31.87,Percent of total billed charges,,,0.95,,30.89,Percent of total billed charges,,,0.97,,31.54,Percent of total billed charges,,,0.97,,31.54,Percent of total billed charges,,,0.96,,31.22,Percent of total billed charges,,,0.95,,30.89,Percent of total billed charges,,,,,,,,,0.95,,30.89,Percent of total billed charges,,30.89,31.87,
IMPERV STOCKINETTE,SUP-3253541,CDM,3253541WWM,LOCAL,270,RC,,outpatient,,,32.52,29.27,,0.95,,30.89,Percent of total billed charges,,,0.98,,31.87,Percent of total billed charges,,,0.95,,30.89,Percent of total billed charges,,,0.95,,30.89,Percent of total billed charges,,,0.97,,31.54,Percent of total billed charges,,,0.96,,31.22,Percent of total billed charges,,,0.95,,30.89,Percent of total billed charges,,,,,,,,,0.95,,30.89,Percent of total billed charges,,30.89,31.87,
ESMARK 6X9,SUP-3253542,CDM,3253542WWM,LOCAL,270,RC,,inpatient,,,25.2,22.68,,0.95,,23.94,Percent of total billed charges,,,0.98,,24.7,Percent of total billed charges,,,0.95,,23.94,Percent of total billed charges,,,0.97,,24.44,Percent of total billed charges,,,0.97,,24.44,Percent of total billed charges,,,0.96,,24.19,Percent of total billed charges,,,0.95,,23.94,Percent of total billed charges,,,,,,,,,0.95,,23.94,Percent of total billed charges,,23.94,24.7,
ESMARK 6X9,SUP-3253542,CDM,3253542WWM,LOCAL,270,RC,,outpatient,,,25.2,22.68,,0.95,,23.94,Percent of total billed charges,,,0.98,,24.7,Percent of total billed charges,,,0.95,,23.94,Percent of total billed charges,,,0.95,,23.94,Percent of total billed charges,,,0.97,,24.44,Percent of total billed charges,,,0.96,,24.19,Percent of total billed charges,,,0.95,,23.94,Percent of total billed charges,,,,,,,,,0.95,,23.94,Percent of total billed charges,,23.94,24.7,
FRAZIER SUCT 10FR#1660,SUP-3253546,CDM,3253546WWM,LOCAL,270,RC,,inpatient,,,17.6,15.84,,0.95,,16.72,Percent of total billed charges,,,0.98,,17.25,Percent of total billed charges,,,0.95,,16.72,Percent of total billed charges,,,0.97,,17.07,Percent of total billed charges,,,0.97,,17.07,Percent of total billed charges,,,0.96,,16.9,Percent of total billed charges,,,0.95,,16.72,Percent of total billed charges,,,,,,,,,0.95,,16.72,Percent of total billed charges,,16.72,17.25,
FRAZIER SUCT 10FR#1660,SUP-3253546,CDM,3253546WWM,LOCAL,270,RC,,outpatient,,,17.6,15.84,,0.95,,16.72,Percent of total billed charges,,,0.98,,17.25,Percent of total billed charges,,,0.95,,16.72,Percent of total billed charges,,,0.95,,16.72,Percent of total billed charges,,,0.97,,17.07,Percent of total billed charges,,,0.96,,16.9,Percent of total billed charges,,,0.95,,16.72,Percent of total billed charges,,,,,,,,,0.95,,16.72,Percent of total billed charges,,16.72,17.25,
CANNULA TWISTIN 7X7,SUP-3253564,CDM,3253564WWM,LOCAL,270,RC,,inpatient,,,125,112.5,,0.95,,118.75,Percent of total billed charges,,,0.98,,122.5,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.96,,120,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,,,,,,,0.95,,118.75,Percent of total billed charges,,118.75,122.5,
CANNULA TWISTIN 7X7,SUP-3253564,CDM,3253564WWM,LOCAL,270,RC,,outpatient,,,125,112.5,,0.95,,118.75,Percent of total billed charges,,,0.98,,122.5,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.96,,120,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,,,,,,,0.95,,118.75,Percent of total billed charges,,118.75,122.5,
SCREW ARTHREX 8X25,SUP-3253566,CDM,3253566WWM,LOCAL,278,RC,,inpatient,,,402.5,362.25,,0.95,,382.38,Percent of total billed charges,,,0.98,,394.45,Percent of total billed charges,,,0.95,,382.38,Percent of total billed charges,,,0.97,,390.43,Percent of total billed charges,,,0.97,,390.43,Percent of total billed charges,,,0.96,,386.4,Percent of total billed charges,,,0.95,,382.38,Percent of total billed charges,,,,,,,,,0.95,,382.38,Percent of total billed charges,,382.38,394.45,
SCREW ARTHREX 8X25,SUP-3253566,CDM,3253566WWM,LOCAL,278,RC,,outpatient,,,402.5,362.25,,0.95,,382.38,Percent of total billed charges,,,0.98,,394.45,Percent of total billed charges,,,0.95,,382.38,Percent of total billed charges,,,0.95,,382.38,Percent of total billed charges,,,0.97,,390.43,Percent of total billed charges,,,0.96,,386.4,Percent of total billed charges,,,0.95,,382.38,Percent of total billed charges,,,,,,,,,0.95,,382.38,Percent of total billed charges,,382.38,394.45,
TRANSTIBIAL ACL,SUP-3253567,CDM,3253567WWM,LOCAL,270,RC,,inpatient,,,507.5,456.75,,0.95,,482.13,Percent of total billed charges,,,0.98,,497.35,Percent of total billed charges,,,0.95,,482.13,Percent of total billed charges,,,0.97,,492.28,Percent of total billed charges,,,0.97,,492.28,Percent of total billed charges,,,0.96,,487.2,Percent of total billed charges,,,0.95,,482.13,Percent of total billed charges,,,,,,,,,0.95,,482.13,Percent of total billed charges,,482.13,497.35,
TRANSTIBIAL ACL,SUP-3253567,CDM,3253567WWM,LOCAL,270,RC,,outpatient,,,507.5,456.75,,0.95,,482.13,Percent of total billed charges,,,0.98,,497.35,Percent of total billed charges,,,0.95,,482.13,Percent of total billed charges,,,0.95,,482.13,Percent of total billed charges,,,0.97,,492.28,Percent of total billed charges,,,0.96,,487.2,Percent of total billed charges,,,0.95,,482.13,Percent of total billed charges,,,,,,,,,0.95,,482.13,Percent of total billed charges,,482.13,497.35,
FIBERSTICK #2   #AR-7209,SUP-3253576,CDM,3253576WWM,LOCAL,270,RC,,inpatient,,,297,267.3,,0.95,,282.15,Percent of total billed charges,,,0.98,,291.06,Percent of total billed charges,,,0.95,,282.15,Percent of total billed charges,,,0.97,,288.09,Percent of total billed charges,,,0.97,,288.09,Percent of total billed charges,,,0.96,,285.12,Percent of total billed charges,,,0.95,,282.15,Percent of total billed charges,,,,,,,,,0.95,,282.15,Percent of total billed charges,,282.15,291.06,
FIBERSTICK #2   #AR-7209,SUP-3253576,CDM,3253576WWM,LOCAL,270,RC,,outpatient,,,297,267.3,,0.95,,282.15,Percent of total billed charges,,,0.98,,291.06,Percent of total billed charges,,,0.95,,282.15,Percent of total billed charges,,,0.95,,282.15,Percent of total billed charges,,,0.97,,288.09,Percent of total billed charges,,,0.96,,285.12,Percent of total billed charges,,,0.95,,282.15,Percent of total billed charges,,,,,,,,,0.95,,282.15,Percent of total billed charges,,282.15,291.06,
BIOTENODESIS KIT,SUP-3253602,CDM,3253602WWM,LOCAL,270,RC,,inpatient,,,612.5,551.25,,0.95,,581.88,Percent of total billed charges,,,0.98,,600.25,Percent of total billed charges,,,0.95,,581.88,Percent of total billed charges,,,0.97,,594.13,Percent of total billed charges,,,0.97,,594.13,Percent of total billed charges,,,0.96,,588,Percent of total billed charges,,,0.95,,581.88,Percent of total billed charges,,,,,,,,,0.95,,581.88,Percent of total billed charges,,581.88,600.25,
BIOTENODESIS KIT,SUP-3253602,CDM,3253602WWM,LOCAL,270,RC,,outpatient,,,612.5,551.25,,0.95,,581.88,Percent of total billed charges,,,0.98,,600.25,Percent of total billed charges,,,0.95,,581.88,Percent of total billed charges,,,0.95,,581.88,Percent of total billed charges,,,0.97,,594.13,Percent of total billed charges,,,0.96,,588,Percent of total billed charges,,,0.95,,581.88,Percent of total billed charges,,,,,,,,,0.95,,581.88,Percent of total billed charges,,581.88,600.25,
DRAIN JP 10FR#SU130132,SUP-3253606,CDM,3253606WWM,LOCAL,270,RC,,inpatient,,,30.17,27.15,,0.95,,28.66,Percent of total billed charges,,,0.98,,29.57,Percent of total billed charges,,,0.95,,28.66,Percent of total billed charges,,,0.97,,29.26,Percent of total billed charges,,,0.97,,29.26,Percent of total billed charges,,,0.96,,28.96,Percent of total billed charges,,,0.95,,28.66,Percent of total billed charges,,,,,,,,,0.95,,28.66,Percent of total billed charges,,28.66,29.57,
DRAIN JP 10FR#SU130132,SUP-3253606,CDM,3253606WWM,LOCAL,270,RC,,outpatient,,,30.17,27.15,,0.95,,28.66,Percent of total billed charges,,,0.98,,29.57,Percent of total billed charges,,,0.95,,28.66,Percent of total billed charges,,,0.95,,28.66,Percent of total billed charges,,,0.97,,29.26,Percent of total billed charges,,,0.96,,28.96,Percent of total billed charges,,,0.95,,28.66,Percent of total billed charges,,,,,,,,,0.95,,28.66,Percent of total billed charges,,28.66,29.57,
BLADE STRK AV/ MD,SUP-3253608,CDM,3253608WWM,LOCAL,270,RC,,inpatient,,,155.25,139.73,,0.95,,147.49,Percent of total billed charges,,,0.98,,152.15,Percent of total billed charges,,,0.95,,147.49,Percent of total billed charges,,,0.97,,150.59,Percent of total billed charges,,,0.97,,150.59,Percent of total billed charges,,,0.96,,149.04,Percent of total billed charges,,,0.95,,147.49,Percent of total billed charges,,,,,,,,,0.95,,147.49,Percent of total billed charges,,147.49,152.15,
BLADE STRK AV/ MD,SUP-3253608,CDM,3253608WWM,LOCAL,270,RC,,outpatient,,,155.25,139.73,,0.95,,147.49,Percent of total billed charges,,,0.98,,152.15,Percent of total billed charges,,,0.95,,147.49,Percent of total billed charges,,,0.95,,147.49,Percent of total billed charges,,,0.97,,150.59,Percent of total billed charges,,,0.96,,149.04,Percent of total billed charges,,,0.95,,147.49,Percent of total billed charges,,,,,,,,,0.95,,147.49,Percent of total billed charges,,147.49,152.15,
BLADE STRK MD/NAR,SUP-3253609,CDM,3253609WWM,LOCAL,270,RC,,inpatient,,,155.25,139.73,,0.95,,147.49,Percent of total billed charges,,,0.98,,152.15,Percent of total billed charges,,,0.95,,147.49,Percent of total billed charges,,,0.97,,150.59,Percent of total billed charges,,,0.97,,150.59,Percent of total billed charges,,,0.96,,149.04,Percent of total billed charges,,,0.95,,147.49,Percent of total billed charges,,,,,,,,,0.95,,147.49,Percent of total billed charges,,147.49,152.15,
BLADE STRK MD/NAR,SUP-3253609,CDM,3253609WWM,LOCAL,270,RC,,outpatient,,,155.25,139.73,,0.95,,147.49,Percent of total billed charges,,,0.98,,152.15,Percent of total billed charges,,,0.95,,147.49,Percent of total billed charges,,,0.95,,147.49,Percent of total billed charges,,,0.97,,150.59,Percent of total billed charges,,,0.96,,149.04,Percent of total billed charges,,,0.95,,147.49,Percent of total billed charges,,,,,,,,,0.95,,147.49,Percent of total billed charges,,147.49,152.15,
BLADE STRK LG/MD,SUP-3253610,CDM,3253610WWM,LOCAL,270,RC,,inpatient,,,155.25,139.73,,0.95,,147.49,Percent of total billed charges,,,0.98,,152.15,Percent of total billed charges,,,0.95,,147.49,Percent of total billed charges,,,0.97,,150.59,Percent of total billed charges,,,0.97,,150.59,Percent of total billed charges,,,0.96,,149.04,Percent of total billed charges,,,0.95,,147.49,Percent of total billed charges,,,,,,,,,0.95,,147.49,Percent of total billed charges,,147.49,152.15,
BLADE STRK LG/MD,SUP-3253610,CDM,3253610WWM,LOCAL,270,RC,,outpatient,,,155.25,139.73,,0.95,,147.49,Percent of total billed charges,,,0.98,,152.15,Percent of total billed charges,,,0.95,,147.49,Percent of total billed charges,,,0.95,,147.49,Percent of total billed charges,,,0.97,,150.59,Percent of total billed charges,,,0.96,,149.04,Percent of total billed charges,,,0.95,,147.49,Percent of total billed charges,,,,,,,,,0.95,,147.49,Percent of total billed charges,,147.49,152.15,
SCREW INTERF 9X25,SUP-3253615,CDM,3253615WWM,LOCAL,278,RC,,inpatient,,,507.5,456.75,,0.95,,482.13,Percent of total billed charges,,,0.98,,497.35,Percent of total billed charges,,,0.95,,482.13,Percent of total billed charges,,,0.97,,492.28,Percent of total billed charges,,,0.97,,492.28,Percent of total billed charges,,,0.96,,487.2,Percent of total billed charges,,,0.95,,482.13,Percent of total billed charges,,,,,,,,,0.95,,482.13,Percent of total billed charges,,482.13,497.35,
SCREW INTERF 9X25,SUP-3253615,CDM,3253615WWM,LOCAL,278,RC,,outpatient,,,507.5,456.75,,0.95,,482.13,Percent of total billed charges,,,0.98,,497.35,Percent of total billed charges,,,0.95,,482.13,Percent of total billed charges,,,0.95,,482.13,Percent of total billed charges,,,0.97,,492.28,Percent of total billed charges,,,0.96,,487.2,Percent of total billed charges,,,0.95,,482.13,Percent of total billed charges,,,,,,,,,0.95,,482.13,Percent of total billed charges,,482.13,497.35,
SCREW SOFT 9X25,SUP-3253616,CDM,3253616WWM,LOCAL,278,RC,,inpatient,,,427.5,384.75,,0.95,,406.13,Percent of total billed charges,,,0.98,,418.95,Percent of total billed charges,,,0.95,,406.13,Percent of total billed charges,,,0.97,,414.68,Percent of total billed charges,,,0.97,,414.68,Percent of total billed charges,,,0.96,,410.4,Percent of total billed charges,,,0.95,,406.13,Percent of total billed charges,,,,,,,,,0.95,,406.13,Percent of total billed charges,,406.13,418.95,
SCREW SOFT 9X25,SUP-3253616,CDM,3253616WWM,LOCAL,278,RC,,outpatient,,,427.5,384.75,,0.95,,406.13,Percent of total billed charges,,,0.98,,418.95,Percent of total billed charges,,,0.95,,406.13,Percent of total billed charges,,,0.95,,406.13,Percent of total billed charges,,,0.97,,414.68,Percent of total billed charges,,,0.96,,410.4,Percent of total billed charges,,,0.95,,406.13,Percent of total billed charges,,,,,,,,,0.95,,406.13,Percent of total billed charges,,406.13,418.95,
SCREW ARTHREX 8X25,SUP-3253628,CDM,3253628WWM,LOCAL,278,RC,,inpatient,,,476,428.4,,0.95,,452.2,Percent of total billed charges,,,0.98,,466.48,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,0.97,,461.72,Percent of total billed charges,,,0.97,,461.72,Percent of total billed charges,,,0.96,,456.96,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,,,,,,,0.95,,452.2,Percent of total billed charges,,452.2,466.48,
SCREW ARTHREX 8X25,SUP-3253628,CDM,3253628WWM,LOCAL,278,RC,,outpatient,,,476,428.4,,0.95,,452.2,Percent of total billed charges,,,0.98,,466.48,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,0.97,,461.72,Percent of total billed charges,,,0.96,,456.96,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,,,,,,,0.95,,452.2,Percent of total billed charges,,452.2,466.48,
SCREW INTERF 8X25,SUP-3253629,CDM,3253629WWM,LOCAL,278,RC,,inpatient,,,476,428.4,,0.95,,452.2,Percent of total billed charges,,,0.98,,466.48,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,0.97,,461.72,Percent of total billed charges,,,0.97,,461.72,Percent of total billed charges,,,0.96,,456.96,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,,,,,,,0.95,,452.2,Percent of total billed charges,,452.2,466.48,
SCREW INTERF 8X25,SUP-3253629,CDM,3253629WWM,LOCAL,278,RC,,outpatient,,,476,428.4,,0.95,,452.2,Percent of total billed charges,,,0.98,,466.48,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,0.97,,461.72,Percent of total billed charges,,,0.96,,456.96,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,,,,,,,0.95,,452.2,Percent of total billed charges,,452.2,466.48,
DRAIN JP RND 15FR SU130-0323,SUP-3253631,CDM,3253631WWM,LOCAL,270,RC,,inpatient,,,58.38,52.54,,0.95,,55.46,Percent of total billed charges,,,0.98,,57.21,Percent of total billed charges,,,0.95,,55.46,Percent of total billed charges,,,0.97,,56.63,Percent of total billed charges,,,0.97,,56.63,Percent of total billed charges,,,0.96,,56.04,Percent of total billed charges,,,0.95,,55.46,Percent of total billed charges,,,,,,,,,0.95,,55.46,Percent of total billed charges,,55.46,57.21,
DRAIN JP RND 15FR SU130-0323,SUP-3253631,CDM,3253631WWM,LOCAL,270,RC,,outpatient,,,58.38,52.54,,0.95,,55.46,Percent of total billed charges,,,0.98,,57.21,Percent of total billed charges,,,0.95,,55.46,Percent of total billed charges,,,0.95,,55.46,Percent of total billed charges,,,0.97,,56.63,Percent of total billed charges,,,0.96,,56.04,Percent of total billed charges,,,0.95,,55.46,Percent of total billed charges,,,,,,,,,0.95,,55.46,Percent of total billed charges,,55.46,57.21,
ALLOGRAFT BTB 17817000,SUP-3253637,CDM,3253637WWM,LOCAL,278,RC,,inpatient,,,5750,5175,,0.95,,5462.5,Percent of total billed charges,,,0.98,,5635,Percent of total billed charges,,,0.95,,5462.5,Percent of total billed charges,,,0.97,,5577.5,Percent of total billed charges,,,0.97,,5577.5,Percent of total billed charges,,,0.96,,5520,Percent of total billed charges,,,0.95,,5462.5,Percent of total billed charges,,,,,,,,,0.95,,5462.5,Percent of total billed charges,,5462.5,5635,
ALLOGRAFT BTB 17817000,SUP-3253637,CDM,3253637WWM,LOCAL,278,RC,,outpatient,,,5750,5175,,0.95,,5462.5,Percent of total billed charges,,,0.98,,5635,Percent of total billed charges,,,0.95,,5462.5,Percent of total billed charges,,,0.95,,5462.5,Percent of total billed charges,,,0.97,,5577.5,Percent of total billed charges,,,0.96,,5520,Percent of total billed charges,,,0.95,,5462.5,Percent of total billed charges,,,,,,,,,0.95,,5462.5,Percent of total billed charges,,5462.5,5635,
DBL ARMED NEEDLE,SUP-3253641,CDM,3253641WWM,LOCAL,270,RC,,inpatient,,,142.5,128.25,,0.95,,135.38,Percent of total billed charges,,,0.98,,139.65,Percent of total billed charges,,,0.95,,135.38,Percent of total billed charges,,,0.97,,138.23,Percent of total billed charges,,,0.97,,138.23,Percent of total billed charges,,,0.96,,136.8,Percent of total billed charges,,,0.95,,135.38,Percent of total billed charges,,,,,,,,,0.95,,135.38,Percent of total billed charges,,135.38,139.65,
DBL ARMED NEEDLE,SUP-3253641,CDM,3253641WWM,LOCAL,270,RC,,outpatient,,,142.5,128.25,,0.95,,135.38,Percent of total billed charges,,,0.98,,139.65,Percent of total billed charges,,,0.95,,135.38,Percent of total billed charges,,,0.95,,135.38,Percent of total billed charges,,,0.97,,138.23,Percent of total billed charges,,,0.96,,136.8,Percent of total billed charges,,,0.95,,135.38,Percent of total billed charges,,,,,,,,,0.95,,135.38,Percent of total billed charges,,135.38,139.65,
FIBER TAPE #AR-7237-7,SUP-3253644,CDM,3253644WWM,LOCAL,270,RC,,inpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
FIBER TAPE #AR-7237-7,SUP-3253644,CDM,3253644WWM,LOCAL,270,RC,,outpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
SCORPION NEEDLE #AR13995N,SUP-3253646,CDM,27010242,LOCAL,270,RC,,inpatient,,,446,401.4,,0.95,,423.7,Percent of total billed charges,,,0.98,,437.08,Percent of total billed charges,,,0.95,,423.7,Percent of total billed charges,,,0.97,,432.62,Percent of total billed charges,,,0.97,,432.62,Percent of total billed charges,,,0.96,,428.16,Percent of total billed charges,,,0.95,,423.7,Percent of total billed charges,,,,,,,,,0.95,,423.7,Percent of total billed charges,,423.7,437.08,
SCORPION NEEDLE #AR13995N,SUP-3253646,CDM,27010242,LOCAL,270,RC,,outpatient,,,446,401.4,,0.95,,423.7,Percent of total billed charges,,,0.98,,437.08,Percent of total billed charges,,,0.95,,423.7,Percent of total billed charges,,,0.95,,423.7,Percent of total billed charges,,,0.97,,432.62,Percent of total billed charges,,,0.96,,428.16,Percent of total billed charges,,,0.95,,423.7,Percent of total billed charges,,,,,,,,,0.95,,423.7,Percent of total billed charges,,423.7,437.08,
CANNULA TWISTIN 8.25X9,SUP-3253652,CDM,3253652WWM,LOCAL,270,RC,,inpatient,,,125,112.5,,0.95,,118.75,Percent of total billed charges,,,0.98,,122.5,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.96,,120,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,,,,,,,0.95,,118.75,Percent of total billed charges,,118.75,122.5,
CANNULA TWISTIN 8.25X9,SUP-3253652,CDM,3253652WWM,LOCAL,270,RC,,outpatient,,,125,112.5,,0.95,,118.75,Percent of total billed charges,,,0.98,,122.5,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.96,,120,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,,,,,,,0.95,,118.75,Percent of total billed charges,,118.75,122.5,
FIBERLINK #AR7235,SUP-3253665,CDM,3253665WWM,LOCAL,270,RC,,inpatient,,,29.19,26.27,,0.95,,27.73,Percent of total billed charges,,,0.98,,28.61,Percent of total billed charges,,,0.95,,27.73,Percent of total billed charges,,,0.97,,28.31,Percent of total billed charges,,,0.97,,28.31,Percent of total billed charges,,,0.96,,28.02,Percent of total billed charges,,,0.95,,27.73,Percent of total billed charges,,,,,,,,,0.95,,27.73,Percent of total billed charges,,27.73,28.61,
FIBERLINK #AR7235,SUP-3253665,CDM,3253665WWM,LOCAL,270,RC,,outpatient,,,29.19,26.27,,0.95,,27.73,Percent of total billed charges,,,0.98,,28.61,Percent of total billed charges,,,0.95,,27.73,Percent of total billed charges,,,0.95,,27.73,Percent of total billed charges,,,0.97,,28.31,Percent of total billed charges,,,0.96,,28.02,Percent of total billed charges,,,0.95,,27.73,Percent of total billed charges,,,,,,,,,0.95,,27.73,Percent of total billed charges,,27.73,28.61,
SU FIBERLINK #2 #AR723,SUP-3253683,CDM,3253683WWM,LOCAL,270,RC,,inpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
SU FIBERLINK #2 #AR723,SUP-3253683,CDM,3253683WWM,LOCAL,270,RC,,outpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
NET FOREIGN BODY,SUP-3253686,CDM,3253686WWM,LOCAL,270,RC,,inpatient,,,450,405,,0.95,,427.5,Percent of total billed charges,,,0.98,,441,Percent of total billed charges,,,0.95,,427.5,Percent of total billed charges,,,0.97,,436.5,Percent of total billed charges,,,0.97,,436.5,Percent of total billed charges,,,0.96,,432,Percent of total billed charges,,,0.95,,427.5,Percent of total billed charges,,,,,,,,,0.95,,427.5,Percent of total billed charges,,427.5,441,
NET FOREIGN BODY,SUP-3253686,CDM,3253686WWM,LOCAL,270,RC,,outpatient,,,450,405,,0.95,,427.5,Percent of total billed charges,,,0.98,,441,Percent of total billed charges,,,0.95,,427.5,Percent of total billed charges,,,0.95,,427.5,Percent of total billed charges,,,0.97,,436.5,Percent of total billed charges,,,0.96,,432,Percent of total billed charges,,,0.95,,427.5,Percent of total billed charges,,,,,,,,,0.95,,427.5,Percent of total billed charges,,427.5,441,
ROTH NET FOOD BOLUS,SUP-3253687,CDM,3253687WWM,LOCAL,270,RC,,inpatient,,,367.5,330.75,,0.95,,349.13,Percent of total billed charges,,,0.98,,360.15,Percent of total billed charges,,,0.95,,349.13,Percent of total billed charges,,,0.97,,356.48,Percent of total billed charges,,,0.97,,356.48,Percent of total billed charges,,,0.96,,352.8,Percent of total billed charges,,,0.95,,349.13,Percent of total billed charges,,,,,,,,,0.95,,349.13,Percent of total billed charges,,349.13,360.15,
ROTH NET FOOD BOLUS,SUP-3253687,CDM,3253687WWM,LOCAL,270,RC,,outpatient,,,367.5,330.75,,0.95,,349.13,Percent of total billed charges,,,0.98,,360.15,Percent of total billed charges,,,0.95,,349.13,Percent of total billed charges,,,0.95,,349.13,Percent of total billed charges,,,0.97,,356.48,Percent of total billed charges,,,0.96,,352.8,Percent of total billed charges,,,0.95,,349.13,Percent of total billed charges,,,,,,,,,0.95,,349.13,Percent of total billed charges,,349.13,360.15,
GRAFT 8 LAYER 13X15,SUP-3253689,CDM,3253689WWM,LOCAL,270,RC,,inpatient,,,5850,5265,,0.95,,5557.5,Percent of total billed charges,,,0.98,,5733,Percent of total billed charges,,,0.95,,5557.5,Percent of total billed charges,,,0.97,,5674.5,Percent of total billed charges,,,0.97,,5674.5,Percent of total billed charges,,,0.96,,5616,Percent of total billed charges,,,0.95,,5557.5,Percent of total billed charges,,,,,,,,,0.95,,5557.5,Percent of total billed charges,,5557.5,5733,
GRAFT 8 LAYER 13X15,SUP-3253689,CDM,3253689WWM,LOCAL,270,RC,,outpatient,,,5850,5265,,0.95,,5557.5,Percent of total billed charges,,,0.98,,5733,Percent of total billed charges,,,0.95,,5557.5,Percent of total billed charges,,,0.95,,5557.5,Percent of total billed charges,,,0.97,,5674.5,Percent of total billed charges,,,0.96,,5616,Percent of total billed charges,,,0.95,,5557.5,Percent of total billed charges,,,,,,,,,0.95,,5557.5,Percent of total billed charges,,5557.5,5733,
POLYP TRAP,SUP-3253692,CDM,3253692WWM,LOCAL,270,RC,,inpatient,,,66,59.4,,0.95,,62.7,Percent of total billed charges,,,0.98,,64.68,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,0.97,,64.02,Percent of total billed charges,,,0.97,,64.02,Percent of total billed charges,,,0.96,,63.36,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,,,,,,,0.95,,62.7,Percent of total billed charges,,62.7,64.68,
POLYP TRAP,SUP-3253692,CDM,3253692WWM,LOCAL,270,RC,,outpatient,,,66,59.4,,0.95,,62.7,Percent of total billed charges,,,0.98,,64.68,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,0.97,,64.02,Percent of total billed charges,,,0.96,,63.36,Percent of total billed charges,,,0.95,,62.7,Percent of total billed charges,,,,,,,,,0.95,,62.7,Percent of total billed charges,,62.7,64.68,
PROTACK #174006,SUP-3253695,CDM,3253695WMM,LOCAL,278,RC,,inpatient,,,1440.62,1296.56,,0.95,,1368.59,Percent of total billed charges,,,0.98,,1411.81,Percent of total billed charges,,,0.95,,1368.59,Percent of total billed charges,,,0.97,,1397.4,Percent of total billed charges,,,0.97,,1397.4,Percent of total billed charges,,,0.96,,1383,Percent of total billed charges,,,0.95,,1368.59,Percent of total billed charges,,,,,,,,,0.95,,1368.59,Percent of total billed charges,,1368.59,1411.81,
PROTACK #174006,SUP-3253695,CDM,3253695WMM,LOCAL,278,RC,,outpatient,,,1440.62,1296.56,,0.95,,1368.59,Percent of total billed charges,,,0.98,,1411.81,Percent of total billed charges,,,0.95,,1368.59,Percent of total billed charges,,,0.95,,1368.59,Percent of total billed charges,,,0.97,,1397.4,Percent of total billed charges,,,0.96,,1383,Percent of total billed charges,,,0.95,,1368.59,Percent of total billed charges,,,,,,,,,0.95,,1368.59,Percent of total billed charges,,1368.59,1411.81,
MESH SOFT 3X6,SUP-3253700,CDM,3253700WWM,LOCAL,278,RC,,inpatient,,,220.5,198.45,,0.95,,209.48,Percent of total billed charges,,,0.98,,216.09,Percent of total billed charges,,,0.95,,209.48,Percent of total billed charges,,,0.97,,213.89,Percent of total billed charges,,,0.97,,213.89,Percent of total billed charges,,,0.96,,211.68,Percent of total billed charges,,,0.95,,209.48,Percent of total billed charges,,,,,,,,,0.95,,209.48,Percent of total billed charges,,209.48,216.09,
MESH SOFT 3X6,SUP-3253700,CDM,3253700WWM,LOCAL,278,RC,,outpatient,,,220.5,198.45,,0.95,,209.48,Percent of total billed charges,,,0.98,,216.09,Percent of total billed charges,,,0.95,,209.48,Percent of total billed charges,,,0.95,,209.48,Percent of total billed charges,,,0.97,,213.89,Percent of total billed charges,,,0.96,,211.68,Percent of total billed charges,,,0.95,,209.48,Percent of total billed charges,,,,,,,,,0.95,,209.48,Percent of total billed charges,,209.48,216.09,
MESH SOFT 4X6,SUP-3253701,CDM,3253701WWM,LOCAL,278,RC,,inpatient,,,283.5,255.15,,0.95,,269.33,Percent of total billed charges,,,0.98,,277.83,Percent of total billed charges,,,0.95,,269.33,Percent of total billed charges,,,0.97,,275,Percent of total billed charges,,,0.97,,275,Percent of total billed charges,,,0.96,,272.16,Percent of total billed charges,,,0.95,,269.33,Percent of total billed charges,,,,,,,,,0.95,,269.33,Percent of total billed charges,,269.33,277.83,
MESH SOFT 4X6,SUP-3253701,CDM,3253701WWM,LOCAL,278,RC,,outpatient,,,283.5,255.15,,0.95,,269.33,Percent of total billed charges,,,0.98,,277.83,Percent of total billed charges,,,0.95,,269.33,Percent of total billed charges,,,0.95,,269.33,Percent of total billed charges,,,0.97,,275,Percent of total billed charges,,,0.96,,272.16,Percent of total billed charges,,,0.95,,269.33,Percent of total billed charges,,,,,,,,,0.95,,269.33,Percent of total billed charges,,269.33,277.83,
MESH 3DMAX MD/LT,SUP-3253702,CDM,3253702WWM,LOCAL,278,RC,,inpatient,,,560,504,,0.95,,532,Percent of total billed charges,,,0.98,,548.8,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,0.97,,543.2,Percent of total billed charges,,,0.97,,543.2,Percent of total billed charges,,,0.96,,537.6,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,,,,,,,0.95,,532,Percent of total billed charges,,532,548.8,
MESH 3DMAX MD/LT,SUP-3253702,CDM,3253702WWM,LOCAL,278,RC,,outpatient,,,560,504,,0.95,,532,Percent of total billed charges,,,0.98,,548.8,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,0.97,,543.2,Percent of total billed charges,,,0.96,,537.6,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,,,,,,,0.95,,532,Percent of total billed charges,,532,548.8,
MESH 3DMAX MD/RT,SUP-3253703,CDM,3253703WWM,LOCAL,278,RC,,inpatient,,,560,504,,0.95,,532,Percent of total billed charges,,,0.98,,548.8,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,0.97,,543.2,Percent of total billed charges,,,0.97,,543.2,Percent of total billed charges,,,0.96,,537.6,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,,,,,,,0.95,,532,Percent of total billed charges,,532,548.8,
MESH 3DMAX MD/RT,SUP-3253703,CDM,3253703WWM,LOCAL,278,RC,,outpatient,,,560,504,,0.95,,532,Percent of total billed charges,,,0.98,,548.8,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,0.97,,543.2,Percent of total billed charges,,,0.96,,537.6,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,,,,,,,0.95,,532,Percent of total billed charges,,532,548.8,
MESH COMPOSIX 4X6,SUP-3253704,CDM,3253704WWM,LOCAL,278,RC,,inpatient,,,1068,961.2,,0.95,,1014.6,Percent of total billed charges,,,0.98,,1046.64,Percent of total billed charges,,,0.95,,1014.6,Percent of total billed charges,,,0.97,,1035.96,Percent of total billed charges,,,0.97,,1035.96,Percent of total billed charges,,,0.96,,1025.28,Percent of total billed charges,,,0.95,,1014.6,Percent of total billed charges,,,,,,,,,0.95,,1014.6,Percent of total billed charges,,1014.6,1046.64,
MESH COMPOSIX 4X6,SUP-3253704,CDM,3253704WWM,LOCAL,278,RC,,outpatient,,,1068,961.2,,0.95,,1014.6,Percent of total billed charges,,,0.98,,1046.64,Percent of total billed charges,,,0.95,,1014.6,Percent of total billed charges,,,0.95,,1014.6,Percent of total billed charges,,,0.97,,1035.96,Percent of total billed charges,,,0.96,,1025.28,Percent of total billed charges,,,0.95,,1014.6,Percent of total billed charges,,,,,,,,,0.95,,1014.6,Percent of total billed charges,,1014.6,1046.64,
MESH COMPOSIX 6X8,SUP-3253705,CDM,3253705WWM,LOCAL,278,RC,,inpatient,,,1876.25,1688.63,,0.95,,1782.44,Percent of total billed charges,,,0.98,,1838.73,Percent of total billed charges,,,0.95,,1782.44,Percent of total billed charges,,,0.97,,1819.96,Percent of total billed charges,,,0.97,,1819.96,Percent of total billed charges,,,0.96,,1801.2,Percent of total billed charges,,,0.95,,1782.44,Percent of total billed charges,,,,,,,,,0.95,,1782.44,Percent of total billed charges,,1782.44,1838.73,
MESH COMPOSIX 6X8,SUP-3253705,CDM,3253705WWM,LOCAL,278,RC,,outpatient,,,1876.25,1688.63,,0.95,,1782.44,Percent of total billed charges,,,0.98,,1838.73,Percent of total billed charges,,,0.95,,1782.44,Percent of total billed charges,,,0.95,,1782.44,Percent of total billed charges,,,0.97,,1819.96,Percent of total billed charges,,,0.96,,1801.2,Percent of total billed charges,,,0.95,,1782.44,Percent of total billed charges,,,,,,,,,0.95,,1782.44,Percent of total billed charges,,1782.44,1838.73,
ABD BINDER MED,SUP-3253708,CDM,3253708WWM,LOCAL,270,RC,,inpatient,,,48.48,43.63,,0.95,,46.06,Percent of total billed charges,,,0.98,,47.51,Percent of total billed charges,,,0.95,,46.06,Percent of total billed charges,,,0.97,,47.03,Percent of total billed charges,,,0.97,,47.03,Percent of total billed charges,,,0.96,,46.54,Percent of total billed charges,,,0.95,,46.06,Percent of total billed charges,,,,,,,,,0.95,,46.06,Percent of total billed charges,,46.06,47.51,
ABD BINDER MED,SUP-3253708,CDM,3253708WWM,LOCAL,270,RC,,outpatient,,,48.48,43.63,,0.95,,46.06,Percent of total billed charges,,,0.98,,47.51,Percent of total billed charges,,,0.95,,46.06,Percent of total billed charges,,,0.95,,46.06,Percent of total billed charges,,,0.97,,47.03,Percent of total billed charges,,,0.96,,46.54,Percent of total billed charges,,,0.95,,46.06,Percent of total billed charges,,,,,,,,,0.95,,46.06,Percent of total billed charges,,46.06,47.51,
ABD BINDER LG,SUP-3253709,CDM,3253709WWM,LOCAL,270,RC,,inpatient,,,48.48,43.63,,0.95,,46.06,Percent of total billed charges,,,0.98,,47.51,Percent of total billed charges,,,0.95,,46.06,Percent of total billed charges,,,0.97,,47.03,Percent of total billed charges,,,0.97,,47.03,Percent of total billed charges,,,0.96,,46.54,Percent of total billed charges,,,0.95,,46.06,Percent of total billed charges,,,,,,,,,0.95,,46.06,Percent of total billed charges,,46.06,47.51,
ABD BINDER LG,SUP-3253709,CDM,3253709WWM,LOCAL,270,RC,,outpatient,,,48.48,43.63,,0.95,,46.06,Percent of total billed charges,,,0.98,,47.51,Percent of total billed charges,,,0.95,,46.06,Percent of total billed charges,,,0.95,,46.06,Percent of total billed charges,,,0.97,,47.03,Percent of total billed charges,,,0.96,,46.54,Percent of total billed charges,,,0.95,,46.06,Percent of total billed charges,,,,,,,,,0.95,,46.06,Percent of total billed charges,,46.06,47.51,
ABD BINDER XLG,SUP-3253710,CDM,3253710WWM,LOCAL,270,RC,,inpatient,,,55.14,49.63,,0.95,,52.38,Percent of total billed charges,,,0.98,,54.04,Percent of total billed charges,,,0.95,,52.38,Percent of total billed charges,,,0.97,,53.49,Percent of total billed charges,,,0.97,,53.49,Percent of total billed charges,,,0.96,,52.93,Percent of total billed charges,,,0.95,,52.38,Percent of total billed charges,,,,,,,,,0.95,,52.38,Percent of total billed charges,,52.38,54.04,
ABD BINDER XLG,SUP-3253710,CDM,3253710WWM,LOCAL,270,RC,,outpatient,,,55.14,49.63,,0.95,,52.38,Percent of total billed charges,,,0.98,,54.04,Percent of total billed charges,,,0.95,,52.38,Percent of total billed charges,,,0.95,,52.38,Percent of total billed charges,,,0.97,,53.49,Percent of total billed charges,,,0.96,,52.93,Percent of total billed charges,,,0.95,,52.38,Percent of total billed charges,,,,,,,,,0.95,,52.38,Percent of total billed charges,,52.38,54.04,
PEG TUBE 24#PEG24PUSH,SUP-3253712,CDM,3253712WWM,LOCAL,270,RC,,inpatient,,,525,472.5,,0.95,,498.75,Percent of total billed charges,,,0.98,,514.5,Percent of total billed charges,,,0.95,,498.75,Percent of total billed charges,,,0.97,,509.25,Percent of total billed charges,,,0.97,,509.25,Percent of total billed charges,,,0.96,,504,Percent of total billed charges,,,0.95,,498.75,Percent of total billed charges,,,,,,,,,0.95,,498.75,Percent of total billed charges,,498.75,514.5,
PEG TUBE 24#PEG24PUSH,SUP-3253712,CDM,3253712WWM,LOCAL,270,RC,,outpatient,,,525,472.5,,0.95,,498.75,Percent of total billed charges,,,0.98,,514.5,Percent of total billed charges,,,0.95,,498.75,Percent of total billed charges,,,0.95,,498.75,Percent of total billed charges,,,0.97,,509.25,Percent of total billed charges,,,0.96,,504,Percent of total billed charges,,,0.95,,498.75,Percent of total billed charges,,,,,,,,,0.95,,498.75,Percent of total billed charges,,498.75,514.5,
STEINMANN PIN 2.0,SUP-3253713,CDM,3253713WWM,LOCAL,278,RC,,inpatient,,,86.46,77.81,,0.95,,82.14,Percent of total billed charges,,,0.98,,84.73,Percent of total billed charges,,,0.95,,82.14,Percent of total billed charges,,,0.97,,83.87,Percent of total billed charges,,,0.97,,83.87,Percent of total billed charges,,,0.96,,83,Percent of total billed charges,,,0.95,,82.14,Percent of total billed charges,,,,,,,,,0.95,,82.14,Percent of total billed charges,,82.14,84.73,
STEINMANN PIN 2.0,SUP-3253713,CDM,3253713WWM,LOCAL,278,RC,,outpatient,,,86.46,77.81,,0.95,,82.14,Percent of total billed charges,,,0.98,,84.73,Percent of total billed charges,,,0.95,,82.14,Percent of total billed charges,,,0.95,,82.14,Percent of total billed charges,,,0.97,,83.87,Percent of total billed charges,,,0.96,,83,Percent of total billed charges,,,0.95,,82.14,Percent of total billed charges,,,,,,,,,0.95,,82.14,Percent of total billed charges,,82.14,84.73,
STEINMANN PIN 2.4,SUP-3253714,CDM,3253714WWM,LOCAL,278,RC,,inpatient,,,83.16,74.84,,0.95,,79,Percent of total billed charges,,,0.98,,81.5,Percent of total billed charges,,,0.95,,79,Percent of total billed charges,,,0.97,,80.67,Percent of total billed charges,,,0.97,,80.67,Percent of total billed charges,,,0.96,,79.83,Percent of total billed charges,,,0.95,,79,Percent of total billed charges,,,,,,,,,0.95,,79,Percent of total billed charges,,79,81.5,
STEINMANN PIN 2.4,SUP-3253714,CDM,3253714WWM,LOCAL,278,RC,,outpatient,,,83.16,74.84,,0.95,,79,Percent of total billed charges,,,0.98,,81.5,Percent of total billed charges,,,0.95,,79,Percent of total billed charges,,,0.95,,79,Percent of total billed charges,,,0.97,,80.67,Percent of total billed charges,,,0.96,,79.83,Percent of total billed charges,,,0.95,,79,Percent of total billed charges,,,,,,,,,0.95,,79,Percent of total billed charges,,79,81.5,
STEINMANN PIN 2.8,SUP-3253715,CDM,3253715WWM,LOCAL,278,RC,,inpatient,,,83.16,74.84,,0.95,,79,Percent of total billed charges,,,0.98,,81.5,Percent of total billed charges,,,0.95,,79,Percent of total billed charges,,,0.97,,80.67,Percent of total billed charges,,,0.97,,80.67,Percent of total billed charges,,,0.96,,79.83,Percent of total billed charges,,,0.95,,79,Percent of total billed charges,,,,,,,,,0.95,,79,Percent of total billed charges,,79,81.5,
STEINMANN PIN 2.8,SUP-3253715,CDM,3253715WWM,LOCAL,278,RC,,outpatient,,,83.16,74.84,,0.95,,79,Percent of total billed charges,,,0.98,,81.5,Percent of total billed charges,,,0.95,,79,Percent of total billed charges,,,0.95,,79,Percent of total billed charges,,,0.97,,80.67,Percent of total billed charges,,,0.96,,79.83,Percent of total billed charges,,,0.95,,79,Percent of total billed charges,,,,,,,,,0.95,,79,Percent of total billed charges,,79,81.5,
STEINMANN PIN 3.2,SUP-3253716,CDM,3253716WWM,LOCAL,278,RC,,inpatient,,,83.16,74.84,,0.95,,79,Percent of total billed charges,,,0.98,,81.5,Percent of total billed charges,,,0.95,,79,Percent of total billed charges,,,0.97,,80.67,Percent of total billed charges,,,0.97,,80.67,Percent of total billed charges,,,0.96,,79.83,Percent of total billed charges,,,0.95,,79,Percent of total billed charges,,,,,,,,,0.95,,79,Percent of total billed charges,,79,81.5,
STEINMANN PIN 3.2,SUP-3253716,CDM,3253716WWM,LOCAL,278,RC,,outpatient,,,83.16,74.84,,0.95,,79,Percent of total billed charges,,,0.98,,81.5,Percent of total billed charges,,,0.95,,79,Percent of total billed charges,,,0.95,,79,Percent of total billed charges,,,0.97,,80.67,Percent of total billed charges,,,0.96,,79.83,Percent of total billed charges,,,0.95,,79,Percent of total billed charges,,,,,,,,,0.95,,79,Percent of total billed charges,,79,81.5,
ESOPH DIL BALL 15,SUP-3253723,CDM,3253723WWM,LOCAL,270,RC,,inpatient,,,700,630,,0.95,,665,Percent of total billed charges,,,0.98,,686,Percent of total billed charges,,,0.95,,665,Percent of total billed charges,,,0.97,,679,Percent of total billed charges,,,0.97,,679,Percent of total billed charges,,,0.96,,672,Percent of total billed charges,,,0.95,,665,Percent of total billed charges,,,,,,,,,0.95,,665,Percent of total billed charges,,665,686,
ESOPH DIL BALL 15,SUP-3253723,CDM,3253723WWM,LOCAL,270,RC,,outpatient,,,700,630,,0.95,,665,Percent of total billed charges,,,0.98,,686,Percent of total billed charges,,,0.95,,665,Percent of total billed charges,,,0.95,,665,Percent of total billed charges,,,0.97,,679,Percent of total billed charges,,,0.96,,672,Percent of total billed charges,,,0.95,,665,Percent of total billed charges,,,,,,,,,0.95,,665,Percent of total billed charges,,665,686,
ESOPH DILAT SYR,SUP-3253724,CDM,3253724WWM,LOCAL,270,RC,,inpatient,,,190,171,,0.95,,180.5,Percent of total billed charges,,,0.98,,186.2,Percent of total billed charges,,,0.95,,180.5,Percent of total billed charges,,,0.97,,184.3,Percent of total billed charges,,,0.97,,184.3,Percent of total billed charges,,,0.96,,182.4,Percent of total billed charges,,,0.95,,180.5,Percent of total billed charges,,,,,,,,,0.95,,180.5,Percent of total billed charges,,180.5,186.2,
ESOPH DILAT SYR,SUP-3253724,CDM,3253724WWM,LOCAL,270,RC,,outpatient,,,190,171,,0.95,,180.5,Percent of total billed charges,,,0.98,,186.2,Percent of total billed charges,,,0.95,,180.5,Percent of total billed charges,,,0.95,,180.5,Percent of total billed charges,,,0.97,,184.3,Percent of total billed charges,,,0.96,,182.4,Percent of total billed charges,,,0.95,,180.5,Percent of total billed charges,,,,,,,,,0.95,,180.5,Percent of total billed charges,,180.5,186.2,
ESOPH DIL BALL 18,SUP-3253743,CDM,3253743WWM,LOCAL,270,RC,,inpatient,,,700,630,,0.95,,665,Percent of total billed charges,,,0.98,,686,Percent of total billed charges,,,0.95,,665,Percent of total billed charges,,,0.97,,679,Percent of total billed charges,,,0.97,,679,Percent of total billed charges,,,0.96,,672,Percent of total billed charges,,,0.95,,665,Percent of total billed charges,,,,,,,,,0.95,,665,Percent of total billed charges,,665,686,
ESOPH DIL BALL 18,SUP-3253743,CDM,3253743WWM,LOCAL,270,RC,,outpatient,,,700,630,,0.95,,665,Percent of total billed charges,,,0.98,,686,Percent of total billed charges,,,0.95,,665,Percent of total billed charges,,,0.95,,665,Percent of total billed charges,,,0.97,,679,Percent of total billed charges,,,0.96,,672,Percent of total billed charges,,,0.95,,665,Percent of total billed charges,,,,,,,,,0.95,,665,Percent of total billed charges,,665,686,
CANNULA PASSPORT 8X4,SUP-3253746,CDM,3253746WWM,LOCAL,270,RC,,inpatient,,,160,144,,0.95,,152,Percent of total billed charges,,,0.98,,156.8,Percent of total billed charges,,,0.95,,152,Percent of total billed charges,,,0.97,,155.2,Percent of total billed charges,,,0.97,,155.2,Percent of total billed charges,,,0.96,,153.6,Percent of total billed charges,,,0.95,,152,Percent of total billed charges,,,,,,,,,0.95,,152,Percent of total billed charges,,152,156.8,
CANNULA PASSPORT 8X4,SUP-3253746,CDM,3253746WWM,LOCAL,270,RC,,outpatient,,,160,144,,0.95,,152,Percent of total billed charges,,,0.98,,156.8,Percent of total billed charges,,,0.95,,152,Percent of total billed charges,,,0.95,,152,Percent of total billed charges,,,0.97,,155.2,Percent of total billed charges,,,0.96,,153.6,Percent of total billed charges,,,0.95,,152,Percent of total billed charges,,,,,,,,,0.95,,152,Percent of total billed charges,,152,156.8,
NEEDLE VERESS #007.00,SUP-3253748,CDM,3253748WWM,LOCAL,270,RC,,inpatient,,,80.76,72.68,,0.95,,76.72,Percent of total billed charges,,,0.98,,79.14,Percent of total billed charges,,,0.95,,76.72,Percent of total billed charges,,,0.97,,78.34,Percent of total billed charges,,,0.97,,78.34,Percent of total billed charges,,,0.96,,77.53,Percent of total billed charges,,,0.95,,76.72,Percent of total billed charges,,,,,,,,,0.95,,76.72,Percent of total billed charges,,76.72,79.14,
NEEDLE VERESS #007.00,SUP-3253748,CDM,3253748WWM,LOCAL,270,RC,,outpatient,,,80.76,72.68,,0.95,,76.72,Percent of total billed charges,,,0.98,,79.14,Percent of total billed charges,,,0.95,,76.72,Percent of total billed charges,,,0.95,,76.72,Percent of total billed charges,,,0.97,,78.34,Percent of total billed charges,,,0.96,,77.53,Percent of total billed charges,,,0.95,,76.72,Percent of total billed charges,,,,,,,,,0.95,,76.72,Percent of total billed charges,,76.72,79.14,
MESH VENTRALEX SM,SUP-3253751,CDM,3253751WWM,LOCAL,278,RC,,inpatient,,,1170,1053,,0.95,,1111.5,Percent of total billed charges,,,0.98,,1146.6,Percent of total billed charges,,,0.95,,1111.5,Percent of total billed charges,,,0.97,,1134.9,Percent of total billed charges,,,0.97,,1134.9,Percent of total billed charges,,,0.96,,1123.2,Percent of total billed charges,,,0.95,,1111.5,Percent of total billed charges,,,,,,,,,0.95,,1111.5,Percent of total billed charges,,1111.5,1146.6,
MESH VENTRALEX SM,SUP-3253751,CDM,3253751WWM,LOCAL,278,RC,,outpatient,,,1170,1053,,0.95,,1111.5,Percent of total billed charges,,,0.98,,1146.6,Percent of total billed charges,,,0.95,,1111.5,Percent of total billed charges,,,0.95,,1111.5,Percent of total billed charges,,,0.97,,1134.9,Percent of total billed charges,,,0.96,,1123.2,Percent of total billed charges,,,0.95,,1111.5,Percent of total billed charges,,,,,,,,,0.95,,1111.5,Percent of total billed charges,,1111.5,1146.6,
LIGAMAX5 #EL5ML,SUP-3253752,CDM,3253752WWM,LOCAL,278,RC,,inpatient,,,503.69,453.32,,0.95,,478.51,Percent of total billed charges,,,0.98,,493.62,Percent of total billed charges,,,0.95,,478.51,Percent of total billed charges,,,0.97,,488.58,Percent of total billed charges,,,0.97,,488.58,Percent of total billed charges,,,0.96,,483.54,Percent of total billed charges,,,0.95,,478.51,Percent of total billed charges,,,,,,,,,0.95,,478.51,Percent of total billed charges,,478.51,493.62,
LIGAMAX5 #EL5ML,SUP-3253752,CDM,3253752WWM,LOCAL,278,RC,,outpatient,,,503.69,453.32,,0.95,,478.51,Percent of total billed charges,,,0.98,,493.62,Percent of total billed charges,,,0.95,,478.51,Percent of total billed charges,,,0.95,,478.51,Percent of total billed charges,,,0.97,,488.58,Percent of total billed charges,,,0.96,,483.54,Percent of total billed charges,,,0.95,,478.51,Percent of total billed charges,,,,,,,,,0.95,,478.51,Percent of total billed charges,,478.51,493.62,
SPOT ENDO MARKER DYE,SUP-3253755,CDM,3253755WWM,LOCAL,270,RC,,inpatient,,,147.5,132.75,,0.95,,140.13,Percent of total billed charges,,,0.98,,144.55,Percent of total billed charges,,,0.95,,140.13,Percent of total billed charges,,,0.97,,143.08,Percent of total billed charges,,,0.97,,143.08,Percent of total billed charges,,,0.96,,141.6,Percent of total billed charges,,,0.95,,140.13,Percent of total billed charges,,,,,,,,,0.95,,140.13,Percent of total billed charges,,140.13,144.55,
SPOT ENDO MARKER DYE,SUP-3253755,CDM,3253755WWM,LOCAL,270,RC,,outpatient,,,147.5,132.75,,0.95,,140.13,Percent of total billed charges,,,0.98,,144.55,Percent of total billed charges,,,0.95,,140.13,Percent of total billed charges,,,0.95,,140.13,Percent of total billed charges,,,0.97,,143.08,Percent of total billed charges,,,0.96,,141.6,Percent of total billed charges,,,0.95,,140.13,Percent of total billed charges,,,,,,,,,0.95,,140.13,Percent of total billed charges,,140.13,144.55,
NEEDLE INJECTOR,SUP-3253773,CDM,3253773WWM,LOCAL,272,RC,,inpatient,,,135.3,121.77,,0.95,,128.54,Percent of total billed charges,,,0.98,,132.59,Percent of total billed charges,,,0.95,,128.54,Percent of total billed charges,,,0.97,,131.24,Percent of total billed charges,,,0.97,,131.24,Percent of total billed charges,,,0.96,,129.89,Percent of total billed charges,,,0.95,,128.54,Percent of total billed charges,,,,,,,,,0.95,,128.54,Percent of total billed charges,,128.54,132.59,
NEEDLE INJECTOR,SUP-3253773,CDM,3253773WWM,LOCAL,272,RC,,outpatient,,,135.3,121.77,,0.95,,128.54,Percent of total billed charges,,,0.98,,132.59,Percent of total billed charges,,,0.95,,128.54,Percent of total billed charges,,,0.95,,128.54,Percent of total billed charges,,,0.97,,131.24,Percent of total billed charges,,,0.96,,129.89,Percent of total billed charges,,,0.95,,128.54,Percent of total billed charges,,,,,,,,,0.95,,128.54,Percent of total billed charges,,128.54,132.59,
DRAIN FLAT 15FR# SU130,SUP-3253788,CDM,3253788WWM,LOCAL,270,RC,,inpatient,,,42.66,38.39,,0.95,,40.53,Percent of total billed charges,,,0.98,,41.81,Percent of total billed charges,,,0.95,,40.53,Percent of total billed charges,,,0.97,,41.38,Percent of total billed charges,,,0.97,,41.38,Percent of total billed charges,,,0.96,,40.95,Percent of total billed charges,,,0.95,,40.53,Percent of total billed charges,,,,,,,,,0.95,,40.53,Percent of total billed charges,,40.53,41.81,
DRAIN FLAT 15FR# SU130,SUP-3253788,CDM,3253788WWM,LOCAL,270,RC,,outpatient,,,42.66,38.39,,0.95,,40.53,Percent of total billed charges,,,0.98,,41.81,Percent of total billed charges,,,0.95,,40.53,Percent of total billed charges,,,0.95,,40.53,Percent of total billed charges,,,0.97,,41.38,Percent of total billed charges,,,0.96,,40.95,Percent of total billed charges,,,0.95,,40.53,Percent of total billed charges,,,,,,,,,0.95,,40.53,Percent of total billed charges,,40.53,41.81,
CANNULA PASSPORT 8X2,SUP-3253796,CDM,3253796WWM,LOCAL,270,RC,,inpatient,,,160,144,,0.95,,152,Percent of total billed charges,,,0.98,,156.8,Percent of total billed charges,,,0.95,,152,Percent of total billed charges,,,0.97,,155.2,Percent of total billed charges,,,0.97,,155.2,Percent of total billed charges,,,0.96,,153.6,Percent of total billed charges,,,0.95,,152,Percent of total billed charges,,,,,,,,,0.95,,152,Percent of total billed charges,,152,156.8,
CANNULA PASSPORT 8X2,SUP-3253796,CDM,3253796WWM,LOCAL,270,RC,,outpatient,,,160,144,,0.95,,152,Percent of total billed charges,,,0.98,,156.8,Percent of total billed charges,,,0.95,,152,Percent of total billed charges,,,0.95,,152,Percent of total billed charges,,,0.97,,155.2,Percent of total billed charges,,,0.96,,153.6,Percent of total billed charges,,,0.95,,152,Percent of total billed charges,,,,,,,,,0.95,,152,Percent of total billed charges,,152,156.8,
CANNULA PASSPORT 8X5,SUP-3253797,CDM,3253797WWM,LOCAL,270,RC,,inpatient,,,207,186.3,,0.95,,196.65,Percent of total billed charges,,,0.98,,202.86,Percent of total billed charges,,,0.95,,196.65,Percent of total billed charges,,,0.97,,200.79,Percent of total billed charges,,,0.97,,200.79,Percent of total billed charges,,,0.96,,198.72,Percent of total billed charges,,,0.95,,196.65,Percent of total billed charges,,,,,,,,,0.95,,196.65,Percent of total billed charges,,196.65,202.86,
CANNULA PASSPORT 8X5,SUP-3253797,CDM,3253797WWM,LOCAL,270,RC,,outpatient,,,207,186.3,,0.95,,196.65,Percent of total billed charges,,,0.98,,202.86,Percent of total billed charges,,,0.95,,196.65,Percent of total billed charges,,,0.95,,196.65,Percent of total billed charges,,,0.97,,200.79,Percent of total billed charges,,,0.96,,198.72,Percent of total billed charges,,,0.95,,196.65,Percent of total billed charges,,,,,,,,,0.95,,196.65,Percent of total billed charges,,196.65,202.86,
HARMONIC ACE #HAR36,SUP-3253798,CDM,3253798WWM,LOCAL,270,RC,,inpatient,,,1722.49,1550.24,,0.95,,1636.37,Percent of total billed charges,,,0.98,,1688.04,Percent of total billed charges,,,0.95,,1636.37,Percent of total billed charges,,,0.97,,1670.82,Percent of total billed charges,,,0.97,,1670.82,Percent of total billed charges,,,0.96,,1653.59,Percent of total billed charges,,,0.95,,1636.37,Percent of total billed charges,,,,,,,,,0.95,,1636.37,Percent of total billed charges,,1636.37,1688.04,
HARMONIC ACE #HAR36,SUP-3253798,CDM,3253798WWM,LOCAL,270,RC,,outpatient,,,1722.49,1550.24,,0.95,,1636.37,Percent of total billed charges,,,0.98,,1688.04,Percent of total billed charges,,,0.95,,1636.37,Percent of total billed charges,,,0.95,,1636.37,Percent of total billed charges,,,0.97,,1670.82,Percent of total billed charges,,,0.96,,1653.59,Percent of total billed charges,,,0.95,,1636.37,Percent of total billed charges,,,,,,,,,0.95,,1636.37,Percent of total billed charges,,1636.37,1688.04,
HARMONIC FOCUS # FCS9,SUP-3253801,CDM,3253801WWM,LOCAL,270,RC,,inpatient,,,1768.39,1591.55,,0.95,,1679.97,Percent of total billed charges,,,0.98,,1733.02,Percent of total billed charges,,,0.95,,1679.97,Percent of total billed charges,,,0.97,,1715.34,Percent of total billed charges,,,0.97,,1715.34,Percent of total billed charges,,,0.96,,1697.65,Percent of total billed charges,,,0.95,,1679.97,Percent of total billed charges,,,,,,,,,0.95,,1679.97,Percent of total billed charges,,1679.97,1733.02,
HARMONIC FOCUS # FCS9,SUP-3253801,CDM,3253801WWM,LOCAL,270,RC,,outpatient,,,1768.39,1591.55,,0.95,,1679.97,Percent of total billed charges,,,0.98,,1733.02,Percent of total billed charges,,,0.95,,1679.97,Percent of total billed charges,,,0.95,,1679.97,Percent of total billed charges,,,0.97,,1715.34,Percent of total billed charges,,,0.96,,1697.65,Percent of total billed charges,,,0.95,,1679.97,Percent of total billed charges,,,,,,,,,0.95,,1679.97,Percent of total billed charges,,1679.97,1733.02,
BAIR PAWS KIT,SUP-3253806,CDM,3253806WWM,LOCAL,270,RC,,inpatient,,,106.2,95.58,,0.95,,100.89,Percent of total billed charges,,,0.98,,104.08,Percent of total billed charges,,,0.95,,100.89,Percent of total billed charges,,,0.97,,103.01,Percent of total billed charges,,,0.97,,103.01,Percent of total billed charges,,,0.96,,101.95,Percent of total billed charges,,,0.95,,100.89,Percent of total billed charges,,,,,,,,,0.95,,100.89,Percent of total billed charges,,100.89,104.08,
BAIR PAWS KIT,SUP-3253806,CDM,3253806WWM,LOCAL,270,RC,,outpatient,,,106.2,95.58,,0.95,,100.89,Percent of total billed charges,,,0.98,,104.08,Percent of total billed charges,,,0.95,,100.89,Percent of total billed charges,,,0.95,,100.89,Percent of total billed charges,,,0.97,,103.01,Percent of total billed charges,,,0.96,,101.95,Percent of total billed charges,,,0.95,,100.89,Percent of total billed charges,,,,,,,,,0.95,,100.89,Percent of total billed charges,,100.89,104.08,
SU GORETEX 0 #ON07A,SUP-3253808,CDM,3253808WWM,LOCAL,270,RC,,inpatient,,,122.1,109.89,,0.95,,116,Percent of total billed charges,,,0.98,,119.66,Percent of total billed charges,,,0.95,,116,Percent of total billed charges,,,0.97,,118.44,Percent of total billed charges,,,0.97,,118.44,Percent of total billed charges,,,0.96,,117.22,Percent of total billed charges,,,0.95,,116,Percent of total billed charges,,,,,,,,,0.95,,116,Percent of total billed charges,,116,119.66,
SU GORETEX 0 #ON07A,SUP-3253808,CDM,3253808WWM,LOCAL,270,RC,,outpatient,,,122.1,109.89,,0.95,,116,Percent of total billed charges,,,0.98,,119.66,Percent of total billed charges,,,0.95,,116,Percent of total billed charges,,,0.95,,116,Percent of total billed charges,,,0.97,,118.44,Percent of total billed charges,,,0.96,,117.22,Percent of total billed charges,,,0.95,,116,Percent of total billed charges,,,,,,,,,0.95,,116,Percent of total billed charges,,116,119.66,
LIGA CLIP SM #LS100,SUP-3253827,CDM,3253827WWM,LOCAL,278,RC,,inpatient,,,111.72,100.55,,0.95,,106.13,Percent of total billed charges,,,0.98,,109.49,Percent of total billed charges,,,0.95,,106.13,Percent of total billed charges,,,0.97,,108.37,Percent of total billed charges,,,0.97,,108.37,Percent of total billed charges,,,0.96,,107.25,Percent of total billed charges,,,0.95,,106.13,Percent of total billed charges,,,,,,,,,0.95,,106.13,Percent of total billed charges,,106.13,109.49,
LIGA CLIP SM #LS100,SUP-3253827,CDM,3253827WWM,LOCAL,278,RC,,outpatient,,,111.72,100.55,,0.95,,106.13,Percent of total billed charges,,,0.98,,109.49,Percent of total billed charges,,,0.95,,106.13,Percent of total billed charges,,,0.95,,106.13,Percent of total billed charges,,,0.97,,108.37,Percent of total billed charges,,,0.96,,107.25,Percent of total billed charges,,,0.95,,106.13,Percent of total billed charges,,,,,,,,,0.95,,106.13,Percent of total billed charges,,106.13,109.49,
LIGA CLIP MED #LS200,SUP-3253828,CDM,3253828WWM,LOCAL,278,RC,,inpatient,,,92.28,83.05,,0.95,,87.67,Percent of total billed charges,,,0.98,,90.43,Percent of total billed charges,,,0.95,,87.67,Percent of total billed charges,,,0.97,,89.51,Percent of total billed charges,,,0.97,,89.51,Percent of total billed charges,,,0.96,,88.59,Percent of total billed charges,,,0.95,,87.67,Percent of total billed charges,,,,,,,,,0.95,,87.67,Percent of total billed charges,,87.67,90.43,
LIGA CLIP MED #LS200,SUP-3253828,CDM,3253828WWM,LOCAL,278,RC,,outpatient,,,92.28,83.05,,0.95,,87.67,Percent of total billed charges,,,0.98,,90.43,Percent of total billed charges,,,0.95,,87.67,Percent of total billed charges,,,0.95,,87.67,Percent of total billed charges,,,0.97,,89.51,Percent of total billed charges,,,0.96,,88.59,Percent of total billed charges,,,0.95,,87.67,Percent of total billed charges,,,,,,,,,0.95,,87.67,Percent of total billed charges,,87.67,90.43,
ENDO CUTTER#EC45A,SUP-3253831,CDM,3253831WWM,LOCAL,270,RC,,inpatient,,,972.37,875.13,,0.95,,923.75,Percent of total billed charges,,,0.98,,952.92,Percent of total billed charges,,,0.95,,923.75,Percent of total billed charges,,,0.97,,943.2,Percent of total billed charges,,,0.97,,943.2,Percent of total billed charges,,,0.96,,933.48,Percent of total billed charges,,,0.95,,923.75,Percent of total billed charges,,,,,,,,,0.95,,923.75,Percent of total billed charges,,923.75,952.92,
ENDO CUTTER#EC45A,SUP-3253831,CDM,3253831WWM,LOCAL,270,RC,,outpatient,,,972.37,875.13,,0.95,,923.75,Percent of total billed charges,,,0.98,,952.92,Percent of total billed charges,,,0.95,,923.75,Percent of total billed charges,,,0.95,,923.75,Percent of total billed charges,,,0.97,,943.2,Percent of total billed charges,,,0.96,,933.48,Percent of total billed charges,,,0.95,,923.75,Percent of total billed charges,,,,,,,,,0.95,,923.75,Percent of total billed charges,,923.75,952.92,
RELOAD VASC #ECR45W,SUP-3253832,CDM,3253832WWM,LOCAL,270,RC,,inpatient,,,475.06,427.55,,0.95,,451.31,Percent of total billed charges,,,0.98,,465.56,Percent of total billed charges,,,0.95,,451.31,Percent of total billed charges,,,0.97,,460.81,Percent of total billed charges,,,0.97,,460.81,Percent of total billed charges,,,0.96,,456.06,Percent of total billed charges,,,0.95,,451.31,Percent of total billed charges,,,,,,,,,0.95,,451.31,Percent of total billed charges,,451.31,465.56,
RELOAD VASC #ECR45W,SUP-3253832,CDM,3253832WWM,LOCAL,270,RC,,outpatient,,,475.06,427.55,,0.95,,451.31,Percent of total billed charges,,,0.98,,465.56,Percent of total billed charges,,,0.95,,451.31,Percent of total billed charges,,,0.95,,451.31,Percent of total billed charges,,,0.97,,460.81,Percent of total billed charges,,,0.96,,456.06,Percent of total billed charges,,,0.95,,451.31,Percent of total billed charges,,,,,,,,,0.95,,451.31,Percent of total billed charges,,451.31,465.56,
RELOAD REG #ECR45B,SUP-3253833,CDM,3253833WWM,LOCAL,270,RC,,inpatient,,,475.06,427.55,,0.95,,451.31,Percent of total billed charges,,,0.98,,465.56,Percent of total billed charges,,,0.95,,451.31,Percent of total billed charges,,,0.97,,460.81,Percent of total billed charges,,,0.97,,460.81,Percent of total billed charges,,,0.96,,456.06,Percent of total billed charges,,,0.95,,451.31,Percent of total billed charges,,,,,,,,,0.95,,451.31,Percent of total billed charges,,451.31,465.56,
RELOAD REG #ECR45B,SUP-3253833,CDM,3253833WWM,LOCAL,270,RC,,outpatient,,,475.06,427.55,,0.95,,451.31,Percent of total billed charges,,,0.98,,465.56,Percent of total billed charges,,,0.95,,451.31,Percent of total billed charges,,,0.95,,451.31,Percent of total billed charges,,,0.97,,460.81,Percent of total billed charges,,,0.96,,456.06,Percent of total billed charges,,,0.95,,451.31,Percent of total billed charges,,,,,,,,,0.95,,451.31,Percent of total billed charges,,451.31,465.56,
ENDOSTITCH 10MM,SUP-3253846,CDM,3253846WWM,LOCAL,270,RC,,inpatient,,,1024.05,921.65,,0.95,,972.85,Percent of total billed charges,,,0.98,,1003.57,Percent of total billed charges,,,0.95,,972.85,Percent of total billed charges,,,0.97,,993.33,Percent of total billed charges,,,0.97,,993.33,Percent of total billed charges,,,0.96,,983.09,Percent of total billed charges,,,0.95,,972.85,Percent of total billed charges,,,,,,,,,0.95,,972.85,Percent of total billed charges,,972.85,1003.57,
ENDOSTITCH 10MM,SUP-3253846,CDM,3253846WWM,LOCAL,270,RC,,outpatient,,,1024.05,921.65,,0.95,,972.85,Percent of total billed charges,,,0.98,,1003.57,Percent of total billed charges,,,0.95,,972.85,Percent of total billed charges,,,0.95,,972.85,Percent of total billed charges,,,0.97,,993.33,Percent of total billed charges,,,0.96,,983.09,Percent of total billed charges,,,0.95,,972.85,Percent of total billed charges,,,,,,,,,0.95,,972.85,Percent of total billed charges,,972.85,1003.57,
ENDOSTITCH SUTURE,SUP-3253847,CDM,3253847WWM,LOCAL,270,RC,,inpatient,,,269.82,242.84,,0.95,,256.33,Percent of total billed charges,,,0.98,,264.42,Percent of total billed charges,,,0.95,,256.33,Percent of total billed charges,,,0.97,,261.73,Percent of total billed charges,,,0.97,,261.73,Percent of total billed charges,,,0.96,,259.03,Percent of total billed charges,,,0.95,,256.33,Percent of total billed charges,,,,,,,,,0.95,,256.33,Percent of total billed charges,,256.33,264.42,
ENDOSTITCH SUTURE,SUP-3253847,CDM,3253847WWM,LOCAL,270,RC,,outpatient,,,269.82,242.84,,0.95,,256.33,Percent of total billed charges,,,0.98,,264.42,Percent of total billed charges,,,0.95,,256.33,Percent of total billed charges,,,0.95,,256.33,Percent of total billed charges,,,0.97,,261.73,Percent of total billed charges,,,0.96,,259.03,Percent of total billed charges,,,0.95,,256.33,Percent of total billed charges,,,,,,,,,0.95,,256.33,Percent of total billed charges,,256.33,264.42,
RUMI TIP 6.7X10,SUP-3253853,CDM,3253853WWM,LOCAL,270,RC,,inpatient,,,197.42,177.68,,0.95,,187.55,Percent of total billed charges,,,0.98,,193.47,Percent of total billed charges,,,0.95,,187.55,Percent of total billed charges,,,0.97,,191.5,Percent of total billed charges,,,0.97,,191.5,Percent of total billed charges,,,0.96,,189.52,Percent of total billed charges,,,0.95,,187.55,Percent of total billed charges,,,,,,,,,0.95,,187.55,Percent of total billed charges,,187.55,193.47,
RUMI TIP 6.7X10,SUP-3253853,CDM,3253853WWM,LOCAL,270,RC,,outpatient,,,197.42,177.68,,0.95,,187.55,Percent of total billed charges,,,0.98,,193.47,Percent of total billed charges,,,0.95,,187.55,Percent of total billed charges,,,0.95,,187.55,Percent of total billed charges,,,0.97,,191.5,Percent of total billed charges,,,0.96,,189.52,Percent of total billed charges,,,0.95,,187.55,Percent of total billed charges,,,,,,,,,0.95,,187.55,Percent of total billed charges,,187.55,193.47,
RUMI TIP 6.7X8,SUP-3253854,CDM,3253854WWM,LOCAL,270,RC,,inpatient,,,207.27,186.54,,0.95,,196.91,Percent of total billed charges,,,0.98,,203.12,Percent of total billed charges,,,0.95,,196.91,Percent of total billed charges,,,0.97,,201.05,Percent of total billed charges,,,0.97,,201.05,Percent of total billed charges,,,0.96,,198.98,Percent of total billed charges,,,0.95,,196.91,Percent of total billed charges,,,,,,,,,0.95,,196.91,Percent of total billed charges,,196.91,203.12,
RUMI TIP 6.7X8,SUP-3253854,CDM,3253854WWM,LOCAL,270,RC,,outpatient,,,207.27,186.54,,0.95,,196.91,Percent of total billed charges,,,0.98,,203.12,Percent of total billed charges,,,0.95,,196.91,Percent of total billed charges,,,0.95,,196.91,Percent of total billed charges,,,0.97,,201.05,Percent of total billed charges,,,0.96,,198.98,Percent of total billed charges,,,0.95,,196.91,Percent of total billed charges,,,,,,,,,0.95,,196.91,Percent of total billed charges,,196.91,203.12,
RUMI TIP 6.7X6,SUP-3253855,CDM,3253855WWM,LOCAL,270,RC,,inpatient,,,197.42,177.68,,0.95,,187.55,Percent of total billed charges,,,0.98,,193.47,Percent of total billed charges,,,0.95,,187.55,Percent of total billed charges,,,0.97,,191.5,Percent of total billed charges,,,0.97,,191.5,Percent of total billed charges,,,0.96,,189.52,Percent of total billed charges,,,0.95,,187.55,Percent of total billed charges,,,,,,,,,0.95,,187.55,Percent of total billed charges,,187.55,193.47,
RUMI TIP 6.7X6,SUP-3253855,CDM,3253855WWM,LOCAL,270,RC,,outpatient,,,197.42,177.68,,0.95,,187.55,Percent of total billed charges,,,0.98,,193.47,Percent of total billed charges,,,0.95,,187.55,Percent of total billed charges,,,0.95,,187.55,Percent of total billed charges,,,0.97,,191.5,Percent of total billed charges,,,0.96,,189.52,Percent of total billed charges,,,0.95,,187.55,Percent of total billed charges,,,,,,,,,0.95,,187.55,Percent of total billed charges,,187.55,193.47,
RUMI TIP 5.1X6,SUP-3253856,CDM,3253856WWM,LOCAL,270,RC,,inpatient,,,197.42,177.68,,0.95,,187.55,Percent of total billed charges,,,0.98,,193.47,Percent of total billed charges,,,0.95,,187.55,Percent of total billed charges,,,0.97,,191.5,Percent of total billed charges,,,0.97,,191.5,Percent of total billed charges,,,0.96,,189.52,Percent of total billed charges,,,0.95,,187.55,Percent of total billed charges,,,,,,,,,0.95,,187.55,Percent of total billed charges,,187.55,193.47,
RUMI TIP 5.1X6,SUP-3253856,CDM,3253856WWM,LOCAL,270,RC,,outpatient,,,197.42,177.68,,0.95,,187.55,Percent of total billed charges,,,0.98,,193.47,Percent of total billed charges,,,0.95,,187.55,Percent of total billed charges,,,0.95,,187.55,Percent of total billed charges,,,0.97,,191.5,Percent of total billed charges,,,0.96,,189.52,Percent of total billed charges,,,0.95,,187.55,Percent of total billed charges,,,,,,,,,0.95,,187.55,Percent of total billed charges,,187.55,193.47,
RUMI OCCLUDER #CPO-6,SUP-3253857,CDM,3253857WWM,LOCAL,270,RC,,inpatient,,,296.37,266.73,,0.95,,281.55,Percent of total billed charges,,,0.98,,290.44,Percent of total billed charges,,,0.95,,281.55,Percent of total billed charges,,,0.97,,287.48,Percent of total billed charges,,,0.97,,287.48,Percent of total billed charges,,,0.96,,284.52,Percent of total billed charges,,,0.95,,281.55,Percent of total billed charges,,,,,,,,,0.95,,281.55,Percent of total billed charges,,281.55,290.44,
RUMI OCCLUDER #CPO-6,SUP-3253857,CDM,3253857WWM,LOCAL,270,RC,,outpatient,,,296.37,266.73,,0.95,,281.55,Percent of total billed charges,,,0.98,,290.44,Percent of total billed charges,,,0.95,,281.55,Percent of total billed charges,,,0.95,,281.55,Percent of total billed charges,,,0.97,,287.48,Percent of total billed charges,,,0.96,,284.52,Percent of total billed charges,,,0.95,,281.55,Percent of total billed charges,,,,,,,,,0.95,,281.55,Percent of total billed charges,,281.55,290.44,
GRAFTBOLT TIBIAL AR5100-10,SUP-3253860,CDM,3253860WWM,LOCAL,270,RC,,inpatient,,,1185,1066.5,,0.95,,1125.75,Percent of total billed charges,,,0.98,,1161.3,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,0.97,,1149.45,Percent of total billed charges,,,0.97,,1149.45,Percent of total billed charges,,,0.96,,1137.6,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,,,,,,,0.95,,1125.75,Percent of total billed charges,,1125.75,1161.3,
GRAFTBOLT TIBIAL AR5100-10,SUP-3253860,CDM,3253860WWM,LOCAL,270,RC,,outpatient,,,1185,1066.5,,0.95,,1125.75,Percent of total billed charges,,,0.98,,1161.3,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,0.97,,1149.45,Percent of total billed charges,,,0.96,,1137.6,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,,,,,,,0.95,,1125.75,Percent of total billed charges,,1125.75,1161.3,
REAMER 6MM #AR1450,SUP-3253869,CDM,3253869WWM,LOCAL,270,RC,,inpatient,,,717.5,645.75,,0.95,,681.63,Percent of total billed charges,,,0.98,,703.15,Percent of total billed charges,,,0.95,,681.63,Percent of total billed charges,,,0.97,,695.98,Percent of total billed charges,,,0.97,,695.98,Percent of total billed charges,,,0.96,,688.8,Percent of total billed charges,,,0.95,,681.63,Percent of total billed charges,,,,,,,,,0.95,,681.63,Percent of total billed charges,,681.63,703.15,
REAMER 6MM #AR1450,SUP-3253869,CDM,3253869WWM,LOCAL,270,RC,,outpatient,,,717.5,645.75,,0.95,,681.63,Percent of total billed charges,,,0.98,,703.15,Percent of total billed charges,,,0.95,,681.63,Percent of total billed charges,,,0.95,,681.63,Percent of total billed charges,,,0.97,,695.98,Percent of total billed charges,,,0.96,,688.8,Percent of total billed charges,,,0.95,,681.63,Percent of total billed charges,,,,,,,,,0.95,,681.63,Percent of total billed charges,,681.63,703.15,
GRAFT BLADE # GB228RS,SUP-3253875,CDM,3253875WWM,LOCAL,270,RC,,inpatient,,,86.76,78.08,,0.95,,82.42,Percent of total billed charges,,,0.98,,85.02,Percent of total billed charges,,,0.95,,82.42,Percent of total billed charges,,,0.97,,84.16,Percent of total billed charges,,,0.97,,84.16,Percent of total billed charges,,,0.96,,83.29,Percent of total billed charges,,,0.95,,82.42,Percent of total billed charges,,,,,,,,,0.95,,82.42,Percent of total billed charges,,82.42,85.02,
GRAFT BLADE # GB228RS,SUP-3253875,CDM,3253875WWM,LOCAL,270,RC,,outpatient,,,86.76,78.08,,0.95,,82.42,Percent of total billed charges,,,0.98,,85.02,Percent of total billed charges,,,0.95,,82.42,Percent of total billed charges,,,0.95,,82.42,Percent of total billed charges,,,0.97,,84.16,Percent of total billed charges,,,0.96,,83.29,Percent of total billed charges,,,0.95,,82.42,Percent of total billed charges,,,,,,,,,0.95,,82.42,Percent of total billed charges,,82.42,85.02,
GRAFT CARR 1:1.5# BA72,SUP-3253876,CDM,3253876WWM,LOCAL,270,RC,,inpatient,,,180.81,162.73,,0.95,,171.77,Percent of total billed charges,,,0.98,,177.19,Percent of total billed charges,,,0.95,,171.77,Percent of total billed charges,,,0.97,,175.39,Percent of total billed charges,,,0.97,,175.39,Percent of total billed charges,,,0.96,,173.58,Percent of total billed charges,,,0.95,,171.77,Percent of total billed charges,,,,,,,,,0.95,,171.77,Percent of total billed charges,,171.77,177.19,
GRAFT CARR 1:1.5# BA72,SUP-3253876,CDM,3253876WWM,LOCAL,270,RC,,outpatient,,,180.81,162.73,,0.95,,171.77,Percent of total billed charges,,,0.98,,177.19,Percent of total billed charges,,,0.95,,171.77,Percent of total billed charges,,,0.95,,171.77,Percent of total billed charges,,,0.97,,175.39,Percent of total billed charges,,,0.96,,173.58,Percent of total billed charges,,,0.95,,171.77,Percent of total billed charges,,,,,,,,,0.95,,171.77,Percent of total billed charges,,171.77,177.19,
CUTTER LIN 75MM# TLC75,SUP-3253881,CDM,3253881WWM,LOCAL,270,RC,,inpatient,,,464.31,417.88,,0.95,,441.09,Percent of total billed charges,,,0.98,,455.02,Percent of total billed charges,,,0.95,,441.09,Percent of total billed charges,,,0.97,,450.38,Percent of total billed charges,,,0.97,,450.38,Percent of total billed charges,,,0.96,,445.74,Percent of total billed charges,,,0.95,,441.09,Percent of total billed charges,,,,,,,,,0.95,,441.09,Percent of total billed charges,,441.09,455.02,
CUTTER LIN 75MM# TLC75,SUP-3253881,CDM,3253881WWM,LOCAL,270,RC,,outpatient,,,464.31,417.88,,0.95,,441.09,Percent of total billed charges,,,0.98,,455.02,Percent of total billed charges,,,0.95,,441.09,Percent of total billed charges,,,0.95,,441.09,Percent of total billed charges,,,0.97,,450.38,Percent of total billed charges,,,0.96,,445.74,Percent of total billed charges,,,0.95,,441.09,Percent of total billed charges,,,,,,,,,0.95,,441.09,Percent of total billed charges,,441.09,455.02,
CUTTER LIN RELOAD#TCR75,SUP-3253882,CDM,3253882WWM,LOCAL,270,RC,,inpatient,,,318.33,286.5,,0.95,,302.41,Percent of total billed charges,,,0.98,,311.96,Percent of total billed charges,,,0.95,,302.41,Percent of total billed charges,,,0.97,,308.78,Percent of total billed charges,,,0.97,,308.78,Percent of total billed charges,,,0.96,,305.6,Percent of total billed charges,,,0.95,,302.41,Percent of total billed charges,,,,,,,,,0.95,,302.41,Percent of total billed charges,,302.41,311.96,
CUTTER LIN RELOAD#TCR75,SUP-3253882,CDM,3253882WWM,LOCAL,270,RC,,outpatient,,,318.33,286.5,,0.95,,302.41,Percent of total billed charges,,,0.98,,311.96,Percent of total billed charges,,,0.95,,302.41,Percent of total billed charges,,,0.95,,302.41,Percent of total billed charges,,,0.97,,308.78,Percent of total billed charges,,,0.96,,305.6,Percent of total billed charges,,,0.95,,302.41,Percent of total billed charges,,,,,,,,,0.95,,302.41,Percent of total billed charges,,302.41,311.96,
POWER PORT,SUP-3253883,CDM,3253883WWM,LOCAL,270,RC,,inpatient,,,1320,1188,,0.95,,1254,Percent of total billed charges,,,0.98,,1293.6,Percent of total billed charges,,,0.95,,1254,Percent of total billed charges,,,0.97,,1280.4,Percent of total billed charges,,,0.97,,1280.4,Percent of total billed charges,,,0.96,,1267.2,Percent of total billed charges,,,0.95,,1254,Percent of total billed charges,,,,,,,,,0.95,,1254,Percent of total billed charges,,1254,1293.6,
POWER PORT,SUP-3253883,CDM,3253883WWM,LOCAL,270,RC,,outpatient,,,1320,1188,,0.95,,1254,Percent of total billed charges,,,0.98,,1293.6,Percent of total billed charges,,,0.95,,1254,Percent of total billed charges,,,0.95,,1254,Percent of total billed charges,,,0.97,,1280.4,Percent of total billed charges,,,0.96,,1267.2,Percent of total billed charges,,,0.95,,1254,Percent of total billed charges,,,,,,,,,0.95,,1254,Percent of total billed charges,,1254,1293.6,
LINEAR STAPLER # AX55B,SUP-3253884,CDM,3253884WWM,LOCAL,270,RC,,inpatient,,,641.45,577.31,,0.95,,609.38,Percent of total billed charges,,,0.98,,628.62,Percent of total billed charges,,,0.95,,609.38,Percent of total billed charges,,,0.97,,622.21,Percent of total billed charges,,,0.97,,622.21,Percent of total billed charges,,,0.96,,615.79,Percent of total billed charges,,,0.95,,609.38,Percent of total billed charges,,,,,,,,,0.95,,609.38,Percent of total billed charges,,609.38,628.62,
LINEAR STAPLER # AX55B,SUP-3253884,CDM,3253884WWM,LOCAL,270,RC,,outpatient,,,641.45,577.31,,0.95,,609.38,Percent of total billed charges,,,0.98,,628.62,Percent of total billed charges,,,0.95,,609.38,Percent of total billed charges,,,0.95,,609.38,Percent of total billed charges,,,0.97,,622.21,Percent of total billed charges,,,0.96,,615.79,Percent of total billed charges,,,0.95,,609.38,Percent of total billed charges,,,,,,,,,0.95,,609.38,Percent of total billed charges,,609.38,628.62,
PUSHLOC 2.9 X15.5,SUP-3253894,CDM,3253894WWM,LOCAL,270,RC,,inpatient,,,1080,972,,0.95,,1026,Percent of total billed charges,,,0.98,,1058.4,Percent of total billed charges,,,0.95,,1026,Percent of total billed charges,,,0.97,,1047.6,Percent of total billed charges,,,0.97,,1047.6,Percent of total billed charges,,,0.96,,1036.8,Percent of total billed charges,,,0.95,,1026,Percent of total billed charges,,,,,,,,,0.95,,1026,Percent of total billed charges,,1026,1058.4,
PUSHLOC 2.9 X15.5,SUP-3253894,CDM,3253894WWM,LOCAL,270,RC,,outpatient,,,1080,972,,0.95,,1026,Percent of total billed charges,,,0.98,,1058.4,Percent of total billed charges,,,0.95,,1026,Percent of total billed charges,,,0.95,,1026,Percent of total billed charges,,,0.97,,1047.6,Percent of total billed charges,,,0.96,,1036.8,Percent of total billed charges,,,0.95,,1026,Percent of total billed charges,,,,,,,,,0.95,,1026,Percent of total billed charges,,1026,1058.4,
SU ANCHOR PEEK 5.5 X 24.5,SUP-3253896,CDM,3253896WWM,LOCAL,270,RC,,inpatient,,,1140,1026,,0.95,,1083,Percent of total billed charges,,,0.98,,1117.2,Percent of total billed charges,,,0.95,,1083,Percent of total billed charges,,,0.97,,1105.8,Percent of total billed charges,,,0.97,,1105.8,Percent of total billed charges,,,0.96,,1094.4,Percent of total billed charges,,,0.95,,1083,Percent of total billed charges,,,,,,,,,0.95,,1083,Percent of total billed charges,,1083,1117.2,
SU ANCHOR PEEK 5.5 X 24.5,SUP-3253896,CDM,3253896WWM,LOCAL,270,RC,,outpatient,,,1140,1026,,0.95,,1083,Percent of total billed charges,,,0.98,,1117.2,Percent of total billed charges,,,0.95,,1083,Percent of total billed charges,,,0.95,,1083,Percent of total billed charges,,,0.97,,1105.8,Percent of total billed charges,,,0.96,,1094.4,Percent of total billed charges,,,0.95,,1083,Percent of total billed charges,,,,,,,,,0.95,,1083,Percent of total billed charges,,1083,1117.2,
SU ANCHOR PEEK 4.75X19.1,SUP-3253897,CDM,3253897WWM,LOCAL,270,RC,,inpatient,,,1125,1012.5,,0.95,,1068.75,Percent of total billed charges,,,0.98,,1102.5,Percent of total billed charges,,,0.95,,1068.75,Percent of total billed charges,,,0.97,,1091.25,Percent of total billed charges,,,0.97,,1091.25,Percent of total billed charges,,,0.96,,1080,Percent of total billed charges,,,0.95,,1068.75,Percent of total billed charges,,,,,,,,,0.95,,1068.75,Percent of total billed charges,,1068.75,1102.5,
SU ANCHOR PEEK 4.75X19.1,SUP-3253897,CDM,3253897WWM,LOCAL,270,RC,,outpatient,,,1125,1012.5,,0.95,,1068.75,Percent of total billed charges,,,0.98,,1102.5,Percent of total billed charges,,,0.95,,1068.75,Percent of total billed charges,,,0.95,,1068.75,Percent of total billed charges,,,0.97,,1091.25,Percent of total billed charges,,,0.96,,1080,Percent of total billed charges,,,0.95,,1068.75,Percent of total billed charges,,,,,,,,,0.95,,1068.75,Percent of total billed charges,,1068.75,1102.5,
SU ANCHOR CORKSCREW,SUP-3253898,CDM,C1713,HCPCS,278,RC,,inpatient,,,1909.5,1718.55,,0.95,,1814.03,Percent of total billed charges,,,0.98,,1871.31,Percent of total billed charges,,,0.95,,1814.03,Percent of total billed charges,,,0.97,,1852.22,Percent of total billed charges,,,0.97,,1852.22,Percent of total billed charges,,,0.96,,1833.12,Percent of total billed charges,,,0.95,,1814.03,Percent of total billed charges,,,,,,,,,0.95,,1814.03,Percent of total billed charges,,1814.03,1871.31,
SU ANCHOR CORKSCREW,SUP-3253898,CDM,C1713,HCPCS,278,RC,,outpatient,,,1909.5,1718.55,,0.95,,1814.03,Percent of total billed charges,,,0.98,,1871.31,Percent of total billed charges,,,0.95,,1814.03,Percent of total billed charges,,,0.95,,1814.03,Percent of total billed charges,,,0.97,,1852.22,Percent of total billed charges,,,0.96,,1833.12,Percent of total billed charges,,,0.95,,1814.03,Percent of total billed charges,,,,,,,,,0.95,,1814.03,Percent of total billed charges,,1814.03,1871.31,
SU ANCHOR PEEK 4.75 X  24.5,SUP-3253899,CDM,3253899WWM,LOCAL,270,RC,,inpatient,,,1065,958.5,,0.95,,1011.75,Percent of total billed charges,,,0.98,,1043.7,Percent of total billed charges,,,0.95,,1011.75,Percent of total billed charges,,,0.97,,1033.05,Percent of total billed charges,,,0.97,,1033.05,Percent of total billed charges,,,0.96,,1022.4,Percent of total billed charges,,,0.95,,1011.75,Percent of total billed charges,,,,,,,,,0.95,,1011.75,Percent of total billed charges,,1011.75,1043.7,
SU ANCHOR PEEK 4.75 X  24.5,SUP-3253899,CDM,3253899WWM,LOCAL,270,RC,,outpatient,,,1065,958.5,,0.95,,1011.75,Percent of total billed charges,,,0.98,,1043.7,Percent of total billed charges,,,0.95,,1011.75,Percent of total billed charges,,,0.95,,1011.75,Percent of total billed charges,,,0.97,,1033.05,Percent of total billed charges,,,0.96,,1022.4,Percent of total billed charges,,,0.95,,1011.75,Percent of total billed charges,,,,,,,,,0.95,,1011.75,Percent of total billed charges,,1011.75,1043.7,
ENDO RELOAD 45M#ECR45D,SUP-3253913,CDM,3253913WWM,LOCAL,270,RC,,inpatient,,,423.36,381.02,,0.95,,402.19,Percent of total billed charges,,,0.98,,414.89,Percent of total billed charges,,,0.95,,402.19,Percent of total billed charges,,,0.97,,410.66,Percent of total billed charges,,,0.97,,410.66,Percent of total billed charges,,,0.96,,406.43,Percent of total billed charges,,,0.95,,402.19,Percent of total billed charges,,,,,,,,,0.95,,402.19,Percent of total billed charges,,402.19,414.89,
ENDO RELOAD 45M#ECR45D,SUP-3253913,CDM,3253913WWM,LOCAL,270,RC,,outpatient,,,423.36,381.02,,0.95,,402.19,Percent of total billed charges,,,0.98,,414.89,Percent of total billed charges,,,0.95,,402.19,Percent of total billed charges,,,0.95,,402.19,Percent of total billed charges,,,0.97,,410.66,Percent of total billed charges,,,0.96,,406.43,Percent of total billed charges,,,0.95,,402.19,Percent of total billed charges,,,,,,,,,0.95,,402.19,Percent of total billed charges,,402.19,414.89,
TUBING PATIENT#AR-6421,SUP-3253915,CDM,3253915WWM,LOCAL,270,RC,,inpatient,,,135,121.5,,0.95,,128.25,Percent of total billed charges,,,0.98,,132.3,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,0.97,,130.95,Percent of total billed charges,,,0.97,,130.95,Percent of total billed charges,,,0.96,,129.6,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,,,,,,,0.95,,128.25,Percent of total billed charges,,128.25,132.3,
TUBING PATIENT#AR-6421,SUP-3253915,CDM,3253915WWM,LOCAL,270,RC,,outpatient,,,135,121.5,,0.95,,128.25,Percent of total billed charges,,,0.98,,132.3,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,0.97,,130.95,Percent of total billed charges,,,0.96,,129.6,Percent of total billed charges,,,0.95,,128.25,Percent of total billed charges,,,,,,,,,0.95,,128.25,Percent of total billed charges,,128.25,132.3,
DISSECTOR CURVED #AR-8400CDS,SUP-3253916,CDM,3253916WWM,LOCAL,270,RC,,inpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
DISSECTOR CURVED #AR-8400CDS,SUP-3253916,CDM,3253916WWM,LOCAL,270,RC,,outpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
TUBING PUMP #AR-6411,SUP-3253918,CDM,3253918WWM,LOCAL,270,RC,,inpatient,,,274.5,247.05,,0.95,,260.78,Percent of total billed charges,,,0.98,,269.01,Percent of total billed charges,,,0.95,,260.78,Percent of total billed charges,,,0.97,,266.27,Percent of total billed charges,,,0.97,,266.27,Percent of total billed charges,,,0.96,,263.52,Percent of total billed charges,,,0.95,,260.78,Percent of total billed charges,,,,,,,,,0.95,,260.78,Percent of total billed charges,,260.78,269.01,
TUBING PUMP #AR-6411,SUP-3253918,CDM,3253918WWM,LOCAL,270,RC,,outpatient,,,274.5,247.05,,0.95,,260.78,Percent of total billed charges,,,0.98,,269.01,Percent of total billed charges,,,0.95,,260.78,Percent of total billed charges,,,0.95,,260.78,Percent of total billed charges,,,0.97,,266.27,Percent of total billed charges,,,0.96,,263.52,Percent of total billed charges,,,0.95,,260.78,Percent of total billed charges,,,,,,,,,0.95,,260.78,Percent of total billed charges,,260.78,269.01,
SCREW TENODESIS 8X23,SUP-3253919,CDM,3253919WWM,LOCAL,270,RC,,inpatient,,,997.5,897.75,,0.95,,947.63,Percent of total billed charges,,,0.98,,977.55,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,0.97,,967.58,Percent of total billed charges,,,0.97,,967.58,Percent of total billed charges,,,0.96,,957.6,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,,,,,,,0.95,,947.63,Percent of total billed charges,,947.63,977.55,
SCREW TENODESIS 8X23,SUP-3253919,CDM,3253919WWM,LOCAL,270,RC,,outpatient,,,997.5,897.75,,0.95,,947.63,Percent of total billed charges,,,0.98,,977.55,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,0.97,,967.58,Percent of total billed charges,,,0.96,,957.6,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,,,,,,,0.95,,947.63,Percent of total billed charges,,947.63,977.55,
REAMER HEAD#AR-1407.5,SUP-3253920,CDM,3253920WWM,LOCAL,270,RC,,inpatient,,,752.5,677.25,,0.95,,714.88,Percent of total billed charges,,,0.98,,737.45,Percent of total billed charges,,,0.95,,714.88,Percent of total billed charges,,,0.97,,729.93,Percent of total billed charges,,,0.97,,729.93,Percent of total billed charges,,,0.96,,722.4,Percent of total billed charges,,,0.95,,714.88,Percent of total billed charges,,,,,,,,,0.95,,714.88,Percent of total billed charges,,714.88,737.45,
REAMER HEAD#AR-1407.5,SUP-3253920,CDM,3253920WWM,LOCAL,270,RC,,outpatient,,,752.5,677.25,,0.95,,714.88,Percent of total billed charges,,,0.98,,737.45,Percent of total billed charges,,,0.95,,714.88,Percent of total billed charges,,,0.95,,714.88,Percent of total billed charges,,,0.97,,729.93,Percent of total billed charges,,,0.96,,722.4,Percent of total billed charges,,,0.95,,714.88,Percent of total billed charges,,,,,,,,,0.95,,714.88,Percent of total billed charges,,714.88,737.45,
LASSO R 45  #AR-6068-45R,SUP-3253921,CDM,3253921WWM,LOCAL,270,RC,,inpatient,,,560,504,,0.95,,532,Percent of total billed charges,,,0.98,,548.8,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,0.97,,543.2,Percent of total billed charges,,,0.97,,543.2,Percent of total billed charges,,,0.96,,537.6,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,,,,,,,0.95,,532,Percent of total billed charges,,532,548.8,
LASSO R 45  #AR-6068-45R,SUP-3253921,CDM,3253921WWM,LOCAL,270,RC,,outpatient,,,560,504,,0.95,,532,Percent of total billed charges,,,0.98,,548.8,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,0.97,,543.2,Percent of total billed charges,,,0.96,,537.6,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,,,,,,,0.95,,532,Percent of total billed charges,,532,548.8,
LASSO R 90  #AR-6068-90R,SUP-3253922,CDM,27010242,LOCAL,270,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
LASSO R 90  #AR-6068-90R,SUP-3253922,CDM,27010242,LOCAL,270,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
PUSHLOC KIT 2.9MM,SUP-3253923,CDM,3253923WWM,LOCAL,270,RC,,inpatient,,,612.5,551.25,,0.95,,581.88,Percent of total billed charges,,,0.98,,600.25,Percent of total billed charges,,,0.95,,581.88,Percent of total billed charges,,,0.97,,594.13,Percent of total billed charges,,,0.97,,594.13,Percent of total billed charges,,,0.96,,588,Percent of total billed charges,,,0.95,,581.88,Percent of total billed charges,,,,,,,,,0.95,,581.88,Percent of total billed charges,,581.88,600.25,
PUSHLOC KIT 2.9MM,SUP-3253923,CDM,3253923WWM,LOCAL,270,RC,,outpatient,,,612.5,551.25,,0.95,,581.88,Percent of total billed charges,,,0.98,,600.25,Percent of total billed charges,,,0.95,,581.88,Percent of total billed charges,,,0.95,,581.88,Percent of total billed charges,,,0.97,,594.13,Percent of total billed charges,,,0.96,,588,Percent of total billed charges,,,0.95,,581.88,Percent of total billed charges,,,,,,,,,0.95,,581.88,Percent of total billed charges,,581.88,600.25,
LASSO L 45  #AR-6068-45L,SUP-3253924,CDM,3253924WWM,LOCAL,270,RC,,inpatient,,,560,504,,0.95,,532,Percent of total billed charges,,,0.98,,548.8,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,0.97,,543.2,Percent of total billed charges,,,0.97,,543.2,Percent of total billed charges,,,0.96,,537.6,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,,,,,,,0.95,,532,Percent of total billed charges,,532,548.8,
LASSO L 45  #AR-6068-45L,SUP-3253924,CDM,3253924WWM,LOCAL,270,RC,,outpatient,,,560,504,,0.95,,532,Percent of total billed charges,,,0.98,,548.8,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,0.97,,543.2,Percent of total billed charges,,,0.96,,537.6,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,,,,,,,0.95,,532,Percent of total billed charges,,532,548.8,
LASSO ST 90 #AR-6068-90,SUP-3253925,CDM,3253925WWM,LOCAL,270,RC,,inpatient,,,560,504,,0.95,,532,Percent of total billed charges,,,0.98,,548.8,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,0.97,,543.2,Percent of total billed charges,,,0.97,,543.2,Percent of total billed charges,,,0.96,,537.6,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,,,,,,,0.95,,532,Percent of total billed charges,,532,548.8,
LASSO ST 90 #AR-6068-90,SUP-3253925,CDM,3253925WWM,LOCAL,270,RC,,outpatient,,,560,504,,0.95,,532,Percent of total billed charges,,,0.98,,548.8,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,0.97,,543.2,Percent of total billed charges,,,0.96,,537.6,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,,,,,,,0.95,,532,Percent of total billed charges,,532,548.8,
TROCAR 5MM #2B5LT,SUP-3253926,CDM,3253926WWM,LOCAL,270,RC,,inpatient,,,205.25,184.73,,0.95,,194.99,Percent of total billed charges,,,0.98,,201.15,Percent of total billed charges,,,0.95,,194.99,Percent of total billed charges,,,0.97,,199.09,Percent of total billed charges,,,0.97,,199.09,Percent of total billed charges,,,0.96,,197.04,Percent of total billed charges,,,0.95,,194.99,Percent of total billed charges,,,,,,,,,0.95,,194.99,Percent of total billed charges,,194.99,201.15,
TROCAR 5MM #2B5LT,SUP-3253926,CDM,3253926WWM,LOCAL,270,RC,,outpatient,,,205.25,184.73,,0.95,,194.99,Percent of total billed charges,,,0.98,,201.15,Percent of total billed charges,,,0.95,,194.99,Percent of total billed charges,,,0.95,,194.99,Percent of total billed charges,,,0.97,,199.09,Percent of total billed charges,,,0.96,,197.04,Percent of total billed charges,,,0.95,,194.99,Percent of total billed charges,,,,,,,,,0.95,,194.99,Percent of total billed charges,,194.99,201.15,
LASSO L 90  #AR-6068-90L,SUP-3253928,CDM,3253928WWM,LOCAL,270,RC,,inpatient,,,560,504,,0.95,,532,Percent of total billed charges,,,0.98,,548.8,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,0.97,,543.2,Percent of total billed charges,,,0.97,,543.2,Percent of total billed charges,,,0.96,,537.6,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,,,,,,,0.95,,532,Percent of total billed charges,,532,548.8,
LASSO L 90  #AR-6068-90L,SUP-3253928,CDM,3253928WWM,LOCAL,270,RC,,outpatient,,,560,504,,0.95,,532,Percent of total billed charges,,,0.98,,548.8,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,0.97,,543.2,Percent of total billed charges,,,0.96,,537.6,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,,,,,,,0.95,,532,Percent of total billed charges,,532,548.8,
EXCALIBUR# AR-8400EX,SUP-3253929,CDM,3253929WWM,LOCAL,270,RC,,inpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
EXCALIBUR# AR-8400EX,SUP-3253929,CDM,3253929WWM,LOCAL,270,RC,,outpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
BURR CLEAR#AR-8500COE,SUP-3253930,CDM,3253930WWM,LOCAL,270,RC,,inpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
BURR CLEAR#AR-8500COE,SUP-3253930,CDM,3253930WWM,LOCAL,270,RC,,outpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
TUBING PUMP#AR-6410,SUP-3253941,CDM,3253941WWM,LOCAL,270,RC,,inpatient,,,274.5,247.05,,0.95,,260.78,Percent of total billed charges,,,0.98,,269.01,Percent of total billed charges,,,0.95,,260.78,Percent of total billed charges,,,0.97,,266.27,Percent of total billed charges,,,0.97,,266.27,Percent of total billed charges,,,0.96,,263.52,Percent of total billed charges,,,0.95,,260.78,Percent of total billed charges,,,,,,,,,0.95,,260.78,Percent of total billed charges,,260.78,269.01,
TUBING PUMP#AR-6410,SUP-3253941,CDM,3253941WWM,LOCAL,270,RC,,outpatient,,,274.5,247.05,,0.95,,260.78,Percent of total billed charges,,,0.98,,269.01,Percent of total billed charges,,,0.95,,260.78,Percent of total billed charges,,,0.95,,260.78,Percent of total billed charges,,,0.97,,266.27,Percent of total billed charges,,,0.96,,263.52,Percent of total billed charges,,,0.95,,260.78,Percent of total billed charges,,,,,,,,,0.95,,260.78,Percent of total billed charges,,260.78,269.01,
REAMER CORE#AR-1224S,SUP-3253942,CDM,3253942WWM,LOCAL,270,RC,,inpatient,,,1025.5,922.95,,0.95,,974.23,Percent of total billed charges,,,0.98,,1004.99,Percent of total billed charges,,,0.95,,974.23,Percent of total billed charges,,,0.97,,994.74,Percent of total billed charges,,,0.97,,994.74,Percent of total billed charges,,,0.96,,984.48,Percent of total billed charges,,,0.95,,974.23,Percent of total billed charges,,,,,,,,,0.95,,974.23,Percent of total billed charges,,974.23,1004.99,
REAMER CORE#AR-1224S,SUP-3253942,CDM,3253942WWM,LOCAL,270,RC,,outpatient,,,1025.5,922.95,,0.95,,974.23,Percent of total billed charges,,,0.98,,1004.99,Percent of total billed charges,,,0.95,,974.23,Percent of total billed charges,,,0.95,,974.23,Percent of total billed charges,,,0.97,,994.74,Percent of total billed charges,,,0.96,,984.48,Percent of total billed charges,,,0.95,,974.23,Percent of total billed charges,,,,,,,,,0.95,,974.23,Percent of total billed charges,,974.23,1004.99,
REAMER LOW# AR-1410LP,SUP-3253943,CDM,3253943WWM,LOCAL,270,RC,,inpatient,,,682.5,614.25,,0.95,,648.38,Percent of total billed charges,,,0.98,,668.85,Percent of total billed charges,,,0.95,,648.38,Percent of total billed charges,,,0.97,,662.03,Percent of total billed charges,,,0.97,,662.03,Percent of total billed charges,,,0.96,,655.2,Percent of total billed charges,,,0.95,,648.38,Percent of total billed charges,,,,,,,,,0.95,,648.38,Percent of total billed charges,,648.38,668.85,
REAMER LOW# AR-1410LP,SUP-3253943,CDM,3253943WWM,LOCAL,270,RC,,outpatient,,,682.5,614.25,,0.95,,648.38,Percent of total billed charges,,,0.98,,668.85,Percent of total billed charges,,,0.95,,648.38,Percent of total billed charges,,,0.95,,648.38,Percent of total billed charges,,,0.97,,662.03,Percent of total billed charges,,,0.96,,655.2,Percent of total billed charges,,,0.95,,648.38,Percent of total billed charges,,,,,,,,,0.95,,648.38,Percent of total billed charges,,648.38,668.85,
REAMER HEAD#AR-1407,SUP-3253944,CDM,3253944WWM,LOCAL,270,RC,,inpatient,,,752.5,677.25,,0.95,,714.88,Percent of total billed charges,,,0.98,,737.45,Percent of total billed charges,,,0.95,,714.88,Percent of total billed charges,,,0.97,,729.93,Percent of total billed charges,,,0.97,,729.93,Percent of total billed charges,,,0.96,,722.4,Percent of total billed charges,,,0.95,,714.88,Percent of total billed charges,,,,,,,,,0.95,,714.88,Percent of total billed charges,,714.88,737.45,
REAMER HEAD#AR-1407,SUP-3253944,CDM,3253944WWM,LOCAL,270,RC,,outpatient,,,752.5,677.25,,0.95,,714.88,Percent of total billed charges,,,0.98,,737.45,Percent of total billed charges,,,0.95,,714.88,Percent of total billed charges,,,0.95,,714.88,Percent of total billed charges,,,0.97,,729.93,Percent of total billed charges,,,0.96,,722.4,Percent of total billed charges,,,0.95,,714.88,Percent of total billed charges,,,,,,,,,0.95,,714.88,Percent of total billed charges,,714.88,737.45,
SWIVELOCK #AR-1662BC-8,SUP-3253945,CDM,3253945WWM,LOCAL,270,RC,,inpatient,,,1398,1258.2,,0.95,,1328.1,Percent of total billed charges,,,0.98,,1370.04,Percent of total billed charges,,,0.95,,1328.1,Percent of total billed charges,,,0.97,,1356.06,Percent of total billed charges,,,0.97,,1356.06,Percent of total billed charges,,,0.96,,1342.08,Percent of total billed charges,,,0.95,,1328.1,Percent of total billed charges,,,,,,,,,0.95,,1328.1,Percent of total billed charges,,1328.1,1370.04,
SWIVELOCK #AR-1662BC-8,SUP-3253945,CDM,3253945WWM,LOCAL,270,RC,,outpatient,,,1398,1258.2,,0.95,,1328.1,Percent of total billed charges,,,0.98,,1370.04,Percent of total billed charges,,,0.95,,1328.1,Percent of total billed charges,,,0.95,,1328.1,Percent of total billed charges,,,0.97,,1356.06,Percent of total billed charges,,,0.96,,1342.08,Percent of total billed charges,,,0.95,,1328.1,Percent of total billed charges,,,,,,,,,0.95,,1328.1,Percent of total billed charges,,1328.1,1370.04,
FIBERWIRE 2-0   #AR-7220,SUP-3253946,CDM,3253946WWM,LOCAL,270,RC,,inpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
FIBERWIRE 2-0   #AR-7220,SUP-3253946,CDM,3253946WWM,LOCAL,270,RC,,outpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
PUSHLOC MINI 2.5X8,SUP-3253947,CDM,3253947WWM,LOCAL,270,RC,,inpatient,,,612.5,551.25,,0.95,,581.88,Percent of total billed charges,,,0.98,,600.25,Percent of total billed charges,,,0.95,,581.88,Percent of total billed charges,,,0.97,,594.13,Percent of total billed charges,,,0.97,,594.13,Percent of total billed charges,,,0.96,,588,Percent of total billed charges,,,0.95,,581.88,Percent of total billed charges,,,,,,,,,0.95,,581.88,Percent of total billed charges,,581.88,600.25,
PUSHLOC MINI 2.5X8,SUP-3253947,CDM,3253947WWM,LOCAL,270,RC,,outpatient,,,612.5,551.25,,0.95,,581.88,Percent of total billed charges,,,0.98,,600.25,Percent of total billed charges,,,0.95,,581.88,Percent of total billed charges,,,0.95,,581.88,Percent of total billed charges,,,0.97,,594.13,Percent of total billed charges,,,0.96,,588,Percent of total billed charges,,,0.95,,581.88,Percent of total billed charges,,,,,,,,,0.95,,581.88,Percent of total billed charges,,581.88,600.25,
PUSHLOC PEEK#AR8825P,SUP-3253948,CDM,3253948WWM,LOCAL,270,RC,,inpatient,,,1020,918,,0.95,,969,Percent of total billed charges,,,0.98,,999.6,Percent of total billed charges,,,0.95,,969,Percent of total billed charges,,,0.97,,989.4,Percent of total billed charges,,,0.97,,989.4,Percent of total billed charges,,,0.96,,979.2,Percent of total billed charges,,,0.95,,969,Percent of total billed charges,,,,,,,,,0.95,,969,Percent of total billed charges,,969,999.6,
PUSHLOC PEEK#AR8825P,SUP-3253948,CDM,3253948WWM,LOCAL,270,RC,,outpatient,,,1020,918,,0.95,,969,Percent of total billed charges,,,0.98,,999.6,Percent of total billed charges,,,0.95,,969,Percent of total billed charges,,,0.95,,969,Percent of total billed charges,,,0.97,,989.4,Percent of total billed charges,,,0.96,,979.2,Percent of total billed charges,,,0.95,,969,Percent of total billed charges,,,,,,,,,0.95,,969,Percent of total billed charges,,969,999.6,
DISSECTOR # AR-7300DS,SUP-3253965,CDM,3253965WWM,LOCAL,270,RC,,inpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
DISSECTOR # AR-7300DS,SUP-3253965,CDM,3253965WWM,LOCAL,270,RC,,outpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
BURR ROUND #AR-7300RBE,SUP-3253966,CDM,3253966WWM,LOCAL,270,RC,,inpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
BURR ROUND #AR-7300RBE,SUP-3253966,CDM,3253966WWM,LOCAL,270,RC,,outpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
ENSEAL TISSUE#NSEALX22,SUP-3253967,CDM,3253967WWM,LOCAL,270,RC,,inpatient,,,1925,1732.5,,0.95,,1828.75,Percent of total billed charges,,,0.98,,1886.5,Percent of total billed charges,,,0.95,,1828.75,Percent of total billed charges,,,0.97,,1867.25,Percent of total billed charges,,,0.97,,1867.25,Percent of total billed charges,,,0.96,,1848,Percent of total billed charges,,,0.95,,1828.75,Percent of total billed charges,,,,,,,,,0.95,,1828.75,Percent of total billed charges,,1828.75,1886.5,
ENSEAL TISSUE#NSEALX22,SUP-3253967,CDM,3253967WWM,LOCAL,270,RC,,outpatient,,,1925,1732.5,,0.95,,1828.75,Percent of total billed charges,,,0.98,,1886.5,Percent of total billed charges,,,0.95,,1828.75,Percent of total billed charges,,,0.95,,1828.75,Percent of total billed charges,,,0.97,,1867.25,Percent of total billed charges,,,0.96,,1848,Percent of total billed charges,,,0.95,,1828.75,Percent of total billed charges,,,,,,,,,0.95,,1828.75,Percent of total billed charges,,1828.75,1886.5,
CATH MALECOT 18FR,SUP-3253968,CDM,3253968WWM,LOCAL,270,RC,,inpatient,,,85.56,77,,0.95,,81.28,Percent of total billed charges,,,0.98,,83.85,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,0.97,,82.99,Percent of total billed charges,,,0.97,,82.99,Percent of total billed charges,,,0.96,,82.14,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,,,,,,,0.95,,81.28,Percent of total billed charges,,81.28,83.85,
CATH MALECOT 18FR,SUP-3253968,CDM,3253968WWM,LOCAL,270,RC,,outpatient,,,85.56,77,,0.95,,81.28,Percent of total billed charges,,,0.98,,83.85,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,0.97,,82.99,Percent of total billed charges,,,0.96,,82.14,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,,,,,,,0.95,,81.28,Percent of total billed charges,,81.28,83.85,
CATH MALECOT 22 FR,SUP-3253969,CDM,3253969WWM,LOCAL,270,RC,,inpatient,,,85.56,77,,0.95,,81.28,Percent of total billed charges,,,0.98,,83.85,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,0.97,,82.99,Percent of total billed charges,,,0.97,,82.99,Percent of total billed charges,,,0.96,,82.14,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,,,,,,,0.95,,81.28,Percent of total billed charges,,81.28,83.85,
CATH MALECOT 22 FR,SUP-3253969,CDM,3253969WWM,LOCAL,270,RC,,outpatient,,,85.56,77,,0.95,,81.28,Percent of total billed charges,,,0.98,,83.85,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,0.97,,82.99,Percent of total billed charges,,,0.96,,82.14,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,,,,,,,0.95,,81.28,Percent of total billed charges,,81.28,83.85,
CATH MALECOT 26FR,SUP-3253970,CDM,3253970WWM,LOCAL,270,RC,,inpatient,,,85.56,77,,0.95,,81.28,Percent of total billed charges,,,0.98,,83.85,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,0.97,,82.99,Percent of total billed charges,,,0.97,,82.99,Percent of total billed charges,,,0.96,,82.14,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,,,,,,,0.95,,81.28,Percent of total billed charges,,81.28,83.85,
CATH MALECOT 26FR,SUP-3253970,CDM,3253970WWM,LOCAL,270,RC,,outpatient,,,85.56,77,,0.95,,81.28,Percent of total billed charges,,,0.98,,83.85,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,0.97,,82.99,Percent of total billed charges,,,0.96,,82.14,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,,,,,,,0.95,,81.28,Percent of total billed charges,,81.28,83.85,
CATH MALECOT 30FR,SUP-3253971,CDM,3253971WWM,LOCAL,270,RC,,inpatient,,,85.56,77,,0.95,,81.28,Percent of total billed charges,,,0.98,,83.85,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,0.97,,82.99,Percent of total billed charges,,,0.97,,82.99,Percent of total billed charges,,,0.96,,82.14,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,,,,,,,0.95,,81.28,Percent of total billed charges,,81.28,83.85,
CATH MALECOT 30FR,SUP-3253971,CDM,3253971WWM,LOCAL,270,RC,,outpatient,,,85.56,77,,0.95,,81.28,Percent of total billed charges,,,0.98,,83.85,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,0.97,,82.99,Percent of total billed charges,,,0.96,,82.14,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,,,,,,,0.95,,81.28,Percent of total billed charges,,81.28,83.85,
CATH MALECOT 34FR,SUP-3253972,CDM,3253972WWM,LOCAL,270,RC,,inpatient,,,85.56,77,,0.95,,81.28,Percent of total billed charges,,,0.98,,83.85,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,0.97,,82.99,Percent of total billed charges,,,0.97,,82.99,Percent of total billed charges,,,0.96,,82.14,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,,,,,,,0.95,,81.28,Percent of total billed charges,,81.28,83.85,
CATH MALECOT 34FR,SUP-3253972,CDM,3253972WWM,LOCAL,270,RC,,outpatient,,,85.56,77,,0.95,,81.28,Percent of total billed charges,,,0.98,,83.85,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,0.97,,82.99,Percent of total billed charges,,,0.96,,82.14,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,,,,,,,0.95,,81.28,Percent of total billed charges,,81.28,83.85,
CATH MALECOT 36FR,SUP-3253973,CDM,3253973WWM,LOCAL,270,RC,,inpatient,,,85.56,77,,0.95,,81.28,Percent of total billed charges,,,0.98,,83.85,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,0.97,,82.99,Percent of total billed charges,,,0.97,,82.99,Percent of total billed charges,,,0.96,,82.14,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,,,,,,,0.95,,81.28,Percent of total billed charges,,81.28,83.85,
CATH MALECOT 36FR,SUP-3253973,CDM,3253973WWM,LOCAL,270,RC,,outpatient,,,85.56,77,,0.95,,81.28,Percent of total billed charges,,,0.98,,83.85,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,0.97,,82.99,Percent of total billed charges,,,0.96,,82.14,Percent of total billed charges,,,0.95,,81.28,Percent of total billed charges,,,,,,,,,0.95,,81.28,Percent of total billed charges,,81.28,83.85,
SWIVELOCK #AR1662PSL-7,SUP-3253974,CDM,3253974WWM,LOCAL,270,RC,,inpatient,,,1493.25,1343.93,,0.95,,1418.59,Percent of total billed charges,,,0.98,,1463.39,Percent of total billed charges,,,0.95,,1418.59,Percent of total billed charges,,,0.97,,1448.45,Percent of total billed charges,,,0.97,,1448.45,Percent of total billed charges,,,0.96,,1433.52,Percent of total billed charges,,,0.95,,1418.59,Percent of total billed charges,,,,,,,,,0.95,,1418.59,Percent of total billed charges,,1418.59,1463.39,
SWIVELOCK #AR1662PSL-7,SUP-3253974,CDM,3253974WWM,LOCAL,270,RC,,outpatient,,,1493.25,1343.93,,0.95,,1418.59,Percent of total billed charges,,,0.98,,1463.39,Percent of total billed charges,,,0.95,,1418.59,Percent of total billed charges,,,0.95,,1418.59,Percent of total billed charges,,,0.97,,1448.45,Percent of total billed charges,,,0.96,,1433.52,Percent of total billed charges,,,0.95,,1418.59,Percent of total billed charges,,,,,,,,,0.95,,1418.59,Percent of total billed charges,,1418.59,1463.39,
FIBERLOOP #AR7234C,SUP-3253975,CDM,3253975WWM,LOCAL,270,RC,,inpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
FIBERLOOP #AR7234C,SUP-3253975,CDM,3253975WWM,LOCAL,270,RC,,outpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
REAMER LOW #AR1409LP-50,SUP-3253978,CDM,3253978WWM,LOCAL,270,RC,,inpatient,,,390,351,,0.95,,370.5,Percent of total billed charges,,,0.98,,382.2,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,0.97,,378.3,Percent of total billed charges,,,0.97,,378.3,Percent of total billed charges,,,0.96,,374.4,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,,,,,,,0.95,,370.5,Percent of total billed charges,,370.5,382.2,
REAMER LOW #AR1409LP-50,SUP-3253978,CDM,3253978WWM,LOCAL,270,RC,,outpatient,,,390,351,,0.95,,370.5,Percent of total billed charges,,,0.98,,382.2,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,0.97,,378.3,Percent of total billed charges,,,0.96,,374.4,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,,,,,,,0.95,,370.5,Percent of total billed charges,,370.5,382.2,
MENISCAL CINCH#AR-4500,SUP-3253979,CDM,3253979WWM,LOCAL,270,RC,,inpatient,,,997.5,897.75,,0.95,,947.63,Percent of total billed charges,,,0.98,,977.55,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,0.97,,967.58,Percent of total billed charges,,,0.97,,967.58,Percent of total billed charges,,,0.96,,957.6,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,,,,,,,0.95,,947.63,Percent of total billed charges,,947.63,977.55,
MENISCAL CINCH#AR-4500,SUP-3253979,CDM,3253979WWM,LOCAL,270,RC,,outpatient,,,997.5,897.75,,0.95,,947.63,Percent of total billed charges,,,0.98,,977.55,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,0.97,,967.58,Percent of total billed charges,,,0.96,,957.6,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,,,,,,,0.95,,947.63,Percent of total billed charges,,947.63,977.55,
MINI FRAG SCREW 2.4X12#02-210-11,SUP-3253999,CDM,3253999WWM,LOCAL,270,RC,,inpatient,,,553,497.7,,0.95,,525.35,Percent of total billed charges,,,0.98,,541.94,Percent of total billed charges,,,0.95,,525.35,Percent of total billed charges,,,0.97,,536.41,Percent of total billed charges,,,0.97,,536.41,Percent of total billed charges,,,0.96,,530.88,Percent of total billed charges,,,0.95,,525.35,Percent of total billed charges,,,,,,,,,0.95,,525.35,Percent of total billed charges,,525.35,541.94,
MINI FRAG SCREW 2.4X12#02-210-11,SUP-3253999,CDM,3253999WWM,LOCAL,270,RC,,outpatient,,,553,497.7,,0.95,,525.35,Percent of total billed charges,,,0.98,,541.94,Percent of total billed charges,,,0.95,,525.35,Percent of total billed charges,,,0.95,,525.35,Percent of total billed charges,,,0.97,,536.41,Percent of total billed charges,,,0.96,,530.88,Percent of total billed charges,,,0.95,,525.35,Percent of total billed charges,,,,,,,,,0.95,,525.35,Percent of total billed charges,,525.35,541.94,
MINI FRAG SCREW 2.4X20#02-210-12,SUP-3254000,CDM,3254000WWM,LOCAL,270,RC,,inpatient,,,553,497.7,,0.95,,525.35,Percent of total billed charges,,,0.98,,541.94,Percent of total billed charges,,,0.95,,525.35,Percent of total billed charges,,,0.97,,536.41,Percent of total billed charges,,,0.97,,536.41,Percent of total billed charges,,,0.96,,530.88,Percent of total billed charges,,,0.95,,525.35,Percent of total billed charges,,,,,,,,,0.95,,525.35,Percent of total billed charges,,525.35,541.94,
MINI FRAG SCREW 2.4X20#02-210-12,SUP-3254000,CDM,3254000WWM,LOCAL,270,RC,,outpatient,,,553,497.7,,0.95,,525.35,Percent of total billed charges,,,0.98,,541.94,Percent of total billed charges,,,0.95,,525.35,Percent of total billed charges,,,0.95,,525.35,Percent of total billed charges,,,0.97,,536.41,Percent of total billed charges,,,0.96,,530.88,Percent of total billed charges,,,0.95,,525.35,Percent of total billed charges,,,,,,,,,0.95,,525.35,Percent of total billed charges,,525.35,541.94,
MINI FRAG SCREW 2.4X22#02-210-12,SUP-3254001,CDM,3254001WWM,LOCAL,270,RC,,inpatient,,,553,497.7,,0.95,,525.35,Percent of total billed charges,,,0.98,,541.94,Percent of total billed charges,,,0.95,,525.35,Percent of total billed charges,,,0.97,,536.41,Percent of total billed charges,,,0.97,,536.41,Percent of total billed charges,,,0.96,,530.88,Percent of total billed charges,,,0.95,,525.35,Percent of total billed charges,,,,,,,,,0.95,,525.35,Percent of total billed charges,,525.35,541.94,
MINI FRAG SCREW 2.4X22#02-210-12,SUP-3254001,CDM,3254001WWM,LOCAL,270,RC,,outpatient,,,553,497.7,,0.95,,525.35,Percent of total billed charges,,,0.98,,541.94,Percent of total billed charges,,,0.95,,525.35,Percent of total billed charges,,,0.95,,525.35,Percent of total billed charges,,,0.97,,536.41,Percent of total billed charges,,,0.96,,530.88,Percent of total billed charges,,,0.95,,525.35,Percent of total billed charges,,,,,,,,,0.95,,525.35,Percent of total billed charges,,525.35,541.94,
SCREW TENODESIS 7X23,SUP-3254005,CDM,3254005WWM,LOCAL,270,RC,,inpatient,,,997.5,897.75,,0.95,,947.63,Percent of total billed charges,,,0.98,,977.55,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,0.97,,967.58,Percent of total billed charges,,,0.97,,967.58,Percent of total billed charges,,,0.96,,957.6,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,,,,,,,0.95,,947.63,Percent of total billed charges,,947.63,977.55,
SCREW TENODESIS 7X23,SUP-3254005,CDM,3254005WWM,LOCAL,270,RC,,outpatient,,,997.5,897.75,,0.95,,947.63,Percent of total billed charges,,,0.98,,977.55,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,0.97,,967.58,Percent of total billed charges,,,0.96,,957.6,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,,,,,,,0.95,,947.63,Percent of total billed charges,,947.63,977.55,
SCREW TENODESIS 9X15,SUP-3254011,CDM,3254011WWM,LOCAL,270,RC,,inpatient,,,997.5,897.75,,0.95,,947.63,Percent of total billed charges,,,0.98,,977.55,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,0.97,,967.58,Percent of total billed charges,,,0.97,,967.58,Percent of total billed charges,,,0.96,,957.6,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,,,,,,,0.95,,947.63,Percent of total billed charges,,947.63,977.55,
SCREW TENODESIS 9X15,SUP-3254011,CDM,3254011WWM,LOCAL,270,RC,,outpatient,,,997.5,897.75,,0.95,,947.63,Percent of total billed charges,,,0.98,,977.55,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,0.97,,967.58,Percent of total billed charges,,,0.96,,957.6,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,,,,,,,0.95,,947.63,Percent of total billed charges,,947.63,977.55,
REAMER HEAD# AR-1408,SUP-3254012,CDM,3254012WWM,LOCAL,270,RC,,inpatient,,,752.5,677.25,,0.95,,714.88,Percent of total billed charges,,,0.98,,737.45,Percent of total billed charges,,,0.95,,714.88,Percent of total billed charges,,,0.97,,729.93,Percent of total billed charges,,,0.97,,729.93,Percent of total billed charges,,,0.96,,722.4,Percent of total billed charges,,,0.95,,714.88,Percent of total billed charges,,,,,,,,,0.95,,714.88,Percent of total billed charges,,714.88,737.45,
REAMER HEAD# AR-1408,SUP-3254012,CDM,3254012WWM,LOCAL,270,RC,,outpatient,,,752.5,677.25,,0.95,,714.88,Percent of total billed charges,,,0.98,,737.45,Percent of total billed charges,,,0.95,,714.88,Percent of total billed charges,,,0.95,,714.88,Percent of total billed charges,,,0.97,,729.93,Percent of total billed charges,,,0.96,,722.4,Percent of total billed charges,,,0.95,,714.88,Percent of total billed charges,,,,,,,,,0.95,,714.88,Percent of total billed charges,,714.88,737.45,
SCREW TENODESIS 4X10,SUP-3254026,CDM,3254026WWM,LOCAL,270,RC,,inpatient,,,997.5,897.75,,0.95,,947.63,Percent of total billed charges,,,0.98,,977.55,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,0.97,,967.58,Percent of total billed charges,,,0.97,,967.58,Percent of total billed charges,,,0.96,,957.6,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,,,,,,,0.95,,947.63,Percent of total billed charges,,947.63,977.55,
SCREW TENODESIS 4X10,SUP-3254026,CDM,3254026WWM,LOCAL,270,RC,,outpatient,,,997.5,897.75,,0.95,,947.63,Percent of total billed charges,,,0.98,,977.55,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,0.97,,967.58,Percent of total billed charges,,,0.96,,957.6,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,,,,,,,0.95,,947.63,Percent of total billed charges,,947.63,977.55,
SCREW TENODESIS 4.75X15,SUP-3254027,CDM,3254027WWM,LOCAL,270,RC,,inpatient,,,997.5,897.75,,0.95,,947.63,Percent of total billed charges,,,0.98,,977.55,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,0.97,,967.58,Percent of total billed charges,,,0.97,,967.58,Percent of total billed charges,,,0.96,,957.6,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,,,,,,,0.95,,947.63,Percent of total billed charges,,947.63,977.55,
SCREW TENODESIS 4.75X15,SUP-3254027,CDM,3254027WWM,LOCAL,270,RC,,outpatient,,,997.5,897.75,,0.95,,947.63,Percent of total billed charges,,,0.98,,977.55,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,0.97,,967.58,Percent of total billed charges,,,0.96,,957.6,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,,,,,,,0.95,,947.63,Percent of total billed charges,,947.63,977.55,
SCREW TENODESIS 5.5X15,SUP-3254028,CDM,3254028WWM,LOCAL,270,RC,,inpatient,,,997.5,897.75,,0.95,,947.63,Percent of total billed charges,,,0.98,,977.55,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,0.97,,967.58,Percent of total billed charges,,,0.97,,967.58,Percent of total billed charges,,,0.96,,957.6,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,,,,,,,0.95,,947.63,Percent of total billed charges,,947.63,977.55,
SCREW TENODESIS 5.5X15,SUP-3254028,CDM,3254028WWM,LOCAL,270,RC,,outpatient,,,997.5,897.75,,0.95,,947.63,Percent of total billed charges,,,0.98,,977.55,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,0.97,,967.58,Percent of total billed charges,,,0.96,,957.6,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,,,,,,,0.95,,947.63,Percent of total billed charges,,947.63,977.55,
SCREW TENODESIS 6.25X15,SUP-3254029,CDM,3254029WWM,LOCAL,270,RC,,inpatient,,,997.5,897.75,,0.95,,947.63,Percent of total billed charges,,,0.98,,977.55,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,0.97,,967.58,Percent of total billed charges,,,0.97,,967.58,Percent of total billed charges,,,0.96,,957.6,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,,,,,,,0.95,,947.63,Percent of total billed charges,,947.63,977.55,
SCREW TENODESIS 6.25X15,SUP-3254029,CDM,3254029WWM,LOCAL,270,RC,,outpatient,,,997.5,897.75,,0.95,,947.63,Percent of total billed charges,,,0.98,,977.55,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,0.97,,967.58,Percent of total billed charges,,,0.96,,957.6,Percent of total billed charges,,,0.95,,947.63,Percent of total billed charges,,,,,,,,,0.95,,947.63,Percent of total billed charges,,947.63,977.55,
MINI FRAG SCREW 2.7X8#DC2825008,SUP-3254038,CDM,3254038WWM,LOCAL,270,RC,,inpatient,,,591.5,532.35,,0.95,,561.93,Percent of total billed charges,,,0.98,,579.67,Percent of total billed charges,,,0.95,,561.93,Percent of total billed charges,,,0.97,,573.76,Percent of total billed charges,,,0.97,,573.76,Percent of total billed charges,,,0.96,,567.84,Percent of total billed charges,,,0.95,,561.93,Percent of total billed charges,,,,,,,,,0.95,,561.93,Percent of total billed charges,,561.93,579.67,
MINI FRAG SCREW 2.7X8#DC2825008,SUP-3254038,CDM,3254038WWM,LOCAL,270,RC,,outpatient,,,591.5,532.35,,0.95,,561.93,Percent of total billed charges,,,0.98,,579.67,Percent of total billed charges,,,0.95,,561.93,Percent of total billed charges,,,0.95,,561.93,Percent of total billed charges,,,0.97,,573.76,Percent of total billed charges,,,0.96,,567.84,Percent of total billed charges,,,0.95,,561.93,Percent of total billed charges,,,,,,,,,0.95,,561.93,Percent of total billed charges,,561.93,579.67,
MINI FRAG SCREW 2.7X10#DC2825010,SUP-3254039,CDM,3254039WWM,LOCAL,270,RC,,inpatient,,,591.5,532.35,,0.95,,561.93,Percent of total billed charges,,,0.98,,579.67,Percent of total billed charges,,,0.95,,561.93,Percent of total billed charges,,,0.97,,573.76,Percent of total billed charges,,,0.97,,573.76,Percent of total billed charges,,,0.96,,567.84,Percent of total billed charges,,,0.95,,561.93,Percent of total billed charges,,,,,,,,,0.95,,561.93,Percent of total billed charges,,561.93,579.67,
MINI FRAG SCREW 2.7X10#DC2825010,SUP-3254039,CDM,3254039WWM,LOCAL,270,RC,,outpatient,,,591.5,532.35,,0.95,,561.93,Percent of total billed charges,,,0.98,,579.67,Percent of total billed charges,,,0.95,,561.93,Percent of total billed charges,,,0.95,,561.93,Percent of total billed charges,,,0.97,,573.76,Percent of total billed charges,,,0.96,,567.84,Percent of total billed charges,,,0.95,,561.93,Percent of total billed charges,,,,,,,,,0.95,,561.93,Percent of total billed charges,,561.93,579.67,
MINI FRAG SCREW 2.7X12#DC2825012,SUP-3254040,CDM,3254040WWM,LOCAL,270,RC,,inpatient,,,591.5,532.35,,0.95,,561.93,Percent of total billed charges,,,0.98,,579.67,Percent of total billed charges,,,0.95,,561.93,Percent of total billed charges,,,0.97,,573.76,Percent of total billed charges,,,0.97,,573.76,Percent of total billed charges,,,0.96,,567.84,Percent of total billed charges,,,0.95,,561.93,Percent of total billed charges,,,,,,,,,0.95,,561.93,Percent of total billed charges,,561.93,579.67,
MINI FRAG SCREW 2.7X12#DC2825012,SUP-3254040,CDM,3254040WWM,LOCAL,270,RC,,outpatient,,,591.5,532.35,,0.95,,561.93,Percent of total billed charges,,,0.98,,579.67,Percent of total billed charges,,,0.95,,561.93,Percent of total billed charges,,,0.95,,561.93,Percent of total billed charges,,,0.97,,573.76,Percent of total billed charges,,,0.96,,567.84,Percent of total billed charges,,,0.95,,561.93,Percent of total billed charges,,,,,,,,,0.95,,561.93,Percent of total billed charges,,561.93,579.67,
MINI FRAG SCREW 2.7X14#DC2825014,SUP-3254041,CDM,3254041WWM,LOCAL,270,RC,,inpatient,,,591.5,532.35,,0.95,,561.93,Percent of total billed charges,,,0.98,,579.67,Percent of total billed charges,,,0.95,,561.93,Percent of total billed charges,,,0.97,,573.76,Percent of total billed charges,,,0.97,,573.76,Percent of total billed charges,,,0.96,,567.84,Percent of total billed charges,,,0.95,,561.93,Percent of total billed charges,,,,,,,,,0.95,,561.93,Percent of total billed charges,,561.93,579.67,
MINI FRAG SCREW 2.7X14#DC2825014,SUP-3254041,CDM,3254041WWM,LOCAL,270,RC,,outpatient,,,591.5,532.35,,0.95,,561.93,Percent of total billed charges,,,0.98,,579.67,Percent of total billed charges,,,0.95,,561.93,Percent of total billed charges,,,0.95,,561.93,Percent of total billed charges,,,0.97,,573.76,Percent of total billed charges,,,0.96,,567.84,Percent of total billed charges,,,0.95,,561.93,Percent of total billed charges,,,,,,,,,0.95,,561.93,Percent of total billed charges,,561.93,579.67,
TIGERSTICK #AR-7209T,SUP-3254046,CDM,3254046WWM,LOCAL,270,RC,,inpatient,,,297,267.3,,0.95,,282.15,Percent of total billed charges,,,0.98,,291.06,Percent of total billed charges,,,0.95,,282.15,Percent of total billed charges,,,0.97,,288.09,Percent of total billed charges,,,0.97,,288.09,Percent of total billed charges,,,0.96,,285.12,Percent of total billed charges,,,0.95,,282.15,Percent of total billed charges,,,,,,,,,0.95,,282.15,Percent of total billed charges,,282.15,291.06,
TIGERSTICK #AR-7209T,SUP-3254046,CDM,3254046WWM,LOCAL,270,RC,,outpatient,,,297,267.3,,0.95,,282.15,Percent of total billed charges,,,0.98,,291.06,Percent of total billed charges,,,0.95,,282.15,Percent of total billed charges,,,0.95,,282.15,Percent of total billed charges,,,0.97,,288.09,Percent of total billed charges,,,0.96,,285.12,Percent of total billed charges,,,0.95,,282.15,Percent of total billed charges,,,,,,,,,0.95,,282.15,Percent of total billed charges,,282.15,291.06,
FLIPCUTTER,SUP-3254047,CDM,3254047WWM,LOCAL,270,RC,,inpatient,,,1395,1255.5,,0.95,,1325.25,Percent of total billed charges,,,0.98,,1367.1,Percent of total billed charges,,,0.95,,1325.25,Percent of total billed charges,,,0.97,,1353.15,Percent of total billed charges,,,0.97,,1353.15,Percent of total billed charges,,,0.96,,1339.2,Percent of total billed charges,,,0.95,,1325.25,Percent of total billed charges,,,,,,,,,0.95,,1325.25,Percent of total billed charges,,1325.25,1367.1,
FLIPCUTTER,SUP-3254047,CDM,3254047WWM,LOCAL,270,RC,,outpatient,,,1395,1255.5,,0.95,,1325.25,Percent of total billed charges,,,0.98,,1367.1,Percent of total billed charges,,,0.95,,1325.25,Percent of total billed charges,,,0.95,,1325.25,Percent of total billed charges,,,0.97,,1353.15,Percent of total billed charges,,,0.96,,1339.2,Percent of total billed charges,,,0.95,,1325.25,Percent of total billed charges,,,,,,,,,0.95,,1325.25,Percent of total billed charges,,1325.25,1367.1,
TIGHTROPE KNOTLESS,SUP-3254048,CDM,3254048WWM,LOCAL,270,RC,,inpatient,,,1179,1061.1,,0.95,,1120.05,Percent of total billed charges,,,0.98,,1155.42,Percent of total billed charges,,,0.95,,1120.05,Percent of total billed charges,,,0.97,,1143.63,Percent of total billed charges,,,0.97,,1143.63,Percent of total billed charges,,,0.96,,1131.84,Percent of total billed charges,,,0.95,,1120.05,Percent of total billed charges,,,,,,,,,0.95,,1120.05,Percent of total billed charges,,1120.05,1155.42,
TIGHTROPE KNOTLESS,SUP-3254048,CDM,3254048WWM,LOCAL,270,RC,,outpatient,,,1179,1061.1,,0.95,,1120.05,Percent of total billed charges,,,0.98,,1155.42,Percent of total billed charges,,,0.95,,1120.05,Percent of total billed charges,,,0.95,,1120.05,Percent of total billed charges,,,0.97,,1143.63,Percent of total billed charges,,,0.96,,1131.84,Percent of total billed charges,,,0.95,,1120.05,Percent of total billed charges,,,,,,,,,0.95,,1120.05,Percent of total billed charges,,1120.05,1155.42,
GRASPER FB,SUP-3254054,CDM,3254054WWM,LOCAL,270,RC,,inpatient,,,476,428.4,,0.95,,452.2,Percent of total billed charges,,,0.98,,466.48,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,0.97,,461.72,Percent of total billed charges,,,0.97,,461.72,Percent of total billed charges,,,0.96,,456.96,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,,,,,,,0.95,,452.2,Percent of total billed charges,,452.2,466.48,
GRASPER FB,SUP-3254054,CDM,3254054WWM,LOCAL,270,RC,,outpatient,,,476,428.4,,0.95,,452.2,Percent of total billed charges,,,0.98,,466.48,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,0.97,,461.72,Percent of total billed charges,,,0.96,,456.96,Percent of total billed charges,,,0.95,,452.2,Percent of total billed charges,,,,,,,,,0.95,,452.2,Percent of total billed charges,,452.2,466.48,
SECURE STRAP #STRAP25,SUP-3254068,CDM,3254068WWM,LOCAL,270,RC,,inpatient,,,1502.19,1351.97,,0.95,,1427.08,Percent of total billed charges,,,0.98,,1472.15,Percent of total billed charges,,,0.95,,1427.08,Percent of total billed charges,,,0.97,,1457.12,Percent of total billed charges,,,0.97,,1457.12,Percent of total billed charges,,,0.96,,1442.1,Percent of total billed charges,,,0.95,,1427.08,Percent of total billed charges,,,,,,,,,0.95,,1427.08,Percent of total billed charges,,1427.08,1472.15,
SECURE STRAP #STRAP25,SUP-3254068,CDM,3254068WWM,LOCAL,270,RC,,outpatient,,,1502.19,1351.97,,0.95,,1427.08,Percent of total billed charges,,,0.98,,1472.15,Percent of total billed charges,,,0.95,,1427.08,Percent of total billed charges,,,0.95,,1427.08,Percent of total billed charges,,,0.97,,1457.12,Percent of total billed charges,,,0.96,,1442.1,Percent of total billed charges,,,0.95,,1427.08,Percent of total billed charges,,,,,,,,,0.95,,1427.08,Percent of total billed charges,,1427.08,1472.15,
ENDO HERNIA STAPLER RELOAD 4.8,SUP-3254074,CDM,3254069WWM,LOCAL,270,RC,,inpatient,,,945,850.5,,0.95,,897.75,Percent of total billed charges,,,0.98,,926.1,Percent of total billed charges,,,0.95,,897.75,Percent of total billed charges,,,0.97,,916.65,Percent of total billed charges,,,0.97,,916.65,Percent of total billed charges,,,0.96,,907.2,Percent of total billed charges,,,0.95,,897.75,Percent of total billed charges,,,,,,,,,0.95,,897.75,Percent of total billed charges,,897.75,926.1,
ENDO HERNIA STAPLER RELOAD 4.8,SUP-3254074,CDM,3254069WWM,LOCAL,270,RC,,outpatient,,,945,850.5,,0.95,,897.75,Percent of total billed charges,,,0.98,,926.1,Percent of total billed charges,,,0.95,,897.75,Percent of total billed charges,,,0.95,,897.75,Percent of total billed charges,,,0.97,,916.65,Percent of total billed charges,,,0.96,,907.2,Percent of total billed charges,,,0.95,,897.75,Percent of total billed charges,,,,,,,,,0.95,,897.75,Percent of total billed charges,,897.75,926.1,
STAPLER ENDO HERNIA,SUP-3254069,CDM,3254074WWM,LOCAL,270,RC,,inpatient,,,1203.06,1082.75,,0.95,,1142.91,Percent of total billed charges,,,0.98,,1179,Percent of total billed charges,,,0.95,,1142.91,Percent of total billed charges,,,0.97,,1166.97,Percent of total billed charges,,,0.97,,1166.97,Percent of total billed charges,,,0.96,,1154.94,Percent of total billed charges,,,0.95,,1142.91,Percent of total billed charges,,,,,,,,,0.95,,1142.91,Percent of total billed charges,,1142.91,1179,
STAPLER ENDO HERNIA,SUP-3254069,CDM,3254074WWM,LOCAL,270,RC,,outpatient,,,1203.06,1082.75,,0.95,,1142.91,Percent of total billed charges,,,0.98,,1179,Percent of total billed charges,,,0.95,,1142.91,Percent of total billed charges,,,0.95,,1142.91,Percent of total billed charges,,,0.97,,1166.97,Percent of total billed charges,,,0.96,,1154.94,Percent of total billed charges,,,0.95,,1142.91,Percent of total billed charges,,,,,,,,,0.95,,1142.91,Percent of total billed charges,,1142.91,1179,
TAPE LABRAL #AR-7276,SUP-3254075,CDM,,,,,,inpatient,,,195,175.5,,0.95,,185.25,Percent of total billed charges,,,0.98,,191.1,Percent of total billed charges,,,0.95,,185.25,Percent of total billed charges,,,0.97,,189.15,Percent of total billed charges,,,0.97,,189.15,Percent of total billed charges,,,0.96,,187.2,Percent of total billed charges,,,0.95,,185.25,Percent of total billed charges,,,,,,,,,0.95,,185.25,Percent of total billed charges,,185.25,191.1,
TAPE LABRAL #AR-7276,SUP-3254075,CDM,,,,,,outpatient,,,195,175.5,,0.95,,185.25,Percent of total billed charges,,,0.98,,191.1,Percent of total billed charges,,,0.95,,185.25,Percent of total billed charges,,,0.95,,185.25,Percent of total billed charges,,,0.97,,189.15,Percent of total billed charges,,,0.96,,187.2,Percent of total billed charges,,,0.95,,185.25,Percent of total billed charges,,,,,,,,,0.95,,185.25,Percent of total billed charges,,185.25,191.1,
SHOULDER SUSP #DYNJSHOULDER,SUP-3254076,CDM,27010242,LOCAL,270,RC,,inpatient,,,80.46,72.41,,0.95,,76.44,Percent of total billed charges,,,0.98,,78.85,Percent of total billed charges,,,0.95,,76.44,Percent of total billed charges,,,0.97,,78.05,Percent of total billed charges,,,0.97,,78.05,Percent of total billed charges,,,0.96,,77.24,Percent of total billed charges,,,0.95,,76.44,Percent of total billed charges,,,,,,,,,0.95,,76.44,Percent of total billed charges,,76.44,78.85,
SHOULDER SUSP #DYNJSHOULDER,SUP-3254076,CDM,27010242,LOCAL,270,RC,,outpatient,,,80.46,72.41,,0.95,,76.44,Percent of total billed charges,,,0.98,,78.85,Percent of total billed charges,,,0.95,,76.44,Percent of total billed charges,,,0.95,,76.44,Percent of total billed charges,,,0.97,,78.05,Percent of total billed charges,,,0.96,,77.24,Percent of total billed charges,,,0.95,,76.44,Percent of total billed charges,,,,,,,,,0.95,,76.44,Percent of total billed charges,,76.44,78.85,
TIGHTROPE RT ACL,SUP-3254048,CDM,3254048WWM,LOCAL,270,RC,,inpatient,,,1050,945,,0.95,,997.5,Percent of total billed charges,,,0.98,,1029,Percent of total billed charges,,,0.95,,997.5,Percent of total billed charges,,,0.97,,1018.5,Percent of total billed charges,,,0.97,,1018.5,Percent of total billed charges,,,0.96,,1008,Percent of total billed charges,,,0.95,,997.5,Percent of total billed charges,,,,,,,,,0.95,,997.5,Percent of total billed charges,,997.5,1029,
TIGHTROPE RT ACL,SUP-3254048,CDM,3254048WWM,LOCAL,270,RC,,outpatient,,,1050,945,,0.95,,997.5,Percent of total billed charges,,,0.98,,1029,Percent of total billed charges,,,0.95,,997.5,Percent of total billed charges,,,0.95,,997.5,Percent of total billed charges,,,0.97,,1018.5,Percent of total billed charges,,,0.96,,1008,Percent of total billed charges,,,0.95,,997.5,Percent of total billed charges,,,,,,,,,0.95,,997.5,Percent of total billed charges,,997.5,1029,
TENODESIS SWIVELOC AR-1662PSL-7,SUP-3254078,CDM,27810126,LOCAL,278,RC,,inpatient,,,608,547.2,,0.95,,577.6,Percent of total billed charges,,,0.98,,595.84,Percent of total billed charges,,,0.95,,577.6,Percent of total billed charges,,,0.97,,589.76,Percent of total billed charges,,,0.97,,589.76,Percent of total billed charges,,,0.96,,583.68,Percent of total billed charges,,,0.95,,577.6,Percent of total billed charges,,,,,,,,,0.95,,577.6,Percent of total billed charges,,577.6,595.84,
TENODESIS SWIVELOC AR-1662PSL-7,SUP-3254078,CDM,27810126,LOCAL,278,RC,,outpatient,,,608,547.2,,0.95,,577.6,Percent of total billed charges,,,0.98,,595.84,Percent of total billed charges,,,0.95,,577.6,Percent of total billed charges,,,0.95,,577.6,Percent of total billed charges,,,0.97,,589.76,Percent of total billed charges,,,0.96,,583.68,Percent of total billed charges,,,0.95,,577.6,Percent of total billed charges,,,,,,,,,0.95,,577.6,Percent of total billed charges,,577.6,595.84,
TENODESIS SWIVELOC AR-1662PSL-8,SUP-3254079,CDM,C1713,HCPCS,278,RC,,inpatient,,,1215,1093.5,,0.95,,1154.25,Percent of total billed charges,,,0.98,,1190.7,Percent of total billed charges,,,0.95,,1154.25,Percent of total billed charges,,,0.97,,1178.55,Percent of total billed charges,,,0.97,,1178.55,Percent of total billed charges,,,0.96,,1166.4,Percent of total billed charges,,,0.95,,1154.25,Percent of total billed charges,,,,,,,,,0.95,,1154.25,Percent of total billed charges,,1154.25,1190.7,
TENODESIS SWIVELOC AR-1662PSL-8,SUP-3254079,CDM,C1713,HCPCS,278,RC,,outpatient,,,1215,1093.5,,0.95,,1154.25,Percent of total billed charges,,,0.98,,1190.7,Percent of total billed charges,,,0.95,,1154.25,Percent of total billed charges,,,0.95,,1154.25,Percent of total billed charges,,,0.97,,1178.55,Percent of total billed charges,,,0.96,,1166.4,Percent of total billed charges,,,0.95,,1154.25,Percent of total billed charges,,,,,,,,,0.95,,1154.25,Percent of total billed charges,,1154.25,1190.7,
TENODESIS SWIVELOC AR-1662PSL-9,SUP-3254080,CDM,C1713,HCPCS,278,RC,,inpatient,,,1215,1093.5,,0.95,,1154.25,Percent of total billed charges,,,0.98,,1190.7,Percent of total billed charges,,,0.95,,1154.25,Percent of total billed charges,,,0.97,,1178.55,Percent of total billed charges,,,0.97,,1178.55,Percent of total billed charges,,,0.96,,1166.4,Percent of total billed charges,,,0.95,,1154.25,Percent of total billed charges,,,,,,,,,0.95,,1154.25,Percent of total billed charges,,1154.25,1190.7,
TENODESIS SWIVELOC AR-1662PSL-9,SUP-3254080,CDM,C1713,HCPCS,278,RC,,outpatient,,,1215,1093.5,,0.95,,1154.25,Percent of total billed charges,,,0.98,,1190.7,Percent of total billed charges,,,0.95,,1154.25,Percent of total billed charges,,,0.95,,1154.25,Percent of total billed charges,,,0.97,,1178.55,Percent of total billed charges,,,0.96,,1166.4,Percent of total billed charges,,,0.95,,1154.25,Percent of total billed charges,,,,,,,,,0.95,,1154.25,Percent of total billed charges,,1154.25,1190.7,
SPEEDBRIDGE IMPLANT AR-2600SBS-4,SUP-3254081,CDM,C1713,HCPCS,278,RC,,inpatient,,,4350,3915,,0.95,,4132.5,Percent of total billed charges,,,0.98,,4263,Percent of total billed charges,,,0.95,,4132.5,Percent of total billed charges,,,0.97,,4219.5,Percent of total billed charges,,,0.97,,4219.5,Percent of total billed charges,,,0.96,,4176,Percent of total billed charges,,,0.95,,4132.5,Percent of total billed charges,,,,,,,,,0.95,,4132.5,Percent of total billed charges,,4132.5,4263,
SPEEDBRIDGE IMPLANT AR-2600SBS-4,SUP-3254081,CDM,C1713,HCPCS,278,RC,,outpatient,,,4350,3915,,0.95,,4132.5,Percent of total billed charges,,,0.98,,4263,Percent of total billed charges,,,0.95,,4132.5,Percent of total billed charges,,,0.95,,4132.5,Percent of total billed charges,,,0.97,,4219.5,Percent of total billed charges,,,0.96,,4176,Percent of total billed charges,,,0.95,,4132.5,Percent of total billed charges,,,,,,,,,0.95,,4132.5,Percent of total billed charges,,4132.5,4263,
SUTURE ANCHOR AR-2324BCC,SUP-3254082,CDM,C1713,HCPCS,278,RC,,inpatient,,,1200,1080,,0.95,,1140,Percent of total billed charges,,,0.98,,1176,Percent of total billed charges,,,0.95,,1140,Percent of total billed charges,,,0.97,,1164,Percent of total billed charges,,,0.97,,1164,Percent of total billed charges,,,0.96,,1152,Percent of total billed charges,,,0.95,,1140,Percent of total billed charges,,,,,,,,,0.95,,1140,Percent of total billed charges,,1140,1176,
SUTURE ANCHOR AR-2324BCC,SUP-3254082,CDM,C1713,HCPCS,278,RC,,outpatient,,,1200,1080,,0.95,,1140,Percent of total billed charges,,,0.98,,1176,Percent of total billed charges,,,0.95,,1140,Percent of total billed charges,,,0.95,,1140,Percent of total billed charges,,,0.97,,1164,Percent of total billed charges,,,0.96,,1152,Percent of total billed charges,,,0.95,,1140,Percent of total billed charges,,,,,,,,,0.95,,1140,Percent of total billed charges,,1140,1176,
TORPEDO 5MM AR-8500TD,SUP-3254083,CDM,3254083WWM,LOCAL,272,RC,,inpatient,,,353.5,318.15,,0.95,,335.83,Percent of total billed charges,,,0.98,,346.43,Percent of total billed charges,,,0.95,,335.83,Percent of total billed charges,,,0.97,,342.9,Percent of total billed charges,,,0.97,,342.9,Percent of total billed charges,,,0.96,,339.36,Percent of total billed charges,,,0.95,,335.83,Percent of total billed charges,,,,,,,,,0.95,,335.83,Percent of total billed charges,,335.83,346.43,
TORPEDO 5MM AR-8500TD,SUP-3254083,CDM,3254083WWM,LOCAL,272,RC,,outpatient,,,353.5,318.15,,0.95,,335.83,Percent of total billed charges,,,0.98,,346.43,Percent of total billed charges,,,0.95,,335.83,Percent of total billed charges,,,0.95,,335.83,Percent of total billed charges,,,0.97,,342.9,Percent of total billed charges,,,0.96,,339.36,Percent of total billed charges,,,0.95,,335.83,Percent of total billed charges,,,,,,,,,0.95,,335.83,Percent of total billed charges,,335.83,346.43,
WASHER ORTH SPKD 13.5/6.5MM,SUP-219.951,CDM,C1713,HCPCS,278,RC,,inpatient,,,419.4,377.46,,0.95,,398.43,Percent of total billed charges,,,0.98,,411.01,Percent of total billed charges,,,0.95,,398.43,Percent of total billed charges,,,0.97,,406.82,Percent of total billed charges,,,0.97,,406.82,Percent of total billed charges,,,0.96,,402.62,Percent of total billed charges,,,0.95,,398.43,Percent of total billed charges,,,,,,,,,0.95,,398.43,Percent of total billed charges,,398.43,411.01,
WASHER ORTH SPKD 13.5/6.5MM,SUP-219.951,CDM,C1713,HCPCS,278,RC,,outpatient,,,419.4,377.46,,0.95,,398.43,Percent of total billed charges,,,0.98,,411.01,Percent of total billed charges,,,0.95,,398.43,Percent of total billed charges,,,0.95,,398.43,Percent of total billed charges,,,0.97,,406.82,Percent of total billed charges,,,0.96,,402.62,Percent of total billed charges,,,0.95,,398.43,Percent of total billed charges,,,,,,,,,0.95,,398.43,Percent of total billed charges,,398.43,411.01,
DRILL BIT 3.2MM - 145MM/120MM,SUP-310.31,CDM,27210093,LOCAL,272,RC,,inpatient,,,306.86,276.17,,0.95,,291.52,Percent of total billed charges,,,0.98,,300.72,Percent of total billed charges,,,0.95,,291.52,Percent of total billed charges,,,0.97,,297.65,Percent of total billed charges,,,0.97,,297.65,Percent of total billed charges,,,0.96,,294.59,Percent of total billed charges,,,0.95,,291.52,Percent of total billed charges,,,,,,,,,0.95,,291.52,Percent of total billed charges,,291.52,300.72,
DRILL BIT 3.2MM - 145MM/120MM,SUP-310.31,CDM,27210093,LOCAL,272,RC,,outpatient,,,306.86,276.17,,0.95,,291.52,Percent of total billed charges,,,0.98,,300.72,Percent of total billed charges,,,0.95,,291.52,Percent of total billed charges,,,0.95,,291.52,Percent of total billed charges,,,0.97,,297.65,Percent of total billed charges,,,0.96,,294.59,Percent of total billed charges,,,0.95,,291.52,Percent of total billed charges,,,,,,,,,0.95,,291.52,Percent of total billed charges,,291.52,300.72,
SCREW 4.5 CORTEX 20MM SELF-TAP,SUP-214.82,CDM,C1713,HCPCS,278,RC,,inpatient,,,153.6,138.24,,0.95,,145.92,Percent of total billed charges,,,0.98,,150.53,Percent of total billed charges,,,0.95,,145.92,Percent of total billed charges,,,0.97,,148.99,Percent of total billed charges,,,0.97,,148.99,Percent of total billed charges,,,0.96,,147.46,Percent of total billed charges,,,0.95,,145.92,Percent of total billed charges,,,,,,,,,0.95,,145.92,Percent of total billed charges,,145.92,150.53,
SCREW 4.5 CORTEX 20MM SELF-TAP,SUP-214.82,CDM,C1713,HCPCS,278,RC,,outpatient,,,153.6,138.24,,0.95,,145.92,Percent of total billed charges,,,0.98,,150.53,Percent of total billed charges,,,0.95,,145.92,Percent of total billed charges,,,0.95,,145.92,Percent of total billed charges,,,0.97,,148.99,Percent of total billed charges,,,0.96,,147.46,Percent of total billed charges,,,0.95,,145.92,Percent of total billed charges,,,,,,,,,0.95,,145.92,Percent of total billed charges,,145.92,150.53,
OR APOLLO RF 90,SUP-3254107,CDM,3254107WWM,LOCAL,270,RC,,inpatient,,,1140,1026,,0.95,,1083,Percent of total billed charges,,,0.98,,1117.2,Percent of total billed charges,,,0.95,,1083,Percent of total billed charges,,,0.97,,1105.8,Percent of total billed charges,,,0.97,,1105.8,Percent of total billed charges,,,0.96,,1094.4,Percent of total billed charges,,,0.95,,1083,Percent of total billed charges,,,,,,,,,0.95,,1083,Percent of total billed charges,,1083,1117.2,
OR APOLLO RF 90,SUP-3254107,CDM,3254107WWM,LOCAL,270,RC,,outpatient,,,1140,1026,,0.95,,1083,Percent of total billed charges,,,0.98,,1117.2,Percent of total billed charges,,,0.95,,1083,Percent of total billed charges,,,0.95,,1083,Percent of total billed charges,,,0.97,,1105.8,Percent of total billed charges,,,0.96,,1094.4,Percent of total billed charges,,,0.95,,1083,Percent of total billed charges,,,,,,,,,0.95,,1083,Percent of total billed charges,,1083,1117.2,
AR-4060S,SUP-AR-4060S,CDM,27810126,LOCAL,278,RC,,inpatient,,,427.5,384.75,,0.95,,406.13,Percent of total billed charges,,,0.98,,418.95,Percent of total billed charges,,,0.95,,406.13,Percent of total billed charges,,,0.97,,414.68,Percent of total billed charges,,,0.97,,414.68,Percent of total billed charges,,,0.96,,410.4,Percent of total billed charges,,,0.95,,406.13,Percent of total billed charges,,,,,,,,,0.95,,406.13,Percent of total billed charges,,406.13,418.95,
AR-4060S,SUP-AR-4060S,CDM,27810126,LOCAL,278,RC,,outpatient,,,427.5,384.75,,0.95,,406.13,Percent of total billed charges,,,0.98,,418.95,Percent of total billed charges,,,0.95,,406.13,Percent of total billed charges,,,0.95,,406.13,Percent of total billed charges,,,0.97,,414.68,Percent of total billed charges,,,0.96,,410.4,Percent of total billed charges,,,0.95,,406.13,Percent of total billed charges,,,,,,,,,0.95,,406.13,Percent of total billed charges,,406.13,418.95,
2-0 FIBERWIRE MENISCUS REPAIR NEEDLES,SUP-AR-7223,CDM,27810126,LOCAL,278,RC,,inpatient,,,324,291.6,,0.95,,307.8,Percent of total billed charges,,,0.98,,317.52,Percent of total billed charges,,,0.95,,307.8,Percent of total billed charges,,,0.97,,314.28,Percent of total billed charges,,,0.97,,314.28,Percent of total billed charges,,,0.96,,311.04,Percent of total billed charges,,,0.95,,307.8,Percent of total billed charges,,,,,,,,,0.95,,307.8,Percent of total billed charges,,307.8,317.52,
2-0 FIBERWIRE MENISCUS REPAIR NEEDLES,SUP-AR-7223,CDM,27810126,LOCAL,278,RC,,outpatient,,,324,291.6,,0.95,,307.8,Percent of total billed charges,,,0.98,,317.52,Percent of total billed charges,,,0.95,,307.8,Percent of total billed charges,,,0.95,,307.8,Percent of total billed charges,,,0.97,,314.28,Percent of total billed charges,,,0.96,,311.04,Percent of total billed charges,,,0.95,,307.8,Percent of total billed charges,,,,,,,,,0.95,,307.8,Percent of total billed charges,,307.8,317.52,
10.0 MM FLIP CUTTER II,SUP-AR-1204AF-100,CDM,27810126,LOCAL,278,RC,,inpatient,,,975,877.5,,0.95,,926.25,Percent of total billed charges,,,0.98,,955.5,Percent of total billed charges,,,0.95,,926.25,Percent of total billed charges,,,0.97,,945.75,Percent of total billed charges,,,0.97,,945.75,Percent of total billed charges,,,0.96,,936,Percent of total billed charges,,,0.95,,926.25,Percent of total billed charges,,,,,,,,,0.95,,926.25,Percent of total billed charges,,926.25,955.5,
10.0 MM FLIP CUTTER II,SUP-AR-1204AF-100,CDM,27810126,LOCAL,278,RC,,outpatient,,,975,877.5,,0.95,,926.25,Percent of total billed charges,,,0.98,,955.5,Percent of total billed charges,,,0.95,,926.25,Percent of total billed charges,,,0.95,,926.25,Percent of total billed charges,,,0.97,,945.75,Percent of total billed charges,,,0.96,,936,Percent of total billed charges,,,0.95,,926.25,Percent of total billed charges,,,,,,,,,0.95,,926.25,Percent of total billed charges,,926.25,955.5,
"DRILL, 10MM CANNULATED",SUP-AR-1218-100,CDM,27010242,LOCAL,270,RC,,inpatient,,,390,351,,0.95,,370.5,Percent of total billed charges,,,0.98,,382.2,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,0.97,,378.3,Percent of total billed charges,,,0.97,,378.3,Percent of total billed charges,,,0.96,,374.4,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,,,,,,,0.95,,370.5,Percent of total billed charges,,370.5,382.2,
"DRILL, 10MM CANNULATED",SUP-AR-1218-100,CDM,27010242,LOCAL,270,RC,,outpatient,,,390,351,,0.95,,370.5,Percent of total billed charges,,,0.98,,382.2,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,0.97,,378.3,Percent of total billed charges,,,0.96,,374.4,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,,,,,,,0.95,,370.5,Percent of total billed charges,,370.5,382.2,
BTB TIGHTROPE,SUP-AR-1588BTB,CDM,27810126,LOCAL,278,RC,,inpatient,,,1275,1147.5,,0.95,,1211.25,Percent of total billed charges,,,0.98,,1249.5,Percent of total billed charges,,,0.95,,1211.25,Percent of total billed charges,,,0.97,,1236.75,Percent of total billed charges,,,0.97,,1236.75,Percent of total billed charges,,,0.96,,1224,Percent of total billed charges,,,0.95,,1211.25,Percent of total billed charges,,,,,,,,,0.95,,1211.25,Percent of total billed charges,,1211.25,1249.5,
BTB TIGHTROPE,SUP-AR-1588BTB,CDM,27810126,LOCAL,278,RC,,outpatient,,,1275,1147.5,,0.95,,1211.25,Percent of total billed charges,,,0.98,,1249.5,Percent of total billed charges,,,0.95,,1211.25,Percent of total billed charges,,,0.95,,1211.25,Percent of total billed charges,,,0.97,,1236.75,Percent of total billed charges,,,0.96,,1224,Percent of total billed charges,,,0.95,,1211.25,Percent of total billed charges,,,,,,,,,0.95,,1211.25,Percent of total billed charges,,1211.25,1249.5,
"BLADE, PARALLEL GRAFT KNIFE, 10MM",SUP-AR-2285-10,CDM,27810126,LOCAL,278,RC,,inpatient,,,211.5,190.35,,0.95,,200.93,Percent of total billed charges,,,0.98,,207.27,Percent of total billed charges,,,0.95,,200.93,Percent of total billed charges,,,0.97,,205.16,Percent of total billed charges,,,0.97,,205.16,Percent of total billed charges,,,0.96,,203.04,Percent of total billed charges,,,0.95,,200.93,Percent of total billed charges,,,,,,,,,0.95,,200.93,Percent of total billed charges,,200.93,207.27,
"BLADE, PARALLEL GRAFT KNIFE, 10MM",SUP-AR-2285-10,CDM,27810126,LOCAL,278,RC,,outpatient,,,211.5,190.35,,0.95,,200.93,Percent of total billed charges,,,0.98,,207.27,Percent of total billed charges,,,0.95,,200.93,Percent of total billed charges,,,0.95,,200.93,Percent of total billed charges,,,0.97,,205.16,Percent of total billed charges,,,0.96,,203.04,Percent of total billed charges,,,0.95,,200.93,Percent of total billed charges,,,,,,,,,0.95,,200.93,Percent of total billed charges,,200.93,207.27,
"8X20MM BC IF SCRW, VENTED",SUP-AR-4020C-08,CDM,27810126,LOCAL,278,RC,,inpatient,,,1032.5,929.25,,0.95,,980.88,Percent of total billed charges,,,0.98,,1011.85,Percent of total billed charges,,,0.95,,980.88,Percent of total billed charges,,,0.97,,1001.53,Percent of total billed charges,,,0.97,,1001.53,Percent of total billed charges,,,0.96,,991.2,Percent of total billed charges,,,0.95,,980.88,Percent of total billed charges,,,,,,,,,0.95,,980.88,Percent of total billed charges,,980.88,1011.85,
"8X20MM BC IF SCRW, VENTED",SUP-AR-4020C-08,CDM,27810126,LOCAL,278,RC,,outpatient,,,1032.5,929.25,,0.95,,980.88,Percent of total billed charges,,,0.98,,1011.85,Percent of total billed charges,,,0.95,,980.88,Percent of total billed charges,,,0.95,,980.88,Percent of total billed charges,,,0.97,,1001.53,Percent of total billed charges,,,0.96,,991.2,Percent of total billed charges,,,0.95,,980.88,Percent of total billed charges,,,,,,,,,0.95,,980.88,Percent of total billed charges,,980.88,1011.85,
FAST-FIX 360 CURVED NDL DELIVERY SYS,SUP-72202468,CDM,27810126,LOCAL,278,RC,,inpatient,,,1436.61,1292.95,,0.95,,1364.78,Percent of total billed charges,,,0.98,,1407.88,Percent of total billed charges,,,0.95,,1364.78,Percent of total billed charges,,,0.97,,1393.51,Percent of total billed charges,,,0.97,,1393.51,Percent of total billed charges,,,0.96,,1379.15,Percent of total billed charges,,,0.95,,1364.78,Percent of total billed charges,,,,,,,,,0.95,,1364.78,Percent of total billed charges,,1364.78,1407.88,
FAST-FIX 360 CURVED NDL DELIVERY SYS,SUP-72202468,CDM,27810126,LOCAL,278,RC,,outpatient,,,1436.61,1292.95,,0.95,,1364.78,Percent of total billed charges,,,0.98,,1407.88,Percent of total billed charges,,,0.95,,1364.78,Percent of total billed charges,,,0.95,,1364.78,Percent of total billed charges,,,0.97,,1393.51,Percent of total billed charges,,,0.96,,1379.15,Percent of total billed charges,,,0.95,,1364.78,Percent of total billed charges,,,,,,,,,0.95,,1364.78,Percent of total billed charges,,1364.78,1407.88,
"BUR, OVAL, FLUSHCUT, 6 FLUT, 5.MMX 13CM",SUP-AR-8500FOS,CDM,27010242,LOCAL,270,RC,,inpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
"BUR, OVAL, FLUSHCUT, 6 FLUT, 5.MMX 13CM",SUP-AR-8500FOS,CDM,27010242,LOCAL,270,RC,,outpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
"SUTR ANCH, BIOCRKSCRW FT, TRI-PLAY",SUP-3254197,CDM,27810126,LOCAL,278,RC,,inpatient,,,1050,945,,0.95,,997.5,Percent of total billed charges,,,0.98,,1029,Percent of total billed charges,,,0.95,,997.5,Percent of total billed charges,,,0.97,,1018.5,Percent of total billed charges,,,0.97,,1018.5,Percent of total billed charges,,,0.96,,1008,Percent of total billed charges,,,0.95,,997.5,Percent of total billed charges,,,,,,,,,0.95,,997.5,Percent of total billed charges,,997.5,1029,
"SUTR ANCH, BIOCRKSCRW FT, TRI-PLAY",SUP-3254197,CDM,27810126,LOCAL,278,RC,,outpatient,,,1050,945,,0.95,,997.5,Percent of total billed charges,,,0.98,,1029,Percent of total billed charges,,,0.95,,997.5,Percent of total billed charges,,,0.95,,997.5,Percent of total billed charges,,,0.97,,1018.5,Percent of total billed charges,,,0.96,,1008,Percent of total billed charges,,,0.95,,997.5,Percent of total billed charges,,,,,,,,,0.95,,997.5,Percent of total billed charges,,997.5,1029,
LPT ANGLES GREAT TOE SIZE 2,SUP-487A002,CDM,27810126,LOCAL,278,RC,,inpatient,,,5682.5,5114.25,,0.95,,5398.38,Percent of total billed charges,,,0.98,,5568.85,Percent of total billed charges,,,0.95,,5398.38,Percent of total billed charges,,,0.97,,5512.03,Percent of total billed charges,,,0.97,,5512.03,Percent of total billed charges,,,0.96,,5455.2,Percent of total billed charges,,,0.95,,5398.38,Percent of total billed charges,,,,,,,,,0.95,,5398.38,Percent of total billed charges,,5398.38,5568.85,
LPT ANGLES GREAT TOE SIZE 2,SUP-487A002,CDM,27810126,LOCAL,278,RC,,outpatient,,,5682.5,5114.25,,0.95,,5398.38,Percent of total billed charges,,,0.98,,5568.85,Percent of total billed charges,,,0.95,,5398.38,Percent of total billed charges,,,0.95,,5398.38,Percent of total billed charges,,,0.97,,5512.03,Percent of total billed charges,,,0.96,,5455.2,Percent of total billed charges,,,0.95,,5398.38,Percent of total billed charges,,,,,,,,,0.95,,5398.38,Percent of total billed charges,,5398.38,5568.85,
4.5MM CORTEX SCREW SELF-TAPPING 20MM,SUP-214.820,CDM,27810126,LOCAL,278,RC,,inpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
4.5MM CORTEX SCREW SELF-TAPPING 20MM,SUP-214.820,CDM,27810126,LOCAL,278,RC,,outpatient,,,198,178.2,,0.95,,188.1,Percent of total billed charges,,,0.98,,194.04,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,0.97,,192.06,Percent of total billed charges,,,0.96,,190.08,Percent of total billed charges,,,0.95,,188.1,Percent of total billed charges,,,,,,,,,0.95,,188.1,Percent of total billed charges,,188.1,194.04,
SPIKED WASHER 13.5MM/6.5MM,SUP-219.951,CDM,27810126,LOCAL,278,RC,,inpatient,,,763,686.7,,0.95,,724.85,Percent of total billed charges,,,0.98,,747.74,Percent of total billed charges,,,0.95,,724.85,Percent of total billed charges,,,0.97,,740.11,Percent of total billed charges,,,0.97,,740.11,Percent of total billed charges,,,0.96,,732.48,Percent of total billed charges,,,0.95,,724.85,Percent of total billed charges,,,,,,,,,0.95,,724.85,Percent of total billed charges,,724.85,747.74,
SPIKED WASHER 13.5MM/6.5MM,SUP-219.951,CDM,27810126,LOCAL,278,RC,,outpatient,,,763,686.7,,0.95,,724.85,Percent of total billed charges,,,0.98,,747.74,Percent of total billed charges,,,0.95,,724.85,Percent of total billed charges,,,0.95,,724.85,Percent of total billed charges,,,0.97,,740.11,Percent of total billed charges,,,0.96,,732.48,Percent of total billed charges,,,0.95,,724.85,Percent of total billed charges,,,,,,,,,0.95,,724.85,Percent of total billed charges,,724.85,747.74,
LAPRO-SHARK,SUP-P10176,CDM,27810126,LOCAL,278,RC,,inpatient,,,274.5,247.05,,0.95,,260.78,Percent of total billed charges,,,0.98,,269.01,Percent of total billed charges,,,0.95,,260.78,Percent of total billed charges,,,0.97,,266.27,Percent of total billed charges,,,0.97,,266.27,Percent of total billed charges,,,0.96,,263.52,Percent of total billed charges,,,0.95,,260.78,Percent of total billed charges,,,,,,,,,0.95,,260.78,Percent of total billed charges,,260.78,269.01,
LAPRO-SHARK,SUP-P10176,CDM,27810126,LOCAL,278,RC,,outpatient,,,274.5,247.05,,0.95,,260.78,Percent of total billed charges,,,0.98,,269.01,Percent of total billed charges,,,0.95,,260.78,Percent of total billed charges,,,0.95,,260.78,Percent of total billed charges,,,0.97,,266.27,Percent of total billed charges,,,0.96,,263.52,Percent of total billed charges,,,0.95,,260.78,Percent of total billed charges,,,,,,,,,0.95,,260.78,Percent of total billed charges,,260.78,269.01,
ENDOPATH ATS-FLEX 45,SUP-3253718,CDM,27810126,LOCAL,278,RC,,inpatient,,,1837.44,1653.7,,0.95,,1745.57,Percent of total billed charges,,,0.98,,1800.69,Percent of total billed charges,,,0.95,,1745.57,Percent of total billed charges,,,0.97,,1782.32,Percent of total billed charges,,,0.97,,1782.32,Percent of total billed charges,,,0.96,,1763.94,Percent of total billed charges,,,0.95,,1745.57,Percent of total billed charges,,,,,,,,,0.95,,1745.57,Percent of total billed charges,,1745.57,1800.69,
ENDOPATH ATS-FLEX 45,SUP-3253718,CDM,27810126,LOCAL,278,RC,,outpatient,,,1837.44,1653.7,,0.95,,1745.57,Percent of total billed charges,,,0.98,,1800.69,Percent of total billed charges,,,0.95,,1745.57,Percent of total billed charges,,,0.95,,1745.57,Percent of total billed charges,,,0.97,,1782.32,Percent of total billed charges,,,0.96,,1763.94,Percent of total billed charges,,,0.95,,1745.57,Percent of total billed charges,,,,,,,,,0.95,,1745.57,Percent of total billed charges,,1745.57,1800.69,
DRILL CANNULATED 10.5MM,SUP-AR-1218-105,CDM,27010242,LOCAL,270,RC,,inpatient,,,390,351,,0.95,,370.5,Percent of total billed charges,,,0.98,,382.2,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,0.97,,378.3,Percent of total billed charges,,,0.97,,378.3,Percent of total billed charges,,,0.96,,374.4,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,,,,,,,0.95,,370.5,Percent of total billed charges,,370.5,382.2,
DRILL CANNULATED 10.5MM,SUP-AR-1218-105,CDM,27010242,LOCAL,270,RC,,outpatient,,,390,351,,0.95,,370.5,Percent of total billed charges,,,0.98,,382.2,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,0.97,,378.3,Percent of total billed charges,,,0.96,,374.4,Percent of total billed charges,,,0.95,,370.5,Percent of total billed charges,,,,,,,,,0.95,,370.5,Percent of total billed charges,,370.5,382.2,
TRUMPET CRE VLV 5MMX32CM,SUP-TRUMPET CRE VLV 5MMX32CM,CDM,27010242,LOCAL,270,RC,,inpatient,,,105.25,94.73,,0.95,,99.99,Percent of total billed charges,,,0.98,,103.15,Percent of total billed charges,,,0.95,,99.99,Percent of total billed charges,,,0.97,,102.09,Percent of total billed charges,,,0.97,,102.09,Percent of total billed charges,,,0.96,,101.04,Percent of total billed charges,,,0.95,,99.99,Percent of total billed charges,,,,,,,,,0.95,,99.99,Percent of total billed charges,,99.99,103.15,
TRUMPET CRE VLV 5MMX32CM,SUP-TRUMPET CRE VLV 5MMX32CM,CDM,27010242,LOCAL,270,RC,,outpatient,,,105.25,94.73,,0.95,,99.99,Percent of total billed charges,,,0.98,,103.15,Percent of total billed charges,,,0.95,,99.99,Percent of total billed charges,,,0.95,,99.99,Percent of total billed charges,,,0.97,,102.09,Percent of total billed charges,,,0.96,,101.04,Percent of total billed charges,,,0.95,,99.99,Percent of total billed charges,,,,,,,,,0.95,,99.99,Percent of total billed charges,,99.99,103.15,
OR ANA TOEMIC IMPLANT 18.5MM,SUP-3254165,CDM,27810126,LOCAL,278,RC,,inpatient,,,1043,938.7,,0.95,,990.85,Percent of total billed charges,,,0.98,,1022.14,Percent of total billed charges,,,0.95,,990.85,Percent of total billed charges,,,0.97,,1011.71,Percent of total billed charges,,,0.97,,1011.71,Percent of total billed charges,,,0.96,,1001.28,Percent of total billed charges,,,0.95,,990.85,Percent of total billed charges,,,,,,,,,0.95,,990.85,Percent of total billed charges,,990.85,1022.14,
OR ANA TOEMIC IMPLANT 18.5MM,SUP-3254165,CDM,27810126,LOCAL,278,RC,,outpatient,,,1043,938.7,,0.95,,990.85,Percent of total billed charges,,,0.98,,1022.14,Percent of total billed charges,,,0.95,,990.85,Percent of total billed charges,,,0.95,,990.85,Percent of total billed charges,,,0.97,,1011.71,Percent of total billed charges,,,0.96,,1001.28,Percent of total billed charges,,,0.95,,990.85,Percent of total billed charges,,,,,,,,,0.95,,990.85,Percent of total billed charges,,990.85,1022.14,
OR ANA TOEMIC IMPLANT 17MM,SUP-3254164,CDM,27810126,LOCAL,278,RC,,inpatient,,,1043,938.7,,0.95,,990.85,Percent of total billed charges,,,0.98,,1022.14,Percent of total billed charges,,,0.95,,990.85,Percent of total billed charges,,,0.97,,1011.71,Percent of total billed charges,,,0.97,,1011.71,Percent of total billed charges,,,0.96,,1001.28,Percent of total billed charges,,,0.95,,990.85,Percent of total billed charges,,,,,,,,,0.95,,990.85,Percent of total billed charges,,990.85,1022.14,
OR ANA TOEMIC IMPLANT 17MM,SUP-3254164,CDM,27810126,LOCAL,278,RC,,outpatient,,,1043,938.7,,0.95,,990.85,Percent of total billed charges,,,0.98,,1022.14,Percent of total billed charges,,,0.95,,990.85,Percent of total billed charges,,,0.95,,990.85,Percent of total billed charges,,,0.97,,1011.71,Percent of total billed charges,,,0.96,,1001.28,Percent of total billed charges,,,0.95,,990.85,Percent of total billed charges,,,,,,,,,0.95,,990.85,Percent of total billed charges,,990.85,1022.14,
OR ANA TOEMIC IMPLANT 23MM,SUP-3254168,CDM,27810126,LOCAL,278,RC,,inpatient,,,1043,938.7,,0.95,,990.85,Percent of total billed charges,,,0.98,,1022.14,Percent of total billed charges,,,0.95,,990.85,Percent of total billed charges,,,0.97,,1011.71,Percent of total billed charges,,,0.97,,1011.71,Percent of total billed charges,,,0.96,,1001.28,Percent of total billed charges,,,0.95,,990.85,Percent of total billed charges,,,,,,,,,0.95,,990.85,Percent of total billed charges,,990.85,1022.14,
OR ANA TOEMIC IMPLANT 23MM,SUP-3254168,CDM,27810126,LOCAL,278,RC,,outpatient,,,1043,938.7,,0.95,,990.85,Percent of total billed charges,,,0.98,,1022.14,Percent of total billed charges,,,0.95,,990.85,Percent of total billed charges,,,0.95,,990.85,Percent of total billed charges,,,0.97,,1011.71,Percent of total billed charges,,,0.96,,1001.28,Percent of total billed charges,,,0.95,,990.85,Percent of total billed charges,,,,,,,,,0.95,,990.85,Percent of total billed charges,,990.85,1022.14,
OR GRAFTBOLT TIBIAL 8MM,SUP-AR-5100-08,CDM,27010242,LOCAL,270,RC,,inpatient,,,1185,1066.5,,0.95,,1125.75,Percent of total billed charges,,,0.98,,1161.3,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,0.97,,1149.45,Percent of total billed charges,,,0.97,,1149.45,Percent of total billed charges,,,0.96,,1137.6,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,,,,,,,0.95,,1125.75,Percent of total billed charges,,1125.75,1161.3,
OR GRAFTBOLT TIBIAL 8MM,SUP-AR-5100-08,CDM,27010242,LOCAL,270,RC,,outpatient,,,1185,1066.5,,0.95,,1125.75,Percent of total billed charges,,,0.98,,1161.3,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,0.97,,1149.45,Percent of total billed charges,,,0.96,,1137.6,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,,,,,,,0.95,,1125.75,Percent of total billed charges,,1125.75,1161.3,
OR TIGHTROPE ACL CLOSED EYE,SUP-3254127,CDM,27010242,LOCAL,270,RC,,inpatient,,,437.5,393.75,,0.95,,415.63,Percent of total billed charges,,,0.98,,428.75,Percent of total billed charges,,,0.95,,415.63,Percent of total billed charges,,,0.97,,424.38,Percent of total billed charges,,,0.97,,424.38,Percent of total billed charges,,,0.96,,420,Percent of total billed charges,,,0.95,,415.63,Percent of total billed charges,,,,,,,,,0.95,,415.63,Percent of total billed charges,,415.63,428.75,
OR TIGHTROPE ACL CLOSED EYE,SUP-3254127,CDM,27010242,LOCAL,270,RC,,outpatient,,,437.5,393.75,,0.95,,415.63,Percent of total billed charges,,,0.98,,428.75,Percent of total billed charges,,,0.95,,415.63,Percent of total billed charges,,,0.95,,415.63,Percent of total billed charges,,,0.97,,424.38,Percent of total billed charges,,,0.96,,420,Percent of total billed charges,,,0.95,,415.63,Percent of total billed charges,,,,,,,,,0.95,,415.63,Percent of total billed charges,,415.63,428.75,
OR DRILL CANN 9.5MM,SUP-3254125,CDM,27010242,LOCAL,270,RC,,inpatient,,,682.5,614.25,,0.95,,648.38,Percent of total billed charges,,,0.98,,668.85,Percent of total billed charges,,,0.95,,648.38,Percent of total billed charges,,,0.97,,662.03,Percent of total billed charges,,,0.97,,662.03,Percent of total billed charges,,,0.96,,655.2,Percent of total billed charges,,,0.95,,648.38,Percent of total billed charges,,,,,,,,,0.95,,648.38,Percent of total billed charges,,648.38,668.85,
OR DRILL CANN 9.5MM,SUP-3254125,CDM,27010242,LOCAL,270,RC,,outpatient,,,682.5,614.25,,0.95,,648.38,Percent of total billed charges,,,0.98,,668.85,Percent of total billed charges,,,0.95,,648.38,Percent of total billed charges,,,0.95,,648.38,Percent of total billed charges,,,0.97,,662.03,Percent of total billed charges,,,0.96,,655.2,Percent of total billed charges,,,0.95,,648.38,Percent of total billed charges,,,,,,,,,0.95,,648.38,Percent of total billed charges,,648.38,668.85,
OR TIGHTROPE RT W/SU,SUP-3254120,CDM,27010242,LOCAL,270,RC,,inpatient,,,1110,999,,0.95,,1054.5,Percent of total billed charges,,,0.98,,1087.8,Percent of total billed charges,,,0.95,,1054.5,Percent of total billed charges,,,0.97,,1076.7,Percent of total billed charges,,,0.97,,1076.7,Percent of total billed charges,,,0.96,,1065.6,Percent of total billed charges,,,0.95,,1054.5,Percent of total billed charges,,,,,,,,,0.95,,1054.5,Percent of total billed charges,,1054.5,1087.8,
OR TIGHTROPE RT W/SU,SUP-3254120,CDM,27010242,LOCAL,270,RC,,outpatient,,,1110,999,,0.95,,1054.5,Percent of total billed charges,,,0.98,,1087.8,Percent of total billed charges,,,0.95,,1054.5,Percent of total billed charges,,,0.95,,1054.5,Percent of total billed charges,,,0.97,,1076.7,Percent of total billed charges,,,0.96,,1065.6,Percent of total billed charges,,,0.95,,1054.5,Percent of total billed charges,,,,,,,,,0.95,,1054.5,Percent of total billed charges,,1054.5,1087.8,
OB CERV RIPEN BALLOON,SUP-3254103,CDM,27010242,LOCAL,270,RC,,inpatient,,,184.5,166.05,,0.95,,175.28,Percent of total billed charges,,,0.98,,180.81,Percent of total billed charges,,,0.95,,175.28,Percent of total billed charges,,,0.97,,178.97,Percent of total billed charges,,,0.97,,178.97,Percent of total billed charges,,,0.96,,177.12,Percent of total billed charges,,,0.95,,175.28,Percent of total billed charges,,,,,,,,,0.95,,175.28,Percent of total billed charges,,175.28,180.81,
OB CERV RIPEN BALLOON,SUP-3254103,CDM,27010242,LOCAL,270,RC,,outpatient,,,184.5,166.05,,0.95,,175.28,Percent of total billed charges,,,0.98,,180.81,Percent of total billed charges,,,0.95,,175.28,Percent of total billed charges,,,0.95,,175.28,Percent of total billed charges,,,0.97,,178.97,Percent of total billed charges,,,0.96,,177.12,Percent of total billed charges,,,0.95,,175.28,Percent of total billed charges,,,,,,,,,0.95,,175.28,Percent of total billed charges,,175.28,180.81,
OR CANNULA TWIST IN 8X7,SUP-AR-6530,CDM,27010242,LOCAL,270,RC,,inpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,,,0.95,,95,Percent of total billed charges,,95,98,
OR CANNULA TWIST IN 8X7,SUP-AR-6530,CDM,27010242,LOCAL,270,RC,,outpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,,,0.95,,95,Percent of total billed charges,,95,98,
BAKRI POSTPARTUM BALLOON,SUP-G24237,CDM,27010242,LOCAL,270,RC,,inpatient,,,815.5,733.95,,0.95,,774.73,Percent of total billed charges,,,0.98,,799.19,Percent of total billed charges,,,0.95,,774.73,Percent of total billed charges,,,0.97,,791.04,Percent of total billed charges,,,0.97,,791.04,Percent of total billed charges,,,0.96,,782.88,Percent of total billed charges,,,0.95,,774.73,Percent of total billed charges,,,,,,,,,0.95,,774.73,Percent of total billed charges,,774.73,799.19,
BAKRI POSTPARTUM BALLOON,SUP-G24237,CDM,27010242,LOCAL,270,RC,,outpatient,,,815.5,733.95,,0.95,,774.73,Percent of total billed charges,,,0.98,,799.19,Percent of total billed charges,,,0.95,,774.73,Percent of total billed charges,,,0.95,,774.73,Percent of total billed charges,,,0.97,,791.04,Percent of total billed charges,,,0.96,,782.88,Percent of total billed charges,,,0.95,,774.73,Percent of total billed charges,,,,,,,,,0.95,,774.73,Percent of total billed charges,,774.73,799.19,
"PIVOT POST DISPOSABLE PAD, NON STERILE",SUP-AR-1560-01,CDM,27010242,LOCAL,270,RC,,inpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
"PIVOT POST DISPOSABLE PAD, NON STERILE",SUP-AR-1560-01,CDM,27010242,LOCAL,270,RC,,outpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
DUALWAVE OUTFLOW TUBE SET,SUP-AR-6430,CDM,27010242,LOCAL,270,RC,,inpatient,,,200,180,,0.95,,190,Percent of total billed charges,,,0.98,,196,Percent of total billed charges,,,0.95,,190,Percent of total billed charges,,,0.97,,194,Percent of total billed charges,,,0.97,,194,Percent of total billed charges,,,0.96,,192,Percent of total billed charges,,,0.95,,190,Percent of total billed charges,,,,,,,,,0.95,,190,Percent of total billed charges,,190,196,
DUALWAVE OUTFLOW TUBE SET,SUP-AR-6430,CDM,27010242,LOCAL,270,RC,,outpatient,,,200,180,,0.95,,190,Percent of total billed charges,,,0.98,,196,Percent of total billed charges,,,0.95,,190,Percent of total billed charges,,,0.95,,190,Percent of total billed charges,,,0.97,,194,Percent of total billed charges,,,0.96,,192,Percent of total billed charges,,,0.95,,190,Percent of total billed charges,,,,,,,,,0.95,,190,Percent of total billed charges,,190,196,
SPLINT W/F LT/X-LG,SUP-210126,CDM,27010242,LOCAL,270,RC,,inpatient,,,31.5,28.35,,0.95,,29.93,Percent of total billed charges,,,0.98,,30.87,Percent of total billed charges,,,0.95,,29.93,Percent of total billed charges,,,0.97,,30.56,Percent of total billed charges,,,0.97,,30.56,Percent of total billed charges,,,0.96,,30.24,Percent of total billed charges,,,0.95,,29.93,Percent of total billed charges,,,,,,,,,0.95,,29.93,Percent of total billed charges,,29.93,30.87,
SPLINT W/F LT/X-LG,SUP-210126,CDM,27010242,LOCAL,270,RC,,outpatient,,,31.5,28.35,,0.95,,29.93,Percent of total billed charges,,,0.98,,30.87,Percent of total billed charges,,,0.95,,29.93,Percent of total billed charges,,,0.95,,29.93,Percent of total billed charges,,,0.97,,30.56,Percent of total billed charges,,,0.96,,30.24,Percent of total billed charges,,,0.95,,29.93,Percent of total billed charges,,,,,,,,,0.95,,29.93,Percent of total billed charges,,29.93,30.87,
MITYVAC,SUP-10058,CDM,27010242,LOCAL,270,RC,,inpatient,,,170.9,153.81,,0.95,,162.36,Percent of total billed charges,,,0.98,,167.48,Percent of total billed charges,,,0.95,,162.36,Percent of total billed charges,,,0.97,,165.77,Percent of total billed charges,,,0.97,,165.77,Percent of total billed charges,,,0.96,,164.06,Percent of total billed charges,,,0.95,,162.36,Percent of total billed charges,,,,,,,,,0.95,,162.36,Percent of total billed charges,,162.36,167.48,
MITYVAC,SUP-10058,CDM,27010242,LOCAL,270,RC,,outpatient,,,170.9,153.81,,0.95,,162.36,Percent of total billed charges,,,0.98,,167.48,Percent of total billed charges,,,0.95,,162.36,Percent of total billed charges,,,0.95,,162.36,Percent of total billed charges,,,0.97,,165.77,Percent of total billed charges,,,0.96,,164.06,Percent of total billed charges,,,0.95,,162.36,Percent of total billed charges,,,,,,,,,0.95,,162.36,Percent of total billed charges,,162.36,167.48,
OR REAMER LOW PROFILE,SUP-3254126,CDM,27010242,LOCAL,270,RC,,inpatient,,,395,355.5,,0.95,,375.25,Percent of total billed charges,,,0.98,,387.1,Percent of total billed charges,,,0.95,,375.25,Percent of total billed charges,,,0.97,,383.15,Percent of total billed charges,,,0.97,,383.15,Percent of total billed charges,,,0.96,,379.2,Percent of total billed charges,,,0.95,,375.25,Percent of total billed charges,,,,,,,,,0.95,,375.25,Percent of total billed charges,,375.25,387.1,
OR REAMER LOW PROFILE,SUP-3254126,CDM,27010242,LOCAL,270,RC,,outpatient,,,395,355.5,,0.95,,375.25,Percent of total billed charges,,,0.98,,387.1,Percent of total billed charges,,,0.95,,375.25,Percent of total billed charges,,,0.95,,375.25,Percent of total billed charges,,,0.97,,383.15,Percent of total billed charges,,,0.96,,379.2,Percent of total billed charges,,,0.95,,375.25,Percent of total billed charges,,,,,,,,,0.95,,375.25,Percent of total billed charges,,375.25,387.1,
OR GRAFTBOLT TIBIAL 9MM,SUP-AR-5100-09,CDM,27810126,LOCAL,278,RC,,inpatient,,,1185,1066.5,,0.95,,1125.75,Percent of total billed charges,,,0.98,,1161.3,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,0.97,,1149.45,Percent of total billed charges,,,0.97,,1149.45,Percent of total billed charges,,,0.96,,1137.6,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,,,,,,,0.95,,1125.75,Percent of total billed charges,,1125.75,1161.3,
OR GRAFTBOLT TIBIAL 9MM,SUP-AR-5100-09,CDM,27810126,LOCAL,278,RC,,outpatient,,,1185,1066.5,,0.95,,1125.75,Percent of total billed charges,,,0.98,,1161.3,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,0.97,,1149.45,Percent of total billed charges,,,0.96,,1137.6,Percent of total billed charges,,,0.95,,1125.75,Percent of total billed charges,,,,,,,,,0.95,,1125.75,Percent of total billed charges,,1125.75,1161.3,
OR TIGHTROPE AR-8921CDS,SUP-AR-8921CDS,CDM,27810126,LOCAL,278,RC,,inpatient,,,1062,955.8,,0.95,,1008.9,Percent of total billed charges,,,0.98,,1040.76,Percent of total billed charges,,,0.95,,1008.9,Percent of total billed charges,,,0.97,,1030.14,Percent of total billed charges,,,0.97,,1030.14,Percent of total billed charges,,,0.96,,1019.52,Percent of total billed charges,,,0.95,,1008.9,Percent of total billed charges,,,,,,,,,0.95,,1008.9,Percent of total billed charges,,1008.9,1040.76,
OR TIGHTROPE AR-8921CDS,SUP-AR-8921CDS,CDM,27810126,LOCAL,278,RC,,outpatient,,,1062,955.8,,0.95,,1008.9,Percent of total billed charges,,,0.98,,1040.76,Percent of total billed charges,,,0.95,,1008.9,Percent of total billed charges,,,0.95,,1008.9,Percent of total billed charges,,,0.97,,1030.14,Percent of total billed charges,,,0.96,,1019.52,Percent of total billed charges,,,0.95,,1008.9,Percent of total billed charges,,,,,,,,,0.95,,1008.9,Percent of total billed charges,,1008.9,1040.76,
OR PEEK CORKSCREW 4.5 AR-1927PSF-45,SUP-AR-1927PSF-45,CDM,27810126,LOCAL,278,RC,,inpatient,,,570,513,,0.95,,541.5,Percent of total billed charges,,,0.98,,558.6,Percent of total billed charges,,,0.95,,541.5,Percent of total billed charges,,,0.97,,552.9,Percent of total billed charges,,,0.97,,552.9,Percent of total billed charges,,,0.96,,547.2,Percent of total billed charges,,,0.95,,541.5,Percent of total billed charges,,,,,,,,,0.95,,541.5,Percent of total billed charges,,541.5,558.6,
OR PEEK CORKSCREW 4.5 AR-1927PSF-45,SUP-AR-1927PSF-45,CDM,27810126,LOCAL,278,RC,,outpatient,,,570,513,,0.95,,541.5,Percent of total billed charges,,,0.98,,558.6,Percent of total billed charges,,,0.95,,541.5,Percent of total billed charges,,,0.95,,541.5,Percent of total billed charges,,,0.97,,552.9,Percent of total billed charges,,,0.96,,547.2,Percent of total billed charges,,,0.95,,541.5,Percent of total billed charges,,,,,,,,,0.95,,541.5,Percent of total billed charges,,541.5,558.6,
OR BLADE STKR LG/NAR #115,SUP-2296-003-115,CDM,27010242,LOCAL,270,RC,,inpatient,,,189.85,170.87,,0.95,,180.36,Percent of total billed charges,,,0.98,,186.05,Percent of total billed charges,,,0.95,,180.36,Percent of total billed charges,,,0.97,,184.15,Percent of total billed charges,,,0.97,,184.15,Percent of total billed charges,,,0.96,,182.26,Percent of total billed charges,,,0.95,,180.36,Percent of total billed charges,,,,,,,,,0.95,,180.36,Percent of total billed charges,,180.36,186.05,
OR BLADE STKR LG/NAR #115,SUP-2296-003-115,CDM,27010242,LOCAL,270,RC,,outpatient,,,189.85,170.87,,0.95,,180.36,Percent of total billed charges,,,0.98,,186.05,Percent of total billed charges,,,0.95,,180.36,Percent of total billed charges,,,0.95,,180.36,Percent of total billed charges,,,0.97,,184.15,Percent of total billed charges,,,0.96,,182.26,Percent of total billed charges,,,0.95,,180.36,Percent of total billed charges,,,,,,,,,0.95,,180.36,Percent of total billed charges,,180.36,186.05,
OR BLADE MD/MD #105,SUP-3253607,CDM,27010242,LOCAL,270,RC,,inpatient,,,199.85,179.87,,0.95,,189.86,Percent of total billed charges,,,0.98,,195.85,Percent of total billed charges,,,0.95,,189.86,Percent of total billed charges,,,0.97,,193.85,Percent of total billed charges,,,0.97,,193.85,Percent of total billed charges,,,0.96,,191.86,Percent of total billed charges,,,0.95,,189.86,Percent of total billed charges,,,,,,,,,0.95,,189.86,Percent of total billed charges,,189.86,195.85,
OR BLADE MD/MD #105,SUP-3253607,CDM,27010242,LOCAL,270,RC,,outpatient,,,199.85,179.87,,0.95,,189.86,Percent of total billed charges,,,0.98,,195.85,Percent of total billed charges,,,0.95,,189.86,Percent of total billed charges,,,0.95,,189.86,Percent of total billed charges,,,0.97,,193.85,Percent of total billed charges,,,0.96,,191.86,Percent of total billed charges,,,0.95,,189.86,Percent of total billed charges,,,,,,,,,0.95,,189.86,Percent of total billed charges,,189.86,195.85,
OR BLADE STRK LG #515,SUP-3253793,CDM,27010242,LOCAL,270,RC,,inpatient,,,199.85,179.87,,0.95,,189.86,Percent of total billed charges,,,0.98,,195.85,Percent of total billed charges,,,0.95,,189.86,Percent of total billed charges,,,0.97,,193.85,Percent of total billed charges,,,0.97,,193.85,Percent of total billed charges,,,0.96,,191.86,Percent of total billed charges,,,0.95,,189.86,Percent of total billed charges,,,,,,,,,0.95,,189.86,Percent of total billed charges,,189.86,195.85,
OR BLADE STRK LG #515,SUP-3253793,CDM,27010242,LOCAL,270,RC,,outpatient,,,199.85,179.87,,0.95,,189.86,Percent of total billed charges,,,0.98,,195.85,Percent of total billed charges,,,0.95,,189.86,Percent of total billed charges,,,0.95,,189.86,Percent of total billed charges,,,0.97,,193.85,Percent of total billed charges,,,0.96,,191.86,Percent of total billed charges,,,0.95,,189.86,Percent of total billed charges,,,,,,,,,0.95,,189.86,Percent of total billed charges,,189.86,195.85,
OR BUTTON BICEPS,SUP-3254173,CDM,27810126,LOCAL,278,RC,,inpatient,,,590,531,,0.95,,560.5,Percent of total billed charges,,,0.98,,578.2,Percent of total billed charges,,,0.95,,560.5,Percent of total billed charges,,,0.97,,572.3,Percent of total billed charges,,,0.97,,572.3,Percent of total billed charges,,,0.96,,566.4,Percent of total billed charges,,,0.95,,560.5,Percent of total billed charges,,,,,,,,,0.95,,560.5,Percent of total billed charges,,560.5,578.2,
OR BUTTON BICEPS,SUP-3254173,CDM,27810126,LOCAL,278,RC,,outpatient,,,590,531,,0.95,,560.5,Percent of total billed charges,,,0.98,,578.2,Percent of total billed charges,,,0.95,,560.5,Percent of total billed charges,,,0.95,,560.5,Percent of total billed charges,,,0.97,,572.3,Percent of total billed charges,,,0.96,,566.4,Percent of total billed charges,,,0.95,,560.5,Percent of total billed charges,,,,,,,,,0.95,,560.5,Percent of total billed charges,,560.5,578.2,
OR BUTTON INSERTER,SUP-AR-2262,CDM,27010242,LOCAL,270,RC,,inpatient,,,280,252,,0.95,,266,Percent of total billed charges,,,0.98,,274.4,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,0.97,,271.6,Percent of total billed charges,,,0.97,,271.6,Percent of total billed charges,,,0.96,,268.8,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,,,,,,,0.95,,266,Percent of total billed charges,,266,274.4,
OR BUTTON INSERTER,SUP-AR-2262,CDM,27010242,LOCAL,270,RC,,outpatient,,,280,252,,0.95,,266,Percent of total billed charges,,,0.98,,274.4,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,0.97,,271.6,Percent of total billed charges,,,0.96,,268.8,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,,,,,,,0.95,,266,Percent of total billed charges,,266,274.4,
OR BUTTON SUTURE,SUP-3254175,CDM,27010242,LOCAL,270,RC,,inpatient,,,190,171,,0.95,,180.5,Percent of total billed charges,,,0.98,,186.2,Percent of total billed charges,,,0.95,,180.5,Percent of total billed charges,,,0.97,,184.3,Percent of total billed charges,,,0.97,,184.3,Percent of total billed charges,,,0.96,,182.4,Percent of total billed charges,,,0.95,,180.5,Percent of total billed charges,,,,,,,,,0.95,,180.5,Percent of total billed charges,,180.5,186.2,
OR BUTTON SUTURE,SUP-3254175,CDM,27010242,LOCAL,270,RC,,outpatient,,,190,171,,0.95,,180.5,Percent of total billed charges,,,0.98,,186.2,Percent of total billed charges,,,0.95,,180.5,Percent of total billed charges,,,0.95,,180.5,Percent of total billed charges,,,0.97,,184.3,Percent of total billed charges,,,0.96,,182.4,Percent of total billed charges,,,0.95,,180.5,Percent of total billed charges,,,,,,,,,0.95,,180.5,Percent of total billed charges,,180.5,186.2,
COLON DILATOR #20,SUP-3254077,CDM,27010242,LOCAL,270,RC,,inpatient,,,1590.22,1431.2,,0.95,,1510.71,Percent of total billed charges,,,0.98,,1558.42,Percent of total billed charges,,,0.95,,1510.71,Percent of total billed charges,,,0.97,,1542.51,Percent of total billed charges,,,0.97,,1542.51,Percent of total billed charges,,,0.96,,1526.61,Percent of total billed charges,,,0.95,,1510.71,Percent of total billed charges,,,,,,,,,0.95,,1510.71,Percent of total billed charges,,1510.71,1558.42,
COLON DILATOR #20,SUP-3254077,CDM,27010242,LOCAL,270,RC,,outpatient,,,1590.22,1431.2,,0.95,,1510.71,Percent of total billed charges,,,0.98,,1558.42,Percent of total billed charges,,,0.95,,1510.71,Percent of total billed charges,,,0.95,,1510.71,Percent of total billed charges,,,0.97,,1542.51,Percent of total billed charges,,,0.96,,1526.61,Percent of total billed charges,,,0.95,,1510.71,Percent of total billed charges,,,,,,,,,0.95,,1510.71,Percent of total billed charges,,1510.71,1558.42,
OR LATERAL TRACTION ARM SLEEVE,SUP-3254178,CDM,27010242,LOCAL,270,RC,,inpatient,,,144,129.6,,0.95,,136.8,Percent of total billed charges,,,0.98,,141.12,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,0.97,,139.68,Percent of total billed charges,,,0.97,,139.68,Percent of total billed charges,,,0.96,,138.24,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,,,,,,,0.95,,136.8,Percent of total billed charges,,136.8,141.12,
OR LATERAL TRACTION ARM SLEEVE,SUP-3254178,CDM,27010242,LOCAL,270,RC,,outpatient,,,144,129.6,,0.95,,136.8,Percent of total billed charges,,,0.98,,141.12,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,0.97,,139.68,Percent of total billed charges,,,0.96,,138.24,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,,,,,,,0.95,,136.8,Percent of total billed charges,,136.8,141.12,
OR ARTHROCELL,SUP-3254180,CDM,27810126,LOCAL,278,RC,,inpatient,,,2900,2610,,0.95,,2755,Percent of total billed charges,,,0.98,,2842,Percent of total billed charges,,,0.95,,2755,Percent of total billed charges,,,0.97,,2813,Percent of total billed charges,,,0.97,,2813,Percent of total billed charges,,,0.96,,2784,Percent of total billed charges,,,0.95,,2755,Percent of total billed charges,,,,,,,,,0.95,,2755,Percent of total billed charges,,2755,2842,
OR ARTHROCELL,SUP-3254180,CDM,27810126,LOCAL,278,RC,,outpatient,,,2900,2610,,0.95,,2755,Percent of total billed charges,,,0.98,,2842,Percent of total billed charges,,,0.95,,2755,Percent of total billed charges,,,0.95,,2755,Percent of total billed charges,,,0.97,,2813,Percent of total billed charges,,,0.96,,2784,Percent of total billed charges,,,0.95,,2755,Percent of total billed charges,,,,,,,,,0.95,,2755,Percent of total billed charges,,2755,2842,
OR ARTHROCELL SYRINGE,SUP-3254181,CDM,27010242,LOCAL,270,RC,,inpatient,,,300,270,,0.95,,285,Percent of total billed charges,,,0.98,,294,Percent of total billed charges,,,0.95,,285,Percent of total billed charges,,,0.97,,291,Percent of total billed charges,,,0.97,,291,Percent of total billed charges,,,0.96,,288,Percent of total billed charges,,,0.95,,285,Percent of total billed charges,,,,,,,,,0.95,,285,Percent of total billed charges,,285,294,
OR ARTHROCELL SYRINGE,SUP-3254181,CDM,27010242,LOCAL,270,RC,,outpatient,,,300,270,,0.95,,285,Percent of total billed charges,,,0.98,,294,Percent of total billed charges,,,0.95,,285,Percent of total billed charges,,,0.95,,285,Percent of total billed charges,,,0.97,,291,Percent of total billed charges,,,0.96,,288,Percent of total billed charges,,,0.95,,285,Percent of total billed charges,,,,,,,,,0.95,,285,Percent of total billed charges,,285,294,
OR ROTHNET RETRIEVER,SUP-3254195,CDM,27010242,LOCAL,270,RC,,inpatient,,,385,346.5,,0.95,,365.75,Percent of total billed charges,,,0.98,,377.3,Percent of total billed charges,,,0.95,,365.75,Percent of total billed charges,,,0.97,,373.45,Percent of total billed charges,,,0.97,,373.45,Percent of total billed charges,,,0.96,,369.6,Percent of total billed charges,,,0.95,,365.75,Percent of total billed charges,,,,,,,,,0.95,,365.75,Percent of total billed charges,,365.75,377.3,
OR ROTHNET RETRIEVER,SUP-3254195,CDM,27010242,LOCAL,270,RC,,outpatient,,,385,346.5,,0.95,,365.75,Percent of total billed charges,,,0.98,,377.3,Percent of total billed charges,,,0.95,,365.75,Percent of total billed charges,,,0.95,,365.75,Percent of total billed charges,,,0.97,,373.45,Percent of total billed charges,,,0.96,,369.6,Percent of total billed charges,,,0.95,,365.75,Percent of total billed charges,,,,,,,,,0.95,,365.75,Percent of total billed charges,,365.75,377.3,
OR ENDO OVERTUBE,SUP-3254192,CDM,27010242,LOCAL,270,RC,,inpatient,,,465,418.5,,0.95,,441.75,Percent of total billed charges,,,0.98,,455.7,Percent of total billed charges,,,0.95,,441.75,Percent of total billed charges,,,0.97,,451.05,Percent of total billed charges,,,0.97,,451.05,Percent of total billed charges,,,0.96,,446.4,Percent of total billed charges,,,0.95,,441.75,Percent of total billed charges,,,,,,,,,0.95,,441.75,Percent of total billed charges,,441.75,455.7,
OR ENDO OVERTUBE,SUP-3254192,CDM,27010242,LOCAL,270,RC,,outpatient,,,465,418.5,,0.95,,441.75,Percent of total billed charges,,,0.98,,455.7,Percent of total billed charges,,,0.95,,441.75,Percent of total billed charges,,,0.95,,441.75,Percent of total billed charges,,,0.97,,451.05,Percent of total billed charges,,,0.96,,446.4,Percent of total billed charges,,,0.95,,441.75,Percent of total billed charges,,,,,,,,,0.95,,441.75,Percent of total billed charges,,441.75,455.7,
OR GRASPING RAPTOR,SUP-3254194,CDM,27010242,LOCAL,270,RC,,inpatient,,,427.5,384.75,,0.95,,406.13,Percent of total billed charges,,,0.98,,418.95,Percent of total billed charges,,,0.95,,406.13,Percent of total billed charges,,,0.97,,414.68,Percent of total billed charges,,,0.97,,414.68,Percent of total billed charges,,,0.96,,410.4,Percent of total billed charges,,,0.95,,406.13,Percent of total billed charges,,,,,,,,,0.95,,406.13,Percent of total billed charges,,406.13,418.95,
OR GRASPING RAPTOR,SUP-3254194,CDM,27010242,LOCAL,270,RC,,outpatient,,,427.5,384.75,,0.95,,406.13,Percent of total billed charges,,,0.98,,418.95,Percent of total billed charges,,,0.95,,406.13,Percent of total billed charges,,,0.95,,406.13,Percent of total billed charges,,,0.97,,414.68,Percent of total billed charges,,,0.96,,410.4,Percent of total billed charges,,,0.95,,406.13,Percent of total billed charges,,,,,,,,,0.95,,406.13,Percent of total billed charges,,406.13,418.95,
OR DERMABOND PRINEO,SUP-3254200,CDM,27010242,LOCAL,270,RC,,inpatient,,,382.5,344.25,,0.95,,363.38,Percent of total billed charges,,,0.98,,374.85,Percent of total billed charges,,,0.95,,363.38,Percent of total billed charges,,,0.97,,371.03,Percent of total billed charges,,,0.97,,371.03,Percent of total billed charges,,,0.96,,367.2,Percent of total billed charges,,,0.95,,363.38,Percent of total billed charges,,,,,,,,,0.95,,363.38,Percent of total billed charges,,363.38,374.85,
OR DERMABOND PRINEO,SUP-3254200,CDM,27010242,LOCAL,270,RC,,outpatient,,,382.5,344.25,,0.95,,363.38,Percent of total billed charges,,,0.98,,374.85,Percent of total billed charges,,,0.95,,363.38,Percent of total billed charges,,,0.95,,363.38,Percent of total billed charges,,,0.97,,371.03,Percent of total billed charges,,,0.96,,367.2,Percent of total billed charges,,,0.95,,363.38,Percent of total billed charges,,,,,,,,,0.95,,363.38,Percent of total billed charges,,363.38,374.85,
OR SURGICEL SNOW,SUP-3254201,CDM,27010242,LOCAL,270,RC,,inpatient,,,663.29,596.96,,0.95,,630.13,Percent of total billed charges,,,0.98,,650.02,Percent of total billed charges,,,0.95,,630.13,Percent of total billed charges,,,0.97,,643.39,Percent of total billed charges,,,0.97,,643.39,Percent of total billed charges,,,0.96,,636.76,Percent of total billed charges,,,0.95,,630.13,Percent of total billed charges,,,,,,,,,0.95,,630.13,Percent of total billed charges,,630.13,650.02,
OR SURGICEL SNOW,SUP-3254201,CDM,27010242,LOCAL,270,RC,,outpatient,,,663.29,596.96,,0.95,,630.13,Percent of total billed charges,,,0.98,,650.02,Percent of total billed charges,,,0.95,,630.13,Percent of total billed charges,,,0.95,,630.13,Percent of total billed charges,,,0.97,,643.39,Percent of total billed charges,,,0.96,,636.76,Percent of total billed charges,,,0.95,,630.13,Percent of total billed charges,,,,,,,,,0.95,,630.13,Percent of total billed charges,,630.13,650.02,
OR BLADE ACE 700,SUP-3254203,CDM,27010242,LOCAL,270,RC,,inpatient,,,400,360,,0.95,,380,Percent of total billed charges,,,0.98,,392,Percent of total billed charges,,,0.95,,380,Percent of total billed charges,,,0.97,,388,Percent of total billed charges,,,0.97,,388,Percent of total billed charges,,,0.96,,384,Percent of total billed charges,,,0.95,,380,Percent of total billed charges,,,,,,,,,0.95,,380,Percent of total billed charges,,380,392,
OR BLADE ACE 700,SUP-3254203,CDM,27010242,LOCAL,270,RC,,outpatient,,,400,360,,0.95,,380,Percent of total billed charges,,,0.98,,392,Percent of total billed charges,,,0.95,,380,Percent of total billed charges,,,0.95,,380,Percent of total billed charges,,,0.97,,388,Percent of total billed charges,,,0.96,,384,Percent of total billed charges,,,0.95,,380,Percent of total billed charges,,,,,,,,,0.95,,380,Percent of total billed charges,,380,392,
OR BURR OVAL,SUP-3254160,CDM,27010242,LOCAL,270,RC,,inpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
OR BURR OVAL,SUP-3254160,CDM,27010242,LOCAL,270,RC,,outpatient,,,225,202.5,,0.95,,213.75,Percent of total billed charges,,,0.98,,220.5,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,0.97,,218.25,Percent of total billed charges,,,0.96,,216,Percent of total billed charges,,,0.95,,213.75,Percent of total billed charges,,,,,,,,,0.95,,213.75,Percent of total billed charges,,213.75,220.5,
CRYSTAL CANNULA,SUP-3254159,CDM,27010242,LOCAL,270,RC,,inpatient,,,125,112.5,,0.95,,118.75,Percent of total billed charges,,,0.98,,122.5,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.96,,120,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,,,,,,,0.95,,118.75,Percent of total billed charges,,118.75,122.5,
CRYSTAL CANNULA,SUP-3254159,CDM,27010242,LOCAL,270,RC,,outpatient,,,125,112.5,,0.95,,118.75,Percent of total billed charges,,,0.98,,122.5,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,0.97,,121.25,Percent of total billed charges,,,0.96,,120,Percent of total billed charges,,,0.95,,118.75,Percent of total billed charges,,,,,,,,,0.95,,118.75,Percent of total billed charges,,118.75,122.5,
OR RELOAD GST 45B,SUP-GST45B,CDM,27810126,LOCAL,278,RC,,inpatient,,,382,343.8,,0.95,,362.9,Percent of total billed charges,,,0.98,,374.36,Percent of total billed charges,,,0.95,,362.9,Percent of total billed charges,,,0.97,,370.54,Percent of total billed charges,,,0.97,,370.54,Percent of total billed charges,,,0.96,,366.72,Percent of total billed charges,,,0.95,,362.9,Percent of total billed charges,,,,,,,,,0.95,,362.9,Percent of total billed charges,,362.9,374.36,
OR RELOAD GST 45B,SUP-GST45B,CDM,27810126,LOCAL,278,RC,,outpatient,,,382,343.8,,0.95,,362.9,Percent of total billed charges,,,0.98,,374.36,Percent of total billed charges,,,0.95,,362.9,Percent of total billed charges,,,0.95,,362.9,Percent of total billed charges,,,0.97,,370.54,Percent of total billed charges,,,0.96,,366.72,Percent of total billed charges,,,0.95,,362.9,Percent of total billed charges,,,,,,,,,0.95,,362.9,Percent of total billed charges,,362.9,374.36,
OR ANA TOEMIC IMPLANT 21.5 MM,SUP-AR-9500-215,CDM,27810126,LOCAL,278,RC,,inpatient,,,1043,938.7,,0.95,,990.85,Percent of total billed charges,,,0.98,,1022.14,Percent of total billed charges,,,0.95,,990.85,Percent of total billed charges,,,0.97,,1011.71,Percent of total billed charges,,,0.97,,1011.71,Percent of total billed charges,,,0.96,,1001.28,Percent of total billed charges,,,0.95,,990.85,Percent of total billed charges,,,,,,,,,0.95,,990.85,Percent of total billed charges,,990.85,1022.14,
OR ANA TOEMIC IMPLANT 21.5 MM,SUP-AR-9500-215,CDM,27810126,LOCAL,278,RC,,outpatient,,,1043,938.7,,0.95,,990.85,Percent of total billed charges,,,0.98,,1022.14,Percent of total billed charges,,,0.95,,990.85,Percent of total billed charges,,,0.95,,990.85,Percent of total billed charges,,,0.97,,1011.71,Percent of total billed charges,,,0.96,,1001.28,Percent of total billed charges,,,0.95,,990.85,Percent of total billed charges,,,,,,,,,0.95,,990.85,Percent of total billed charges,,990.85,1022.14,
OR TIGERLINK,SUP-3254211,CDM,27010242,LOCAL,270,RC,,inpatient,,,333,299.7,,0.95,,316.35,Percent of total billed charges,,,0.98,,326.34,Percent of total billed charges,,,0.95,,316.35,Percent of total billed charges,,,0.97,,323.01,Percent of total billed charges,,,0.97,,323.01,Percent of total billed charges,,,0.96,,319.68,Percent of total billed charges,,,0.95,,316.35,Percent of total billed charges,,,,,,,,,0.95,,316.35,Percent of total billed charges,,316.35,326.34,
OR TIGERLINK,SUP-3254211,CDM,27010242,LOCAL,270,RC,,outpatient,,,333,299.7,,0.95,,316.35,Percent of total billed charges,,,0.98,,326.34,Percent of total billed charges,,,0.95,,316.35,Percent of total billed charges,,,0.95,,316.35,Percent of total billed charges,,,0.97,,323.01,Percent of total billed charges,,,0.96,,319.68,Percent of total billed charges,,,0.95,,316.35,Percent of total billed charges,,,,,,,,,0.95,,316.35,Percent of total billed charges,,316.35,326.34,
FIBERWIRE #5 AR-7211,SUP-3254218,CDM,27010242,LOCAL,270,RC,,inpatient,,,160,144,,0.95,,152,Percent of total billed charges,,,0.98,,156.8,Percent of total billed charges,,,0.95,,152,Percent of total billed charges,,,0.97,,155.2,Percent of total billed charges,,,0.97,,155.2,Percent of total billed charges,,,0.96,,153.6,Percent of total billed charges,,,0.95,,152,Percent of total billed charges,,,,,,,,,0.95,,152,Percent of total billed charges,,152,156.8,
FIBERWIRE #5 AR-7211,SUP-3254218,CDM,27010242,LOCAL,270,RC,,outpatient,,,160,144,,0.95,,152,Percent of total billed charges,,,0.98,,156.8,Percent of total billed charges,,,0.95,,152,Percent of total billed charges,,,0.95,,152,Percent of total billed charges,,,0.97,,155.2,Percent of total billed charges,,,0.96,,153.6,Percent of total billed charges,,,0.95,,152,Percent of total billed charges,,,,,,,,,0.95,,152,Percent of total billed charges,,152,156.8,
BONE CUTTER AR-8400BC,SUP-3254219,CDM,27010242,LOCAL,270,RC,,inpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
BONE CUTTER AR-8400BC,SUP-3254219,CDM,27010242,LOCAL,270,RC,,outpatient,,,175,157.5,,0.95,,166.25,Percent of total billed charges,,,0.98,,171.5,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,0.97,,169.75,Percent of total billed charges,,,0.96,,168,Percent of total billed charges,,,0.95,,166.25,Percent of total billed charges,,,,,,,,,0.95,,166.25,Percent of total billed charges,,166.25,171.5,
CAUT. NEEDLE TIP,SUP-3254217,CDM,27010242,LOCAL,270,RC,,inpatient,,,31,27.9,,0.95,,29.45,Percent of total billed charges,,,0.98,,30.38,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.96,,29.76,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,,,,,,,0.95,,29.45,Percent of total billed charges,,29.45,30.38,
CAUT. NEEDLE TIP,SUP-3254217,CDM,27010242,LOCAL,270,RC,,outpatient,,,31,27.9,,0.95,,29.45,Percent of total billed charges,,,0.98,,30.38,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,0.97,,30.07,Percent of total billed charges,,,0.96,,29.76,Percent of total billed charges,,,0.95,,29.45,Percent of total billed charges,,,,,,,,,0.95,,29.45,Percent of total billed charges,,29.45,30.38,
K-WIRE 0.035,SUP-3254221,CDM,27010242,LOCAL,270,RC,,inpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
K-WIRE 0.035,SUP-3254221,CDM,27010242,LOCAL,270,RC,,outpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
K-WIRE 0.028,SUP-3254222,CDM,27010242,LOCAL,270,RC,,inpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
K-WIRE 0.028,SUP-3254222,CDM,27010242,LOCAL,270,RC,,outpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
"STERILE TOURNIQUET 18""",SUP-3254223,CDM,27010242,LOCAL,270,RC,,inpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"STERILE TOURNIQUET 18""",SUP-3254223,CDM,27010242,LOCAL,270,RC,,outpatient,,,287,258.3,,0.95,,272.65,Percent of total billed charges,,,0.98,,281.26,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,0.97,,278.39,Percent of total billed charges,,,0.96,,275.52,Percent of total billed charges,,,0.95,,272.65,Percent of total billed charges,,,,,,,,,0.95,,272.65,Percent of total billed charges,,272.65,281.26,
"STERILE TOURNIQUET 24""",SUP-3254224,CDM,27010242,LOCAL,270,RC,,inpatient,,,292,262.8,,0.95,,277.4,Percent of total billed charges,,,0.98,,286.16,Percent of total billed charges,,,0.95,,277.4,Percent of total billed charges,,,0.97,,283.24,Percent of total billed charges,,,0.97,,283.24,Percent of total billed charges,,,0.96,,280.32,Percent of total billed charges,,,0.95,,277.4,Percent of total billed charges,,,,,,,,,0.95,,277.4,Percent of total billed charges,,277.4,286.16,
"STERILE TOURNIQUET 24""",SUP-3254224,CDM,27010242,LOCAL,270,RC,,outpatient,,,292,262.8,,0.95,,277.4,Percent of total billed charges,,,0.98,,286.16,Percent of total billed charges,,,0.95,,277.4,Percent of total billed charges,,,0.95,,277.4,Percent of total billed charges,,,0.97,,283.24,Percent of total billed charges,,,0.96,,280.32,Percent of total billed charges,,,0.95,,277.4,Percent of total billed charges,,,,,,,,,0.95,,277.4,Percent of total billed charges,,277.4,286.16,
"STERILE TOURNIQUET 34""",SUP-3254225,CDM,27010242,LOCAL,270,RC,,inpatient,,,339,305.1,,0.95,,322.05,Percent of total billed charges,,,0.98,,332.22,Percent of total billed charges,,,0.95,,322.05,Percent of total billed charges,,,0.97,,328.83,Percent of total billed charges,,,0.97,,328.83,Percent of total billed charges,,,0.96,,325.44,Percent of total billed charges,,,0.95,,322.05,Percent of total billed charges,,,,,,,,,0.95,,322.05,Percent of total billed charges,,322.05,332.22,
"STERILE TOURNIQUET 34""",SUP-3254225,CDM,27010242,LOCAL,270,RC,,outpatient,,,339,305.1,,0.95,,322.05,Percent of total billed charges,,,0.98,,332.22,Percent of total billed charges,,,0.95,,322.05,Percent of total billed charges,,,0.95,,322.05,Percent of total billed charges,,,0.97,,328.83,Percent of total billed charges,,,0.96,,325.44,Percent of total billed charges,,,0.95,,322.05,Percent of total billed charges,,,,,,,,,0.95,,322.05,Percent of total billed charges,,322.05,332.22,
MINI VESSEL LOOPS,SUP-3254226,CDM,27010242,LOCAL,270,RC,,inpatient,,,18,16.2,,0.95,,17.1,Percent of total billed charges,,,0.98,,17.64,Percent of total billed charges,,,0.95,,17.1,Percent of total billed charges,,,0.97,,17.46,Percent of total billed charges,,,0.97,,17.46,Percent of total billed charges,,,0.96,,17.28,Percent of total billed charges,,,0.95,,17.1,Percent of total billed charges,,,,,,,,,0.95,,17.1,Percent of total billed charges,,17.1,17.64,
MINI VESSEL LOOPS,SUP-3254226,CDM,27010242,LOCAL,270,RC,,outpatient,,,18,16.2,,0.95,,17.1,Percent of total billed charges,,,0.98,,17.64,Percent of total billed charges,,,0.95,,17.1,Percent of total billed charges,,,0.95,,17.1,Percent of total billed charges,,,0.97,,17.46,Percent of total billed charges,,,0.96,,17.28,Percent of total billed charges,,,0.95,,17.1,Percent of total billed charges,,,,,,,,,0.95,,17.1,Percent of total billed charges,,17.1,17.64,
SUTURE RETRIEVER,SUP-3254227,CDM,27010242,LOCAL,270,RC,,inpatient,,,425,382.5,,0.95,,403.75,Percent of total billed charges,,,0.98,,416.5,Percent of total billed charges,,,0.95,,403.75,Percent of total billed charges,,,0.97,,412.25,Percent of total billed charges,,,0.97,,412.25,Percent of total billed charges,,,0.96,,408,Percent of total billed charges,,,0.95,,403.75,Percent of total billed charges,,,,,,,,,0.95,,403.75,Percent of total billed charges,,403.75,416.5,
SUTURE RETRIEVER,SUP-3254227,CDM,27010242,LOCAL,270,RC,,outpatient,,,425,382.5,,0.95,,403.75,Percent of total billed charges,,,0.98,,416.5,Percent of total billed charges,,,0.95,,403.75,Percent of total billed charges,,,0.95,,403.75,Percent of total billed charges,,,0.97,,412.25,Percent of total billed charges,,,0.96,,408,Percent of total billed charges,,,0.95,,403.75,Percent of total billed charges,,,,,,,,,0.95,,403.75,Percent of total billed charges,,403.75,416.5,
"OR BB-TAK, SMOOTH",SUP-3254241,CDM,27010242,LOCAL,270,RC,,inpatient,,,69,62.1,,0.95,,65.55,Percent of total billed charges,,,0.98,,67.62,Percent of total billed charges,,,0.95,,65.55,Percent of total billed charges,,,0.97,,66.93,Percent of total billed charges,,,0.97,,66.93,Percent of total billed charges,,,0.96,,66.24,Percent of total billed charges,,,0.95,,65.55,Percent of total billed charges,,,,,,,,,0.95,,65.55,Percent of total billed charges,,65.55,67.62,
"OR BB-TAK, SMOOTH",SUP-3254241,CDM,27010242,LOCAL,270,RC,,outpatient,,,69,62.1,,0.95,,65.55,Percent of total billed charges,,,0.98,,67.62,Percent of total billed charges,,,0.95,,65.55,Percent of total billed charges,,,0.95,,65.55,Percent of total billed charges,,,0.97,,66.93,Percent of total billed charges,,,0.96,,66.24,Percent of total billed charges,,,0.95,,65.55,Percent of total billed charges,,,,,,,,,0.95,,65.55,Percent of total billed charges,,65.55,67.62,
OR SCREW LP LOCK 2.7X18MM,SUP-3254242,CDM,27210093,LOCAL,272,RC,,inpatient,,,153.1,137.79,,0.95,,145.45,Percent of total billed charges,,,0.98,,150.04,Percent of total billed charges,,,0.95,,145.45,Percent of total billed charges,,,0.97,,148.51,Percent of total billed charges,,,0.97,,148.51,Percent of total billed charges,,,0.96,,146.98,Percent of total billed charges,,,0.95,,145.45,Percent of total billed charges,,,,,,,,,0.95,,145.45,Percent of total billed charges,,145.45,150.04,
OR SCREW LP LOCK 2.7X18MM,SUP-3254242,CDM,27210093,LOCAL,272,RC,,outpatient,,,153.1,137.79,,0.95,,145.45,Percent of total billed charges,,,0.98,,150.04,Percent of total billed charges,,,0.95,,145.45,Percent of total billed charges,,,0.95,,145.45,Percent of total billed charges,,,0.97,,148.51,Percent of total billed charges,,,0.96,,146.98,Percent of total billed charges,,,0.95,,145.45,Percent of total billed charges,,,,,,,,,0.95,,145.45,Percent of total billed charges,,145.45,150.04,
OR SCREW LP LOCK 2.7X20MM,SUP-3254243,CDM,27810126,LOCAL,278,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
OR SCREW LP LOCK 2.7X20MM,SUP-3254243,CDM,27810126,LOCAL,278,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
OR SCREW CANCEL 3X16MM,SUP-3254244,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
OR SCREW CANCEL 3X16MM,SUP-3254244,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
OR SCREW CANCEL 3X18,SUP-3254245,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
OR SCREW CANCEL 3X18,SUP-3254245,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
OR PLATE DIS FIB R/6 HOLE,SUP-3254229,CDM,27810126,LOCAL,278,RC,,inpatient,,,1725,1552.5,,0.95,,1638.75,Percent of total billed charges,,,0.98,,1690.5,Percent of total billed charges,,,0.95,,1638.75,Percent of total billed charges,,,0.97,,1673.25,Percent of total billed charges,,,0.97,,1673.25,Percent of total billed charges,,,0.96,,1656,Percent of total billed charges,,,0.95,,1638.75,Percent of total billed charges,,,,,,,,,0.95,,1638.75,Percent of total billed charges,,1638.75,1690.5,
OR PLATE DIS FIB R/6 HOLE,SUP-3254229,CDM,27810126,LOCAL,278,RC,,outpatient,,,1725,1552.5,,0.95,,1638.75,Percent of total billed charges,,,0.98,,1690.5,Percent of total billed charges,,,0.95,,1638.75,Percent of total billed charges,,,0.95,,1638.75,Percent of total billed charges,,,0.97,,1673.25,Percent of total billed charges,,,0.96,,1656,Percent of total billed charges,,,0.95,,1638.75,Percent of total billed charges,,,,,,,,,0.95,,1638.75,Percent of total billed charges,,1638.75,1690.5,
OR PLATE DIST FIB R/8 HOLE,SUP-3254230,CDM,27810126,LOCAL,278,RC,,inpatient,,,1800,1620,,0.95,,1710,Percent of total billed charges,,,0.98,,1764,Percent of total billed charges,,,0.95,,1710,Percent of total billed charges,,,0.97,,1746,Percent of total billed charges,,,0.97,,1746,Percent of total billed charges,,,0.96,,1728,Percent of total billed charges,,,0.95,,1710,Percent of total billed charges,,,,,,,,,0.95,,1710,Percent of total billed charges,,1710,1764,
OR PLATE DIST FIB R/8 HOLE,SUP-3254230,CDM,27810126,LOCAL,278,RC,,outpatient,,,1800,1620,,0.95,,1710,Percent of total billed charges,,,0.98,,1764,Percent of total billed charges,,,0.95,,1710,Percent of total billed charges,,,0.95,,1710,Percent of total billed charges,,,0.97,,1746,Percent of total billed charges,,,0.96,,1728,Percent of total billed charges,,,0.95,,1710,Percent of total billed charges,,,,,,,,,0.95,,1710,Percent of total billed charges,,1710,1764,
OR PLATE DIST  FIB R/10 HOLE,SUP-3254231,CDM,27810126,LOCAL,278,RC,,inpatient,,,1875,1687.5,,0.95,,1781.25,Percent of total billed charges,,,0.98,,1837.5,Percent of total billed charges,,,0.95,,1781.25,Percent of total billed charges,,,0.97,,1818.75,Percent of total billed charges,,,0.97,,1818.75,Percent of total billed charges,,,0.96,,1800,Percent of total billed charges,,,0.95,,1781.25,Percent of total billed charges,,,,,,,,,0.95,,1781.25,Percent of total billed charges,,1781.25,1837.5,
OR PLATE DIST  FIB R/10 HOLE,SUP-3254231,CDM,27810126,LOCAL,278,RC,,outpatient,,,1875,1687.5,,0.95,,1781.25,Percent of total billed charges,,,0.98,,1837.5,Percent of total billed charges,,,0.95,,1781.25,Percent of total billed charges,,,0.95,,1781.25,Percent of total billed charges,,,0.97,,1818.75,Percent of total billed charges,,,0.96,,1800,Percent of total billed charges,,,0.95,,1781.25,Percent of total billed charges,,,,,,,,,0.95,,1781.25,Percent of total billed charges,,1781.25,1837.5,
OR PLATE DIST FIB L/6 HOLE,SUP-3254232,CDM,27810126,LOCAL,278,RC,,inpatient,,,1725,1552.5,,0.95,,1638.75,Percent of total billed charges,,,0.98,,1690.5,Percent of total billed charges,,,0.95,,1638.75,Percent of total billed charges,,,0.97,,1673.25,Percent of total billed charges,,,0.97,,1673.25,Percent of total billed charges,,,0.96,,1656,Percent of total billed charges,,,0.95,,1638.75,Percent of total billed charges,,,,,,,,,0.95,,1638.75,Percent of total billed charges,,1638.75,1690.5,
OR PLATE DIST FIB L/6 HOLE,SUP-3254232,CDM,27810126,LOCAL,278,RC,,outpatient,,,1725,1552.5,,0.95,,1638.75,Percent of total billed charges,,,0.98,,1690.5,Percent of total billed charges,,,0.95,,1638.75,Percent of total billed charges,,,0.95,,1638.75,Percent of total billed charges,,,0.97,,1673.25,Percent of total billed charges,,,0.96,,1656,Percent of total billed charges,,,0.95,,1638.75,Percent of total billed charges,,,,,,,,,0.95,,1638.75,Percent of total billed charges,,1638.75,1690.5,
OR PLATE DIST FIB L/8 HOLE,SUP-3254233,CDM,27810126,LOCAL,278,RC,,inpatient,,,1800,1620,,0.95,,1710,Percent of total billed charges,,,0.98,,1764,Percent of total billed charges,,,0.95,,1710,Percent of total billed charges,,,0.97,,1746,Percent of total billed charges,,,0.97,,1746,Percent of total billed charges,,,0.96,,1728,Percent of total billed charges,,,0.95,,1710,Percent of total billed charges,,,,,,,,,0.95,,1710,Percent of total billed charges,,1710,1764,
OR PLATE DIST FIB L/8 HOLE,SUP-3254233,CDM,27810126,LOCAL,278,RC,,outpatient,,,1800,1620,,0.95,,1710,Percent of total billed charges,,,0.98,,1764,Percent of total billed charges,,,0.95,,1710,Percent of total billed charges,,,0.95,,1710,Percent of total billed charges,,,0.97,,1746,Percent of total billed charges,,,0.96,,1728,Percent of total billed charges,,,0.95,,1710,Percent of total billed charges,,,,,,,,,0.95,,1710,Percent of total billed charges,,1710,1764,
OR PLATE DIST FIB L/10 HOLE,SUP-3254234,CDM,27810126,LOCAL,278,RC,,inpatient,,,1875,1687.5,,0.95,,1781.25,Percent of total billed charges,,,0.98,,1837.5,Percent of total billed charges,,,0.95,,1781.25,Percent of total billed charges,,,0.97,,1818.75,Percent of total billed charges,,,0.97,,1818.75,Percent of total billed charges,,,0.96,,1800,Percent of total billed charges,,,0.95,,1781.25,Percent of total billed charges,,,,,,,,,0.95,,1781.25,Percent of total billed charges,,1781.25,1837.5,
OR PLATE DIST FIB L/10 HOLE,SUP-3254234,CDM,27810126,LOCAL,278,RC,,outpatient,,,1875,1687.5,,0.95,,1781.25,Percent of total billed charges,,,0.98,,1837.5,Percent of total billed charges,,,0.95,,1781.25,Percent of total billed charges,,,0.95,,1781.25,Percent of total billed charges,,,0.97,,1818.75,Percent of total billed charges,,,0.96,,1800,Percent of total billed charges,,,0.95,,1781.25,Percent of total billed charges,,,,,,,,,0.95,,1781.25,Percent of total billed charges,,1781.25,1837.5,
OR PLATE DIST TIB 3 HOLE,SUP-3254235,CDM,27810126,LOCAL,278,RC,,inpatient,,,1493,1343.7,,0.95,,1418.35,Percent of total billed charges,,,0.98,,1463.14,Percent of total billed charges,,,0.95,,1418.35,Percent of total billed charges,,,0.97,,1448.21,Percent of total billed charges,,,0.97,,1448.21,Percent of total billed charges,,,0.96,,1433.28,Percent of total billed charges,,,0.95,,1418.35,Percent of total billed charges,,,,,,,,,0.95,,1418.35,Percent of total billed charges,,1418.35,1463.14,
OR PLATE DIST TIB 3 HOLE,SUP-3254235,CDM,27810126,LOCAL,278,RC,,outpatient,,,1493,1343.7,,0.95,,1418.35,Percent of total billed charges,,,0.98,,1463.14,Percent of total billed charges,,,0.95,,1418.35,Percent of total billed charges,,,0.95,,1418.35,Percent of total billed charges,,,0.97,,1448.21,Percent of total billed charges,,,0.96,,1433.28,Percent of total billed charges,,,0.95,,1418.35,Percent of total billed charges,,,,,,,,,0.95,,1418.35,Percent of total billed charges,,1418.35,1463.14,
OR PLATE DIST TIB 7 HOLE,SUP-3254236,CDM,27810126,LOCAL,278,RC,,inpatient,,,1650,1485,,0.95,,1567.5,Percent of total billed charges,,,0.98,,1617,Percent of total billed charges,,,0.95,,1567.5,Percent of total billed charges,,,0.97,,1600.5,Percent of total billed charges,,,0.97,,1600.5,Percent of total billed charges,,,0.96,,1584,Percent of total billed charges,,,0.95,,1567.5,Percent of total billed charges,,,,,,,,,0.95,,1567.5,Percent of total billed charges,,1567.5,1617,
OR PLATE DIST TIB 7 HOLE,SUP-3254236,CDM,27810126,LOCAL,278,RC,,outpatient,,,1650,1485,,0.95,,1567.5,Percent of total billed charges,,,0.98,,1617,Percent of total billed charges,,,0.95,,1567.5,Percent of total billed charges,,,0.95,,1567.5,Percent of total billed charges,,,0.97,,1600.5,Percent of total billed charges,,,0.96,,1584,Percent of total billed charges,,,0.95,,1567.5,Percent of total billed charges,,,,,,,,,0.95,,1567.5,Percent of total billed charges,,1567.5,1617,
OR BLADE SAG 18.5X10X.55MM,SUP-3254237,CDM,27010242,LOCAL,270,RC,,inpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,,,0.95,,95,Percent of total billed charges,,95,98,
OR BLADE SAG 18.5X10X.55MM,SUP-3254237,CDM,27010242,LOCAL,270,RC,,outpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,,,0.95,,95,Percent of total billed charges,,95,98,
OR BLADE SAG 16X5.5X.6,SUP-3254238,CDM,27010242,LOCAL,270,RC,,inpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,,,0.95,,95,Percent of total billed charges,,95,98,
OR BLADE SAG 16X5.5X.6,SUP-3254238,CDM,27010242,LOCAL,270,RC,,outpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,,,0.95,,95,Percent of total billed charges,,95,98,
OR BLADE RECIP,SUP-3254239,CDM,27010242,LOCAL,270,RC,,inpatient,,,298,268.2,,0.95,,283.1,Percent of total billed charges,,,0.98,,292.04,Percent of total billed charges,,,0.95,,283.1,Percent of total billed charges,,,0.97,,289.06,Percent of total billed charges,,,0.97,,289.06,Percent of total billed charges,,,0.96,,286.08,Percent of total billed charges,,,0.95,,283.1,Percent of total billed charges,,,,,,,,,0.95,,283.1,Percent of total billed charges,,283.1,292.04,
OR BLADE RECIP,SUP-3254239,CDM,27010242,LOCAL,270,RC,,outpatient,,,298,268.2,,0.95,,283.1,Percent of total billed charges,,,0.98,,292.04,Percent of total billed charges,,,0.95,,283.1,Percent of total billed charges,,,0.95,,283.1,Percent of total billed charges,,,0.97,,289.06,Percent of total billed charges,,,0.96,,286.08,Percent of total billed charges,,,0.95,,283.1,Percent of total billed charges,,,,,,,,,0.95,,283.1,Percent of total billed charges,,283.1,292.04,
OR BLADE SAG 90X25.4X1.19,SUP-3254240,CDM,27010242,LOCAL,270,RC,,inpatient,,,298,268.2,,0.95,,283.1,Percent of total billed charges,,,0.98,,292.04,Percent of total billed charges,,,0.95,,283.1,Percent of total billed charges,,,0.97,,289.06,Percent of total billed charges,,,0.97,,289.06,Percent of total billed charges,,,0.96,,286.08,Percent of total billed charges,,,0.95,,283.1,Percent of total billed charges,,,,,,,,,0.95,,283.1,Percent of total billed charges,,283.1,292.04,
OR BLADE SAG 90X25.4X1.19,SUP-3254240,CDM,27010242,LOCAL,270,RC,,outpatient,,,298,268.2,,0.95,,283.1,Percent of total billed charges,,,0.98,,292.04,Percent of total billed charges,,,0.95,,283.1,Percent of total billed charges,,,0.95,,283.1,Percent of total billed charges,,,0.97,,289.06,Percent of total billed charges,,,0.96,,286.08,Percent of total billed charges,,,0.95,,283.1,Percent of total billed charges,,,,,,,,,0.95,,283.1,Percent of total billed charges,,283.1,292.04,
OR SCREW CORTICAL 3.5X12MM,SUP-3254246,CDM,27810126,LOCAL,278,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
OR SCREW CORTICAL 3.5X12MM,SUP-3254246,CDM,27810126,LOCAL,278,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
OR SCREW CORTICAL 3.5X16MM,SUP-3254247,CDM,27810126,LOCAL,278,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
OR SCREW CORTICAL 3.5X16MM,SUP-3254247,CDM,27810126,LOCAL,278,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
OR SCREW CORTICAL 3.5X22MM,SUP-3254248,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
OR SCREW CORTICAL 3.5X22MM,SUP-3254248,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR BB-TAK, THREADED",SUP-3254256,CDM,27010242,LOCAL,270,RC,,inpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,,,0.95,,95,Percent of total billed charges,,95,98,
"OR BB-TAK, THREADED",SUP-3254256,CDM,27010242,LOCAL,270,RC,,outpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,,,0.95,,95,Percent of total billed charges,,95,98,
"OR LO-PRO LOCK SCRW, SS 2.7X10MM",SUP-3254258,CDM,27810126,LOCAL,278,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"OR LO-PRO LOCK SCRW, SS 2.7X10MM",SUP-3254258,CDM,27810126,LOCAL,278,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"OR LO-PRO LOCK SCRW, SS 2.7X12MM",SUP-325,CDM,27810126,LOCAL,278,RC,,inpatient,,,153.1,137.79,,0.95,,145.45,Percent of total billed charges,,,0.98,,150.04,Percent of total billed charges,,,0.95,,145.45,Percent of total billed charges,,,0.97,,148.51,Percent of total billed charges,,,0.97,,148.51,Percent of total billed charges,,,0.96,,146.98,Percent of total billed charges,,,0.95,,145.45,Percent of total billed charges,,,,,,,,,0.95,,145.45,Percent of total billed charges,,145.45,150.04,
"OR LO-PRO LOCK SCRW, SS 2.7X12MM",SUP-325,CDM,27810126,LOCAL,278,RC,,outpatient,,,153.1,137.79,,0.95,,145.45,Percent of total billed charges,,,0.98,,150.04,Percent of total billed charges,,,0.95,,145.45,Percent of total billed charges,,,0.95,,145.45,Percent of total billed charges,,,0.97,,148.51,Percent of total billed charges,,,0.96,,146.98,Percent of total billed charges,,,0.95,,145.45,Percent of total billed charges,,,,,,,,,0.95,,145.45,Percent of total billed charges,,145.45,150.04,
"OR LO-PRO LOCK SCRW, SS 2.7X14MM",SUP-3254260,CDM,27810126,LOCAL,278,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"OR LO-PRO LOCK SCRW, SS 2.7X14MM",SUP-3254260,CDM,27810126,LOCAL,278,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"OR LO-PRO LOCK SCRW, SS 2.7X16MM",SUP-325,CDM,27810126,LOCAL,278,RC,,inpatient,,,153.1,137.79,,0.95,,145.45,Percent of total billed charges,,,0.98,,150.04,Percent of total billed charges,,,0.95,,145.45,Percent of total billed charges,,,0.97,,148.51,Percent of total billed charges,,,0.97,,148.51,Percent of total billed charges,,,0.96,,146.98,Percent of total billed charges,,,0.95,,145.45,Percent of total billed charges,,,,,,,,,0.95,,145.45,Percent of total billed charges,,145.45,150.04,
"OR LO-PRO LOCK SCRW, SS 2.7X16MM",SUP-325,CDM,27810126,LOCAL,278,RC,,outpatient,,,153.1,137.79,,0.95,,145.45,Percent of total billed charges,,,0.98,,150.04,Percent of total billed charges,,,0.95,,145.45,Percent of total billed charges,,,0.95,,145.45,Percent of total billed charges,,,0.97,,148.51,Percent of total billed charges,,,0.96,,146.98,Percent of total billed charges,,,0.95,,145.45,Percent of total billed charges,,,,,,,,,0.95,,145.45,Percent of total billed charges,,145.45,150.04,
"OR LO-PRO LOCK SCRW, SS 2.7X24MM",SUP-3254263,CDM,27810126,LOCAL,278,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"OR LO-PRO LOCK SCRW, SS 2.7X24MM",SUP-3254263,CDM,27810126,LOCAL,278,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"OR LO-PRO LOCK SCRW, SS 2.7X26MM",SUP-3254264,CDM,27810126,LOCAL,278,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"OR LO-PRO LOCK SCRW, SS 2.7X26MM",SUP-3254264,CDM,27810126,LOCAL,278,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"OR CANCLUS SCRW, FULLY THRDED, SS 3X10MM",SUP-3254265,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR CANCLUS SCRW, FULLY THRDED, SS 3X10MM",SUP-3254265,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR CANCLUS SCRW, FULLY THRDED, SS 3X12MM",SUP-3254266,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR CANCLUS SCRW, FULLY THRDED, SS 3X12MM",SUP-3254266,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR CANCLUS SCRW, FULLY THRDED, SS 3X14MM",SUP-3254267,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR CANCLUS SCRW, FULLY THRDED, SS 3X14MM",SUP-3254267,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR CANCLUS SCRW, FULLY THRDED, SS 3X20MM",SUP-3254268,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR CANCLUS SCRW, FULLY THRDED, SS 3X20MM",SUP-3254268,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR CANCLUS SCRW, FULLY THRDED, SS 3X22MM",SUP-3254269,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR CANCLUS SCRW, FULLY THRDED, SS 3X22MM",SUP-3254269,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR CANCLUS SCRW, FULLY THRDED, SS 3X24MM",SUP-3254270,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR CANCLUS SCRW, FULLY THRDED, SS 3X24MM",SUP-3254270,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR CANCLUS SCRW, FULLY THRDED, SS 3X26MM",SUP-3254271,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR CANCLUS SCRW, FULLY THRDED, SS 3X26MM",SUP-3254271,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR CANCLUS SCRW, FULLY THRDED, SS 3X28MM",SUP-3254272,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR CANCLUS SCRW, FULLY THRDED, SS 3X28MM",SUP-3254272,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR CANCLUS SCRW, FULLY THRDED, SS 3X30MM",SUP-3254273,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR CANCLUS SCRW, FULLY THRDED, SS 3X30MM",SUP-3254273,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR LO-PRO SCRW TM, SS 3.5X10MM CORT",SUP-3254274,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR LO-PRO SCRW TM, SS 3.5X10MM CORT",SUP-3254274,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR LO-PRO SCRW TM, SS 3.5X14MM CORT",SUP-3254252,CDM,27810126,LOCAL,278,RC,,inpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,,,0.95,,133,Percent of total billed charges,,133,137.2,
"OR LO-PRO SCRW TM, SS 3.5X14MM CORT",SUP-3254252,CDM,27810126,LOCAL,278,RC,,outpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,,,0.95,,133,Percent of total billed charges,,133,137.2,
"OR LO-PRO SCRW TM, SS 3.5X18MM CORT",SUP-3254275,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR LO-PRO SCRW TM, SS 3.5X18MM CORT",SUP-3254275,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR LO-PRO SCRW TM, SS 3.5X20MM CORT",SUP-3254276,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR LO-PRO SCRW TM, SS 3.5X20MM CORT",SUP-3254276,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR LO-PRO SCRW TM, SS 3.5X24MM CORT",SUP-3254277,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR LO-PRO SCRW TM, SS 3.5X24MM CORT",SUP-3254277,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR LO-PRO SCRW TM, SS 3.5X26MM CORT",SUP-3254278,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR LO-PRO SCRW TM, SS 3.5X26MM CORT",SUP-3254278,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR LO-PRO SCRW TM, SS 3.5X28MM CORT",SUP-3254279,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR LO-PRO SCRW TM, SS 3.5X28MM CORT",SUP-3254279,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR LO-PRO SCRW TM, SS 3.5X30MM CORT",SUP-3254280,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR LO-PRO SCRW TM, SS 3.5X30MM CORT",SUP-3254280,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR LO-PRO SCRW TM, SS 3.5X35MM CORT",SUP-3254281,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR LO-PRO SCRW TM, SS 3.5X35MM CORT",SUP-3254281,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR LO-PRO SCRW TM, SS 3.5X40MM CORT",SUP-3254282,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR LO-PRO SCRW TM, SS 3.5X40MM CORT",SUP-3254282,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
OR SCREW LP LOCK 2.7X16MM,SUP-3254261,CDM,27810126,LOCAL,278,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
OR SCREW LP LOCK 2.7X16MM,SUP-3254261,CDM,27810126,LOCAL,278,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
OR SCREW LP LOCK 2.7X12MM,SUP-3254259,CDM,27810126,LOCAL,278,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
OR SCREW LP LOCK 2.7X12MM,SUP-3254259,CDM,27810126,LOCAL,278,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"OR LO-PRO SCRW TM, SS 3.5X45MM CORT",SUP-3254283,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR LO-PRO SCRW TM, SS 3.5X45MM CORT",SUP-3254283,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR LO-PRO SCRW TM, SS 3.5X50MM CORT",SUP-3254284,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR LO-PRO SCRW TM, SS 3.5X50MM CORT",SUP-3254284,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR LO-PRO SCRW TM, SS 3.5X55MM CORT",SUP-3254285,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR LO-PRO SCRW TM, SS 3.5X55MM CORT",SUP-3254285,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR LO-PRO SCRW TM, SS 3.5X60MM CORT",SUP-3254286,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR LO-PRO SCRW TM, SS 3.5X60MM CORT",SUP-3254286,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR SCREW LP LOCK, SS 3.5X10MM",SUP-3254287,CDM,27810126,LOCAL,278,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"OR SCREW LP LOCK, SS 3.5X10MM",SUP-3254287,CDM,27810126,LOCAL,278,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"OR SCREW LP LOCK, SS 3.5X12MM",SUP-3254288,CDM,27810126,LOCAL,278,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"OR SCREW LP LOCK, SS 3.5X12MM",SUP-3254288,CDM,27810126,LOCAL,278,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"OR SCREW LP LOCK, SS 3.5X14MM",SUP-3254289,CDM,27810126,LOCAL,278,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"OR SCREW LP LOCK, SS 3.5X14MM",SUP-3254289,CDM,27810126,LOCAL,278,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"OR SCREW LP LOCK, SS 3.5X16MM",SUP-3254290,CDM,27810126,LOCAL,278,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"OR SCREW LP LOCK, SS 3.5X16MM",SUP-3254290,CDM,27810126,LOCAL,278,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"OR SCREW LP LOCK, SS 3.5X18MM",SUP-3254253,CDM,27810126,LOCAL,278,RC,,inpatient,,,288,259.2,,0.95,,273.6,Percent of total billed charges,,,0.98,,282.24,Percent of total billed charges,,,0.95,,273.6,Percent of total billed charges,,,0.97,,279.36,Percent of total billed charges,,,0.97,,279.36,Percent of total billed charges,,,0.96,,276.48,Percent of total billed charges,,,0.95,,273.6,Percent of total billed charges,,,,,,,,,0.95,,273.6,Percent of total billed charges,,273.6,282.24,
"OR SCREW LP LOCK, SS 3.5X18MM",SUP-3254253,CDM,27810126,LOCAL,278,RC,,outpatient,,,288,259.2,,0.95,,273.6,Percent of total billed charges,,,0.98,,282.24,Percent of total billed charges,,,0.95,,273.6,Percent of total billed charges,,,0.95,,273.6,Percent of total billed charges,,,0.97,,279.36,Percent of total billed charges,,,0.96,,276.48,Percent of total billed charges,,,0.95,,273.6,Percent of total billed charges,,,,,,,,,0.95,,273.6,Percent of total billed charges,,273.6,282.24,
"OR SCREW LP LOCK, SS 3.5X20MM",SUP-3254291,CDM,27810126,LOCAL,278,RC,,inpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"OR SCREW LP LOCK, SS 3.5X20MM",SUP-3254291,CDM,27810126,LOCAL,278,RC,,outpatient,,,122,109.8,,0.95,,115.9,Percent of total billed charges,,,0.98,,119.56,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,0.97,,118.34,Percent of total billed charges,,,0.96,,117.12,Percent of total billed charges,,,0.95,,115.9,Percent of total billed charges,,,,,,,,,0.95,,115.9,Percent of total billed charges,,115.9,119.56,
"OR SCREW LP CANCLUS, SS 4.0X10MM",SUP-3254292,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR SCREW LP CANCLUS, SS 4.0X10MM",SUP-3254292,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR SCREW LP CANCLUS, SS 4.0X12MM",SUP-3254293,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR SCREW LP CANCLUS, SS 4.0X12MM",SUP-3254293,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR SCREW LP CANCLUS, SS 4.0X14MM",SUP-3254294,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR SCREW LP CANCLUS, SS 4.0X14MM",SUP-3254294,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR SCREW LP CANCLUS, SS 4.0X16MM",SUP-3254295,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR SCREW LP CANCLUS, SS 4.0X16MM",SUP-3254295,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR SCREW LP CANCLUS, SS 4.0X18MM",SUP-3254296,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR SCREW LP CANCLUS, SS 4.0X18MM",SUP-3254296,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR SCREW LP CANCLUS, SS 4.0X20MM",SUP-3254297,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR SCREW LP CANCLUS, SS 4.0X20MM",SUP-3254297,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR SCREW LP CANCLUS, SS 4.0X22MM",SUP-3254298,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR SCREW LP CANCLUS, SS 4.0X22MM",SUP-3254298,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR SCREW LP CANCLUS, SS 4.0X24MM",SUP-3254299,CDM,27810126,LOCAL,278,RC,,inpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR SCREW LP CANCLUS, SS 4.0X24MM",SUP-3254299,CDM,27810126,LOCAL,278,RC,,outpatient,,,47,42.3,,0.95,,44.65,Percent of total billed charges,,,0.98,,46.06,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,0.97,,45.59,Percent of total billed charges,,,0.96,,45.12,Percent of total billed charges,,,0.95,,44.65,Percent of total billed charges,,,,,,,,,0.95,,44.65,Percent of total billed charges,,44.65,46.06,
"OR SCREW LP CANN, SHT THD, SS 4.0X30MM",SUP-3254300,CDM,27810126,LOCAL,278,RC,,inpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, SHT THD, SS 4.0X30MM",SUP-3254300,CDM,27810126,LOCAL,278,RC,,outpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, SHT THD, SS 4.0X35MM",SUP-3254301,CDM,27810126,LOCAL,278,RC,,inpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, SHT THD, SS 4.0X35MM",SUP-3254301,CDM,27810126,LOCAL,278,RC,,outpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, SHT THD, SS 4.0X40MM",SUP-3254302,CDM,27810126,LOCAL,278,RC,,inpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, SHT THD, SS 4.0X40MM",SUP-3254302,CDM,27810126,LOCAL,278,RC,,outpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, SHT THD, SS 4.0X45MM",SUP-3254303,CDM,27810126,LOCAL,278,RC,,inpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, SHT THD, SS 4.0X45MM",SUP-3254303,CDM,27810126,LOCAL,278,RC,,outpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, SHT THD, SS 4.0X50MM",SUP-3254304,CDM,27810126,LOCAL,278,RC,,inpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, SHT THD, SS 4.0X50MM",SUP-3254304,CDM,27810126,LOCAL,278,RC,,outpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, SHT THD, SS 4.0X55MM",SUP-3254305,CDM,27810126,LOCAL,278,RC,,inpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, SHT THD, SS 4.0X55MM",SUP-3254305,CDM,27810126,LOCAL,278,RC,,outpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, SHT THD, SS 4.0X60MM",SUP-3254306,CDM,27810126,LOCAL,278,RC,,inpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, SHT THD, SS 4.0X60MM",SUP-3254306,CDM,27810126,LOCAL,278,RC,,outpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, LNG THD, SS 4.0X30MM",SUP-3254307,CDM,27810126,LOCAL,278,RC,,inpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, LNG THD, SS 4.0X30MM",SUP-3254307,CDM,27810126,LOCAL,278,RC,,outpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, LNG THD, SS 4.0X35MM",SUP-3254308,CDM,27810126,LOCAL,278,RC,,inpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, LNG THD, SS 4.0X35MM",SUP-3254308,CDM,27810126,LOCAL,278,RC,,outpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, LNG THD, SS 4.0X40MM",SUP-3254309,CDM,27810126,LOCAL,278,RC,,inpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, LNG THD, SS 4.0X40MM",SUP-3254309,CDM,27810126,LOCAL,278,RC,,outpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, LNG THD, SS 4.0X45MM",SUP-3254310,CDM,27810126,LOCAL,278,RC,,inpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, LNG THD, SS 4.0X45MM",SUP-3254310,CDM,27810126,LOCAL,278,RC,,outpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, LNG THD, SS 4.0X50MM",SUP-3254311,CDM,27810126,LOCAL,278,RC,,inpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, LNG THD, SS 4.0X50MM",SUP-3254311,CDM,27810126,LOCAL,278,RC,,outpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, LNG THD, SS 4.0X55MM",SUP-3254312,CDM,27810126,LOCAL,278,RC,,inpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, LNG THD, SS 4.0X55MM",SUP-3254312,CDM,27810126,LOCAL,278,RC,,outpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, LNG THD, SS 4.0X60MM",SUP-3254255,CDM,27810126,LOCAL,278,RC,,inpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR SCREW LP CANN, LNG THD, SS 4.0X60MM",SUP-3254255,CDM,27810126,LOCAL,278,RC,,outpatient,,,154,138.6,,0.95,,146.3,Percent of total billed charges,,,0.98,,150.92,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,0.97,,149.38,Percent of total billed charges,,,0.96,,147.84,Percent of total billed charges,,,0.95,,146.3,Percent of total billed charges,,,,,,,,,0.95,,146.3,Percent of total billed charges,,146.3,150.92,
"OR WASHER, 7.0 STAINLESS STEEL",SUP-3254254,CDM,27810126,LOCAL,278,RC,,inpatient,,,128,115.2,,0.95,,121.6,Percent of total billed charges,,,0.98,,125.44,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.96,,122.88,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,,,,,,,0.95,,121.6,Percent of total billed charges,,121.6,125.44,
"OR WASHER, 7.0 STAINLESS STEEL",SUP-3254254,CDM,27810126,LOCAL,278,RC,,outpatient,,,128,115.2,,0.95,,121.6,Percent of total billed charges,,,0.98,,125.44,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.96,,122.88,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,,,,,,,0.95,,121.6,Percent of total billed charges,,121.6,125.44,
OR 0.062 GUIDEWIRE WITH TROCAR TIP,SUP-3254314,CDM,27010242,LOCAL,270,RC,,inpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
OR 0.062 GUIDEWIRE WITH TROCAR TIP,SUP-3254314,CDM,27010242,LOCAL,270,RC,,outpatient,,,27,24.3,,0.95,,25.65,Percent of total billed charges,,,0.98,,26.46,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,0.97,,26.19,Percent of total billed charges,,,0.96,,25.92,Percent of total billed charges,,,0.95,,25.65,Percent of total billed charges,,,,,,,,,0.95,,25.65,Percent of total billed charges,,25.65,26.46,
"OR GUIDE WIRE, TROCAR TIP, 1.35MM",SUP-3254249,CDM,27010242,LOCAL,270,RC,,inpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,,,0.95,,95,Percent of total billed charges,,95,98,
"OR GUIDE WIRE, TROCAR TIP, 1.35MM",SUP-3254249,CDM,27010242,LOCAL,270,RC,,outpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,,,0.95,,95,Percent of total billed charges,,95,98,
"OR PLT LOCK DISTAL FIB, SS LFT, 4H",SUP-3254322,CDM,27810126,LOCAL,278,RC,,inpatient,,,406,365.4,,0.95,,385.7,Percent of total billed charges,,,0.98,,397.88,Percent of total billed charges,,,0.95,,385.7,Percent of total billed charges,,,0.97,,393.82,Percent of total billed charges,,,0.97,,393.82,Percent of total billed charges,,,0.96,,389.76,Percent of total billed charges,,,0.95,,385.7,Percent of total billed charges,,,,,,,,,0.95,,385.7,Percent of total billed charges,,385.7,397.88,
"OR PLT LOCK DISTAL FIB, SS LFT, 4H",SUP-3254322,CDM,27810126,LOCAL,278,RC,,outpatient,,,406,365.4,,0.95,,385.7,Percent of total billed charges,,,0.98,,397.88,Percent of total billed charges,,,0.95,,385.7,Percent of total billed charges,,,0.95,,385.7,Percent of total billed charges,,,0.97,,393.82,Percent of total billed charges,,,0.96,,389.76,Percent of total billed charges,,,0.95,,385.7,Percent of total billed charges,,,,,,,,,0.95,,385.7,Percent of total billed charges,,385.7,397.88,
"OR PLT LOCK DISTAL FIB, SS LFT, 5H",SUP-3254323,CDM,27810126,LOCAL,278,RC,,inpatient,,,480,432,,0.95,,456,Percent of total billed charges,,,0.98,,470.4,Percent of total billed charges,,,0.95,,456,Percent of total billed charges,,,0.97,,465.6,Percent of total billed charges,,,0.97,,465.6,Percent of total billed charges,,,0.96,,460.8,Percent of total billed charges,,,0.95,,456,Percent of total billed charges,,,,,,,,,0.95,,456,Percent of total billed charges,,456,470.4,
"OR PLT LOCK DISTAL FIB, SS LFT, 5H",SUP-3254323,CDM,27810126,LOCAL,278,RC,,outpatient,,,480,432,,0.95,,456,Percent of total billed charges,,,0.98,,470.4,Percent of total billed charges,,,0.95,,456,Percent of total billed charges,,,0.95,,456,Percent of total billed charges,,,0.97,,465.6,Percent of total billed charges,,,0.96,,460.8,Percent of total billed charges,,,0.95,,456,Percent of total billed charges,,,,,,,,,0.95,,456,Percent of total billed charges,,456,470.4,
"OR PLT LOCK DISTAL FIB, SS LFT, 6H",SUP-3254324,CDM,27810126,LOCAL,278,RC,,inpatient,,,536,482.4,,0.95,,509.2,Percent of total billed charges,,,0.98,,525.28,Percent of total billed charges,,,0.95,,509.2,Percent of total billed charges,,,0.97,,519.92,Percent of total billed charges,,,0.97,,519.92,Percent of total billed charges,,,0.96,,514.56,Percent of total billed charges,,,0.95,,509.2,Percent of total billed charges,,,,,,,,,0.95,,509.2,Percent of total billed charges,,509.2,525.28,
"OR PLT LOCK DISTAL FIB, SS LFT, 6H",SUP-3254324,CDM,27810126,LOCAL,278,RC,,outpatient,,,536,482.4,,0.95,,509.2,Percent of total billed charges,,,0.98,,525.28,Percent of total billed charges,,,0.95,,509.2,Percent of total billed charges,,,0.95,,509.2,Percent of total billed charges,,,0.97,,519.92,Percent of total billed charges,,,0.96,,514.56,Percent of total billed charges,,,0.95,,509.2,Percent of total billed charges,,,,,,,,,0.95,,509.2,Percent of total billed charges,,509.2,525.28,
"OR PLT LOCK DISTAL FIB, SS LFT, 8H",SUP-3254325,CDM,27810126,LOCAL,278,RC,,inpatient,,,587,528.3,,0.95,,557.65,Percent of total billed charges,,,0.98,,575.26,Percent of total billed charges,,,0.95,,557.65,Percent of total billed charges,,,0.97,,569.39,Percent of total billed charges,,,0.97,,569.39,Percent of total billed charges,,,0.96,,563.52,Percent of total billed charges,,,0.95,,557.65,Percent of total billed charges,,,,,,,,,0.95,,557.65,Percent of total billed charges,,557.65,575.26,
"OR PLT LOCK DISTAL FIB, SS LFT, 8H",SUP-3254325,CDM,27810126,LOCAL,278,RC,,outpatient,,,587,528.3,,0.95,,557.65,Percent of total billed charges,,,0.98,,575.26,Percent of total billed charges,,,0.95,,557.65,Percent of total billed charges,,,0.95,,557.65,Percent of total billed charges,,,0.97,,569.39,Percent of total billed charges,,,0.96,,563.52,Percent of total billed charges,,,0.95,,557.65,Percent of total billed charges,,,,,,,,,0.95,,557.65,Percent of total billed charges,,557.65,575.26,
"OR PLT LOCK DISTAL FIB, SS RT, 4H",SUP-3254326,CDM,27810126,LOCAL,278,RC,,inpatient,,,406,365.4,,0.95,,385.7,Percent of total billed charges,,,0.98,,397.88,Percent of total billed charges,,,0.95,,385.7,Percent of total billed charges,,,0.97,,393.82,Percent of total billed charges,,,0.97,,393.82,Percent of total billed charges,,,0.96,,389.76,Percent of total billed charges,,,0.95,,385.7,Percent of total billed charges,,,,,,,,,0.95,,385.7,Percent of total billed charges,,385.7,397.88,
"OR PLT LOCK DISTAL FIB, SS RT, 4H",SUP-3254326,CDM,27810126,LOCAL,278,RC,,outpatient,,,406,365.4,,0.95,,385.7,Percent of total billed charges,,,0.98,,397.88,Percent of total billed charges,,,0.95,,385.7,Percent of total billed charges,,,0.95,,385.7,Percent of total billed charges,,,0.97,,393.82,Percent of total billed charges,,,0.96,,389.76,Percent of total billed charges,,,0.95,,385.7,Percent of total billed charges,,,,,,,,,0.95,,385.7,Percent of total billed charges,,385.7,397.88,
"OR PLT LOCK DISTAL FIB, SS RT, 5H",SUP-3254327,CDM,27810126,LOCAL,278,RC,,inpatient,,,480,432,,0.95,,456,Percent of total billed charges,,,0.98,,470.4,Percent of total billed charges,,,0.95,,456,Percent of total billed charges,,,0.97,,465.6,Percent of total billed charges,,,0.97,,465.6,Percent of total billed charges,,,0.96,,460.8,Percent of total billed charges,,,0.95,,456,Percent of total billed charges,,,,,,,,,0.95,,456,Percent of total billed charges,,456,470.4,
"OR PLT LOCK DISTAL FIB, SS RT, 5H",SUP-3254327,CDM,27810126,LOCAL,278,RC,,outpatient,,,480,432,,0.95,,456,Percent of total billed charges,,,0.98,,470.4,Percent of total billed charges,,,0.95,,456,Percent of total billed charges,,,0.95,,456,Percent of total billed charges,,,0.97,,465.6,Percent of total billed charges,,,0.96,,460.8,Percent of total billed charges,,,0.95,,456,Percent of total billed charges,,,,,,,,,0.95,,456,Percent of total billed charges,,456,470.4,
"OR PLT LOCK DISTAL FIB, SS RT, 6H",SUP-3254328,CDM,27810126,LOCAL,278,RC,,inpatient,,,536,482.4,,0.95,,509.2,Percent of total billed charges,,,0.98,,525.28,Percent of total billed charges,,,0.95,,509.2,Percent of total billed charges,,,0.97,,519.92,Percent of total billed charges,,,0.97,,519.92,Percent of total billed charges,,,0.96,,514.56,Percent of total billed charges,,,0.95,,509.2,Percent of total billed charges,,,,,,,,,0.95,,509.2,Percent of total billed charges,,509.2,525.28,
"OR PLT LOCK DISTAL FIB, SS RT, 6H",SUP-3254328,CDM,27810126,LOCAL,278,RC,,outpatient,,,536,482.4,,0.95,,509.2,Percent of total billed charges,,,0.98,,525.28,Percent of total billed charges,,,0.95,,509.2,Percent of total billed charges,,,0.95,,509.2,Percent of total billed charges,,,0.97,,519.92,Percent of total billed charges,,,0.96,,514.56,Percent of total billed charges,,,0.95,,509.2,Percent of total billed charges,,,,,,,,,0.95,,509.2,Percent of total billed charges,,509.2,525.28,
"OR PLT LOCK DISTAL FIB, SS RT, 8H",SUP-3254329,CDM,27810126,LOCAL,278,RC,,inpatient,,,587,528.3,,0.95,,557.65,Percent of total billed charges,,,0.98,,575.26,Percent of total billed charges,,,0.95,,557.65,Percent of total billed charges,,,0.97,,569.39,Percent of total billed charges,,,0.97,,569.39,Percent of total billed charges,,,0.96,,563.52,Percent of total billed charges,,,0.95,,557.65,Percent of total billed charges,,,,,,,,,0.95,,557.65,Percent of total billed charges,,557.65,575.26,
"OR PLT LOCK DISTAL FIB, SS RT, 8H",SUP-3254329,CDM,27810126,LOCAL,278,RC,,outpatient,,,587,528.3,,0.95,,557.65,Percent of total billed charges,,,0.98,,575.26,Percent of total billed charges,,,0.95,,557.65,Percent of total billed charges,,,0.95,,557.65,Percent of total billed charges,,,0.97,,569.39,Percent of total billed charges,,,0.96,,563.52,Percent of total billed charges,,,0.95,,557.65,Percent of total billed charges,,,,,,,,,0.95,,557.65,Percent of total billed charges,,557.65,575.26,
"OR PLT LOCK STRAIGHT, SS, 4H",SUP-3254330,CDM,27810126,LOCAL,278,RC,,inpatient,,,300,270,,0.95,,285,Percent of total billed charges,,,0.98,,294,Percent of total billed charges,,,0.95,,285,Percent of total billed charges,,,0.97,,291,Percent of total billed charges,,,0.97,,291,Percent of total billed charges,,,0.96,,288,Percent of total billed charges,,,0.95,,285,Percent of total billed charges,,,,,,,,,0.95,,285,Percent of total billed charges,,285,294,
"OR PLT LOCK STRAIGHT, SS, 4H",SUP-3254330,CDM,27810126,LOCAL,278,RC,,outpatient,,,300,270,,0.95,,285,Percent of total billed charges,,,0.98,,294,Percent of total billed charges,,,0.95,,285,Percent of total billed charges,,,0.95,,285,Percent of total billed charges,,,0.97,,291,Percent of total billed charges,,,0.96,,288,Percent of total billed charges,,,0.95,,285,Percent of total billed charges,,,,,,,,,0.95,,285,Percent of total billed charges,,285,294,
"OR PLT LOCK STRAIGHT, SS, 6H",SUP-3254331,CDM,27810126,LOCAL,278,RC,,inpatient,,,316,284.4,,0.95,,300.2,Percent of total billed charges,,,0.98,,309.68,Percent of total billed charges,,,0.95,,300.2,Percent of total billed charges,,,0.97,,306.52,Percent of total billed charges,,,0.97,,306.52,Percent of total billed charges,,,0.96,,303.36,Percent of total billed charges,,,0.95,,300.2,Percent of total billed charges,,,,,,,,,0.95,,300.2,Percent of total billed charges,,300.2,309.68,
"OR PLT LOCK STRAIGHT, SS, 6H",SUP-3254331,CDM,27810126,LOCAL,278,RC,,outpatient,,,316,284.4,,0.95,,300.2,Percent of total billed charges,,,0.98,,309.68,Percent of total billed charges,,,0.95,,300.2,Percent of total billed charges,,,0.95,,300.2,Percent of total billed charges,,,0.97,,306.52,Percent of total billed charges,,,0.96,,303.36,Percent of total billed charges,,,0.95,,300.2,Percent of total billed charges,,,,,,,,,0.95,,300.2,Percent of total billed charges,,300.2,309.68,
"OR PLT LOCK STRAIGHT, SS, 7H",SUP-3254332,CDM,27810126,LOCAL,278,RC,,inpatient,,,349,314.1,,0.95,,331.55,Percent of total billed charges,,,0.98,,342.02,Percent of total billed charges,,,0.95,,331.55,Percent of total billed charges,,,0.97,,338.53,Percent of total billed charges,,,0.97,,338.53,Percent of total billed charges,,,0.96,,335.04,Percent of total billed charges,,,0.95,,331.55,Percent of total billed charges,,,,,,,,,0.95,,331.55,Percent of total billed charges,,331.55,342.02,
"OR PLT LOCK STRAIGHT, SS, 7H",SUP-3254332,CDM,27810126,LOCAL,278,RC,,outpatient,,,349,314.1,,0.95,,331.55,Percent of total billed charges,,,0.98,,342.02,Percent of total billed charges,,,0.95,,331.55,Percent of total billed charges,,,0.95,,331.55,Percent of total billed charges,,,0.97,,338.53,Percent of total billed charges,,,0.96,,335.04,Percent of total billed charges,,,0.95,,331.55,Percent of total billed charges,,,,,,,,,0.95,,331.55,Percent of total billed charges,,331.55,342.02,
"OR PLT LOCK STRAIGHT, SS, 8H",SUP-3254333,CDM,27810126,LOCAL,278,RC,,inpatient,,,366,329.4,,0.95,,347.7,Percent of total billed charges,,,0.98,,358.68,Percent of total billed charges,,,0.95,,347.7,Percent of total billed charges,,,0.97,,355.02,Percent of total billed charges,,,0.97,,355.02,Percent of total billed charges,,,0.96,,351.36,Percent of total billed charges,,,0.95,,347.7,Percent of total billed charges,,,,,,,,,0.95,,347.7,Percent of total billed charges,,347.7,358.68,
"OR PLT LOCK STRAIGHT, SS, 8H",SUP-3254333,CDM,27810126,LOCAL,278,RC,,outpatient,,,366,329.4,,0.95,,347.7,Percent of total billed charges,,,0.98,,358.68,Percent of total billed charges,,,0.95,,347.7,Percent of total billed charges,,,0.95,,347.7,Percent of total billed charges,,,0.97,,355.02,Percent of total billed charges,,,0.96,,351.36,Percent of total billed charges,,,0.95,,347.7,Percent of total billed charges,,,,,,,,,0.95,,347.7,Percent of total billed charges,,347.7,358.68,
"OR PLT LOCK STRAIGHT, SS, 10H",SUP-3254334,CDM,27810126,LOCAL,278,RC,,inpatient,,,396,356.4,,0.95,,376.2,Percent of total billed charges,,,0.98,,388.08,Percent of total billed charges,,,0.95,,376.2,Percent of total billed charges,,,0.97,,384.12,Percent of total billed charges,,,0.97,,384.12,Percent of total billed charges,,,0.96,,380.16,Percent of total billed charges,,,0.95,,376.2,Percent of total billed charges,,,,,,,,,0.95,,376.2,Percent of total billed charges,,376.2,388.08,
"OR PLT LOCK STRAIGHT, SS, 10H",SUP-3254334,CDM,27810126,LOCAL,278,RC,,outpatient,,,396,356.4,,0.95,,376.2,Percent of total billed charges,,,0.98,,388.08,Percent of total billed charges,,,0.95,,376.2,Percent of total billed charges,,,0.95,,376.2,Percent of total billed charges,,,0.97,,384.12,Percent of total billed charges,,,0.96,,380.16,Percent of total billed charges,,,0.95,,376.2,Percent of total billed charges,,,,,,,,,0.95,,376.2,Percent of total billed charges,,376.2,388.08,
"OR PLT LOCK STRAIGHT, SS, 12H",SUP-3254335,CDM,27810126,LOCAL,278,RC,,inpatient,,,463,416.7,,0.95,,439.85,Percent of total billed charges,,,0.98,,453.74,Percent of total billed charges,,,0.95,,439.85,Percent of total billed charges,,,0.97,,449.11,Percent of total billed charges,,,0.97,,449.11,Percent of total billed charges,,,0.96,,444.48,Percent of total billed charges,,,0.95,,439.85,Percent of total billed charges,,,,,,,,,0.95,,439.85,Percent of total billed charges,,439.85,453.74,
"OR PLT LOCK STRAIGHT, SS, 12H",SUP-3254335,CDM,27810126,LOCAL,278,RC,,outpatient,,,463,416.7,,0.95,,439.85,Percent of total billed charges,,,0.98,,453.74,Percent of total billed charges,,,0.95,,439.85,Percent of total billed charges,,,0.95,,439.85,Percent of total billed charges,,,0.97,,449.11,Percent of total billed charges,,,0.96,,444.48,Percent of total billed charges,,,0.95,,439.85,Percent of total billed charges,,,,,,,,,0.95,,439.85,Percent of total billed charges,,439.85,453.74,
"OR PLT LOCK MEDIAL HOOK, SS, 3H",SUP-3254336,CDM,27810126,LOCAL,278,RC,,inpatient,,,609,548.1,,0.95,,578.55,Percent of total billed charges,,,0.98,,596.82,Percent of total billed charges,,,0.95,,578.55,Percent of total billed charges,,,0.97,,590.73,Percent of total billed charges,,,0.97,,590.73,Percent of total billed charges,,,0.96,,584.64,Percent of total billed charges,,,0.95,,578.55,Percent of total billed charges,,,,,,,,,0.95,,578.55,Percent of total billed charges,,578.55,596.82,
"OR PLT LOCK MEDIAL HOOK, SS, 3H",SUP-3254336,CDM,27810126,LOCAL,278,RC,,outpatient,,,609,548.1,,0.95,,578.55,Percent of total billed charges,,,0.98,,596.82,Percent of total billed charges,,,0.95,,578.55,Percent of total billed charges,,,0.95,,578.55,Percent of total billed charges,,,0.97,,590.73,Percent of total billed charges,,,0.96,,584.64,Percent of total billed charges,,,0.95,,578.55,Percent of total billed charges,,,,,,,,,0.95,,578.55,Percent of total billed charges,,578.55,596.82,
"OR PLT LOCK MEDIAL HOOK, SS, 5H",SUP-3254337,CDM,27810126,LOCAL,278,RC,,inpatient,,,609,548.1,,0.95,,578.55,Percent of total billed charges,,,0.98,,596.82,Percent of total billed charges,,,0.95,,578.55,Percent of total billed charges,,,0.97,,590.73,Percent of total billed charges,,,0.97,,590.73,Percent of total billed charges,,,0.96,,584.64,Percent of total billed charges,,,0.95,,578.55,Percent of total billed charges,,,,,,,,,0.95,,578.55,Percent of total billed charges,,578.55,596.82,
"OR PLT LOCK MEDIAL HOOK, SS, 5H",SUP-3254337,CDM,27810126,LOCAL,278,RC,,outpatient,,,609,548.1,,0.95,,578.55,Percent of total billed charges,,,0.98,,596.82,Percent of total billed charges,,,0.95,,578.55,Percent of total billed charges,,,0.95,,578.55,Percent of total billed charges,,,0.97,,590.73,Percent of total billed charges,,,0.96,,584.64,Percent of total billed charges,,,0.95,,578.55,Percent of total billed charges,,,,,,,,,0.95,,578.55,Percent of total billed charges,,578.55,596.82,
"OR PLT LOCK MEDIAL HOOK, SS, 7H",SUP-3254338,CDM,27810126,LOCAL,278,RC,,inpatient,,,662,595.8,,0.95,,628.9,Percent of total billed charges,,,0.98,,648.76,Percent of total billed charges,,,0.95,,628.9,Percent of total billed charges,,,0.97,,642.14,Percent of total billed charges,,,0.97,,642.14,Percent of total billed charges,,,0.96,,635.52,Percent of total billed charges,,,0.95,,628.9,Percent of total billed charges,,,,,,,,,0.95,,628.9,Percent of total billed charges,,628.9,648.76,
"OR PLT LOCK MEDIAL HOOK, SS, 7H",SUP-3254338,CDM,27810126,LOCAL,278,RC,,outpatient,,,662,595.8,,0.95,,628.9,Percent of total billed charges,,,0.98,,648.76,Percent of total billed charges,,,0.95,,628.9,Percent of total billed charges,,,0.95,,628.9,Percent of total billed charges,,,0.97,,642.14,Percent of total billed charges,,,0.96,,635.52,Percent of total billed charges,,,0.95,,628.9,Percent of total billed charges,,,,,,,,,0.95,,628.9,Percent of total billed charges,,628.9,648.76,
"OR PLT LOCK THIRD TUBULAR, SS, 4H",SUP-3254339,CDM,27810126,LOCAL,278,RC,,inpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
"OR PLT LOCK THIRD TUBULAR, SS, 4H",SUP-3254339,CDM,27810126,LOCAL,278,RC,,outpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
"OR PLT LOCK THIRD TUBULAR, SS, 5H",SUP-3254215,CDM,27810126,LOCAL,278,RC,,inpatient,,,219,197.1,,0.95,,208.05,Percent of total billed charges,,,0.98,,214.62,Percent of total billed charges,,,0.95,,208.05,Percent of total billed charges,,,0.97,,212.43,Percent of total billed charges,,,0.97,,212.43,Percent of total billed charges,,,0.96,,210.24,Percent of total billed charges,,,0.95,,208.05,Percent of total billed charges,,,,,,,,,0.95,,208.05,Percent of total billed charges,,208.05,214.62,
"OR PLT LOCK THIRD TUBULAR, SS, 5H",SUP-3254215,CDM,27810126,LOCAL,278,RC,,outpatient,,,219,197.1,,0.95,,208.05,Percent of total billed charges,,,0.98,,214.62,Percent of total billed charges,,,0.95,,208.05,Percent of total billed charges,,,0.95,,208.05,Percent of total billed charges,,,0.97,,212.43,Percent of total billed charges,,,0.96,,210.24,Percent of total billed charges,,,0.95,,208.05,Percent of total billed charges,,,,,,,,,0.95,,208.05,Percent of total billed charges,,208.05,214.62,
SKIN DERMABOND,SUP-3253987,CDM,27010242,LOCAL,270,RC,,inpatient,,,81,72.9,,0.95,,76.95,Percent of total billed charges,,,0.98,,79.38,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.96,,77.76,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,,,,,,,0.95,,76.95,Percent of total billed charges,,76.95,79.38,
SKIN DERMABOND,SUP-3253987,CDM,27010242,LOCAL,270,RC,,outpatient,,,81,72.9,,0.95,,76.95,Percent of total billed charges,,,0.98,,79.38,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,0.97,,78.57,Percent of total billed charges,,,0.96,,77.76,Percent of total billed charges,,,0.95,,76.95,Percent of total billed charges,,,,,,,,,0.95,,76.95,Percent of total billed charges,,76.95,79.38,
"OR PLT LOCK THIRD TUBULAR, SS, 6H",SUP-3254340,CDM,27810126,LOCAL,278,RC,,inpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
"OR PLT LOCK THIRD TUBULAR, SS, 6H",SUP-3254340,CDM,27810126,LOCAL,278,RC,,outpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
"OR PLT LOCK THIRD TUBULAR, SS, 7H",SUP-3254341,CDM,27810126,LOCAL,278,RC,,inpatient,,,238,214.2,,0.95,,226.1,Percent of total billed charges,,,0.98,,233.24,Percent of total billed charges,,,0.95,,226.1,Percent of total billed charges,,,0.97,,230.86,Percent of total billed charges,,,0.97,,230.86,Percent of total billed charges,,,0.96,,228.48,Percent of total billed charges,,,0.95,,226.1,Percent of total billed charges,,,,,,,,,0.95,,226.1,Percent of total billed charges,,226.1,233.24,
"OR PLT LOCK THIRD TUBULAR, SS, 7H",SUP-3254341,CDM,27810126,LOCAL,278,RC,,outpatient,,,238,214.2,,0.95,,226.1,Percent of total billed charges,,,0.98,,233.24,Percent of total billed charges,,,0.95,,226.1,Percent of total billed charges,,,0.95,,226.1,Percent of total billed charges,,,0.97,,230.86,Percent of total billed charges,,,0.96,,228.48,Percent of total billed charges,,,0.95,,226.1,Percent of total billed charges,,,,,,,,,0.95,,226.1,Percent of total billed charges,,226.1,233.24,
"OR PLT LOCK THIRD TUBULAR, SS, 10H",SUP-3254343,CDM,27810126,LOCAL,278,RC,,inpatient,,,261,234.9,,0.95,,247.95,Percent of total billed charges,,,0.98,,255.78,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,0.97,,253.17,Percent of total billed charges,,,0.97,,253.17,Percent of total billed charges,,,0.96,,250.56,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,,,,,,,0.95,,247.95,Percent of total billed charges,,247.95,255.78,
"OR PLT LOCK THIRD TUBULAR, SS, 10H",SUP-3254343,CDM,27810126,LOCAL,278,RC,,outpatient,,,261,234.9,,0.95,,247.95,Percent of total billed charges,,,0.98,,255.78,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,0.97,,253.17,Percent of total billed charges,,,0.96,,250.56,Percent of total billed charges,,,0.95,,247.95,Percent of total billed charges,,,,,,,,,0.95,,247.95,Percent of total billed charges,,247.95,255.78,
"OR PLT LOCK THIRD TUBULAR, SS, 12H",SUP-3254344,CDM,27810126,LOCAL,278,RC,,inpatient,,,280,252,,0.95,,266,Percent of total billed charges,,,0.98,,274.4,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,0.97,,271.6,Percent of total billed charges,,,0.97,,271.6,Percent of total billed charges,,,0.96,,268.8,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,,,,,,,0.95,,266,Percent of total billed charges,,266,274.4,
"OR PLT LOCK THIRD TUBULAR, SS, 12H",SUP-3254344,CDM,27810126,LOCAL,278,RC,,outpatient,,,280,252,,0.95,,266,Percent of total billed charges,,,0.98,,274.4,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,0.97,,271.6,Percent of total billed charges,,,0.96,,268.8,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,,,,,,,0.95,,266,Percent of total billed charges,,266,274.4,
"OR PLT LOCK LATERAL HOOK, SS, 7H",SUP-3254347,CDM,27810126,LOCAL,278,RC,,inpatient,,,517,465.3,,0.95,,491.15,Percent of total billed charges,,,0.98,,506.66,Percent of total billed charges,,,0.95,,491.15,Percent of total billed charges,,,0.97,,501.49,Percent of total billed charges,,,0.97,,501.49,Percent of total billed charges,,,0.96,,496.32,Percent of total billed charges,,,0.95,,491.15,Percent of total billed charges,,,,,,,,,0.95,,491.15,Percent of total billed charges,,491.15,506.66,
"OR PLT LOCK LATERAL HOOK, SS, 7H",SUP-3254347,CDM,27810126,LOCAL,278,RC,,outpatient,,,517,465.3,,0.95,,491.15,Percent of total billed charges,,,0.98,,506.66,Percent of total billed charges,,,0.95,,491.15,Percent of total billed charges,,,0.95,,491.15,Percent of total billed charges,,,0.97,,501.49,Percent of total billed charges,,,0.96,,496.32,Percent of total billed charges,,,0.95,,491.15,Percent of total billed charges,,,,,,,,,0.95,,491.15,Percent of total billed charges,,491.15,506.66,
"OR G-WIRE W/TRCR TIP 0.078""X5.91""",SUP-3254250,CDM,27810126,LOCAL,278,RC,,inpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,,,0.95,,47.5,Percent of total billed charges,,47.5,49,
"OR G-WIRE W/TRCR TIP 0.078""X5.91""",SUP-3254250,CDM,27810126,LOCAL,278,RC,,outpatient,,,50,45,,0.95,,47.5,Percent of total billed charges,,,0.98,,49,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,0.97,,48.5,Percent of total billed charges,,,0.96,,48,Percent of total billed charges,,,0.95,,47.5,Percent of total billed charges,,,,,,,,,0.95,,47.5,Percent of total billed charges,,47.5,49,
"OR K-WIRE TROCAR PT 9"" 0.62",SUP-325,CDM,27810126,LOCAL,278,RC,,inpatient,,,21.28,19.15,,0.95,,20.22,Percent of total billed charges,,,0.98,,20.85,Percent of total billed charges,,,0.95,,20.22,Percent of total billed charges,,,0.97,,20.64,Percent of total billed charges,,,0.97,,20.64,Percent of total billed charges,,,0.96,,20.43,Percent of total billed charges,,,0.95,,20.22,Percent of total billed charges,,,,,,,,,0.95,,20.22,Percent of total billed charges,,20.22,20.85,
"OR K-WIRE TROCAR PT 9"" 0.62",SUP-325,CDM,27810126,LOCAL,278,RC,,outpatient,,,21.28,19.15,,0.95,,20.22,Percent of total billed charges,,,0.98,,20.85,Percent of total billed charges,,,0.95,,20.22,Percent of total billed charges,,,0.95,,20.22,Percent of total billed charges,,,0.97,,20.64,Percent of total billed charges,,,0.96,,20.43,Percent of total billed charges,,,0.95,,20.22,Percent of total billed charges,,,,,,,,,0.95,,20.22,Percent of total billed charges,,20.22,20.85,
"OR SCREW SELF-DRILL SANCHEZ, SS 4.0X125MM",SUP-3254262,CDM,27810126,LOCAL,278,RC,,inpatient,,,313,281.7,,0.95,,297.35,Percent of total billed charges,,,0.98,,306.74,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,0.97,,303.61,Percent of total billed charges,,,0.97,,303.61,Percent of total billed charges,,,0.96,,300.48,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,,,,,,,0.95,,297.35,Percent of total billed charges,,297.35,306.74,
"OR SCREW SELF-DRILL SANCHEZ, SS 4.0X125MM",SUP-3254262,CDM,27810126,LOCAL,278,RC,,outpatient,,,313,281.7,,0.95,,297.35,Percent of total billed charges,,,0.98,,306.74,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,0.97,,303.61,Percent of total billed charges,,,0.96,,300.48,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,,,,,,,0.95,,297.35,Percent of total billed charges,,297.35,306.74,
"OR SCREW SELF-DRILL SANCHEZ, SS 4.0X150MM",SUP-3254349,CDM,27810126,LOCAL,278,RC,,inpatient,,,313,281.7,,0.95,,297.35,Percent of total billed charges,,,0.98,,306.74,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,0.97,,303.61,Percent of total billed charges,,,0.97,,303.61,Percent of total billed charges,,,0.96,,300.48,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,,,,,,,0.95,,297.35,Percent of total billed charges,,297.35,306.74,
"OR SCREW SELF-DRILL SANCHEZ, SS 4.0X150MM",SUP-3254349,CDM,27810126,LOCAL,278,RC,,outpatient,,,313,281.7,,0.95,,297.35,Percent of total billed charges,,,0.98,,306.74,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,0.97,,303.61,Percent of total billed charges,,,0.96,,300.48,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,,,,,,,0.95,,297.35,Percent of total billed charges,,297.35,306.74,
"OR SCREW SELF-DRILL SANCHEZ, SS 5.0X175MM",SUP-3254350,CDM,27810126,LOCAL,278,RC,,inpatient,,,313,281.7,,0.95,,297.35,Percent of total billed charges,,,0.98,,306.74,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,0.97,,303.61,Percent of total billed charges,,,0.97,,303.61,Percent of total billed charges,,,0.96,,300.48,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,,,,,,,0.95,,297.35,Percent of total billed charges,,297.35,306.74,
"OR SCREW SELF-DRILL SANCHEZ, SS 5.0X175MM",SUP-3254350,CDM,27810126,LOCAL,278,RC,,outpatient,,,313,281.7,,0.95,,297.35,Percent of total billed charges,,,0.98,,306.74,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,0.97,,303.61,Percent of total billed charges,,,0.96,,300.48,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,,,,,,,0.95,,297.35,Percent of total billed charges,,297.35,306.74,
"OR SCREW SELF-DRILL SANCHEZ, SS 5.0X200MM",SUP-3254351,CDM,27810126,LOCAL,278,RC,,inpatient,,,313,281.7,,0.95,,297.35,Percent of total billed charges,,,0.98,,306.74,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,0.97,,303.61,Percent of total billed charges,,,0.97,,303.61,Percent of total billed charges,,,0.96,,300.48,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,,,,,,,0.95,,297.35,Percent of total billed charges,,297.35,306.74,
"OR SCREW SELF-DRILL SANCHEZ, SS 5.0X200MM",SUP-3254351,CDM,27810126,LOCAL,278,RC,,outpatient,,,313,281.7,,0.95,,297.35,Percent of total billed charges,,,0.98,,306.74,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,0.97,,303.61,Percent of total billed charges,,,0.96,,300.48,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,,,,,,,0.95,,297.35,Percent of total billed charges,,297.35,306.74,
"OR PIN TRANSFIXATION, SS, 6.0X225MM",SUP-3254353,CDM,27810126,LOCAL,278,RC,,inpatient,,,315,283.5,,0.95,,299.25,Percent of total billed charges,,,0.98,,308.7,Percent of total billed charges,,,0.95,,299.25,Percent of total billed charges,,,0.97,,305.55,Percent of total billed charges,,,0.97,,305.55,Percent of total billed charges,,,0.96,,302.4,Percent of total billed charges,,,0.95,,299.25,Percent of total billed charges,,,,,,,,,0.95,,299.25,Percent of total billed charges,,299.25,308.7,
"OR PIN TRANSFIXATION, SS, 6.0X225MM",SUP-3254353,CDM,27810126,LOCAL,278,RC,,outpatient,,,315,283.5,,0.95,,299.25,Percent of total billed charges,,,0.98,,308.7,Percent of total billed charges,,,0.95,,299.25,Percent of total billed charges,,,0.95,,299.25,Percent of total billed charges,,,0.97,,305.55,Percent of total billed charges,,,0.96,,302.4,Percent of total billed charges,,,0.95,,299.25,Percent of total billed charges,,,,,,,,,0.95,,299.25,Percent of total billed charges,,299.25,308.7,
"OR PIN TRANSFIXATION, SS, 6.0X300MM",SUP-3254354,CDM,27810126,LOCAL,278,RC,,inpatient,,,315,283.5,,0.95,,299.25,Percent of total billed charges,,,0.98,,308.7,Percent of total billed charges,,,0.95,,299.25,Percent of total billed charges,,,0.97,,305.55,Percent of total billed charges,,,0.97,,305.55,Percent of total billed charges,,,0.96,,302.4,Percent of total billed charges,,,0.95,,299.25,Percent of total billed charges,,,,,,,,,0.95,,299.25,Percent of total billed charges,,299.25,308.7,
"OR PIN TRANSFIXATION, SS, 6.0X300MM",SUP-3254354,CDM,27810126,LOCAL,278,RC,,outpatient,,,315,283.5,,0.95,,299.25,Percent of total billed charges,,,0.98,,308.7,Percent of total billed charges,,,0.95,,299.25,Percent of total billed charges,,,0.95,,299.25,Percent of total billed charges,,,0.97,,305.55,Percent of total billed charges,,,0.96,,302.4,Percent of total billed charges,,,0.95,,299.25,Percent of total billed charges,,,,,,,,,0.95,,299.25,Percent of total billed charges,,299.25,308.7,
"OR SCREW SELF-DRILL SANCHEZ, SS 5.0X250MM",SUP-3254352,CDM,27810126,LOCAL,278,RC,,inpatient,,,313,281.7,,0.95,,297.35,Percent of total billed charges,,,0.98,,306.74,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,0.97,,303.61,Percent of total billed charges,,,0.97,,303.61,Percent of total billed charges,,,0.96,,300.48,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,,,,,,,0.95,,297.35,Percent of total billed charges,,297.35,306.74,
"OR SCREW SELF-DRILL SANCHEZ, SS 5.0X250MM",SUP-3254352,CDM,27810126,LOCAL,278,RC,,outpatient,,,313,281.7,,0.95,,297.35,Percent of total billed charges,,,0.98,,306.74,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,0.97,,303.61,Percent of total billed charges,,,0.96,,300.48,Percent of total billed charges,,,0.95,,297.35,Percent of total billed charges,,,,,,,,,0.95,,297.35,Percent of total billed charges,,297.35,306.74,
"OR CARBON ROD, 100MM",SUP-3254355,CDM,27010242,LOCAL,270,RC,,inpatient,,,423,380.7,,0.95,,401.85,Percent of total billed charges,,,0.98,,414.54,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,0.97,,410.31,Percent of total billed charges,,,0.97,,410.31,Percent of total billed charges,,,0.96,,406.08,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,,,,,,,0.95,,401.85,Percent of total billed charges,,401.85,414.54,
"OR CARBON ROD, 100MM",SUP-3254355,CDM,27010242,LOCAL,270,RC,,outpatient,,,423,380.7,,0.95,,401.85,Percent of total billed charges,,,0.98,,414.54,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,0.97,,410.31,Percent of total billed charges,,,0.96,,406.08,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,,,,,,,0.95,,401.85,Percent of total billed charges,,401.85,414.54,
"OR CARBON ROD, 150MM",SUP-3254356,CDM,27010242,LOCAL,270,RC,,inpatient,,,423,380.7,,0.95,,401.85,Percent of total billed charges,,,0.98,,414.54,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,0.97,,410.31,Percent of total billed charges,,,0.97,,410.31,Percent of total billed charges,,,0.96,,406.08,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,,,,,,,0.95,,401.85,Percent of total billed charges,,401.85,414.54,
"OR CARBON ROD, 150MM",SUP-3254356,CDM,27010242,LOCAL,270,RC,,outpatient,,,423,380.7,,0.95,,401.85,Percent of total billed charges,,,0.98,,414.54,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,0.97,,410.31,Percent of total billed charges,,,0.96,,406.08,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,,,,,,,0.95,,401.85,Percent of total billed charges,,401.85,414.54,
"OR CARBON ROD, 200MM",SUP-3254358,CDM,27010242,LOCAL,270,RC,,inpatient,,,423,380.7,,0.95,,401.85,Percent of total billed charges,,,0.98,,414.54,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,0.97,,410.31,Percent of total billed charges,,,0.97,,410.31,Percent of total billed charges,,,0.96,,406.08,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,,,,,,,0.95,,401.85,Percent of total billed charges,,401.85,414.54,
"OR CARBON ROD, 200MM",SUP-3254358,CDM,27010242,LOCAL,270,RC,,outpatient,,,423,380.7,,0.95,,401.85,Percent of total billed charges,,,0.98,,414.54,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,0.97,,410.31,Percent of total billed charges,,,0.96,,406.08,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,,,,,,,0.95,,401.85,Percent of total billed charges,,401.85,414.54,
"OR CARBON ROD, 250MM",SUP-3254359,CDM,27010242,LOCAL,270,RC,,inpatient,,,423,380.7,,0.95,,401.85,Percent of total billed charges,,,0.98,,414.54,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,0.97,,410.31,Percent of total billed charges,,,0.97,,410.31,Percent of total billed charges,,,0.96,,406.08,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,,,,,,,0.95,,401.85,Percent of total billed charges,,401.85,414.54,
"OR CARBON ROD, 250MM",SUP-3254359,CDM,27010242,LOCAL,270,RC,,outpatient,,,423,380.7,,0.95,,401.85,Percent of total billed charges,,,0.98,,414.54,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,0.97,,410.31,Percent of total billed charges,,,0.96,,406.08,Percent of total billed charges,,,0.95,,401.85,Percent of total billed charges,,,,,,,,,0.95,,401.85,Percent of total billed charges,,401.85,414.54,
"OR CARBON ROD, 300MM",SUP-3254360,CDM,27010242,LOCAL,270,RC,,inpatient,,,475,427.5,,0.95,,451.25,Percent of total billed charges,,,0.98,,465.5,Percent of total billed charges,,,0.95,,451.25,Percent of total billed charges,,,0.97,,460.75,Percent of total billed charges,,,0.97,,460.75,Percent of total billed charges,,,0.96,,456,Percent of total billed charges,,,0.95,,451.25,Percent of total billed charges,,,,,,,,,0.95,,451.25,Percent of total billed charges,,451.25,465.5,
"OR CARBON ROD, 300MM",SUP-3254360,CDM,27010242,LOCAL,270,RC,,outpatient,,,475,427.5,,0.95,,451.25,Percent of total billed charges,,,0.98,,465.5,Percent of total billed charges,,,0.95,,451.25,Percent of total billed charges,,,0.95,,451.25,Percent of total billed charges,,,0.97,,460.75,Percent of total billed charges,,,0.96,,456,Percent of total billed charges,,,0.95,,451.25,Percent of total billed charges,,,,,,,,,0.95,,451.25,Percent of total billed charges,,451.25,465.5,
"OR CARBON ROD, 350MM",SUP-3254361,CDM,27010242,LOCAL,270,RC,,inpatient,,,475,427.5,,0.95,,451.25,Percent of total billed charges,,,0.98,,465.5,Percent of total billed charges,,,0.95,,451.25,Percent of total billed charges,,,0.97,,460.75,Percent of total billed charges,,,0.97,,460.75,Percent of total billed charges,,,0.96,,456,Percent of total billed charges,,,0.95,,451.25,Percent of total billed charges,,,,,,,,,0.95,,451.25,Percent of total billed charges,,451.25,465.5,
"OR CARBON ROD, 350MM",SUP-3254361,CDM,27010242,LOCAL,270,RC,,outpatient,,,475,427.5,,0.95,,451.25,Percent of total billed charges,,,0.98,,465.5,Percent of total billed charges,,,0.95,,451.25,Percent of total billed charges,,,0.95,,451.25,Percent of total billed charges,,,0.97,,460.75,Percent of total billed charges,,,0.96,,456,Percent of total billed charges,,,0.95,,451.25,Percent of total billed charges,,,,,,,,,0.95,,451.25,Percent of total billed charges,,451.25,465.5,
"OR CARBON ROD, 400MM",SUP-3254362,CDM,27010242,LOCAL,270,RC,,inpatient,,,500,450,,0.95,,475,Percent of total billed charges,,,0.98,,490,Percent of total billed charges,,,0.95,,475,Percent of total billed charges,,,0.97,,485,Percent of total billed charges,,,0.97,,485,Percent of total billed charges,,,0.96,,480,Percent of total billed charges,,,0.95,,475,Percent of total billed charges,,,,,,,,,0.95,,475,Percent of total billed charges,,475,490,
"OR CARBON ROD, 400MM",SUP-3254362,CDM,27010242,LOCAL,270,RC,,outpatient,,,500,450,,0.95,,475,Percent of total billed charges,,,0.98,,490,Percent of total billed charges,,,0.95,,475,Percent of total billed charges,,,0.95,,475,Percent of total billed charges,,,0.97,,485,Percent of total billed charges,,,0.96,,480,Percent of total billed charges,,,0.95,,475,Percent of total billed charges,,,,,,,,,0.95,,475,Percent of total billed charges,,475,490,
"OR CARBON ROD, 450MM",SUP-3254363,CDM,27010242,LOCAL,270,RC,,inpatient,,,500,450,,0.95,,475,Percent of total billed charges,,,0.98,,490,Percent of total billed charges,,,0.95,,475,Percent of total billed charges,,,0.97,,485,Percent of total billed charges,,,0.97,,485,Percent of total billed charges,,,0.96,,480,Percent of total billed charges,,,0.95,,475,Percent of total billed charges,,,,,,,,,0.95,,475,Percent of total billed charges,,475,490,
"OR CARBON ROD, 450MM",SUP-3254363,CDM,27010242,LOCAL,270,RC,,outpatient,,,500,450,,0.95,,475,Percent of total billed charges,,,0.98,,490,Percent of total billed charges,,,0.95,,475,Percent of total billed charges,,,0.95,,475,Percent of total billed charges,,,0.97,,485,Percent of total billed charges,,,0.96,,480,Percent of total billed charges,,,0.95,,475,Percent of total billed charges,,,,,,,,,0.95,,475,Percent of total billed charges,,475,490,
"OR LO-PRO SCRW, TI, 3.5X14MM",SUP-3254364,CDM,27810126,LOCAL,278,RC,,inpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
"OR LO-PRO SCRW, TI, 3.5X14MM",SUP-3254364,CDM,27810126,LOCAL,278,RC,,outpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
"OR LO-PRO SCRW, TI, 3.5X16MM",SUP-3254365,CDM,27810126,LOCAL,278,RC,,inpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
"OR LO-PRO SCRW, TI, 3.5X16MM",SUP-3254365,CDM,27810126,LOCAL,278,RC,,outpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
"OR LO-PRO SCRW, TI, 3.5X18MM",SUP-3254366,CDM,27810126,LOCAL,278,RC,,inpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
"OR LO-PRO SCRW, TI, 3.5X18MM",SUP-3254366,CDM,27810126,LOCAL,278,RC,,outpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
"OR LO-PRO SCRW, TI, 3.5X20MM",SUP-3254367,CDM,27810126,LOCAL,278,RC,,inpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
"OR LO-PRO SCRW, TI, 3.5X20MM",SUP-3254367,CDM,27810126,LOCAL,278,RC,,outpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
"OR SCREW LOCKING, TITANIUM 3.5X14MM",SUP-3254368,CDM,27810126,LOCAL,278,RC,,inpatient,,,375,337.5,,0.95,,356.25,Percent of total billed charges,,,0.98,,367.5,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.96,,360,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,,,,,,,0.95,,356.25,Percent of total billed charges,,356.25,367.5,
"OR SCREW LOCKING, TITANIUM 3.5X14MM",SUP-3254368,CDM,27810126,LOCAL,278,RC,,outpatient,,,375,337.5,,0.95,,356.25,Percent of total billed charges,,,0.98,,367.5,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.96,,360,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,,,,,,,0.95,,356.25,Percent of total billed charges,,356.25,367.5,
"OR SCREW LOCKING, TITANIUM 3.5X16MM",SUP-3254369,CDM,27810126,LOCAL,278,RC,,inpatient,,,375,337.5,,0.95,,356.25,Percent of total billed charges,,,0.98,,367.5,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.96,,360,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,,,,,,,0.95,,356.25,Percent of total billed charges,,356.25,367.5,
"OR SCREW LOCKING, TITANIUM 3.5X16MM",SUP-3254369,CDM,27810126,LOCAL,278,RC,,outpatient,,,375,337.5,,0.95,,356.25,Percent of total billed charges,,,0.98,,367.5,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.96,,360,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,,,,,,,0.95,,356.25,Percent of total billed charges,,356.25,367.5,
"OR SCREW LOCKING, TITANIUM 3.5X18MM",SUP-3254370,CDM,27810126,LOCAL,278,RC,,inpatient,,,375,337.5,,0.95,,356.25,Percent of total billed charges,,,0.98,,367.5,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.96,,360,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,,,,,,,0.95,,356.25,Percent of total billed charges,,356.25,367.5,
"OR SCREW LOCKING, TITANIUM 3.5X18MM",SUP-3254370,CDM,27810126,LOCAL,278,RC,,outpatient,,,375,337.5,,0.95,,356.25,Percent of total billed charges,,,0.98,,367.5,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.96,,360,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,,,,,,,0.95,,356.25,Percent of total billed charges,,356.25,367.5,
"OR SCREW LOCKING, TITANIUM 3.5X20MM",SUP-3254371,CDM,27810126,LOCAL,278,RC,,inpatient,,,375,337.5,,0.95,,356.25,Percent of total billed charges,,,0.98,,367.5,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.96,,360,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,,,,,,,0.95,,356.25,Percent of total billed charges,,356.25,367.5,
"OR SCREW LOCKING, TITANIUM 3.5X20MM",SUP-3254371,CDM,27810126,LOCAL,278,RC,,outpatient,,,375,337.5,,0.95,,356.25,Percent of total billed charges,,,0.98,,367.5,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.96,,360,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,,,,,,,0.95,,356.25,Percent of total billed charges,,356.25,367.5,
"OR SCREW LO-PRO LOCK, TI, 3.5X12MM",SUP-3254372,CDM,27810126,LOCAL,278,RC,,inpatient,,,375,337.5,,0.95,,356.25,Percent of total billed charges,,,0.98,,367.5,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.96,,360,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,,,,,,,0.95,,356.25,Percent of total billed charges,,356.25,367.5,
"OR SCREW LO-PRO LOCK, TI, 3.5X12MM",SUP-3254372,CDM,27810126,LOCAL,278,RC,,outpatient,,,375,337.5,,0.95,,356.25,Percent of total billed charges,,,0.98,,367.5,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.96,,360,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,,,,,,,0.95,,356.25,Percent of total billed charges,,356.25,367.5,
"OR SCREW LO-PRO LOCK, TI, 3.5X10MM",SUP-3254373,CDM,27810126,LOCAL,278,RC,,inpatient,,,375,337.5,,0.95,,356.25,Percent of total billed charges,,,0.98,,367.5,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.96,,360,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,,,,,,,0.95,,356.25,Percent of total billed charges,,356.25,367.5,
"OR SCREW LO-PRO LOCK, TI, 3.5X10MM",SUP-3254373,CDM,27810126,LOCAL,278,RC,,outpatient,,,375,337.5,,0.95,,356.25,Percent of total billed charges,,,0.98,,367.5,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.96,,360,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,,,,,,,0.95,,356.25,Percent of total billed charges,,356.25,367.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X8MM",SUP-3254374,CDM,27810126,LOCAL,278,RC,,inpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X8MM",SUP-3254374,CDM,27810126,LOCAL,278,RC,,outpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X10MM",SUP-3254375,CDM,27810126,LOCAL,278,RC,,inpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X10MM",SUP-3254375,CDM,27810126,LOCAL,278,RC,,outpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X12MM",SUP-3254376,CDM,27810126,LOCAL,278,RC,,inpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X12MM",SUP-3254376,CDM,27810126,LOCAL,278,RC,,outpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X14MM",SUP-3254377,CDM,27810126,LOCAL,278,RC,,inpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X14MM",SUP-3254377,CDM,27810126,LOCAL,278,RC,,outpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X16MM",SUP-3254378,CDM,27810126,LOCAL,278,RC,,inpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X16MM",SUP-3254378,CDM,27810126,LOCAL,278,RC,,outpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X18MM",SUP-3254379,CDM,27810126,LOCAL,278,RC,,inpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X18MM",SUP-3254379,CDM,27810126,LOCAL,278,RC,,outpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X20MM",SUP-3254380,CDM,27810126,LOCAL,278,RC,,inpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X20MM",SUP-3254380,CDM,27810126,LOCAL,278,RC,,outpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X22MM",SUP-3254381,CDM,27810126,LOCAL,278,RC,,inpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X22MM",SUP-3254381,CDM,27810126,LOCAL,278,RC,,outpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X24MM",SUP-3254382,CDM,27810126,LOCAL,278,RC,,inpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X24MM",SUP-3254382,CDM,27810126,LOCAL,278,RC,,outpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X26MM",SUP-3254383,CDM,27810126,LOCAL,278,RC,,inpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X26MM",SUP-3254383,CDM,27810126,LOCAL,278,RC,,outpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X28MM",SUP-3254384,CDM,27810126,LOCAL,278,RC,,inpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X28MM",SUP-3254384,CDM,27810126,LOCAL,278,RC,,outpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X30MM",SUP-3254385,CDM,27810126,LOCAL,278,RC,,inpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X30MM",SUP-3254385,CDM,27810126,LOCAL,278,RC,,outpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X32MM",SUP-3254386,CDM,27810126,LOCAL,278,RC,,inpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X32MM",SUP-3254386,CDM,27810126,LOCAL,278,RC,,outpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X34MM",SUP-3254387,CDM,27810126,LOCAL,278,RC,,inpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR SCREW LOW PROFILE SCREW, CORTEX, 2.4X34MM",SUP-3254387,CDM,27810126,LOCAL,278,RC,,outpatient,,,275,247.5,,0.95,,261.25,Percent of total billed charges,,,0.98,,269.5,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,0.97,,266.75,Percent of total billed charges,,,0.96,,264,Percent of total billed charges,,,0.95,,261.25,Percent of total billed charges,,,,,,,,,0.95,,261.25,Percent of total billed charges,,261.25,269.5,
"OR VAL SCREW, TI 2.4X8MM",SUP-3254389,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X8MM",SUP-3254389,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X10MM",SUP-3254390,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X10MM",SUP-3254390,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X12MM",SUP-3254391,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X12MM",SUP-3254391,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X14MM",SUP-3254392,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X14MM",SUP-3254392,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X16MM",SUP-3254393,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X16MM",SUP-3254393,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SYNDESMOSIS TIGHTROPE IMPLANT,SUP-3254357,CDM,27810126,LOCAL,278,RC,,inpatient,,,2243,2018.7,,0.95,,2130.85,Percent of total billed charges,,,0.98,,2198.14,Percent of total billed charges,,,0.95,,2130.85,Percent of total billed charges,,,0.97,,2175.71,Percent of total billed charges,,,0.97,,2175.71,Percent of total billed charges,,,0.96,,2153.28,Percent of total billed charges,,,0.95,,2130.85,Percent of total billed charges,,,,,,,,,0.95,,2130.85,Percent of total billed charges,,2130.85,2198.14,
OR SYNDESMOSIS TIGHTROPE IMPLANT,SUP-3254357,CDM,27810126,LOCAL,278,RC,,outpatient,,,2243,2018.7,,0.95,,2130.85,Percent of total billed charges,,,0.98,,2198.14,Percent of total billed charges,,,0.95,,2130.85,Percent of total billed charges,,,0.95,,2130.85,Percent of total billed charges,,,0.97,,2175.71,Percent of total billed charges,,,0.96,,2153.28,Percent of total billed charges,,,0.95,,2130.85,Percent of total billed charges,,,,,,,,,0.95,,2130.85,Percent of total billed charges,,2130.85,2198.14,
"OR K-WIRE TROCAR PT. 9"" 0.028"" 0.7MM",SUP-325,CDM,27810126,LOCAL,278,RC,,inpatient,,,95.7,86.13,,0.95,,90.92,Percent of total billed charges,,,0.98,,93.79,Percent of total billed charges,,,0.95,,90.92,Percent of total billed charges,,,0.97,,92.83,Percent of total billed charges,,,0.97,,92.83,Percent of total billed charges,,,0.96,,91.87,Percent of total billed charges,,,0.95,,90.92,Percent of total billed charges,,,,,,,,,0.95,,90.92,Percent of total billed charges,,90.92,93.79,
"OR K-WIRE TROCAR PT. 9"" 0.028"" 0.7MM",SUP-325,CDM,27810126,LOCAL,278,RC,,outpatient,,,95.7,86.13,,0.95,,90.92,Percent of total billed charges,,,0.98,,93.79,Percent of total billed charges,,,0.95,,90.92,Percent of total billed charges,,,0.95,,90.92,Percent of total billed charges,,,0.97,,92.83,Percent of total billed charges,,,0.96,,91.87,Percent of total billed charges,,,0.95,,90.92,Percent of total billed charges,,,,,,,,,0.95,,90.92,Percent of total billed charges,,90.92,93.79,
"OR K-WIRE TROCAR PT. 9"" 0.035""",SUP-325,CDM,27810126,LOCAL,278,RC,,inpatient,,,95.7,86.13,,0.95,,90.92,Percent of total billed charges,,,0.98,,93.79,Percent of total billed charges,,,0.95,,90.92,Percent of total billed charges,,,0.97,,92.83,Percent of total billed charges,,,0.97,,92.83,Percent of total billed charges,,,0.96,,91.87,Percent of total billed charges,,,0.95,,90.92,Percent of total billed charges,,,,,,,,,0.95,,90.92,Percent of total billed charges,,90.92,93.79,
"OR K-WIRE TROCAR PT. 9"" 0.035""",SUP-325,CDM,27810126,LOCAL,278,RC,,outpatient,,,95.7,86.13,,0.95,,90.92,Percent of total billed charges,,,0.98,,93.79,Percent of total billed charges,,,0.95,,90.92,Percent of total billed charges,,,0.95,,90.92,Percent of total billed charges,,,0.97,,92.83,Percent of total billed charges,,,0.96,,91.87,Percent of total billed charges,,,0.95,,90.92,Percent of total billed charges,,,,,,,,,0.95,,90.92,Percent of total billed charges,,90.92,93.79,
"OR K-WIRE TROCAR PT 9"" 0.045""",SUP-325,CDM,27810126,LOCAL,278,RC,,inpatient,,,95.7,86.13,,0.95,,90.92,Percent of total billed charges,,,0.98,,93.79,Percent of total billed charges,,,0.95,,90.92,Percent of total billed charges,,,0.97,,92.83,Percent of total billed charges,,,0.97,,92.83,Percent of total billed charges,,,0.96,,91.87,Percent of total billed charges,,,0.95,,90.92,Percent of total billed charges,,,,,,,,,0.95,,90.92,Percent of total billed charges,,90.92,93.79,
"OR K-WIRE TROCAR PT 9"" 0.045""",SUP-325,CDM,27810126,LOCAL,278,RC,,outpatient,,,95.7,86.13,,0.95,,90.92,Percent of total billed charges,,,0.98,,93.79,Percent of total billed charges,,,0.95,,90.92,Percent of total billed charges,,,0.95,,90.92,Percent of total billed charges,,,0.97,,92.83,Percent of total billed charges,,,0.96,,91.87,Percent of total billed charges,,,0.95,,90.92,Percent of total billed charges,,,,,,,,,0.95,,90.92,Percent of total billed charges,,90.92,93.79,
"OR K-WIRE TROCAR PT 9"" 0.054""",SUP-325,CDM,27810126,LOCAL,278,RC,,inpatient,,,95.7,86.13,,0.95,,90.92,Percent of total billed charges,,,0.98,,93.79,Percent of total billed charges,,,0.95,,90.92,Percent of total billed charges,,,0.97,,92.83,Percent of total billed charges,,,0.97,,92.83,Percent of total billed charges,,,0.96,,91.87,Percent of total billed charges,,,0.95,,90.92,Percent of total billed charges,,,,,,,,,0.95,,90.92,Percent of total billed charges,,90.92,93.79,
"OR K-WIRE TROCAR PT 9"" 0.054""",SUP-325,CDM,27810126,LOCAL,278,RC,,outpatient,,,95.7,86.13,,0.95,,90.92,Percent of total billed charges,,,0.98,,93.79,Percent of total billed charges,,,0.95,,90.92,Percent of total billed charges,,,0.95,,90.92,Percent of total billed charges,,,0.97,,92.83,Percent of total billed charges,,,0.96,,91.87,Percent of total billed charges,,,0.95,,90.92,Percent of total billed charges,,,,,,,,,0.95,,90.92,Percent of total billed charges,,90.92,93.79,
"OR STEIN PIN TROCAR 9"" 5/64"" 2.0MM",SUP-325,CDM,27810126,LOCAL,278,RC,,inpatient,,,95.7,86.13,,0.95,,90.92,Percent of total billed charges,,,0.98,,93.79,Percent of total billed charges,,,0.95,,90.92,Percent of total billed charges,,,0.97,,92.83,Percent of total billed charges,,,0.97,,92.83,Percent of total billed charges,,,0.96,,91.87,Percent of total billed charges,,,0.95,,90.92,Percent of total billed charges,,,,,,,,,0.95,,90.92,Percent of total billed charges,,90.92,93.79,
"OR STEIN PIN TROCAR 9"" 5/64"" 2.0MM",SUP-325,CDM,27810126,LOCAL,278,RC,,outpatient,,,95.7,86.13,,0.95,,90.92,Percent of total billed charges,,,0.98,,93.79,Percent of total billed charges,,,0.95,,90.92,Percent of total billed charges,,,0.95,,90.92,Percent of total billed charges,,,0.97,,92.83,Percent of total billed charges,,,0.96,,91.87,Percent of total billed charges,,,0.95,,90.92,Percent of total billed charges,,,,,,,,,0.95,,90.92,Percent of total billed charges,,90.92,93.79,
"OR STEIN PIN TROCAR 9"" 0.177"" 4.5MM",SUP-325,CDM,27810126,LOCAL,278,RC,,inpatient,,,288.18,259.36,,0.95,,273.77,Percent of total billed charges,,,0.98,,282.42,Percent of total billed charges,,,0.95,,273.77,Percent of total billed charges,,,0.97,,279.53,Percent of total billed charges,,,0.97,,279.53,Percent of total billed charges,,,0.96,,276.65,Percent of total billed charges,,,0.95,,273.77,Percent of total billed charges,,,,,,,,,0.95,,273.77,Percent of total billed charges,,273.77,282.42,
"OR STEIN PIN TROCAR 9"" 0.177"" 4.5MM",SUP-325,CDM,27810126,LOCAL,278,RC,,outpatient,,,288.18,259.36,,0.95,,273.77,Percent of total billed charges,,,0.98,,282.42,Percent of total billed charges,,,0.95,,273.77,Percent of total billed charges,,,0.95,,273.77,Percent of total billed charges,,,0.97,,279.53,Percent of total billed charges,,,0.96,,276.65,Percent of total billed charges,,,0.95,,273.77,Percent of total billed charges,,,,,,,,,0.95,,273.77,Percent of total billed charges,,273.77,282.42,
"OR STEIN PIN TROCAR 9"" 1/8"" 3.2MM",SUP-325,CDM,27810126,LOCAL,278,RC,,inpatient,,,192.5,173.25,,0.95,,182.88,Percent of total billed charges,,,0.98,,188.65,Percent of total billed charges,,,0.95,,182.88,Percent of total billed charges,,,0.97,,186.73,Percent of total billed charges,,,0.97,,186.73,Percent of total billed charges,,,0.96,,184.8,Percent of total billed charges,,,0.95,,182.88,Percent of total billed charges,,,,,,,,,0.95,,182.88,Percent of total billed charges,,182.88,188.65,
"OR STEIN PIN TROCAR 9"" 1/8"" 3.2MM",SUP-325,CDM,27810126,LOCAL,278,RC,,outpatient,,,192.5,173.25,,0.95,,182.88,Percent of total billed charges,,,0.98,,188.65,Percent of total billed charges,,,0.95,,182.88,Percent of total billed charges,,,0.95,,182.88,Percent of total billed charges,,,0.97,,186.73,Percent of total billed charges,,,0.96,,184.8,Percent of total billed charges,,,0.95,,182.88,Percent of total billed charges,,,,,,,,,0.95,,182.88,Percent of total billed charges,,182.88,188.65,
"OR VAL SCREW, TI 2.4X18MM",SUP-3254394,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X18MM",SUP-3254394,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X20MM",SUP-3254395,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X20MM",SUP-3254395,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X22MM",SUP-3254396,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X22MM",SUP-3254396,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X24MM",SUP-3254397,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X24MM",SUP-3254397,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X26MM",SUP-3254398,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X26MM",SUP-3254398,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X28MM",SUP-3254399,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X28MM",SUP-3254399,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X30MM",SUP-3254400,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X30MM",SUP-3254400,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X32MM",SUP-3254401,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X32MM",SUP-3254401,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X34MM",SUP-3254402,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
"OR VAL SCREW, TI 2.4X34MM",SUP-3254402,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR PLATE DIST RAD VOL LT 3H,SUP-3254404,CDM,27810126,LOCAL,278,RC,,inpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL LT 3H,SUP-3254404,CDM,27810126,LOCAL,278,RC,,outpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL LT 5H,SUP-3254405,CDM,27810126,LOCAL,278,RC,,inpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL LT 5H,SUP-3254405,CDM,27810126,LOCAL,278,RC,,outpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL RT 3H,SUP-3254406,CDM,27810126,LOCAL,278,RC,,inpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL RT 3H,SUP-3254406,CDM,27810126,LOCAL,278,RC,,outpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL RT 5H,SUP-3254407,CDM,27810126,LOCAL,278,RC,,inpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL RT 5H,SUP-3254407,CDM,27810126,LOCAL,278,RC,,outpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL STD LT 3H,SUP-3254408,CDM,27810126,LOCAL,278,RC,,inpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL STD LT 3H,SUP-3254408,CDM,27810126,LOCAL,278,RC,,outpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL STD LT 5H,SUP-3254409,CDM,27810126,LOCAL,278,RC,,inpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL STD LT 5H,SUP-3254409,CDM,27810126,LOCAL,278,RC,,outpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL STD RT 3H,SUP-3254410,CDM,27810126,LOCAL,278,RC,,inpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL STD RT 3H,SUP-3254410,CDM,27810126,LOCAL,278,RC,,outpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL STD RT 5H,SUP-3254411,CDM,27810126,LOCAL,278,RC,,inpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL STD RT 5H,SUP-3254411,CDM,27810126,LOCAL,278,RC,,outpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL W LT 3H,SUP-3254412,CDM,27810126,LOCAL,278,RC,,inpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL W LT 3H,SUP-3254412,CDM,27810126,LOCAL,278,RC,,outpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL W LT 5H,SUP-3254413,CDM,27810126,LOCAL,278,RC,,inpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL W LT 5H,SUP-3254413,CDM,27810126,LOCAL,278,RC,,outpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL W RT 5H,SUP-3254414,CDM,27810126,LOCAL,278,RC,,inpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL W RT 5H,SUP-3254414,CDM,27810126,LOCAL,278,RC,,outpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL W RT 3H,SUP-3254415,CDM,27810126,LOCAL,278,RC,,inpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL W RT 3H,SUP-3254415,CDM,27810126,LOCAL,278,RC,,outpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR SCREW CORT VAL NEAR 2.4X8MM,SUP-3254416,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X8MM,SUP-3254416,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X14MM,SUP-3254417,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X14MM,SUP-3254417,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X20MM,SUP-3254418,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X20MM,SUP-3254418,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X22MM,SUP-3254419,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X22MM,SUP-3254419,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X24MM,SUP-3254420,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X24MM,SUP-3254420,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X34MM,SUP-3254421,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X34MM,SUP-3254421,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X16MM,SUP-3254422,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X16MM,SUP-3254422,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X28MM,SUP-3254423,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X28MM,SUP-3254423,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X12MM,SUP-3254424,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X12MM,SUP-3254424,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X18MM,SUP-3254425,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X18MM,SUP-3254425,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X26MM,SUP-3254426,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X26MM,SUP-3254426,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X30MM,SUP-3254427,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X30MM,SUP-3254427,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X32MM,SUP-3254428,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X32MM,SUP-3254428,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW LP 3.5X10MM,SUP-3254429,CDM,27810126,LOCAL,278,RC,,inpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR SCREW LP 3.5X10MM,SUP-3254429,CDM,27810126,LOCAL,278,RC,,outpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR SCREW LP 3.5X11MM,SUP-3254430,CDM,27810126,LOCAL,278,RC,,inpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR SCREW LP 3.5X11MM,SUP-3254430,CDM,27810126,LOCAL,278,RC,,outpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR SCREW LP 3.5X12MM,SUP-3254431,CDM,27810126,LOCAL,278,RC,,inpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR SCREW LP 3.5X12MM,SUP-3254431,CDM,27810126,LOCAL,278,RC,,outpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR SCREW LP 3.5X13MM,SUP-3254432,CDM,27810126,LOCAL,278,RC,,inpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR SCREW LP 3.5X13MM,SUP-3254432,CDM,27810126,LOCAL,278,RC,,outpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR SCREW CORT VAL NEAR 2.4X10MM,SUP-3254433,CDM,27810126,LOCAL,278,RC,,inpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR SCREW CORT VAL NEAR 2.4X10MM,SUP-3254433,CDM,27810126,LOCAL,278,RC,,outpatient,,,350,315,,0.95,,332.5,Percent of total billed charges,,,0.98,,343,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,0.97,,339.5,Percent of total billed charges,,,0.96,,336,Percent of total billed charges,,,0.95,,332.5,Percent of total billed charges,,,,,,,,,0.95,,332.5,Percent of total billed charges,,332.5,343,
OR PLATE 5TH METARSAL HOOK,SUP-3254434,CDM,27810126,LOCAL,278,RC,,inpatient,,,1388,1249.2,,0.95,,1318.6,Percent of total billed charges,,,0.98,,1360.24,Percent of total billed charges,,,0.95,,1318.6,Percent of total billed charges,,,0.97,,1346.36,Percent of total billed charges,,,0.97,,1346.36,Percent of total billed charges,,,0.96,,1332.48,Percent of total billed charges,,,0.95,,1318.6,Percent of total billed charges,,,,,,,,,0.95,,1318.6,Percent of total billed charges,,1318.6,1360.24,
OR PLATE 5TH METARSAL HOOK,SUP-3254434,CDM,27810126,LOCAL,278,RC,,outpatient,,,1388,1249.2,,0.95,,1318.6,Percent of total billed charges,,,0.98,,1360.24,Percent of total billed charges,,,0.95,,1318.6,Percent of total billed charges,,,0.95,,1318.6,Percent of total billed charges,,,0.97,,1346.36,Percent of total billed charges,,,0.96,,1332.48,Percent of total billed charges,,,0.95,,1318.6,Percent of total billed charges,,,,,,,,,0.95,,1318.6,Percent of total billed charges,,1318.6,1360.24,
OR PLATE DORS DIST RAD LT 4H,SUP-3254435,CDM,27810126,LOCAL,278,RC,,inpatient,,,1943,1748.7,,0.95,,1845.85,Percent of total billed charges,,,0.98,,1904.14,Percent of total billed charges,,,0.95,,1845.85,Percent of total billed charges,,,0.97,,1884.71,Percent of total billed charges,,,0.97,,1884.71,Percent of total billed charges,,,0.96,,1865.28,Percent of total billed charges,,,0.95,,1845.85,Percent of total billed charges,,,,,,,,,0.95,,1845.85,Percent of total billed charges,,1845.85,1904.14,
OR PLATE DORS DIST RAD LT 4H,SUP-3254435,CDM,27810126,LOCAL,278,RC,,outpatient,,,1943,1748.7,,0.95,,1845.85,Percent of total billed charges,,,0.98,,1904.14,Percent of total billed charges,,,0.95,,1845.85,Percent of total billed charges,,,0.95,,1845.85,Percent of total billed charges,,,0.97,,1884.71,Percent of total billed charges,,,0.96,,1865.28,Percent of total billed charges,,,0.95,,1845.85,Percent of total billed charges,,,,,,,,,0.95,,1845.85,Percent of total billed charges,,1845.85,1904.14,
OR PLATE DORS DIST RAD RT 4H,SUP-3254436,CDM,27810126,LOCAL,278,RC,,inpatient,,,1943,1748.7,,0.95,,1845.85,Percent of total billed charges,,,0.98,,1904.14,Percent of total billed charges,,,0.95,,1845.85,Percent of total billed charges,,,0.97,,1884.71,Percent of total billed charges,,,0.97,,1884.71,Percent of total billed charges,,,0.96,,1865.28,Percent of total billed charges,,,0.95,,1845.85,Percent of total billed charges,,,,,,,,,0.95,,1845.85,Percent of total billed charges,,1845.85,1904.14,
OR PLATE DORS DIST RAD RT 4H,SUP-3254436,CDM,27810126,LOCAL,278,RC,,outpatient,,,1943,1748.7,,0.95,,1845.85,Percent of total billed charges,,,0.98,,1904.14,Percent of total billed charges,,,0.95,,1845.85,Percent of total billed charges,,,0.95,,1845.85,Percent of total billed charges,,,0.97,,1884.71,Percent of total billed charges,,,0.96,,1865.28,Percent of total billed charges,,,0.95,,1845.85,Percent of total billed charges,,,,,,,,,0.95,,1845.85,Percent of total billed charges,,1845.85,1904.14,
OR PLATE DORS DIST RAD  STD LT 4H,SUP-3254437,CDM,27810126,LOCAL,278,RC,,inpatient,,,1943,1748.7,,0.95,,1845.85,Percent of total billed charges,,,0.98,,1904.14,Percent of total billed charges,,,0.95,,1845.85,Percent of total billed charges,,,0.97,,1884.71,Percent of total billed charges,,,0.97,,1884.71,Percent of total billed charges,,,0.96,,1865.28,Percent of total billed charges,,,0.95,,1845.85,Percent of total billed charges,,,,,,,,,0.95,,1845.85,Percent of total billed charges,,1845.85,1904.14,
OR PLATE DORS DIST RAD  STD LT 4H,SUP-3254437,CDM,27810126,LOCAL,278,RC,,outpatient,,,1943,1748.7,,0.95,,1845.85,Percent of total billed charges,,,0.98,,1904.14,Percent of total billed charges,,,0.95,,1845.85,Percent of total billed charges,,,0.95,,1845.85,Percent of total billed charges,,,0.97,,1884.71,Percent of total billed charges,,,0.96,,1865.28,Percent of total billed charges,,,0.95,,1845.85,Percent of total billed charges,,,,,,,,,0.95,,1845.85,Percent of total billed charges,,1845.85,1904.14,
OR PLATE DORS DIST RAD  STD RT 4H,SUP-3254438,CDM,27810126,LOCAL,278,RC,,inpatient,,,1943,1748.7,,0.95,,1845.85,Percent of total billed charges,,,0.98,,1904.14,Percent of total billed charges,,,0.95,,1845.85,Percent of total billed charges,,,0.97,,1884.71,Percent of total billed charges,,,0.97,,1884.71,Percent of total billed charges,,,0.96,,1865.28,Percent of total billed charges,,,0.95,,1845.85,Percent of total billed charges,,,,,,,,,0.95,,1845.85,Percent of total billed charges,,1845.85,1904.14,
OR PLATE DORS DIST RAD  STD RT 4H,SUP-3254438,CDM,27810126,LOCAL,278,RC,,outpatient,,,1943,1748.7,,0.95,,1845.85,Percent of total billed charges,,,0.98,,1904.14,Percent of total billed charges,,,0.95,,1845.85,Percent of total billed charges,,,0.95,,1845.85,Percent of total billed charges,,,0.97,,1884.71,Percent of total billed charges,,,0.96,,1865.28,Percent of total billed charges,,,0.95,,1845.85,Percent of total billed charges,,,,,,,,,0.95,,1845.85,Percent of total billed charges,,1845.85,1904.14,
OR PLATE DIST RAD STYLOID 5H,SUP-3254439,CDM,27810126,LOCAL,278,RC,,inpatient,,,1343,1208.7,,0.95,,1275.85,Percent of total billed charges,,,0.98,,1316.14,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,0.97,,1302.71,Percent of total billed charges,,,0.97,,1302.71,Percent of total billed charges,,,0.96,,1289.28,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,,,,,,,0.95,,1275.85,Percent of total billed charges,,1275.85,1316.14,
OR PLATE DIST RAD STYLOID 5H,SUP-3254439,CDM,27810126,LOCAL,278,RC,,outpatient,,,1343,1208.7,,0.95,,1275.85,Percent of total billed charges,,,0.98,,1316.14,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,0.97,,1302.71,Percent of total billed charges,,,0.96,,1289.28,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,,,,,,,0.95,,1275.85,Percent of total billed charges,,1275.85,1316.14,
OR PLATE WRIST SPANNING,SUP-3254440,CDM,27810126,LOCAL,278,RC,,inpatient,,,2693,2423.7,,0.95,,2558.35,Percent of total billed charges,,,0.98,,2639.14,Percent of total billed charges,,,0.95,,2558.35,Percent of total billed charges,,,0.97,,2612.21,Percent of total billed charges,,,0.97,,2612.21,Percent of total billed charges,,,0.96,,2585.28,Percent of total billed charges,,,0.95,,2558.35,Percent of total billed charges,,,,,,,,,0.95,,2558.35,Percent of total billed charges,,2558.35,2639.14,
OR PLATE WRIST SPANNING,SUP-3254440,CDM,27810126,LOCAL,278,RC,,outpatient,,,2693,2423.7,,0.95,,2558.35,Percent of total billed charges,,,0.98,,2639.14,Percent of total billed charges,,,0.95,,2558.35,Percent of total billed charges,,,0.95,,2558.35,Percent of total billed charges,,,0.97,,2612.21,Percent of total billed charges,,,0.96,,2585.28,Percent of total billed charges,,,0.95,,2558.35,Percent of total billed charges,,,,,,,,,0.95,,2558.35,Percent of total billed charges,,2558.35,2639.14,
OR PLATE DIST RAD VOL HOOK 4H,SUP-3254441,CDM,27810126,LOCAL,278,RC,,inpatient,,,1343,1208.7,,0.95,,1275.85,Percent of total billed charges,,,0.98,,1316.14,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,0.97,,1302.71,Percent of total billed charges,,,0.97,,1302.71,Percent of total billed charges,,,0.96,,1289.28,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,,,,,,,0.95,,1275.85,Percent of total billed charges,,1275.85,1316.14,
OR PLATE DIST RAD VOL HOOK 4H,SUP-3254441,CDM,27810126,LOCAL,278,RC,,outpatient,,,1343,1208.7,,0.95,,1275.85,Percent of total billed charges,,,0.98,,1316.14,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,0.97,,1302.71,Percent of total billed charges,,,0.96,,1289.28,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,,,,,,,0.95,,1275.85,Percent of total billed charges,,1275.85,1316.14,
OR PLATE DIST RAD VOL HOOK 6H,SUP-3254442,CDM,27810126,LOCAL,278,RC,,inpatient,,,1343,1208.7,,0.95,,1275.85,Percent of total billed charges,,,0.98,,1316.14,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,0.97,,1302.71,Percent of total billed charges,,,0.97,,1302.71,Percent of total billed charges,,,0.96,,1289.28,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,,,,,,,0.95,,1275.85,Percent of total billed charges,,1275.85,1316.14,
OR PLATE DIST RAD VOL HOOK 6H,SUP-3254442,CDM,27810126,LOCAL,278,RC,,outpatient,,,1343,1208.7,,0.95,,1275.85,Percent of total billed charges,,,0.98,,1316.14,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,0.97,,1302.71,Percent of total billed charges,,,0.96,,1289.28,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,,,,,,,0.95,,1275.85,Percent of total billed charges,,1275.85,1316.14,
OR L-PLATE 2.4MM 2H LT 5H,SUP-3254443,CDM,27810126,LOCAL,278,RC,,inpatient,,,1343,1208.7,,0.95,,1275.85,Percent of total billed charges,,,0.98,,1316.14,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,0.97,,1302.71,Percent of total billed charges,,,0.97,,1302.71,Percent of total billed charges,,,0.96,,1289.28,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,,,,,,,0.95,,1275.85,Percent of total billed charges,,1275.85,1316.14,
OR L-PLATE 2.4MM 2H LT 5H,SUP-3254443,CDM,27810126,LOCAL,278,RC,,outpatient,,,1343,1208.7,,0.95,,1275.85,Percent of total billed charges,,,0.98,,1316.14,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,0.97,,1302.71,Percent of total billed charges,,,0.96,,1289.28,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,,,,,,,0.95,,1275.85,Percent of total billed charges,,1275.85,1316.14,
OR L-PLATE 2.4MM 2H RT 5H,SUP-3254444,CDM,27810126,LOCAL,278,RC,,inpatient,,,1343,1208.7,,0.95,,1275.85,Percent of total billed charges,,,0.98,,1316.14,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,0.97,,1302.71,Percent of total billed charges,,,0.97,,1302.71,Percent of total billed charges,,,0.96,,1289.28,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,,,,,,,0.95,,1275.85,Percent of total billed charges,,1275.85,1316.14,
OR L-PLATE 2.4MM 2H RT 5H,SUP-3254444,CDM,27810126,LOCAL,278,RC,,outpatient,,,1343,1208.7,,0.95,,1275.85,Percent of total billed charges,,,0.98,,1316.14,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,0.97,,1302.71,Percent of total billed charges,,,0.96,,1289.28,Percent of total billed charges,,,0.95,,1275.85,Percent of total billed charges,,,,,,,,,0.95,,1275.85,Percent of total billed charges,,1275.85,1316.14,
"OR WIRE K TROCAR PT 9"" 0.028X0.7MM",SUP-3254445,CDM,27810126,LOCAL,278,RC,,inpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
"OR WIRE K TROCAR PT 9"" 0.028X0.7MM",SUP-3254445,CDM,27810126,LOCAL,278,RC,,outpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
"OR WIRE K TROCAR PT 9"" 0.035X0.9MM",SUP-3254446,CDM,27810126,LOCAL,278,RC,,inpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
"OR WIRE K TROCAR PT 9"" 0.035X0.9MM",SUP-3254446,CDM,27810126,LOCAL,278,RC,,outpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
"OR WIRE K TROCAR PT 9"" 0.045X1.1MM",SUP-3254447,CDM,27810126,LOCAL,278,RC,,inpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
"OR WIRE K TROCAR PT 9"" 0.045X1.1MM",SUP-3254447,CDM,27810126,LOCAL,278,RC,,outpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
"OR WIRE K TROCAR PT 9"" 0.054X1.4MM",SUP-3254448,CDM,27810126,LOCAL,278,RC,,inpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
"OR WIRE K TROCAR PT 9"" 0.054X1.4MM",SUP-3254448,CDM,27810126,LOCAL,278,RC,,outpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
"OR WIRE K TROCAR PT 9"" 0.062X1.6MM",SUP-3254449,CDM,27810126,LOCAL,278,RC,,inpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
"OR WIRE K TROCAR PT 9"" 0.062X1.6MM",SUP-3254449,CDM,27810126,LOCAL,278,RC,,outpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
"OR PIN STEIN TROCAR 9"" 5/64X2MM",SUP-3254450,CDM,27810126,LOCAL,278,RC,,inpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,,,0.95,,19,Percent of total billed charges,,19,19.6,
"OR PIN STEIN TROCAR 9"" 5/64X2MM",SUP-3254450,CDM,27810126,LOCAL,278,RC,,outpatient,,,20,18,,0.95,,19,Percent of total billed charges,,,0.98,,19.6,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,0.97,,19.4,Percent of total billed charges,,,0.96,,19.2,Percent of total billed charges,,,0.95,,19,Percent of total billed charges,,,,,,,,,0.95,,19,Percent of total billed charges,,19,19.6,
"OR PIN STEIN TROCAR 9"" 1/8X3.2MM",SUP-3254451,CDM,27810126,LOCAL,278,RC,,inpatient,,,32,28.8,,0.95,,30.4,Percent of total billed charges,,,0.98,,31.36,Percent of total billed charges,,,0.95,,30.4,Percent of total billed charges,,,0.97,,31.04,Percent of total billed charges,,,0.97,,31.04,Percent of total billed charges,,,0.96,,30.72,Percent of total billed charges,,,0.95,,30.4,Percent of total billed charges,,,,,,,,,0.95,,30.4,Percent of total billed charges,,30.4,31.36,
"OR PIN STEIN TROCAR 9"" 1/8X3.2MM",SUP-3254451,CDM,27810126,LOCAL,278,RC,,outpatient,,,32,28.8,,0.95,,30.4,Percent of total billed charges,,,0.98,,31.36,Percent of total billed charges,,,0.95,,30.4,Percent of total billed charges,,,0.95,,30.4,Percent of total billed charges,,,0.97,,31.04,Percent of total billed charges,,,0.96,,30.72,Percent of total billed charges,,,0.95,,30.4,Percent of total billed charges,,,,,,,,,0.95,,30.4,Percent of total billed charges,,30.4,31.36,
"OR PIN STEIN TROCAR 9"" 0.177X4.5MM",SUP-3254452,CDM,27810126,LOCAL,278,RC,,inpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
"OR PIN STEIN TROCAR 9"" 0.177X4.5MM",SUP-3254452,CDM,27810126,LOCAL,278,RC,,outpatient,,,53,47.7,,0.95,,50.35,Percent of total billed charges,,,0.98,,51.94,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,0.97,,51.41,Percent of total billed charges,,,0.96,,50.88,Percent of total billed charges,,,0.95,,50.35,Percent of total billed charges,,,,,,,,,0.95,,50.35,Percent of total billed charges,,50.35,51.94,
"OR WIRE K TORCAR PT 0.045X6""",SUP-3254453,CDM,27810126,LOCAL,278,RC,,inpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
"OR WIRE K TORCAR PT 0.045X6""",SUP-3254453,CDM,27810126,LOCAL,278,RC,,outpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
OR WIRE K TOCAR PT 0.028X0.7MM,SUP-3254454,CDM,27810126,LOCAL,278,RC,,inpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
OR WIRE K TOCAR PT 0.028X0.7MM,SUP-3254454,CDM,27810126,LOCAL,278,RC,,outpatient,,,19,17.1,,0.95,,18.05,Percent of total billed charges,,,0.98,,18.62,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,0.97,,18.43,Percent of total billed charges,,,0.96,,18.24,Percent of total billed charges,,,0.95,,18.05,Percent of total billed charges,,,,,,,,,0.95,,18.05,Percent of total billed charges,,18.05,18.62,
OR GUIDEWIRE TROC THRD 1.35,SUP-3254321,CDM,27810126,LOCAL,278,RC,,inpatient,,,30,27,,0.95,,28.5,Percent of total billed charges,,,0.98,,29.4,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,0.97,,29.1,Percent of total billed charges,,,0.97,,29.1,Percent of total billed charges,,,0.96,,28.8,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,,,,,,,0.95,,28.5,Percent of total billed charges,,28.5,29.4,
OR GUIDEWIRE TROC THRD 1.35,SUP-3254321,CDM,27810126,LOCAL,278,RC,,outpatient,,,30,27,,0.95,,28.5,Percent of total billed charges,,,0.98,,29.4,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,0.97,,29.1,Percent of total billed charges,,,0.96,,28.8,Percent of total billed charges,,,0.95,,28.5,Percent of total billed charges,,,,,,,,,0.95,,28.5,Percent of total billed charges,,28.5,29.4,
"OR PLT LOCK THIRD TUBULAR, SS, 8H",SUP-3254342,CDM,27810126,LOCAL,278,RC,,inpatient,,,247,222.3,,0.95,,234.65,Percent of total billed charges,,,0.98,,242.06,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.96,,237.12,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,,,,,,,0.95,,234.65,Percent of total billed charges,,234.65,242.06,
"OR PLT LOCK THIRD TUBULAR, SS, 8H",SUP-3254342,CDM,27810126,LOCAL,278,RC,,outpatient,,,247,222.3,,0.95,,234.65,Percent of total billed charges,,,0.98,,242.06,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,0.97,,239.59,Percent of total billed charges,,,0.96,,237.12,Percent of total billed charges,,,0.95,,234.65,Percent of total billed charges,,,,,,,,,0.95,,234.65,Percent of total billed charges,,234.65,242.06,
"OR PLT LOCK LATERAL HOOK, SS, 3H",SUP-3254345,CDM,27810126,LOCAL,278,RC,,inpatient,,,517,465.3,,0.95,,491.15,Percent of total billed charges,,,0.98,,506.66,Percent of total billed charges,,,0.95,,491.15,Percent of total billed charges,,,0.97,,501.49,Percent of total billed charges,,,0.97,,501.49,Percent of total billed charges,,,0.96,,496.32,Percent of total billed charges,,,0.95,,491.15,Percent of total billed charges,,,,,,,,,0.95,,491.15,Percent of total billed charges,,491.15,506.66,
"OR PLT LOCK LATERAL HOOK, SS, 3H",SUP-3254345,CDM,27810126,LOCAL,278,RC,,outpatient,,,517,465.3,,0.95,,491.15,Percent of total billed charges,,,0.98,,506.66,Percent of total billed charges,,,0.95,,491.15,Percent of total billed charges,,,0.95,,491.15,Percent of total billed charges,,,0.97,,501.49,Percent of total billed charges,,,0.96,,496.32,Percent of total billed charges,,,0.95,,491.15,Percent of total billed charges,,,,,,,,,0.95,,491.15,Percent of total billed charges,,491.15,506.66,
"OR PLT LOCK LATERAL HOOK, SS, 5H",SUP-3254346,CDM,27810126,LOCAL,278,RC,,inpatient,,,517,465.3,,0.95,,491.15,Percent of total billed charges,,,0.98,,506.66,Percent of total billed charges,,,0.95,,491.15,Percent of total billed charges,,,0.97,,501.49,Percent of total billed charges,,,0.97,,501.49,Percent of total billed charges,,,0.96,,496.32,Percent of total billed charges,,,0.95,,491.15,Percent of total billed charges,,,,,,,,,0.95,,491.15,Percent of total billed charges,,491.15,506.66,
"OR PLT LOCK LATERAL HOOK, SS, 5H",SUP-3254346,CDM,27810126,LOCAL,278,RC,,outpatient,,,517,465.3,,0.95,,491.15,Percent of total billed charges,,,0.98,,506.66,Percent of total billed charges,,,0.95,,491.15,Percent of total billed charges,,,0.95,,491.15,Percent of total billed charges,,,0.97,,501.49,Percent of total billed charges,,,0.96,,496.32,Percent of total billed charges,,,0.95,,491.15,Percent of total billed charges,,,,,,,,,0.95,,491.15,Percent of total billed charges,,491.15,506.66,
OR PEEK SWIVELOCK 6,SUP-3254456,CDM,27810126,LOCAL,278,RC,,inpatient,,,2400,2160,,0.95,,2280,Percent of total billed charges,,,0.98,,2352,Percent of total billed charges,,,0.95,,2280,Percent of total billed charges,,,0.97,,2328,Percent of total billed charges,,,0.97,,2328,Percent of total billed charges,,,0.96,,2304,Percent of total billed charges,,,0.95,,2280,Percent of total billed charges,,,,,,,,,0.95,,2280,Percent of total billed charges,,2280,2352,
OR PEEK SWIVELOCK 6,SUP-3254456,CDM,27810126,LOCAL,278,RC,,outpatient,,,2400,2160,,0.95,,2280,Percent of total billed charges,,,0.98,,2352,Percent of total billed charges,,,0.95,,2280,Percent of total billed charges,,,0.95,,2280,Percent of total billed charges,,,0.97,,2328,Percent of total billed charges,,,0.96,,2304,Percent of total billed charges,,,0.95,,2280,Percent of total billed charges,,,,,,,,,0.95,,2280,Percent of total billed charges,,2280,2352,
OR PASSPORT BUTTON 10X4,SUP-3254457,CDM,27210093,LOCAL,272,RC,,inpatient,,,128,115.2,,0.95,,121.6,Percent of total billed charges,,,0.98,,125.44,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.96,,122.88,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,,,,,,,0.95,,121.6,Percent of total billed charges,,121.6,125.44,
OR PASSPORT BUTTON 10X4,SUP-3254457,CDM,27210093,LOCAL,272,RC,,outpatient,,,128,115.2,,0.95,,121.6,Percent of total billed charges,,,0.98,,125.44,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.96,,122.88,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,,,,,,,0.95,,121.6,Percent of total billed charges,,121.6,125.44,
OR KNOT PUSHER 6TH FGR,SUP-3254458,CDM,27210093,LOCAL,272,RC,,inpatient,,,280,252,,0.95,,266,Percent of total billed charges,,,0.98,,274.4,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,0.97,,271.6,Percent of total billed charges,,,0.97,,271.6,Percent of total billed charges,,,0.96,,268.8,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,,,,,,,0.95,,266,Percent of total billed charges,,266,274.4,
OR KNOT PUSHER 6TH FGR,SUP-3254458,CDM,27210093,LOCAL,272,RC,,outpatient,,,280,252,,0.95,,266,Percent of total billed charges,,,0.98,,274.4,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,0.97,,271.6,Percent of total billed charges,,,0.96,,268.8,Percent of total billed charges,,,0.95,,266,Percent of total billed charges,,,,,,,,,0.95,,266,Percent of total billed charges,,266,274.4,
OR PEEK SWIVELOCK 5.5,SUP-3254459,CDM,27810126,LOCAL,278,RC,,inpatient,,,870,783,,0.95,,826.5,Percent of total billed charges,,,0.98,,852.6,Percent of total billed charges,,,0.95,,826.5,Percent of total billed charges,,,0.97,,843.9,Percent of total billed charges,,,0.97,,843.9,Percent of total billed charges,,,0.96,,835.2,Percent of total billed charges,,,0.95,,826.5,Percent of total billed charges,,,,,,,,,0.95,,826.5,Percent of total billed charges,,826.5,852.6,
OR PEEK SWIVELOCK 5.5,SUP-3254459,CDM,27810126,LOCAL,278,RC,,outpatient,,,870,783,,0.95,,826.5,Percent of total billed charges,,,0.98,,852.6,Percent of total billed charges,,,0.95,,826.5,Percent of total billed charges,,,0.95,,826.5,Percent of total billed charges,,,0.97,,843.9,Percent of total billed charges,,,0.96,,835.2,Percent of total billed charges,,,0.95,,826.5,Percent of total billed charges,,,,,,,,,0.95,,826.5,Percent of total billed charges,,826.5,852.6,
OR SHOULDER STABIL KIT,SUP-3254471,CDM,27010242,LOCAL,270,RC,,inpatient,,,240,216,,0.95,,228,Percent of total billed charges,,,0.98,,235.2,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,0.97,,232.8,Percent of total billed charges,,,0.97,,232.8,Percent of total billed charges,,,0.96,,230.4,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,,,,,,,0.95,,228,Percent of total billed charges,,228,235.2,
OR SHOULDER STABIL KIT,SUP-3254471,CDM,27010242,LOCAL,270,RC,,outpatient,,,240,216,,0.95,,228,Percent of total billed charges,,,0.98,,235.2,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,0.97,,232.8,Percent of total billed charges,,,0.96,,230.4,Percent of total billed charges,,,0.95,,228,Percent of total billed charges,,,,,,,,,0.95,,228,Percent of total billed charges,,228,235.2,
OR SCREW LP NOLOCK 3.5X10,SUP-3254472,CDM,27810126,LOCAL,278,RC,,inpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR SCREW LP NOLOCK 3.5X10,SUP-3254472,CDM,27810126,LOCAL,278,RC,,outpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR SCREW LP NOLOCK 3.5X11,SUP-3254473,CDM,27810126,LOCAL,278,RC,,inpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR SCREW LP NOLOCK 3.5X11,SUP-3254473,CDM,27810126,LOCAL,278,RC,,outpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR SCREW LP NOLOCK 3.5X12,SUP-3254474,CDM,27810126,LOCAL,278,RC,,inpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR SCREW LP NOLOCK 3.5X12,SUP-3254474,CDM,27810126,LOCAL,278,RC,,outpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR SCREW LP NOLOCK 3.5X13,SUP-3254475,CDM,27810126,LOCAL,278,RC,,inpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR SCREW LP NOLOCK 3.5X13,SUP-3254475,CDM,27810126,LOCAL,278,RC,,outpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR SCREW LP NOLOCK 3.5X14,SUP-3254476,CDM,27810126,LOCAL,278,RC,,inpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR SCREW LP NOLOCK 3.5X14,SUP-3254476,CDM,27810126,LOCAL,278,RC,,outpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR SCREW LP NOLOCK 3.5X16,SUP-3254477,CDM,27810126,LOCAL,278,RC,,inpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR SCREW LP NOLOCK 3.5X16,SUP-3254477,CDM,27810126,LOCAL,278,RC,,outpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR SCREW LP NOLOCK 3.5X18,SUP-3254478,CDM,27810126,LOCAL,278,RC,,inpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR SCREW LP NOLOCK 3.5X18,SUP-3254478,CDM,27810126,LOCAL,278,RC,,outpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR SCREW LP NOLOCK 3.5X20,SUP-3254479,CDM,27810126,LOCAL,278,RC,,inpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR SCREW LP NOLOCK 3.5X20,SUP-3254479,CDM,27810126,LOCAL,278,RC,,outpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR WIRE K TROCAR 2.0X150,SUP-3254480,CDM,27010242,LOCAL,270,RC,,inpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
OR WIRE K TROCAR 2.0X150,SUP-3254480,CDM,27010242,LOCAL,270,RC,,outpatient,,,89,80.1,,0.95,,84.55,Percent of total billed charges,,,0.98,,87.22,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,0.97,,86.33,Percent of total billed charges,,,0.96,,85.44,Percent of total billed charges,,,0.95,,84.55,Percent of total billed charges,,,,,,,,,0.95,,84.55,Percent of total billed charges,,84.55,87.22,
OR SCREW CORTEX ST 3.5X36MM,SUP-3254470,CDM,27810126,LOCAL,278,RC,,inpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
OR SCREW CORTEX ST 3.5X36MM,SUP-3254470,CDM,27810126,LOCAL,278,RC,,outpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
OR SCREW CORTEX ST 3.5X34MM,SUP-3254469,CDM,27810126,LOCAL,278,RC,,inpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
OR SCREW CORTEX ST 3.5X34MM,SUP-3254469,CDM,27810126,LOCAL,278,RC,,outpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
OR SCREW CORTEX ST 3.5X32MM,SUP-3254468,CDM,27810126,LOCAL,278,RC,,inpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
OR SCREW CORTEX ST 3.5X32MM,SUP-3254468,CDM,27810126,LOCAL,278,RC,,outpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
OR SCREW CORTEX ST 3.5X30MM,SUP-3254467,CDM,27810126,LOCAL,278,RC,,inpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
OR SCREW CORTEX ST 3.5X30MM,SUP-3254467,CDM,27810126,LOCAL,278,RC,,outpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
OR SCREW CORTEX ST 3.5X28MM,SUP-3254466,CDM,27810126,LOCAL,278,RC,,inpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
OR SCREW CORTEX ST 3.5X28MM,SUP-3254466,CDM,27810126,LOCAL,278,RC,,outpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
OR SCREW CORTEX ST 3.5X22MM,SUP-3254465,CDM,27810126,LOCAL,278,RC,,inpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
OR SCREW CORTEX ST 3.5X22MM,SUP-3254465,CDM,27810126,LOCAL,278,RC,,outpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
OR SO SCREW LOCK ST 3.5X45MM,SUP-212.119,CDM,27810126,LOCAL,278,RC,,inpatient,,,620,558,,0.95,,589,Percent of total billed charges,,,0.98,,607.6,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.96,,595.2,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,,,,,,,0.95,,589,Percent of total billed charges,,589,607.6,
OR SO SCREW LOCK ST 3.5X45MM,SUP-212.119,CDM,27810126,LOCAL,278,RC,,outpatient,,,620,558,,0.95,,589,Percent of total billed charges,,,0.98,,607.6,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.96,,595.2,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,,,,,,,0.95,,589,Percent of total billed charges,,589,607.6,
OR SO SCREW LOCK ST 3.5X40MM,SUP-212.117,CDM,27810126,LOCAL,278,RC,,inpatient,,,620,558,,0.95,,589,Percent of total billed charges,,,0.98,,607.6,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.96,,595.2,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,,,,,,,0.95,,589,Percent of total billed charges,,589,607.6,
OR SO SCREW LOCK ST 3.5X40MM,SUP-212.117,CDM,27810126,LOCAL,278,RC,,outpatient,,,620,558,,0.95,,589,Percent of total billed charges,,,0.98,,607.6,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.96,,595.2,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,,,,,,,0.95,,589,Percent of total billed charges,,589,607.6,
OR SO SCREW LOCK ST 3.5X38MM,SUP-212.116,CDM,27810126,LOCAL,278,RC,,inpatient,,,620,558,,0.95,,589,Percent of total billed charges,,,0.98,,607.6,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.96,,595.2,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,,,,,,,0.95,,589,Percent of total billed charges,,589,607.6,
OR SO SCREW LOCK ST 3.5X38MM,SUP-212.116,CDM,27810126,LOCAL,278,RC,,outpatient,,,620,558,,0.95,,589,Percent of total billed charges,,,0.98,,607.6,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.96,,595.2,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,,,,,,,0.95,,589,Percent of total billed charges,,589,607.6,
OR SO SCREW LOCK ST 3.5X34MM,SUP-212.113,CDM,27810126,LOCAL,278,RC,,inpatient,,,620,558,,0.95,,589,Percent of total billed charges,,,0.98,,607.6,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.96,,595.2,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,,,,,,,0.95,,589,Percent of total billed charges,,589,607.6,
OR SO SCREW LOCK ST 3.5X34MM,SUP-212.113,CDM,27810126,LOCAL,278,RC,,outpatient,,,620,558,,0.95,,589,Percent of total billed charges,,,0.98,,607.6,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,0.97,,601.4,Percent of total billed charges,,,0.96,,595.2,Percent of total billed charges,,,0.95,,589,Percent of total billed charges,,,,,,,,,0.95,,589,Percent of total billed charges,,589,607.6,
OR SCREW LOCK ST 3.5X28MM,SUP-3254460,CDM,27810126,LOCAL,278,RC,,inpatient,,,658,592.2,,0.95,,625.1,Percent of total billed charges,,,0.98,,644.84,Percent of total billed charges,,,0.95,,625.1,Percent of total billed charges,,,0.97,,638.26,Percent of total billed charges,,,0.97,,638.26,Percent of total billed charges,,,0.96,,631.68,Percent of total billed charges,,,0.95,,625.1,Percent of total billed charges,,,,,,,,,0.95,,625.1,Percent of total billed charges,,625.1,644.84,
OR SCREW LOCK ST 3.5X28MM,SUP-3254460,CDM,27810126,LOCAL,278,RC,,outpatient,,,658,592.2,,0.95,,625.1,Percent of total billed charges,,,0.98,,644.84,Percent of total billed charges,,,0.95,,625.1,Percent of total billed charges,,,0.95,,625.1,Percent of total billed charges,,,0.97,,638.26,Percent of total billed charges,,,0.96,,631.68,Percent of total billed charges,,,0.95,,625.1,Percent of total billed charges,,,,,,,,,0.95,,625.1,Percent of total billed charges,,625.1,644.84,
OR DRILL BIT GOLD 2.5X180MM,SUP-7420299,CDM,27010242,LOCAL,270,RC,,inpatient,,,468,421.2,,0.95,,444.6,Percent of total billed charges,,,0.98,,458.64,Percent of total billed charges,,,0.95,,444.6,Percent of total billed charges,,,0.97,,453.96,Percent of total billed charges,,,0.97,,453.96,Percent of total billed charges,,,0.96,,449.28,Percent of total billed charges,,,0.95,,444.6,Percent of total billed charges,,,,,,,,,0.95,,444.6,Percent of total billed charges,,444.6,458.64,
OR DRILL BIT GOLD 2.5X180MM,SUP-7420299,CDM,27010242,LOCAL,270,RC,,outpatient,,,468,421.2,,0.95,,444.6,Percent of total billed charges,,,0.98,,458.64,Percent of total billed charges,,,0.95,,444.6,Percent of total billed charges,,,0.95,,444.6,Percent of total billed charges,,,0.97,,453.96,Percent of total billed charges,,,0.96,,449.28,Percent of total billed charges,,,0.95,,444.6,Percent of total billed charges,,,,,,,,,0.95,,444.6,Percent of total billed charges,,444.6,458.64,
OR SO DRILL BIT 2.8X165MM,SUP-310.288,CDM,27010242,LOCAL,270,RC,,inpatient,,,518,466.2,,0.95,,492.1,Percent of total billed charges,,,0.98,,507.64,Percent of total billed charges,,,0.95,,492.1,Percent of total billed charges,,,0.97,,502.46,Percent of total billed charges,,,0.97,,502.46,Percent of total billed charges,,,0.96,,497.28,Percent of total billed charges,,,0.95,,492.1,Percent of total billed charges,,,,,,,,,0.95,,492.1,Percent of total billed charges,,492.1,507.64,
OR SO DRILL BIT 2.8X165MM,SUP-310.288,CDM,27010242,LOCAL,270,RC,,outpatient,,,518,466.2,,0.95,,492.1,Percent of total billed charges,,,0.98,,507.64,Percent of total billed charges,,,0.95,,492.1,Percent of total billed charges,,,0.95,,492.1,Percent of total billed charges,,,0.97,,502.46,Percent of total billed charges,,,0.96,,497.28,Percent of total billed charges,,,0.95,,492.1,Percent of total billed charges,,,,,,,,,0.95,,492.1,Percent of total billed charges,,492.1,507.64,
OR PLATE SO 2.7/3.5 PROX OLEC 2H/LT,SUP-3254482,CDM,27810126,LOCAL,278,RC,,inpatient,,,2817,2535.3,,0.95,,2676.15,Percent of total billed charges,,,0.98,,2760.66,Percent of total billed charges,,,0.95,,2676.15,Percent of total billed charges,,,0.97,,2732.49,Percent of total billed charges,,,0.97,,2732.49,Percent of total billed charges,,,0.96,,2704.32,Percent of total billed charges,,,0.95,,2676.15,Percent of total billed charges,,,,,,,,,0.95,,2676.15,Percent of total billed charges,,2676.15,2760.66,
OR PLATE SO 2.7/3.5 PROX OLEC 2H/LT,SUP-3254482,CDM,27810126,LOCAL,278,RC,,outpatient,,,2817,2535.3,,0.95,,2676.15,Percent of total billed charges,,,0.98,,2760.66,Percent of total billed charges,,,0.95,,2676.15,Percent of total billed charges,,,0.95,,2676.15,Percent of total billed charges,,,0.97,,2732.49,Percent of total billed charges,,,0.96,,2704.32,Percent of total billed charges,,,0.95,,2676.15,Percent of total billed charges,,,,,,,,,0.95,,2676.15,Percent of total billed charges,,2676.15,2760.66,
OR SCREW SO 2.7 META ST T8/14,SUP-3254483,CDM,27810126,LOCAL,278,RC,,inpatient,,,398,358.2,,0.95,,378.1,Percent of total billed charges,,,0.98,,390.04,Percent of total billed charges,,,0.95,,378.1,Percent of total billed charges,,,0.97,,386.06,Percent of total billed charges,,,0.97,,386.06,Percent of total billed charges,,,0.96,,382.08,Percent of total billed charges,,,0.95,,378.1,Percent of total billed charges,,,,,,,,,0.95,,378.1,Percent of total billed charges,,378.1,390.04,
OR SCREW SO 2.7 META ST T8/14,SUP-3254483,CDM,27810126,LOCAL,278,RC,,outpatient,,,398,358.2,,0.95,,378.1,Percent of total billed charges,,,0.98,,390.04,Percent of total billed charges,,,0.95,,378.1,Percent of total billed charges,,,0.95,,378.1,Percent of total billed charges,,,0.97,,386.06,Percent of total billed charges,,,0.96,,382.08,Percent of total billed charges,,,0.95,,378.1,Percent of total billed charges,,,,,,,,,0.95,,378.1,Percent of total billed charges,,378.1,390.04,
OR SCREW SO 2.7 META ST T8/38,SUP-3254484,CDM,27810126,LOCAL,278,RC,,inpatient,,,398,358.2,,0.95,,378.1,Percent of total billed charges,,,0.98,,390.04,Percent of total billed charges,,,0.95,,378.1,Percent of total billed charges,,,0.97,,386.06,Percent of total billed charges,,,0.97,,386.06,Percent of total billed charges,,,0.96,,382.08,Percent of total billed charges,,,0.95,,378.1,Percent of total billed charges,,,,,,,,,0.95,,378.1,Percent of total billed charges,,378.1,390.04,
OR SCREW SO 2.7 META ST T8/38,SUP-3254484,CDM,27810126,LOCAL,278,RC,,outpatient,,,398,358.2,,0.95,,378.1,Percent of total billed charges,,,0.98,,390.04,Percent of total billed charges,,,0.95,,378.1,Percent of total billed charges,,,0.95,,378.1,Percent of total billed charges,,,0.97,,386.06,Percent of total billed charges,,,0.96,,382.08,Percent of total billed charges,,,0.95,,378.1,Percent of total billed charges,,,,,,,,,0.95,,378.1,Percent of total billed charges,,378.1,390.04,
OR SCREW SO 2.7 META ST T8/60,SUP-3254485,CDM,27810126,LOCAL,278,RC,,inpatient,,,398,358.2,,0.95,,378.1,Percent of total billed charges,,,0.98,,390.04,Percent of total billed charges,,,0.95,,378.1,Percent of total billed charges,,,0.97,,386.06,Percent of total billed charges,,,0.97,,386.06,Percent of total billed charges,,,0.96,,382.08,Percent of total billed charges,,,0.95,,378.1,Percent of total billed charges,,,,,,,,,0.95,,378.1,Percent of total billed charges,,378.1,390.04,
OR SCREW SO 2.7 META ST T8/60,SUP-3254485,CDM,27810126,LOCAL,278,RC,,outpatient,,,398,358.2,,0.95,,378.1,Percent of total billed charges,,,0.98,,390.04,Percent of total billed charges,,,0.95,,378.1,Percent of total billed charges,,,0.95,,378.1,Percent of total billed charges,,,0.97,,386.06,Percent of total billed charges,,,0.96,,382.08,Percent of total billed charges,,,0.95,,378.1,Percent of total billed charges,,,,,,,,,0.95,,378.1,Percent of total billed charges,,378.1,390.04,
OR SCREW SO 3.5 CORTEX ST 22MM,SUP-3254486,CDM,27810126,LOCAL,278,RC,,inpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
OR SCREW SO 3.5 CORTEX ST 22MM,SUP-3254486,CDM,27810126,LOCAL,278,RC,,outpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
OR SCREW SO 3.5 CORTEX ST 24MM,SUP-3254487,CDM,27810126,LOCAL,278,RC,,inpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
OR SCREW SO 3.5 CORTEX ST 24MM,SUP-3254487,CDM,27810126,LOCAL,278,RC,,outpatient,,,224,201.6,,0.95,,212.8,Percent of total billed charges,,,0.98,,219.52,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,0.97,,217.28,Percent of total billed charges,,,0.96,,215.04,Percent of total billed charges,,,0.95,,212.8,Percent of total billed charges,,,,,,,,,0.95,,212.8,Percent of total billed charges,,212.8,219.52,
OR DRILL BIT SO QC 2.0X125MM,SUP-3254488,CDM,27010242,LOCAL,270,RC,,inpatient,,,408,367.2,,0.95,,387.6,Percent of total billed charges,,,0.98,,399.84,Percent of total billed charges,,,0.95,,387.6,Percent of total billed charges,,,0.97,,395.76,Percent of total billed charges,,,0.97,,395.76,Percent of total billed charges,,,0.96,,391.68,Percent of total billed charges,,,0.95,,387.6,Percent of total billed charges,,,,,,,,,0.95,,387.6,Percent of total billed charges,,387.6,399.84,
OR DRILL BIT SO QC 2.0X125MM,SUP-3254488,CDM,27010242,LOCAL,270,RC,,outpatient,,,408,367.2,,0.95,,387.6,Percent of total billed charges,,,0.98,,399.84,Percent of total billed charges,,,0.95,,387.6,Percent of total billed charges,,,0.95,,387.6,Percent of total billed charges,,,0.97,,395.76,Percent of total billed charges,,,0.96,,391.68,Percent of total billed charges,,,0.95,,387.6,Percent of total billed charges,,,,,,,,,0.95,,387.6,Percent of total billed charges,,387.6,399.84,
OR SO DRILL BIT QC GOLD 2.5X110MM,SUP-310.25,CDM,27010242,LOCAL,270,RC,,inpatient,,,413,371.7,,0.95,,392.35,Percent of total billed charges,,,0.98,,404.74,Percent of total billed charges,,,0.95,,392.35,Percent of total billed charges,,,0.97,,400.61,Percent of total billed charges,,,0.97,,400.61,Percent of total billed charges,,,0.96,,396.48,Percent of total billed charges,,,0.95,,392.35,Percent of total billed charges,,,,,,,,,0.95,,392.35,Percent of total billed charges,,392.35,404.74,
OR SO DRILL BIT QC GOLD 2.5X110MM,SUP-310.25,CDM,27010242,LOCAL,270,RC,,outpatient,,,413,371.7,,0.95,,392.35,Percent of total billed charges,,,0.98,,404.74,Percent of total billed charges,,,0.95,,392.35,Percent of total billed charges,,,0.95,,392.35,Percent of total billed charges,,,0.97,,400.61,Percent of total billed charges,,,0.96,,396.48,Percent of total billed charges,,,0.95,,392.35,Percent of total billed charges,,,,,,,,,0.95,,392.35,Percent of total billed charges,,392.35,404.74,
OR SO ROD REAM BALL TIP 2.5/950-S,SUP-3254490,CDM,27010242,LOCAL,270,RC,,inpatient,,,692,622.8,,0.95,,657.4,Percent of total billed charges,,,0.98,,678.16,Percent of total billed charges,,,0.95,,657.4,Percent of total billed charges,,,0.97,,671.24,Percent of total billed charges,,,0.97,,671.24,Percent of total billed charges,,,0.96,,664.32,Percent of total billed charges,,,0.95,,657.4,Percent of total billed charges,,,,,,,,,0.95,,657.4,Percent of total billed charges,,657.4,678.16,
OR SO ROD REAM BALL TIP 2.5/950-S,SUP-3254490,CDM,27010242,LOCAL,270,RC,,outpatient,,,692,622.8,,0.95,,657.4,Percent of total billed charges,,,0.98,,678.16,Percent of total billed charges,,,0.95,,657.4,Percent of total billed charges,,,0.95,,657.4,Percent of total billed charges,,,0.97,,671.24,Percent of total billed charges,,,0.96,,664.32,Percent of total billed charges,,,0.95,,657.4,Percent of total billed charges,,,,,,,,,0.95,,657.4,Percent of total billed charges,,657.4,678.16,
OR CANN SO 11/130 DEG TFNA 420/RT,SUP-3254491,CDM,27810126,LOCAL,278,RC,,inpatient,,,6575,5917.5,,0.95,,6246.25,Percent of total billed charges,,,0.98,,6443.5,Percent of total billed charges,,,0.95,,6246.25,Percent of total billed charges,,,0.97,,6377.75,Percent of total billed charges,,,0.97,,6377.75,Percent of total billed charges,,,0.96,,6312,Percent of total billed charges,,,0.95,,6246.25,Percent of total billed charges,,,,,,,,,0.95,,6246.25,Percent of total billed charges,,6246.25,6443.5,
OR CANN SO 11/130 DEG TFNA 420/RT,SUP-3254491,CDM,27810126,LOCAL,278,RC,,outpatient,,,6575,5917.5,,0.95,,6246.25,Percent of total billed charges,,,0.98,,6443.5,Percent of total billed charges,,,0.95,,6246.25,Percent of total billed charges,,,0.95,,6246.25,Percent of total billed charges,,,0.97,,6377.75,Percent of total billed charges,,,0.96,,6312,Percent of total billed charges,,,0.95,,6246.25,Percent of total billed charges,,,,,,,,,0.95,,6246.25,Percent of total billed charges,,6246.25,6443.5,
OR SCREW SO TFNA FENE 115MM,SUP-3254492,CDM,27810126,LOCAL,278,RC,,inpatient,,,1781,1602.9,,0.95,,1691.95,Percent of total billed charges,,,0.98,,1745.38,Percent of total billed charges,,,0.95,,1691.95,Percent of total billed charges,,,0.97,,1727.57,Percent of total billed charges,,,0.97,,1727.57,Percent of total billed charges,,,0.96,,1709.76,Percent of total billed charges,,,0.95,,1691.95,Percent of total billed charges,,,,,,,,,0.95,,1691.95,Percent of total billed charges,,1691.95,1745.38,
OR SCREW SO TFNA FENE 115MM,SUP-3254492,CDM,27810126,LOCAL,278,RC,,outpatient,,,1781,1602.9,,0.95,,1691.95,Percent of total billed charges,,,0.98,,1745.38,Percent of total billed charges,,,0.95,,1691.95,Percent of total billed charges,,,0.95,,1691.95,Percent of total billed charges,,,0.97,,1727.57,Percent of total billed charges,,,0.96,,1709.76,Percent of total billed charges,,,0.95,,1691.95,Percent of total billed charges,,,,,,,,,0.95,,1691.95,Percent of total billed charges,,1691.95,1745.38,
OR SO WIRE GUIDE 3.2MM/400MM,SUP-3254493,CDM,27010242,LOCAL,270,RC,,inpatient,,,680,612,,0.95,,646,Percent of total billed charges,,,0.98,,666.4,Percent of total billed charges,,,0.95,,646,Percent of total billed charges,,,0.97,,659.6,Percent of total billed charges,,,0.97,,659.6,Percent of total billed charges,,,0.96,,652.8,Percent of total billed charges,,,0.95,,646,Percent of total billed charges,,,,,,,,,0.95,,646,Percent of total billed charges,,646,666.4,
OR SO WIRE GUIDE 3.2MM/400MM,SUP-3254493,CDM,27010242,LOCAL,270,RC,,outpatient,,,680,612,,0.95,,646,Percent of total billed charges,,,0.98,,666.4,Percent of total billed charges,,,0.95,,646,Percent of total billed charges,,,0.95,,646,Percent of total billed charges,,,0.97,,659.6,Percent of total billed charges,,,0.96,,652.8,Percent of total billed charges,,,0.95,,646,Percent of total billed charges,,,,,,,,,0.95,,646,Percent of total billed charges,,646,666.4,
OR PASSPORT BUTTON 8X3,SUP-3254502,CDM,27010242,LOCAL,270,RC,,inpatient,,,128,115.2,,0.95,,121.6,Percent of total billed charges,,,0.98,,125.44,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.96,,122.88,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,,,,,,,0.95,,121.6,Percent of total billed charges,,121.6,125.44,
OR PASSPORT BUTTON 8X3,SUP-3254502,CDM,27010242,LOCAL,270,RC,,outpatient,,,128,115.2,,0.95,,121.6,Percent of total billed charges,,,0.98,,125.44,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.96,,122.88,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,,,,,,,0.95,,121.6,Percent of total billed charges,,121.6,125.44,
OR GUIDEWIRE DUAL TROC 1.35MM,SUP-3254496,CDM,27010242,LOCAL,270,RC,,inpatient,,,144,129.6,,0.95,,136.8,Percent of total billed charges,,,0.98,,141.12,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,0.97,,139.68,Percent of total billed charges,,,0.97,,139.68,Percent of total billed charges,,,0.96,,138.24,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,,,,,,,0.95,,136.8,Percent of total billed charges,,136.8,141.12,
OR GUIDEWIRE DUAL TROC 1.35MM,SUP-3254496,CDM,27010242,LOCAL,270,RC,,outpatient,,,144,129.6,,0.95,,136.8,Percent of total billed charges,,,0.98,,141.12,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,0.97,,139.68,Percent of total billed charges,,,0.96,,138.24,Percent of total billed charges,,,0.95,,136.8,Percent of total billed charges,,,,,,,,,0.95,,136.8,Percent of total billed charges,,136.8,141.12,
OR SCREW LP CANN BLUNT 4X32,SUP-3254497,CDM,27810126,LOCAL,278,RC,,inpatient,,,413,371.7,,0.95,,392.35,Percent of total billed charges,,,0.98,,404.74,Percent of total billed charges,,,0.95,,392.35,Percent of total billed charges,,,0.97,,400.61,Percent of total billed charges,,,0.97,,400.61,Percent of total billed charges,,,0.96,,396.48,Percent of total billed charges,,,0.95,,392.35,Percent of total billed charges,,,,,,,,,0.95,,392.35,Percent of total billed charges,,392.35,404.74,
OR SCREW LP CANN BLUNT 4X32,SUP-3254497,CDM,27810126,LOCAL,278,RC,,outpatient,,,413,371.7,,0.95,,392.35,Percent of total billed charges,,,0.98,,404.74,Percent of total billed charges,,,0.95,,392.35,Percent of total billed charges,,,0.95,,392.35,Percent of total billed charges,,,0.97,,400.61,Percent of total billed charges,,,0.96,,396.48,Percent of total billed charges,,,0.95,,392.35,Percent of total billed charges,,,,,,,,,0.95,,392.35,Percent of total billed charges,,392.35,404.74,
OR SCREW LP CANN BLUNT 4X34,SUP-3254498,CDM,27810126,LOCAL,278,RC,,inpatient,,,413,371.7,,0.95,,392.35,Percent of total billed charges,,,0.98,,404.74,Percent of total billed charges,,,0.95,,392.35,Percent of total billed charges,,,0.97,,400.61,Percent of total billed charges,,,0.97,,400.61,Percent of total billed charges,,,0.96,,396.48,Percent of total billed charges,,,0.95,,392.35,Percent of total billed charges,,,,,,,,,0.95,,392.35,Percent of total billed charges,,392.35,404.74,
OR SCREW LP CANN BLUNT 4X34,SUP-3254498,CDM,27810126,LOCAL,278,RC,,outpatient,,,413,371.7,,0.95,,392.35,Percent of total billed charges,,,0.98,,404.74,Percent of total billed charges,,,0.95,,392.35,Percent of total billed charges,,,0.95,,392.35,Percent of total billed charges,,,0.97,,400.61,Percent of total billed charges,,,0.96,,396.48,Percent of total billed charges,,,0.95,,392.35,Percent of total billed charges,,,,,,,,,0.95,,392.35,Percent of total billed charges,,392.35,404.74,
OR SCREW LP CANN BLUNT 4X36,SUP-3254499,CDM,27810126,LOCAL,278,RC,,inpatient,,,413,371.7,,0.95,,392.35,Percent of total billed charges,,,0.98,,404.74,Percent of total billed charges,,,0.95,,392.35,Percent of total billed charges,,,0.97,,400.61,Percent of total billed charges,,,0.97,,400.61,Percent of total billed charges,,,0.96,,396.48,Percent of total billed charges,,,0.95,,392.35,Percent of total billed charges,,,,,,,,,0.95,,392.35,Percent of total billed charges,,392.35,404.74,
OR SCREW LP CANN BLUNT 4X36,SUP-3254499,CDM,27810126,LOCAL,278,RC,,outpatient,,,413,371.7,,0.95,,392.35,Percent of total billed charges,,,0.98,,404.74,Percent of total billed charges,,,0.95,,392.35,Percent of total billed charges,,,0.95,,392.35,Percent of total billed charges,,,0.97,,400.61,Percent of total billed charges,,,0.96,,396.48,Percent of total billed charges,,,0.95,,392.35,Percent of total billed charges,,,,,,,,,0.95,,392.35,Percent of total billed charges,,392.35,404.74,
"OR FIBER TAPE 17"" W/ST NEEDLE",SUP-3254500,CDM,27810126,LOCAL,278,RC,,inpatient,,,488,439.2,,0.95,,463.6,Percent of total billed charges,,,0.98,,478.24,Percent of total billed charges,,,0.95,,463.6,Percent of total billed charges,,,0.97,,473.36,Percent of total billed charges,,,0.97,,473.36,Percent of total billed charges,,,0.96,,468.48,Percent of total billed charges,,,0.95,,463.6,Percent of total billed charges,,,,,,,,,0.95,,463.6,Percent of total billed charges,,463.6,478.24,
"OR FIBER TAPE 17"" W/ST NEEDLE",SUP-3254500,CDM,27810126,LOCAL,278,RC,,outpatient,,,488,439.2,,0.95,,463.6,Percent of total billed charges,,,0.98,,478.24,Percent of total billed charges,,,0.95,,463.6,Percent of total billed charges,,,0.95,,463.6,Percent of total billed charges,,,0.97,,473.36,Percent of total billed charges,,,0.96,,468.48,Percent of total billed charges,,,0.95,,463.6,Percent of total billed charges,,,,,,,,,0.95,,463.6,Percent of total billed charges,,463.6,478.24,
OR TIGERTAPE CERCLAGE W/O NEEDLE,SUP-3254501,CDM,27810126,LOCAL,278,RC,,inpatient,,,950,855,,0.95,,902.5,Percent of total billed charges,,,0.98,,931,Percent of total billed charges,,,0.95,,902.5,Percent of total billed charges,,,0.97,,921.5,Percent of total billed charges,,,0.97,,921.5,Percent of total billed charges,,,0.96,,912,Percent of total billed charges,,,0.95,,902.5,Percent of total billed charges,,,,,,,,,0.95,,902.5,Percent of total billed charges,,902.5,931,
OR TIGERTAPE CERCLAGE W/O NEEDLE,SUP-3254501,CDM,27810126,LOCAL,278,RC,,outpatient,,,950,855,,0.95,,902.5,Percent of total billed charges,,,0.98,,931,Percent of total billed charges,,,0.95,,902.5,Percent of total billed charges,,,0.95,,902.5,Percent of total billed charges,,,0.97,,921.5,Percent of total billed charges,,,0.96,,912,Percent of total billed charges,,,0.95,,902.5,Percent of total billed charges,,,,,,,,,0.95,,902.5,Percent of total billed charges,,902.5,931,
OR ENSEAL LAP X1 37CM CURVED,SUP-3254503,CDM,27010242,LOCAL,270,RC,,inpatient,,,911,819.9,,0.95,,865.45,Percent of total billed charges,,,0.98,,892.78,Percent of total billed charges,,,0.95,,865.45,Percent of total billed charges,,,0.97,,883.67,Percent of total billed charges,,,0.97,,883.67,Percent of total billed charges,,,0.96,,874.56,Percent of total billed charges,,,0.95,,865.45,Percent of total billed charges,,,,,,,,,0.95,,865.45,Percent of total billed charges,,865.45,892.78,
OR ENSEAL LAP X1 37CM CURVED,SUP-3254503,CDM,27010242,LOCAL,270,RC,,outpatient,,,911,819.9,,0.95,,865.45,Percent of total billed charges,,,0.98,,892.78,Percent of total billed charges,,,0.95,,865.45,Percent of total billed charges,,,0.95,,865.45,Percent of total billed charges,,,0.97,,883.67,Percent of total billed charges,,,0.96,,874.56,Percent of total billed charges,,,0.95,,865.45,Percent of total billed charges,,,,,,,,,0.95,,865.45,Percent of total billed charges,,865.45,892.78,
OR BLADE SAG 25MMX9.4X0.6,SUP-3254504,CDM,27010242,LOCAL,270,RC,,inpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,,,0.95,,95,Percent of total billed charges,,95,98,
OR BLADE SAG 25MMX9.4X0.6,SUP-3254504,CDM,27010242,LOCAL,270,RC,,outpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,,,0.95,,95,Percent of total billed charges,,95,98,
OR BLADE SAG 40MMX9.5X0.6,SUP-3254505,CDM,27010242,LOCAL,270,RC,,inpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,,,0.95,,95,Percent of total billed charges,,95,98,
OR BLADE SAG 40MMX9.5X0.6,SUP-3254505,CDM,27010242,LOCAL,270,RC,,outpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,,,0.95,,95,Percent of total billed charges,,95,98,
OR TUBE HEATED INSUFF,SUP-3254506,CDM,27010242,LOCAL,270,RC,,inpatient,,,284,255.6,,0.95,,269.8,Percent of total billed charges,,,0.98,,278.32,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,0.97,,275.48,Percent of total billed charges,,,0.97,,275.48,Percent of total billed charges,,,0.96,,272.64,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,,,,,,,0.95,,269.8,Percent of total billed charges,,269.8,278.32,
OR TUBE HEATED INSUFF,SUP-3254506,CDM,27010242,LOCAL,270,RC,,outpatient,,,284,255.6,,0.95,,269.8,Percent of total billed charges,,,0.98,,278.32,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,0.97,,275.48,Percent of total billed charges,,,0.96,,272.64,Percent of total billed charges,,,0.95,,269.8,Percent of total billed charges,,,,,,,,,0.95,,269.8,Percent of total billed charges,,269.8,278.32,
OR PLATE DIST RAD VOL LT 7H,SUP-3254507,CDM,27810126,LOCAL,278,RC,,inpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL LT 7H,SUP-3254507,CDM,27810126,LOCAL,278,RC,,outpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL RT 7H,SUP-3254508,CDM,27810126,LOCAL,278,RC,,inpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL RT 7H,SUP-3254508,CDM,27810126,LOCAL,278,RC,,outpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL W LT 7H,SUP-3254509,CDM,27810126,LOCAL,278,RC,,inpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL W LT 7H,SUP-3254509,CDM,27810126,LOCAL,278,RC,,outpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL W RT 7H,SUP-3254510,CDM,27810126,LOCAL,278,RC,,inpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL W RT 7H,SUP-3254510,CDM,27810126,LOCAL,278,RC,,outpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL STD LT 7H,SUP-3254511,CDM,27810126,LOCAL,278,RC,,inpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL STD LT 7H,SUP-3254511,CDM,27810126,LOCAL,278,RC,,outpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL STD RT 7H,SUP-3254512,CDM,27810126,LOCAL,278,RC,,inpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR PLATE DIST RAD VOL STD RT 7H,SUP-3254512,CDM,27810126,LOCAL,278,RC,,outpatient,,,1193,1073.7,,0.95,,1133.35,Percent of total billed charges,,,0.98,,1169.14,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,0.97,,1157.21,Percent of total billed charges,,,0.96,,1145.28,Percent of total billed charges,,,0.95,,1133.35,Percent of total billed charges,,,,,,,,,0.95,,1133.35,Percent of total billed charges,,1133.35,1169.14,
OR TOE GREAT ANGLED SZ 2,SUP-3254513,CDM,27810126,LOCAL,278,RC,,inpatient,,,4014,3612.6,,0.95,,3813.3,Percent of total billed charges,,,0.98,,3933.72,Percent of total billed charges,,,0.95,,3813.3,Percent of total billed charges,,,0.97,,3893.58,Percent of total billed charges,,,0.97,,3893.58,Percent of total billed charges,,,0.96,,3853.44,Percent of total billed charges,,,0.95,,3813.3,Percent of total billed charges,,,,,,,,,0.95,,3813.3,Percent of total billed charges,,3813.3,3933.72,
OR TOE GREAT ANGLED SZ 2,SUP-3254513,CDM,27810126,LOCAL,278,RC,,outpatient,,,4014,3612.6,,0.95,,3813.3,Percent of total billed charges,,,0.98,,3933.72,Percent of total billed charges,,,0.95,,3813.3,Percent of total billed charges,,,0.95,,3813.3,Percent of total billed charges,,,0.97,,3893.58,Percent of total billed charges,,,0.96,,3853.44,Percent of total billed charges,,,0.95,,3813.3,Percent of total billed charges,,,,,,,,,0.95,,3813.3,Percent of total billed charges,,3813.3,3933.72,
OR K WIRE 1.4 MM,SUP-3254514,CDM,27010242,LOCAL,270,RC,,inpatient,,,196,176.4,,0.95,,186.2,Percent of total billed charges,,,0.98,,192.08,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,0.97,,190.12,Percent of total billed charges,,,0.97,,190.12,Percent of total billed charges,,,0.96,,188.16,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,,,,,,,0.95,,186.2,Percent of total billed charges,,186.2,192.08,
OR K WIRE 1.4 MM,SUP-3254514,CDM,27010242,LOCAL,270,RC,,outpatient,,,196,176.4,,0.95,,186.2,Percent of total billed charges,,,0.98,,192.08,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,0.97,,190.12,Percent of total billed charges,,,0.96,,188.16,Percent of total billed charges,,,0.95,,186.2,Percent of total billed charges,,,,,,,,,0.95,,186.2,Percent of total billed charges,,186.2,192.08,
OR GUIDE WIRE 1.6MMX102MM,SUP-3254515,CDM,27010242,LOCAL,270,RC,,inpatient,,,463,416.7,,0.95,,439.85,Percent of total billed charges,,,0.98,,453.74,Percent of total billed charges,,,0.95,,439.85,Percent of total billed charges,,,0.97,,449.11,Percent of total billed charges,,,0.97,,449.11,Percent of total billed charges,,,0.96,,444.48,Percent of total billed charges,,,0.95,,439.85,Percent of total billed charges,,,,,,,,,0.95,,439.85,Percent of total billed charges,,439.85,453.74,
OR GUIDE WIRE 1.6MMX102MM,SUP-3254515,CDM,27010242,LOCAL,270,RC,,outpatient,,,463,416.7,,0.95,,439.85,Percent of total billed charges,,,0.98,,453.74,Percent of total billed charges,,,0.95,,439.85,Percent of total billed charges,,,0.95,,439.85,Percent of total billed charges,,,0.97,,449.11,Percent of total billed charges,,,0.96,,444.48,Percent of total billed charges,,,0.95,,439.85,Percent of total billed charges,,,,,,,,,0.95,,439.85,Percent of total billed charges,,439.85,453.74,
OR GUIDE WIRE TRO DIA 1.35MM,SUP-3254516,CDM,27010242,LOCAL,270,RC,,inpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
OR GUIDE WIRE TRO DIA 1.35MM,SUP-3254516,CDM,27010242,LOCAL,270,RC,,outpatient,,,75,67.5,,0.95,,71.25,Percent of total billed charges,,,0.98,,73.5,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,0.97,,72.75,Percent of total billed charges,,,0.96,,72,Percent of total billed charges,,,0.95,,71.25,Percent of total billed charges,,,,,,,,,0.95,,71.25,Percent of total billed charges,,71.25,73.5,
OR PLATE PLANT LAP R/SH,SUP-3254517,CDM,27810126,LOCAL,278,RC,,inpatient,,,2243,2018.7,,0.95,,2130.85,Percent of total billed charges,,,0.98,,2198.14,Percent of total billed charges,,,0.95,,2130.85,Percent of total billed charges,,,0.97,,2175.71,Percent of total billed charges,,,0.97,,2175.71,Percent of total billed charges,,,0.96,,2153.28,Percent of total billed charges,,,0.95,,2130.85,Percent of total billed charges,,,,,,,,,0.95,,2130.85,Percent of total billed charges,,2130.85,2198.14,
OR PLATE PLANT LAP R/SH,SUP-3254517,CDM,27810126,LOCAL,278,RC,,outpatient,,,2243,2018.7,,0.95,,2130.85,Percent of total billed charges,,,0.98,,2198.14,Percent of total billed charges,,,0.95,,2130.85,Percent of total billed charges,,,0.95,,2130.85,Percent of total billed charges,,,0.97,,2175.71,Percent of total billed charges,,,0.96,,2153.28,Percent of total billed charges,,,0.95,,2130.85,Percent of total billed charges,,,,,,,,,0.95,,2130.85,Percent of total billed charges,,2130.85,2198.14,
OR SCREW LP LOCK TITA 3.5X22MM,SUP-3254518,CDM,27810126,LOCAL,278,RC,,inpatient,,,375,337.5,,0.95,,356.25,Percent of total billed charges,,,0.98,,367.5,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.96,,360,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,,,,,,,0.95,,356.25,Percent of total billed charges,,356.25,367.5,
OR SCREW LP LOCK TITA 3.5X22MM,SUP-3254518,CDM,27810126,LOCAL,278,RC,,outpatient,,,375,337.5,,0.95,,356.25,Percent of total billed charges,,,0.98,,367.5,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.96,,360,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,,,,,,,0.95,,356.25,Percent of total billed charges,,356.25,367.5,
OR SCREW LP LOCK TITA 3.5X38,SUP-3254519,CDM,27810126,LOCAL,278,RC,,inpatient,,,375,337.5,,0.95,,356.25,Percent of total billed charges,,,0.98,,367.5,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.96,,360,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,,,,,,,0.95,,356.25,Percent of total billed charges,,356.25,367.5,
OR SCREW LP LOCK TITA 3.5X38,SUP-3254519,CDM,27810126,LOCAL,278,RC,,outpatient,,,375,337.5,,0.95,,356.25,Percent of total billed charges,,,0.98,,367.5,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,0.97,,363.75,Percent of total billed charges,,,0.96,,360,Percent of total billed charges,,,0.95,,356.25,Percent of total billed charges,,,,,,,,,0.95,,356.25,Percent of total billed charges,,356.25,367.5,
OR SCREW LP TITA CANCEL 4X38,SUP-3254520,CDM,27810126,LOCAL,278,RC,,inpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR SCREW LP TITA CANCEL 4X38,SUP-3254520,CDM,27810126,LOCAL,278,RC,,outpatient,,,210,189,,0.95,,199.5,Percent of total billed charges,,,0.98,,205.8,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,0.97,,203.7,Percent of total billed charges,,,0.96,,201.6,Percent of total billed charges,,,0.95,,199.5,Percent of total billed charges,,,,,,,,,0.95,,199.5,Percent of total billed charges,,199.5,205.8,
OR IMPLANT SYS MINI SCORP,SUP-3254521,CDM,27810126,LOCAL,278,RC,,inpatient,,,1643,1478.7,,0.95,,1560.85,Percent of total billed charges,,,0.98,,1610.14,Percent of total billed charges,,,0.95,,1560.85,Percent of total billed charges,,,0.97,,1593.71,Percent of total billed charges,,,0.97,,1593.71,Percent of total billed charges,,,0.96,,1577.28,Percent of total billed charges,,,0.95,,1560.85,Percent of total billed charges,,,,,,,,,0.95,,1560.85,Percent of total billed charges,,1560.85,1610.14,
OR IMPLANT SYS MINI SCORP,SUP-3254521,CDM,27810126,LOCAL,278,RC,,outpatient,,,1643,1478.7,,0.95,,1560.85,Percent of total billed charges,,,0.98,,1610.14,Percent of total billed charges,,,0.95,,1560.85,Percent of total billed charges,,,0.95,,1560.85,Percent of total billed charges,,,0.97,,1593.71,Percent of total billed charges,,,0.96,,1577.28,Percent of total billed charges,,,0.95,,1560.85,Percent of total billed charges,,,,,,,,,0.95,,1560.85,Percent of total billed charges,,1560.85,1610.14,
OR IMPLANT SYS FOOT PEEK,SUP-3254522,CDM,27810126,LOCAL,278,RC,,inpatient,,,2093,1883.7,,0.95,,1988.35,Percent of total billed charges,,,0.98,,2051.14,Percent of total billed charges,,,0.95,,1988.35,Percent of total billed charges,,,0.97,,2030.21,Percent of total billed charges,,,0.97,,2030.21,Percent of total billed charges,,,0.96,,2009.28,Percent of total billed charges,,,0.95,,1988.35,Percent of total billed charges,,,,,,,,,0.95,,1988.35,Percent of total billed charges,,1988.35,2051.14,
OR IMPLANT SYS FOOT PEEK,SUP-3254522,CDM,27810126,LOCAL,278,RC,,outpatient,,,2093,1883.7,,0.95,,1988.35,Percent of total billed charges,,,0.98,,2051.14,Percent of total billed charges,,,0.95,,1988.35,Percent of total billed charges,,,0.95,,1988.35,Percent of total billed charges,,,0.97,,2030.21,Percent of total billed charges,,,0.96,,2009.28,Percent of total billed charges,,,0.95,,1988.35,Percent of total billed charges,,,,,,,,,0.95,,1988.35,Percent of total billed charges,,1988.35,2051.14,
OR DART PIP PEEK 10DEG 2.5X30,SUP-3254523,CDM,27810126,LOCAL,278,RC,,inpatient,,,1042,937.8,,0.95,,989.9,Percent of total billed charges,,,0.98,,1021.16,Percent of total billed charges,,,0.95,,989.9,Percent of total billed charges,,,0.97,,1010.74,Percent of total billed charges,,,0.97,,1010.74,Percent of total billed charges,,,0.96,,1000.32,Percent of total billed charges,,,0.95,,989.9,Percent of total billed charges,,,,,,,,,0.95,,989.9,Percent of total billed charges,,989.9,1021.16,
OR DART PIP PEEK 10DEG 2.5X30,SUP-3254523,CDM,27810126,LOCAL,278,RC,,outpatient,,,1042,937.8,,0.95,,989.9,Percent of total billed charges,,,0.98,,1021.16,Percent of total billed charges,,,0.95,,989.9,Percent of total billed charges,,,0.95,,989.9,Percent of total billed charges,,,0.97,,1010.74,Percent of total billed charges,,,0.96,,1000.32,Percent of total billed charges,,,0.95,,989.9,Percent of total billed charges,,,,,,,,,0.95,,989.9,Percent of total billed charges,,989.9,1021.16,
OR IMPLANT SYS BIO COMP ACHILLES,SUP-3254524,CDM,27810126,LOCAL,278,RC,,inpatient,,,1463,1316.7,,0.95,,1389.85,Percent of total billed charges,,,0.98,,1433.74,Percent of total billed charges,,,0.95,,1389.85,Percent of total billed charges,,,0.97,,1419.11,Percent of total billed charges,,,0.97,,1419.11,Percent of total billed charges,,,0.96,,1404.48,Percent of total billed charges,,,0.95,,1389.85,Percent of total billed charges,,,,,,,,,0.95,,1389.85,Percent of total billed charges,,1389.85,1433.74,
OR IMPLANT SYS BIO COMP ACHILLES,SUP-3254524,CDM,27810126,LOCAL,278,RC,,outpatient,,,1463,1316.7,,0.95,,1389.85,Percent of total billed charges,,,0.98,,1433.74,Percent of total billed charges,,,0.95,,1389.85,Percent of total billed charges,,,0.95,,1389.85,Percent of total billed charges,,,0.97,,1419.11,Percent of total billed charges,,,0.96,,1404.48,Percent of total billed charges,,,0.95,,1389.85,Percent of total billed charges,,,,,,,,,0.95,,1389.85,Percent of total billed charges,,1389.85,1433.74,
OR IMPLANT PARS SU/TAPE,SUP-3254526,CDM,27810126,LOCAL,278,RC,,inpatient,,,2243,2018.7,,0.95,,2130.85,Percent of total billed charges,,,0.98,,2198.14,Percent of total billed charges,,,0.95,,2130.85,Percent of total billed charges,,,0.97,,2175.71,Percent of total billed charges,,,0.97,,2175.71,Percent of total billed charges,,,0.96,,2153.28,Percent of total billed charges,,,0.95,,2130.85,Percent of total billed charges,,,,,,,,,0.95,,2130.85,Percent of total billed charges,,2130.85,2198.14,
OR IMPLANT PARS SU/TAPE,SUP-3254526,CDM,27810126,LOCAL,278,RC,,outpatient,,,2243,2018.7,,0.95,,2130.85,Percent of total billed charges,,,0.98,,2198.14,Percent of total billed charges,,,0.95,,2130.85,Percent of total billed charges,,,0.95,,2130.85,Percent of total billed charges,,,0.97,,2175.71,Percent of total billed charges,,,0.96,,2153.28,Percent of total billed charges,,,0.95,,2130.85,Percent of total billed charges,,,,,,,,,0.95,,2130.85,Percent of total billed charges,,2130.85,2198.14,
OR FLIPCUTTER 7.5MM,SUP-3254527,CDM,27010242,LOCAL,270,RC,,inpatient,,,650,585,,0.95,,617.5,Percent of total billed charges,,,0.98,,637,Percent of total billed charges,,,0.95,,617.5,Percent of total billed charges,,,0.97,,630.5,Percent of total billed charges,,,0.97,,630.5,Percent of total billed charges,,,0.96,,624,Percent of total billed charges,,,0.95,,617.5,Percent of total billed charges,,,,,,,,,0.95,,617.5,Percent of total billed charges,,617.5,637,
OR FLIPCUTTER 7.5MM,SUP-3254527,CDM,27010242,LOCAL,270,RC,,outpatient,,,650,585,,0.95,,617.5,Percent of total billed charges,,,0.98,,637,Percent of total billed charges,,,0.95,,617.5,Percent of total billed charges,,,0.95,,617.5,Percent of total billed charges,,,0.97,,630.5,Percent of total billed charges,,,0.96,,624,Percent of total billed charges,,,0.95,,617.5,Percent of total billed charges,,,,,,,,,0.95,,617.5,Percent of total billed charges,,617.5,637,
OR TIGHTROPE ABS BUT 14MM,SUP-3254528,CDM,27810126,LOCAL,278,RC,,inpatient,,,560,504,,0.95,,532,Percent of total billed charges,,,0.98,,548.8,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,0.97,,543.2,Percent of total billed charges,,,0.97,,543.2,Percent of total billed charges,,,0.96,,537.6,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,,,,,,,0.95,,532,Percent of total billed charges,,532,548.8,
OR TIGHTROPE ABS BUT 14MM,SUP-3254528,CDM,27810126,LOCAL,278,RC,,outpatient,,,560,504,,0.95,,532,Percent of total billed charges,,,0.98,,548.8,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,0.97,,543.2,Percent of total billed charges,,,0.96,,537.6,Percent of total billed charges,,,0.95,,532,Percent of total billed charges,,,,,,,,,0.95,,532,Percent of total billed charges,,532,548.8,
OR TIGHTROPE ABS IMP,SUP-3254529,CDM,27810126,LOCAL,278,RC,,inpatient,,,748,673.2,,0.95,,710.6,Percent of total billed charges,,,0.98,,733.04,Percent of total billed charges,,,0.95,,710.6,Percent of total billed charges,,,0.97,,725.56,Percent of total billed charges,,,0.97,,725.56,Percent of total billed charges,,,0.96,,718.08,Percent of total billed charges,,,0.95,,710.6,Percent of total billed charges,,,,,,,,,0.95,,710.6,Percent of total billed charges,,710.6,733.04,
OR TIGHTROPE ABS IMP,SUP-3254529,CDM,27810126,LOCAL,278,RC,,outpatient,,,748,673.2,,0.95,,710.6,Percent of total billed charges,,,0.98,,733.04,Percent of total billed charges,,,0.95,,710.6,Percent of total billed charges,,,0.95,,710.6,Percent of total billed charges,,,0.97,,725.56,Percent of total billed charges,,,0.96,,718.08,Percent of total billed charges,,,0.95,,710.6,Percent of total billed charges,,,,,,,,,0.95,,710.6,Percent of total billed charges,,710.6,733.04,
OR SUTURE TAPE FIBERLOOP W/NEEDLE,SUP-3254530,CDM,27810126,LOCAL,278,RC,,inpatient,,,245,220.5,,0.95,,232.75,Percent of total billed charges,,,0.98,,240.1,Percent of total billed charges,,,0.95,,232.75,Percent of total billed charges,,,0.97,,237.65,Percent of total billed charges,,,0.97,,237.65,Percent of total billed charges,,,0.96,,235.2,Percent of total billed charges,,,0.95,,232.75,Percent of total billed charges,,,,,,,,,0.95,,232.75,Percent of total billed charges,,232.75,240.1,
OR SUTURE TAPE FIBERLOOP W/NEEDLE,SUP-3254530,CDM,27810126,LOCAL,278,RC,,outpatient,,,245,220.5,,0.95,,232.75,Percent of total billed charges,,,0.98,,240.1,Percent of total billed charges,,,0.95,,232.75,Percent of total billed charges,,,0.95,,232.75,Percent of total billed charges,,,0.97,,237.65,Percent of total billed charges,,,0.96,,235.2,Percent of total billed charges,,,0.95,,232.75,Percent of total billed charges,,,,,,,,,0.95,,232.75,Percent of total billed charges,,232.75,240.1,
OR TIGHTROPE II RT W/DEPLOY SU,SUP-3254531,CDM,27810126,LOCAL,278,RC,,inpatient,,,977,879.3,,0.95,,928.15,Percent of total billed charges,,,0.98,,957.46,Percent of total billed charges,,,0.95,,928.15,Percent of total billed charges,,,0.97,,947.69,Percent of total billed charges,,,0.97,,947.69,Percent of total billed charges,,,0.96,,937.92,Percent of total billed charges,,,0.95,,928.15,Percent of total billed charges,,,,,,,,,0.95,,928.15,Percent of total billed charges,,928.15,957.46,
OR TIGHTROPE II RT W/DEPLOY SU,SUP-3254531,CDM,27810126,LOCAL,278,RC,,outpatient,,,977,879.3,,0.95,,928.15,Percent of total billed charges,,,0.98,,957.46,Percent of total billed charges,,,0.95,,928.15,Percent of total billed charges,,,0.95,,928.15,Percent of total billed charges,,,0.97,,947.69,Percent of total billed charges,,,0.96,,937.92,Percent of total billed charges,,,0.95,,928.15,Percent of total billed charges,,,,,,,,,0.95,,928.15,Percent of total billed charges,,928.15,957.46,
OR SCREW LP CANCEL SS 4X60,SUP-3254532,CDM,27810126,LOCAL,278,RC,,inpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,,,0.95,,133,Percent of total billed charges,,133,137.2,
OR SCREW LP CANCEL SS 4X60,SUP-3254532,CDM,27810126,LOCAL,278,RC,,outpatient,,,140,126,,0.95,,133,Percent of total billed charges,,,0.98,,137.2,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,0.97,,135.8,Percent of total billed charges,,,0.96,,134.4,Percent of total billed charges,,,0.95,,133,Percent of total billed charges,,,,,,,,,0.95,,133,Percent of total billed charges,,133,137.2,
OR DRILL BIT 3.5MM (AR-4160-35),SUP-3254257,CDM,27210093,LOCAL,272,RC,,inpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
OR DRILL BIT 3.5MM (AR-4160-35),SUP-3254257,CDM,27210093,LOCAL,272,RC,,outpatient,,,93,83.7,,0.95,,88.35,Percent of total billed charges,,,0.98,,91.14,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,0.97,,90.21,Percent of total billed charges,,,0.96,,89.28,Percent of total billed charges,,,0.95,,88.35,Percent of total billed charges,,,,,,,,,0.95,,88.35,Percent of total billed charges,,88.35,91.14,
OR SCREW LP LOCK 2.7X22MM (AR-8827L-22),SUP-3254251,CDM,C1713,HCPCS,278,RC,,inpatient,,,288,259.2,,0.95,,273.6,Percent of total billed charges,,,0.98,,282.24,Percent of total billed charges,,,0.95,,273.6,Percent of total billed charges,,,0.97,,279.36,Percent of total billed charges,,,0.97,,279.36,Percent of total billed charges,,,0.96,,276.48,Percent of total billed charges,,,0.95,,273.6,Percent of total billed charges,,,,,,,,,0.95,,273.6,Percent of total billed charges,,273.6,282.24,
OR SCREW LP LOCK 2.7X22MM (AR-8827L-22),SUP-3254251,CDM,C1713,HCPCS,278,RC,,outpatient,,,288,259.2,,0.95,,273.6,Percent of total billed charges,,,0.98,,282.24,Percent of total billed charges,,,0.95,,273.6,Percent of total billed charges,,,0.95,,273.6,Percent of total billed charges,,,0.97,,279.36,Percent of total billed charges,,,0.96,,276.48,Percent of total billed charges,,,0.95,,273.6,Percent of total billed charges,,,,,,,,,0.95,,273.6,Percent of total billed charges,,273.6,282.24,
OR DRILL BIT CALI 2.5MM (AR-8916-06),SUP-3254403,CDM,27210093,LOCAL,272,RC,,inpatient,,,238,214.2,,0.95,,226.1,Percent of total billed charges,,,0.98,,233.24,Percent of total billed charges,,,0.95,,226.1,Percent of total billed charges,,,0.97,,230.86,Percent of total billed charges,,,0.97,,230.86,Percent of total billed charges,,,0.96,,228.48,Percent of total billed charges,,,0.95,,226.1,Percent of total billed charges,,,,,,,,,0.95,,226.1,Percent of total billed charges,,226.1,233.24,
OR DRILL BIT CALI 2.5MM (AR-8916-06),SUP-3254403,CDM,27210093,LOCAL,272,RC,,outpatient,,,238,214.2,,0.95,,226.1,Percent of total billed charges,,,0.98,,233.24,Percent of total billed charges,,,0.95,,226.1,Percent of total billed charges,,,0.95,,226.1,Percent of total billed charges,,,0.97,,230.86,Percent of total billed charges,,,0.96,,228.48,Percent of total billed charges,,,0.95,,226.1,Percent of total billed charges,,,,,,,,,0.95,,226.1,Percent of total billed charges,,226.1,233.24,
OR DRILL BIT 1.7MM (AR-8916-14),SUP-3254388,CDM,27210093,LOCAL,272,RC,,inpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
OR DRILL BIT 1.7MM (AR-8916-14),SUP-3254388,CDM,27210093,LOCAL,272,RC,,outpatient,,,277,249.3,,0.95,,263.15,Percent of total billed charges,,,0.98,,271.46,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,0.97,,268.69,Percent of total billed charges,,,0.96,,265.92,Percent of total billed charges,,,0.95,,263.15,Percent of total billed charges,,,,,,,,,0.95,,263.15,Percent of total billed charges,,263.15,271.46,
OR DRILL BIT CANN 2.6 (AR-8943-02),SUP-3254316,CDM,27210093,LOCAL,272,RC,,inpatient,,,181,162.9,,0.95,,171.95,Percent of total billed charges,,,0.98,,177.38,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,0.97,,175.57,Percent of total billed charges,,,0.97,,175.57,Percent of total billed charges,,,0.96,,173.76,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,,,,,,,0.95,,171.95,Percent of total billed charges,,171.95,177.38,
OR DRILL BIT CANN 2.6 (AR-8943-02),SUP-3254316,CDM,27210093,LOCAL,272,RC,,outpatient,,,181,162.9,,0.95,,171.95,Percent of total billed charges,,,0.98,,177.38,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,0.97,,175.57,Percent of total billed charges,,,0.96,,173.76,Percent of total billed charges,,,0.95,,171.95,Percent of total billed charges,,,,,,,,,0.95,,171.95,Percent of total billed charges,,171.95,177.38,
OR DRILL BIT CALI 2.0 (AR-8943-16),SUP-3254317,CDM,27210093,LOCAL,272,RC,,inpatient,,,112,100.8,,0.95,,106.4,Percent of total billed charges,,,0.98,,109.76,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.96,,107.52,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,,,,,,,0.95,,106.4,Percent of total billed charges,,106.4,109.76,
OR DRILL BIT CALI 2.0 (AR-8943-16),SUP-3254317,CDM,27210093,LOCAL,272,RC,,outpatient,,,112,100.8,,0.95,,106.4,Percent of total billed charges,,,0.98,,109.76,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,0.97,,108.64,Percent of total billed charges,,,0.96,,107.52,Percent of total billed charges,,,0.95,,106.4,Percent of total billed charges,,,,,,,,,0.95,,106.4,Percent of total billed charges,,106.4,109.76,
OR DRILL BIT 2.5 (AR-8943-30),SUP-3254318,CDM,27210093,LOCAL,272,RC,,inpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,,,0.95,,95,Percent of total billed charges,,95,98,
OR DRILL BIT 2.5 (AR-8943-30),SUP-3254318,CDM,27210093,LOCAL,272,RC,,outpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,,,0.95,,95,Percent of total billed charges,,95,98,
OR DRILL BIT 3.0 (AR-8943-36),SUP-3254319,CDM,27210093,LOCAL,272,RC,,inpatient,,,136,122.4,,0.95,,129.2,Percent of total billed charges,,,0.98,,133.28,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,0.97,,131.92,Percent of total billed charges,,,0.97,,131.92,Percent of total billed charges,,,0.96,,130.56,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,,,,,,,0.95,,129.2,Percent of total billed charges,,129.2,133.28,
OR DRILL BIT 3.0 (AR-8943-36),SUP-3254319,CDM,27210093,LOCAL,272,RC,,outpatient,,,136,122.4,,0.95,,129.2,Percent of total billed charges,,,0.98,,133.28,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,0.97,,131.92,Percent of total billed charges,,,0.96,,130.56,Percent of total billed charges,,,0.95,,129.2,Percent of total billed charges,,,,,,,,,0.95,,129.2,Percent of total billed charges,,129.2,133.28,
OR DRILL BIT CALI 2.5 (AR-8943-42),SUP-3254320,CDM,27210093,LOCAL,272,RC,,inpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,,,0.95,,95,Percent of total billed charges,,95,98,
OR DRILL BIT CALI 2.5 (AR-8943-42),SUP-3254320,CDM,27210093,LOCAL,272,RC,,outpatient,,,100,90,,0.95,,95,Percent of total billed charges,,,0.98,,98,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,0.97,,97,Percent of total billed charges,,,0.96,,96,Percent of total billed charges,,,0.95,,95,Percent of total billed charges,,,,,,,,,0.95,,95,Percent of total billed charges,,95,98,
OR SO ACTIC COLLAR STD SIZE 4,SUP-3254535,CDM,27810126,LOCAL,278,RC,,inpatient,,,15175.5,13657.95,,0.95,,14416.73,Percent of total billed charges,,,0.98,,14871.99,Percent of total billed charges,,,0.95,,14416.73,Percent of total billed charges,,,0.97,,14720.24,Percent of total billed charges,,,0.97,,14720.24,Percent of total billed charges,,,0.96,,14568.48,Percent of total billed charges,,,0.95,,14416.73,Percent of total billed charges,,,,,,,,,0.95,,14416.73,Percent of total billed charges,,14416.73,14871.99,
OR SO ACTIC COLLAR STD SIZE 4,SUP-3254535,CDM,27810126,LOCAL,278,RC,,outpatient,,,15175.5,13657.95,,0.95,,14416.73,Percent of total billed charges,,,0.98,,14871.99,Percent of total billed charges,,,0.95,,14416.73,Percent of total billed charges,,,0.95,,14416.73,Percent of total billed charges,,,0.97,,14720.24,Percent of total billed charges,,,0.96,,14568.48,Percent of total billed charges,,,0.95,,14416.73,Percent of total billed charges,,,,,,,,,0.95,,14416.73,Percent of total billed charges,,14416.73,14871.99,
OR SO SELF CENT HIP 43X28 GRY,SUP-3254536,CDM,27810126,LOCAL,278,RC,,inpatient,,,2898,2608.2,,0.95,,2753.1,Percent of total billed charges,,,0.98,,2840.04,Percent of total billed charges,,,0.95,,2753.1,Percent of total billed charges,,,0.97,,2811.06,Percent of total billed charges,,,0.97,,2811.06,Percent of total billed charges,,,0.96,,2782.08,Percent of total billed charges,,,0.95,,2753.1,Percent of total billed charges,,,,,,,,,0.95,,2753.1,Percent of total billed charges,,2753.1,2840.04,
OR SO SELF CENT HIP 43X28 GRY,SUP-3254536,CDM,27810126,LOCAL,278,RC,,outpatient,,,2898,2608.2,,0.95,,2753.1,Percent of total billed charges,,,0.98,,2840.04,Percent of total billed charges,,,0.95,,2753.1,Percent of total billed charges,,,0.95,,2753.1,Percent of total billed charges,,,0.97,,2811.06,Percent of total billed charges,,,0.96,,2782.08,Percent of total billed charges,,,0.95,,2753.1,Percent of total billed charges,,,,,,,,,0.95,,2753.1,Percent of total billed charges,,2753.1,2840.04,
OR SO ARTICUL/EZE BALL 28+1.5GR,SUP-3254537,CDM,27810126,LOCAL,278,RC,,inpatient,,,2026,1823.4,,0.95,,1924.7,Percent of total billed charges,,,0.98,,1985.48,Percent of total billed charges,,,0.95,,1924.7,Percent of total billed charges,,,0.97,,1965.22,Percent of total billed charges,,,0.97,,1965.22,Percent of total billed charges,,,0.96,,1944.96,Percent of total billed charges,,,0.95,,1924.7,Percent of total billed charges,,,,,,,,,0.95,,1924.7,Percent of total billed charges,,1924.7,1985.48,
OR SO ARTICUL/EZE BALL 28+1.5GR,SUP-3254537,CDM,27810126,LOCAL,278,RC,,outpatient,,,2026,1823.4,,0.95,,1924.7,Percent of total billed charges,,,0.98,,1985.48,Percent of total billed charges,,,0.95,,1924.7,Percent of total billed charges,,,0.95,,1924.7,Percent of total billed charges,,,0.97,,1965.22,Percent of total billed charges,,,0.96,,1944.96,Percent of total billed charges,,,0.95,,1924.7,Percent of total billed charges,,,,,,,,,0.95,,1924.7,Percent of total billed charges,,1924.7,1985.48,
OR FIBERTAK,SUP-3254538,CDM,27010242,LOCAL,270,RC,,inpatient,,,840,756,,0.95,,798,Percent of total billed charges,,,0.98,,823.2,Percent of total billed charges,,,0.95,,798,Percent of total billed charges,,,0.97,,814.8,Percent of total billed charges,,,0.97,,814.8,Percent of total billed charges,,,0.96,,806.4,Percent of total billed charges,,,0.95,,798,Percent of total billed charges,,,,,,,,,0.95,,798,Percent of total billed charges,,798,823.2,
OR FIBERTAK,SUP-3254538,CDM,27010242,LOCAL,270,RC,,outpatient,,,840,756,,0.95,,798,Percent of total billed charges,,,0.98,,823.2,Percent of total billed charges,,,0.95,,798,Percent of total billed charges,,,0.95,,798,Percent of total billed charges,,,0.97,,814.8,Percent of total billed charges,,,0.96,,806.4,Percent of total billed charges,,,0.95,,798,Percent of total billed charges,,,,,,,,,0.95,,798,Percent of total billed charges,,798,823.2,
OR FIBERTAK DISP ST KIT,SUP-3254539,CDM,27010242,LOCAL,270,RC,,inpatient,,,437,393.3,,0.95,,415.15,Percent of total billed charges,,,0.98,,428.26,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,0.97,,423.89,Percent of total billed charges,,,0.97,,423.89,Percent of total billed charges,,,0.96,,419.52,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,,,,,,,0.95,,415.15,Percent of total billed charges,,415.15,428.26,
OR FIBERTAK DISP ST KIT,SUP-3254539,CDM,27010242,LOCAL,270,RC,,outpatient,,,437,393.3,,0.95,,415.15,Percent of total billed charges,,,0.98,,428.26,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,0.97,,423.89,Percent of total billed charges,,,0.96,,419.52,Percent of total billed charges,,,0.95,,415.15,Percent of total billed charges,,,,,,,,,0.95,,415.15,Percent of total billed charges,,415.15,428.26,
OR FIBERTAK KNOTLESS PERC DRILL KIT,SUP-3254540,CDM,27810126,LOCAL,278,RC,,inpatient,,,563,506.7,,0.95,,534.85,Percent of total billed charges,,,0.98,,551.74,Percent of total billed charges,,,0.95,,534.85,Percent of total billed charges,,,0.97,,546.11,Percent of total billed charges,,,0.97,,546.11,Percent of total billed charges,,,0.96,,540.48,Percent of total billed charges,,,0.95,,534.85,Percent of total billed charges,,,,,,,,,0.95,,534.85,Percent of total billed charges,,534.85,551.74,
OR FIBERTAK KNOTLESS PERC DRILL KIT,SUP-3254540,CDM,27810126,LOCAL,278,RC,,outpatient,,,563,506.7,,0.95,,534.85,Percent of total billed charges,,,0.98,,551.74,Percent of total billed charges,,,0.95,,534.85,Percent of total billed charges,,,0.95,,534.85,Percent of total billed charges,,,0.97,,546.11,Percent of total billed charges,,,0.96,,540.48,Percent of total billed charges,,,0.95,,534.85,Percent of total billed charges,,,,,,,,,0.95,,534.85,Percent of total billed charges,,534.85,551.74,
OR BONESYNC,SUP-3254541,CDM,27010242,LOCAL,270,RC,,inpatient,,,1875,1687.5,,0.95,,1781.25,Percent of total billed charges,,,0.98,,1837.5,Percent of total billed charges,,,0.95,,1781.25,Percent of total billed charges,,,0.97,,1818.75,Percent of total billed charges,,,0.97,,1818.75,Percent of total billed charges,,,0.96,,1800,Percent of total billed charges,,,0.95,,1781.25,Percent of total billed charges,,,,,,,,,0.95,,1781.25,Percent of total billed charges,,1781.25,1837.5,
OR BONESYNC,SUP-3254541,CDM,27010242,LOCAL,270,RC,,outpatient,,,1875,1687.5,,0.95,,1781.25,Percent of total billed charges,,,0.98,,1837.5,Percent of total billed charges,,,0.95,,1781.25,Percent of total billed charges,,,0.95,,1781.25,Percent of total billed charges,,,0.97,,1818.75,Percent of total billed charges,,,0.96,,1800,Percent of total billed charges,,,0.95,,1781.25,Percent of total billed charges,,,,,,,,,0.95,,1781.25,Percent of total billed charges,,1781.25,1837.5,
OR FIBERTAK KNOTLESS 2.6,SUP-3254533,CDM,27810126,LOCAL,278,RC,,inpatient,,,900,810,,0.95,,855,Percent of total billed charges,,,0.98,,882,Percent of total billed charges,,,0.95,,855,Percent of total billed charges,,,0.97,,873,Percent of total billed charges,,,0.97,,873,Percent of total billed charges,,,0.96,,864,Percent of total billed charges,,,0.95,,855,Percent of total billed charges,,,,,,,,,0.95,,855,Percent of total billed charges,,855,882,
OR FIBERTAK KNOTLESS 2.6,SUP-3254533,CDM,27810126,LOCAL,278,RC,,outpatient,,,900,810,,0.95,,855,Percent of total billed charges,,,0.98,,882,Percent of total billed charges,,,0.95,,855,Percent of total billed charges,,,0.95,,855,Percent of total billed charges,,,0.97,,873,Percent of total billed charges,,,0.96,,864,Percent of total billed charges,,,0.95,,855,Percent of total billed charges,,,,,,,,,0.95,,855,Percent of total billed charges,,855,882,
OR GEMINI CANNULA,SUP-3254551,CDM,27010242,LOCAL,270,RC,,inpatient,,,128,115.2,,0.95,,121.6,Percent of total billed charges,,,0.98,,125.44,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.96,,122.88,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,,,,,,,0.95,,121.6,Percent of total billed charges,,121.6,125.44,
OR GEMINI CANNULA,SUP-3254551,CDM,27010242,LOCAL,270,RC,,outpatient,,,128,115.2,,0.95,,121.6,Percent of total billed charges,,,0.98,,125.44,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,0.97,,124.16,Percent of total billed charges,,,0.96,,122.88,Percent of total billed charges,,,0.95,,121.6,Percent of total billed charges,,,,,,,,,0.95,,121.6,Percent of total billed charges,,121.6,125.44,
OR FIBERTAPE CERCLAGE WO NEEDLE,SUP-3254555,CDM,27810126,LOCAL,278,RC,,inpatient,,,950,855,,0.95,,902.5,Percent of total billed charges,,,0.98,,931,Percent of total billed charges,,,0.95,,902.5,Percent of total billed charges,,,0.97,,921.5,Percent of total billed charges,,,0.97,,921.5,Percent of total billed charges,,,0.96,,912,Percent of total billed charges,,,0.95,,902.5,Percent of total billed charges,,,,,,,,,0.95,,902.5,Percent of total billed charges,,902.5,931,
OR FIBERTAPE CERCLAGE WO NEEDLE,SUP-3254555,CDM,27810126,LOCAL,278,RC,,outpatient,,,950,855,,0.95,,902.5,Percent of total billed charges,,,0.98,,931,Percent of total billed charges,,,0.95,,902.5,Percent of total billed charges,,,0.95,,902.5,Percent of total billed charges,,,0.97,,921.5,Percent of total billed charges,,,0.96,,912,Percent of total billed charges,,,0.95,,902.5,Percent of total billed charges,,,,,,,,,0.95,,902.5,Percent of total billed charges,,902.5,931,
OR PLATE 1/4 TUBE 3 HOLE,SUP-3254556,CDM,27810126,LOCAL,278,RC,,inpatient,,,664,597.6,,0.95,,630.8,Percent of total billed charges,,,0.98,,650.72,Percent of total billed charges,,,0.95,,630.8,Percent of total billed charges,,,0.97,,644.08,Percent of total billed charges,,,0.97,,644.08,Percent of total billed charges,,,0.96,,637.44,Percent of total billed charges,,,0.95,,630.8,Percent of total billed charges,,,,,,,,,0.95,,630.8,Percent of total billed charges,,630.8,650.72,
OR PLATE 1/4 TUBE 3 HOLE,SUP-3254556,CDM,27810126,LOCAL,278,RC,,outpatient,,,664,597.6,,0.95,,630.8,Percent of total billed charges,,,0.98,,650.72,Percent of total billed charges,,,0.95,,630.8,Percent of total billed charges,,,0.95,,630.8,Percent of total billed charges,,,0.97,,644.08,Percent of total billed charges,,,0.96,,637.44,Percent of total billed charges,,,0.95,,630.8,Percent of total billed charges,,,,,,,,,0.95,,630.8,Percent of total billed charges,,630.8,650.72,
OR STAPLER ECHELON,SUP-3254542,CDM,27010242,LOCAL,270,RC,,inpatient,,,722,649.8,,0.95,,685.9,Percent of total billed charges,,,0.98,,707.56,Percent of total billed charges,,,0.95,,685.9,Percent of total billed charges,,,0.97,,700.34,Percent of total billed charges,,,0.97,,700.34,Percent of total billed charges,,,0.96,,693.12,Percent of total billed charges,,,0.95,,685.9,Percent of total billed charges,,,,,,,,,0.95,,685.9,Percent of total billed charges,,685.9,707.56,
OR STAPLER ECHELON,SUP-3254542,CDM,27010242,LOCAL,270,RC,,outpatient,,,722,649.8,,0.95,,685.9,Percent of total billed charges,,,0.98,,707.56,Percent of total billed charges,,,0.95,,685.9,Percent of total billed charges,,,0.95,,685.9,Percent of total billed charges,,,0.97,,700.34,Percent of total billed charges,,,0.96,,693.12,Percent of total billed charges,,,0.95,,685.9,Percent of total billed charges,,,,,,,,,0.95,,685.9,Percent of total billed charges,,685.9,707.56,
OR RELOAD GST45W,SUP-3254543,CDM,27810126,LOCAL,278,RC,,inpatient,,,382,343.8,,0.95,,362.9,Percent of total billed charges,,,0.98,,374.36,Percent of total billed charges,,,0.95,,362.9,Percent of total billed charges,,,0.97,,370.54,Percent of total billed charges,,,0.97,,370.54,Percent of total billed charges,,,0.96,,366.72,Percent of total billed charges,,,0.95,,362.9,Percent of total billed charges,,,,,,,,,0.95,,362.9,Percent of total billed charges,,362.9,374.36,
OR RELOAD GST45W,SUP-3254543,CDM,27810126,LOCAL,278,RC,,outpatient,,,382,343.8,,0.95,,362.9,Percent of total billed charges,,,0.98,,374.36,Percent of total billed charges,,,0.95,,362.9,Percent of total billed charges,,,0.95,,362.9,Percent of total billed charges,,,0.97,,370.54,Percent of total billed charges,,,0.96,,366.72,Percent of total billed charges,,,0.95,,362.9,Percent of total billed charges,,,,,,,,,0.95,,362.9,Percent of total billed charges,,362.9,374.36,
OR ENSEAL TISSUE,SUP-3253967,CDM,27010242,LOCAL,270,RC,,inpatient,,,880,792,,0.95,,836,Percent of total billed charges,,,0.98,,862.4,Percent of total billed charges,,,0.95,,836,Percent of total billed charges,,,0.97,,853.6,Percent of total billed charges,,,0.97,,853.6,Percent of total billed charges,,,0.96,,844.8,Percent of total billed charges,,,0.95,,836,Percent of total billed charges,,,,,,,,,0.95,,836,Percent of total billed charges,,836,862.4,
OR ENSEAL TISSUE,SUP-3253967,CDM,27010242,LOCAL,270,RC,,outpatient,,,880,792,,0.95,,836,Percent of total billed charges,,,0.98,,862.4,Percent of total billed charges,,,0.95,,836,Percent of total billed charges,,,0.95,,836,Percent of total billed charges,,,0.97,,853.6,Percent of total billed charges,,,0.96,,844.8,Percent of total billed charges,,,0.95,,836,Percent of total billed charges,,,,,,,,,0.95,,836,Percent of total billed charges,,836,862.4,
OR RELOAD GST GOLD,SUP-3254569,CDM,27810126,LOCAL,278,RC,,inpatient,,,382,343.8,,0.95,,362.9,Percent of total billed charges,,,0.98,,374.36,Percent of total billed charges,,,0.95,,362.9,Percent of total billed charges,,,0.97,,370.54,Percent of total billed charges,,,0.97,,370.54,Percent of total billed charges,,,0.96,,366.72,Percent of total billed charges,,,0.95,,362.9,Percent of total billed charges,,,,,,,,,0.95,,362.9,Percent of total billed charges,,362.9,374.36,
OR RELOAD GST GOLD,SUP-3254569,CDM,27810126,LOCAL,278,RC,,outpatient,,,382,343.8,,0.95,,362.9,Percent of total billed charges,,,0.98,,374.36,Percent of total billed charges,,,0.95,,362.9,Percent of total billed charges,,,0.95,,362.9,Percent of total billed charges,,,0.97,,370.54,Percent of total billed charges,,,0.96,,366.72,Percent of total billed charges,,,0.95,,362.9,Percent of total billed charges,,,,,,,,,0.95,,362.9,Percent of total billed charges,,362.9,374.36,
OR FIBERWIRE TAPER POINT,SUP-3254570,CDM,27010242,LOCAL,270,RC,,inpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
OR FIBERWIRE TAPER POINT,SUP-3254570,CDM,27010242,LOCAL,270,RC,,outpatient,,,88,79.2,,0.95,,83.6,Percent of total billed charges,,,0.98,,86.24,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,0.97,,85.36,Percent of total billed charges,,,0.96,,84.48,Percent of total billed charges,,,0.95,,83.6,Percent of total billed charges,,,,,,,,,0.95,,83.6,Percent of total billed charges,,83.6,86.24,
OR PRECISION SAW BLADE,SUP-3254573,CDM,27010242,LOCAL,270,RC,,inpatient,,,1260,1134,,0.95,,1197,Percent of total billed charges,,,0.98,,1234.8,Percent of total billed charges,,,0.95,,1197,Percent of total billed charges,,,0.97,,1222.2,Percent of total billed charges,,,0.97,,1222.2,Percent of total billed charges,,,0.96,,1209.6,Percent of total billed charges,,,0.95,,1197,Percent of total billed charges,,,,,,,,,0.95,,1197,Percent of total billed charges,,1197,1234.8,
OR PRECISION SAW BLADE,SUP-3254573,CDM,27010242,LOCAL,270,RC,,outpatient,,,1260,1134,,0.95,,1197,Percent of total billed charges,,,0.98,,1234.8,Percent of total billed charges,,,0.95,,1197,Percent of total billed charges,,,0.95,,1197,Percent of total billed charges,,,0.97,,1222.2,Percent of total billed charges,,,0.96,,1209.6,Percent of total billed charges,,,0.95,,1197,Percent of total billed charges,,,,,,,,,0.95,,1197,Percent of total billed charges,,1197,1234.8,
SO OR 3.5 VA PROX TIP PL SMALL BEND/6H/117/LFT,SUP-02.127.221,CDM,27810126,LOCAL,278,RC,,inpatient,,,5565,5008.5,,0.95,,5286.75,Percent of total billed charges,,,0.98,,5453.7,Percent of total billed charges,,,0.95,,5286.75,Percent of total billed charges,,,0.97,,5398.05,Percent of total billed charges,,,0.97,,5398.05,Percent of total billed charges,,,0.96,,5342.4,Percent of total billed charges,,,0.95,,5286.75,Percent of total billed charges,,,,,,,,,0.95,,5286.75,Percent of total billed charges,,5286.75,5453.7,
SO OR 3.5 VA PROX TIP PL SMALL BEND/6H/117/LFT,SUP-02.127.221,CDM,27810126,LOCAL,278,RC,,outpatient,,,5565,5008.5,,0.95,,5286.75,Percent of total billed charges,,,0.98,,5453.7,Percent of total billed charges,,,0.95,,5286.75,Percent of total billed charges,,,0.95,,5286.75,Percent of total billed charges,,,0.97,,5398.05,Percent of total billed charges,,,0.96,,5342.4,Percent of total billed charges,,,0.95,,5286.75,Percent of total billed charges,,,,,,,,,0.95,,5286.75,Percent of total billed charges,,5286.75,5453.7,
SO OR CALIBRATED DRILL BIT QC 250MM/95MM,SUP-03.113.023,CDM,27010242,LOCAL,270,RC,,inpatient,,,748,673.2,,0.95,,710.6,Percent of total billed charges,,,0.98,,733.04,Percent of total billed charges,,,0.95,,710.6,Percent of total billed charges,,,0.97,,725.56,Percent of total billed charges,,,0.97,,725.56,Percent of total billed charges,,,0.96,,718.08,Percent of total billed charges,,,0.95,,710.6,Percent of total billed charges,,,,,,,,,0.95,,710.6,Percent of total billed charges,,710.6,733.04,
SO OR CALIBRATED DRILL BIT QC 250MM/95MM,SUP-03.113.023,CDM,27010242,LOCAL,270,RC,,outpatient,,,748,673.2,,0.95,,710.6,Percent of total billed charges,,,0.98,,733.04,Percent of total billed charges,,,0.95,,710.6,Percent of total billed charges,,,0.95,,710.6,Percent of total billed charges,,,0.97,,725.56,Percent of total billed charges,,,0.96,,718.08,Percent of total billed charges,,,0.95,,710.6,Percent of total billed charges,,,,,,,,,0.95,,710.6,Percent of total billed charges,,710.6,733.04,
SO OR KIRSCHNER WIRE TROCAR POINT 150,SUP-292.20,CDM,27010242,LOCAL,270,RC,,inpatient,,,14,12.6,,0.95,,13.3,Percent of total billed charges,,,0.98,,13.72,Percent of total billed charges,,,0.95,,13.3,Percent of total billed charges,,,0.97,,13.58,Percent of total billed charges,,,0.97,,13.58,Percent of total billed charges,,,0.96,,13.44,Percent of total billed charges,,,0.95,,13.3,Percent of total billed charges,,,,,,,,,0.95,,13.3,Percent of total billed charges,,13.3,13.72,
SO OR KIRSCHNER WIRE TROCAR POINT 150,SUP-292.20,CDM,27010242,LOCAL,270,RC,,outpatient,,,14,12.6,,0.95,,13.3,Percent of total billed charges,,,0.98,,13.72,Percent of total billed charges,,,0.95,,13.3,Percent of total billed charges,,,0.95,,13.3,Percent of total billed charges,,,0.97,,13.58,Percent of total billed charges,,,0.96,,13.44,Percent of total billed charges,,,0.95,,13.3,Percent of total billed charges,,,,,,,,,0.95,,13.3,Percent of total billed charges,,13.3,13.72,
SO OR 3.5 VA LCKNG SCR SLF-TPNG/SD/75,SUP-02.127.175,CDM,27810126,LOCAL,278,RC,,inpatient,,,718,646.2,,0.95,,682.1,Percent of total billed charges,,,0.98,,703.64,Percent of total billed charges,,,0.95,,682.1,Percent of total billed charges,,,0.97,,696.46,Percent of total billed charges,,,0.97,,696.46,Percent of total billed charges,,,0.96,,689.28,Percent of total billed charges,,,0.95,,682.1,Percent of total billed charges,,,,,,,,,0.95,,682.1,Percent of total billed charges,,682.1,703.64,
SO OR 3.5 VA LCKNG SCR SLF-TPNG/SD/75,SUP-02.127.175,CDM,27810126,LOCAL,278,RC,,outpatient,,,718,646.2,,0.95,,682.1,Percent of total billed charges,,,0.98,,703.64,Percent of total billed charges,,,0.95,,682.1,Percent of total billed charges,,,0.95,,682.1,Percent of total billed charges,,,0.97,,696.46,Percent of total billed charges,,,0.96,,689.28,Percent of total billed charges,,,0.95,,682.1,Percent of total billed charges,,,,,,,,,0.95,,682.1,Percent of total billed charges,,682.1,703.64,
SO OR 3.5 VA LCKNG SCR SLF-TPNG/SD/80,SUP-02.127.180,CDM,27810126,LOCAL,278,RC,,inpatient,,,718,646.2,,0.95,,682.1,Percent of total billed charges,,,0.98,,703.64,Percent of total billed charges,,,0.95,,682.1,Percent of total billed charges,,,0.97,,696.46,Percent of total billed charges,,,0.97,,696.46,Percent of total billed charges,,,0.96,,689.28,Percent of total billed charges,,,0.95,,682.1,Percent of total billed charges,,,,,,,,,0.95,,682.1,Percent of total billed charges,,682.1,703.64,
SO OR 3.5 VA LCKNG SCR SLF-TPNG/SD/80,SUP-02.127.180,CDM,27810126,LOCAL,278,RC,,outpatient,,,718,646.2,,0.95,,682.1,Percent of total billed charges,,,0.98,,703.64,Percent of total billed charges,,,0.95,,682.1,Percent of total billed charges,,,0.95,,682.1,Percent of total billed charges,,,0.97,,696.46,Percent of total billed charges,,,0.96,,689.28,Percent of total billed charges,,,0.95,,682.1,Percent of total billed charges,,,,,,,,,0.95,,682.1,Percent of total billed charges,,682.1,703.64,
SO OR 3.5 VA LCKNG SCR SLF-TPNG/SD/70,SUP-02.127.170,CDM,27810126,LOCAL,278,RC,,inpatient,,,718,646.2,,0.95,,682.1,Percent of total billed charges,,,0.98,,703.64,Percent of total billed charges,,,0.95,,682.1,Percent of total billed charges,,,0.97,,696.46,Percent of total billed charges,,,0.97,,696.46,Percent of total billed charges,,,0.96,,689.28,Percent of total billed charges,,,0.95,,682.1,Percent of total billed charges,,,,,,,,,0.95,,682.1,Percent of total billed charges,,682.1,703.64,
SO OR 3.5 VA LCKNG SCR SLF-TPNG/SD/70,SUP-02.127.170,CDM,27810126,LOCAL,278,RC,,outpatient,,,718,646.2,,0.95,,682.1,Percent of total billed charges,,,0.98,,703.64,Percent of total billed charges,,,0.95,,682.1,Percent of total billed charges,,,0.95,,682.1,Percent of total billed charges,,,0.97,,696.46,Percent of total billed charges,,,0.96,,689.28,Percent of total billed charges,,,0.95,,682.1,Percent of total billed charges,,,,,,,,,0.95,,682.1,Percent of total billed charges,,682.1,703.64,
SO OR 3.5MM CORTEX SCREW SELF-TAPPING 50MM,SUP-204.850,CDM,27810126,LOCAL,278,RC,,inpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
SO OR 3.5MM CORTEX SCREW SELF-TAPPING 50MM,SUP-204.850,CDM,27810126,LOCAL,278,RC,,outpatient,,,263,236.7,,0.95,,249.85,Percent of total billed charges,,,0.98,,257.74,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,0.97,,255.11,Percent of total billed charges,,,0.96,,252.48,Percent of total billed charges,,,0.95,,249.85,Percent of total billed charges,,,,,,,,,0.95,,249.85,Percent of total billed charges,,249.85,257.74,
SO OR NORIAN DRILLABLE FAST SET PUTTY 10CC-S,SUP-07.704.110S,CDM,27810126,LOCAL,278,RC,,inpatient,,,9056,8150.4,,0.95,,8603.2,Percent of total billed charges,,,0.98,,8874.88,Percent of total billed charges,,,0.95,,8603.2,Percent of total billed charges,,,0.97,,8784.32,Percent of total billed charges,,,0.97,,8784.32,Percent of total billed charges,,,0.96,,8693.76,Percent of total billed charges,,,0.95,,8603.2,Percent of total billed charges,,,,,,,,,0.95,,8603.2,Percent of total billed charges,,8603.2,8874.88,
SO OR NORIAN DRILLABLE FAST SET PUTTY 10CC-S,SUP-07.704.110S,CDM,27810126,LOCAL,278,RC,,outpatient,,,9056,8150.4,,0.95,,8603.2,Percent of total billed charges,,,0.98,,8874.88,Percent of total billed charges,,,0.95,,8603.2,Percent of total billed charges,,,0.95,,8603.2,Percent of total billed charges,,,0.97,,8784.32,Percent of total billed charges,,,0.96,,8693.76,Percent of total billed charges,,,0.95,,8603.2,Percent of total billed charges,,,,,,,,,0.95,,8603.2,Percent of total billed charges,,8603.2,8874.88,
SO OR GRAFT DELIVERY DEVICE-STERILE,SUP-03.950.001S,CDM,27010242,LOCAL,270,RC,,inpatient,,,616,554.4,,0.95,,585.2,Percent of total billed charges,,,0.98,,603.68,Percent of total billed charges,,,0.95,,585.2,Percent of total billed charges,,,0.97,,597.52,Percent of total billed charges,,,0.97,,597.52,Percent of total billed charges,,,0.96,,591.36,Percent of total billed charges,,,0.95,,585.2,Percent of total billed charges,,,,,,,,,0.95,,585.2,Percent of total billed charges,,585.2,603.68,
SO OR GRAFT DELIVERY DEVICE-STERILE,SUP-03.950.001S,CDM,27010242,LOCAL,270,RC,,outpatient,,,616,554.4,,0.95,,585.2,Percent of total billed charges,,,0.98,,603.68,Percent of total billed charges,,,0.95,,585.2,Percent of total billed charges,,,0.95,,585.2,Percent of total billed charges,,,0.97,,597.52,Percent of total billed charges,,,0.96,,591.36,Percent of total billed charges,,,0.95,,585.2,Percent of total billed charges,,,,,,,,,0.95,,585.2,Percent of total billed charges,,585.2,603.68,