	Addendum A.- OPPS APCs for CY 2022							
 APC 	Group Title	SI	Relative Weight 	Payment Rate	National Unadjusted Copayment 	Minimum Unadjusted Copayment 	"Note: Actual copayments would be lower due to the cap on copayments at the Inpatient Deductible of $1,484.00 (based on CY 2021)"	Drug Pass-Through Expiration during Calendar Year
0701	Sr89 strontium	K		"$3,975.000"	.	$795.00		
0726	Dexrazoxane HCl injection	K		$192.330	.	$38.47		
0731	Sargramostim injection	K		$51.546	.	$10.31		
0736	Amphotericin b liposome inj	K		$28.747	.	$5.75		
0738	Rasburicase	K		$315.057	.	$63.02		
0751	Mechlorethamine hcl inj	K		$11.740	.	$2.35		
0752	Dactinomycin injection	K		$890.643	.	$178.13		
0759	"Naltrexone, depot form"	K		$3.527	.	$0.71		
0800	Leuprolide acetate	K		"$1,406.366"	.	$281.28		
0802	Etoposide oral	K		$75.626	.	$15.13		
0807	Aldesleukin injection	K		"$3,795.260"	.	$759.06		
0810	Goserelin acetate implant	K		$525.213	.	$105.05		
0812	Carmustine injection	K		"$1,234.457"	.	$246.90		
0820	Daunorubicin injection	K		$40.356	.	$8.08		
0825	Nelarabine injection	K		$155.897	.	$31.18		
0836	Interferon alfa-2b inj	K		$33.239	.	$6.65		
0840	Inj melpha hydroch nos 50 mg	K		$208.409	.	$41.69		
0843	Pegaspargase injection	K		"$21,561.047"	.	"$4,312.21"	*	
0844	Pentostatin injection	K		"$1,880.666"	.	$376.14		
0850	Streptozocin injection	K		$348.509	.	$69.71		
0851	Thiotepa injection	K		$305.844	.	$61.17		
0856	Porfimer sodium injection	K		"$21,856.352"	.	"$4,371.28"	*	
0858	Inj cladribine	K		$18.023	.	$3.61		
0864	Mitoxantrone hydrochl	K		$26.285	.	$5.26		
0874	Synvisc or synvisc-one	K		$11.236	.	$2.25		
0875	Euflexxa inj per dose	K		$138.818	.	$27.77		
0877	Orthovisc inj per dose	K		$148.742	.	$29.75		
0887	Azathioprine parenteral	K		$245.019	.	$49.01		
0890	Lymphocyte immune globulin	K		"$2,355.534"	.	$471.11		
0901	Alpha 1 proteinase inhibitor	K		$4.539	.	$0.91		
0902	"Injection,onabotulinumtoxinA"	K		$6.085	.	$1.22		
0903	Cytomegalovirus imm IV /vial	K		"$1,538.699"	.	$307.74		
0910	Interferon beta-1b / .25 MG	K		$406.238	.	$81.25		
0925	Factor viii	K		$1.122	.	$0.23		
0927	Factor viii recombinant	K		$1.425	.	$0.29		
0928	Factor ix complex	K		$1.536	.	$0.31		
0929	Anti-inhibitor	K		$2.207	.	$0.45		
0931	Factor IX non-recombinant	K		$1.165	.	$0.24		
0932	Factor ix recombinant nos	K		$1.607	.	$0.33		
0943	Octagam injection	K		$41.628	.	$8.33		
0944	Gammagard liquid injection	K		$44.491	.	$8.90		
0946	Hepagam b im injection	K		$70.935	.	$14.19		
0947	Flebogamma injection	K		$36.804	.	$7.37		
0948	Gamunex-C/Gammaked	K		$48.219	.	$9.65		
0961	"Albumin (human),5%, 50ml"	K		$10.490	.	$2.10		
0963	"Albumin (human), 5%, 250 ml"	K		$52.450	.	$10.49		
0964	"Albumin (human), 25%, 20 ml"	K		$20.980	.	$4.20		
0965	"Albumin (human), 25%, 50ml"	K		$52.450	.	$10.49		
1015	Injection glatiramer acetate	K		$141.293	.	$28.26		
1064	"I131 iodide cap, rx"	K		$20.120	.	$4.03		
1083	Adalimumab injection	K		"$1,581.568"	.	$316.32		
1138	"Hepagam b intravenous, inj"	K		$71.237	.	$14.25		
1139	Protein c concentrate	K		$15.128	.	$3.03		
1142	Supprelin LA implant	K		"$43,467.031"	.	"$8,693.41"	*	
1150	"I131 iodide sol, rx"	K		$13.340	.	$2.67		
1168	"Inj, temsirolimus"	K		$38.247	.	$7.65		
1178	Busulfan injection	K		$1.708	.	$0.35		
1203	Verteporfin injection	K		$11.252	.	$2.26		
1207	"Octreotide injection, depot"	K		$205.372	.	$41.08		
1213	Antihemophilic viii/vwf comp	K		$1.135	.	$0.23		
1214	Inj IVIG privigen 500 mg	K		$44.480	.	$8.90		
1232	Mitomycin injection	K		$38.629	.	$7.73		
1235	Valrubicin injection	K		"$1,425.369"	.	$285.08		
1237	Inj iron dextran	K		$15.838	.	$3.17		
1263	Antithrombin iii injection	K		$3.204	.	$0.65		
1268	Xyntha inj	K		$1.328	.	$0.27		
1274	Edetate calcium disodium inj	K 		"$5,708.594"	.	"$1,141.72"		
1281	Bevacizumab injection	K		$1.760	.	$0.36		
1289	AbobotulinumtoxinA	K		$8.408	.	$1.69		
1295	Sm 153 lexidronam	K		"$17,259.853"	.	"$3,451.98"	*	
1296	Degarelix injection	K		$4.120	.	$0.83		
1297	"Ferumoxytol, non-esrd"	K		$0.997	.	$0.20		
1311	Canakinumab injection	K		$115.606	.	$23.13		
1312	Hizentra injection	K		$11.582	.	$2.32		
1327	Imiglucerase injection	K		$44.049	.	$8.81		
1331	Olanzapine long-acting inj	K		$2.914	.	$0.59		
1340	"Collagenase, clost hist inj"	K		$56.658	.	$11.34		
1341	Amobarbital 125 MG inj	K		$125.220	.	$25.05		
1352	Wilate injection	K		$1.164	.	$0.24		
1353	Belimumab injection	K		$47.566	.	$9.52		
1408	Cyclophosphamide 100 MG inj	K		$29.153	.	$5.84		
1413	Lumizyme injection	K		$180.349	.	$36.07		
1415	Glassia injection	K		$4.950	.	$0.99		
1416	Factor xiii anti-hem factor	K		$9.141	.	$1.83		
1417	Gel-one	K		"$1,219.000"	.	$243.80		
1420	Aflibercept injection	K		$917.943	.	$183.59		
1421	Imported lipodox inj	K		$311.040	.	$62.21		
1426	Eribulin mesylate injection	K		$123.930	.	$24.79		
1431	Centruroides immune f(ab)	K		"$5,190.146"	.	"$1,038.03"		
1433	Calcitonin salmon injection	K		"$3,100.794"	.	$620.16		
1440	Inj desmopressin acetate	K		$9.402	.	$1.89		
1442	Non-HEU TC-99M add-on/dose	K		$10.000	.	$2.00		
1443	Icatibant injection	K		$204.964	.	$41.00		
1446	Visualization adjunct	K		$6.726	.	$1.35		
1458	Phentolaine mesylate inj	K		$416.001	.	$83.21		
1466	"Inj, vincristine sul lip 1mg"	K		"$3,370.225"	.	$674.05		
1467	Factor ix recombinan rixubis	K		$1.538	.	$0.31		
1468	Inj Aripiprazole Ext Rel 1mg	K		$6.006	.	$1.21		
1469	Inj filgrastim excl biosimil	K		$0.972	.	$0.20		
1471	"Injection, Pertuzumab, 1 mg"	K		$13.557	.	$2.72		
1472	Inj beta interferon im 1 mcg	K		$55.292	.	$11.06		
1474	Certolizumab pegol inj 1mg	K		$6.272	.	$1.26		
1475	Golimumab for iv use 1mg	K		$16.818	.	$3.37		
1476	Obinutuzumab inj	K		$64.536	.	$12.91		
1478	Inj human fibrinogen con nos	K		$1.297	.	$0.26		
1480	"Elosulfase alfa, injection"	K		$250.329	.	$50.07		
1482	"	Darbepoetin alfa, esrd use"	K		$3.154	.	$0.64		
1485	"	Ferumoxytol, esrd use"	K		$0.997	.	$0.20		
1486	Factor ix fc fusion recomb	K		$3.280	.	$0.66		
1488	"Injection, ramucirumab"	K		$62.690	.	$12.54		
1489	"Injection, vedolizumab"	K		$21.279	.	$4.26		
1490	Inj pembrolizumab	K		$52.754	.	$10.56		
1491	New Technology  - Level 1A ($0-$10)	S		$5.00	.	$1.00		
1492	New Technology  - Level 1B ($11-$20)	S		$15.50	.	$3.10		
1493	New Technology  - Level 1C ($21-$30)	S		$25.50	.	$5.10		
1494	New Technology  - Level 1D ($31-$40)	S		$35.50	.	$7.10		
1495	New Technology  - Level 1E ($41-$50)	S		$45.50	.	$9.10		
1496	New Technology  - Level 1A ($0-$10)	T		$5.00	.	$1.00		
1497	New Technology  - Level 1B ($11-$20)	T		$15.50	.	$3.10		
1498	New Technology  - Level 1C ($21-$30)	T		$25.50	.	$5.10		
1499	New Technology  - Level 1D ($31-$40)	T		$35.50	.	$7.10		
1500	New Technology  - Level 1E ($41-$50)	T		$45.50	.	$9.10		
1502	New Technology - Level 2 ($51 - $100)	S		$75.50	.	$15.10		
1503	New Technology - Level 3 ($101 - $200)	S		$150.50	.	$30.10		
1504	New Technology - Level 4 ($201 - $300)	S		$250.50	.	$50.10		
1505	New Technology - Level 5 ($301 - $400)	S		$350.50	.	$70.10		
1506	New Technology - Level 6 ($401 - $500)	S		$450.50	.	$90.10		
1507	New Technology - Level 7 ($501 - $600)	S		$550.50	.	$110.10		
1508	New Technology - Level 8 ($601 - $700)	S		$650.50	.	$130.10		
1509	New Technology - Level 9 ($701 - $800)	S		$750.50	.	$150.10		
1510	New Technology - Level 10 ($801 - $900)	S		$850.50	.	$170.10		
1511	New Technology - Level 11 ($901 - $1000)	S		$950.50	.	$190.10		
1512	New Technology - Level 12 ($1001 - $1100)	S		"$1,050.50"	.	$210.10		
1513	New Technology - Level 13 ($1101 - $1200)	S		"$1,150.50"	.	$230.10		
1514	New Technology - Level 14 ($1201- $1300)	S		"$1,250.50"	.	$250.10		
1515	New Technology - Level 15 ($1301 - $1400)	S		"$1,350.50"	.	$270.10		
1516	New Technology - Level 16  ($1401 - $1500)	S		"$1,450.50"	.	$290.10		
1517	New Technology - Level 17 ($1501-$1600)	S		"$1,550.50"	.	$310.10		
1518	New Technology - Level 18 ($1601-$1700)	S		"$1,650.50"	.	$330.10		
1519	New Technology - Level 19 ($1701-$1800)	S		"$1,750.50"	.	$350.10		
1520	New Technology - Level 20 ($1801-$1900)	S		"$1,850.50"	.	$370.10		
1521	New Technology - Level 21 ($1901-$2000)	S		"$1,950.50"	.	$390.10		
1522	New Technology - Level 22 ($2001-$2500)	S		"$2,250.50"	.	$450.10		
1523	New Technology - Level 23 ($2501-$3000)	S		"$2,750.50"	.	$550.10		
1524	New Technology - Level 24 ($3001-$3500)	S		"$3,250.50"	.	$650.10		
1525	New Technology - Level 25 ($3501-$4000)	S		"$3,750.50"	.	$750.10		
1526	New Technology - Level 26 ($4001-$4500)	S		"$4,250.50"	.	$850.10		
1527	New Technology - Level 27 ($4501-$5000)	S		"$4,750.50"	.	$950.10		
1528	New Technology - Level 28 ($5001-$5500)	S		"$5,250.50"	.	"$1,050.10"		
1529	New Technology - Level 29 ($5501-$6000)	S		"$5,750.50"	.	"$1,150.10"		
1530	New Technology - Level 30 ($6001-$6500)	S		"$6,250.50"	.	"$1,250.10"		
1531	New Technology - Level 31 ($6501-$7000)	S		"$6,750.50"	.	"$1,350.10"		
1532	New Technology - Level 32 ($7001-$7500)	S		"$7,250.50"	.	"$1,450.10"		
1533	New Technology - Level 33 ($7501-$8000)	S		"$7,750.50"	.	"$1,550.10"		
1534	New Technology - Level 34 ($8001-$8500)	S		"$8,250.50"	.	"$1,650.10"	*	
1535	New Technology - Level 35 ($8501-$9000)	S		"$8,750.50"	.	"$1,750.10"	*	
1536	New Technology - Level 36 ($9001-$9500)	S		"$9,250.50"	.	"$1,850.10"	*	
1537	New Technology - Level 37 ($9501-$10000)	S		"$9,750.50"	.	"$1,950.10"	*	
1539	New Technology - Level 2 ($51 - $100)	T		$75.50	.	$15.10		
1540	New Technology - Level 3 ($101 - $200)	T		$150.50	.	$30.10		
1541	New Technology - Level 4 ($201 - $300)	T		$250.50	.	$50.10		
1542	New Technology - Level 5 ($301 - $400)	T		$350.50	.	$70.10		
1543	New Technology - Level 6 ($401 - $500)	T		$450.50	.	$90.10		
1544	New Technology - Level 7 ($501 - $600)	T		$550.50	.	$110.10		
1545	New Technology - Level 8 ($601 - $700)	T		$650.50	.	$130.10		
1546	New Technology - Level 9 ($701 - $800)	T		$750.50	.	$150.10		
1547	New Technology - Level 10 ($801 - $900)	T		$850.50	.	$170.10		
1548	New Technology - Level 11 ($901 - $1000)	T		$950.50	.	$190.10		
1549	New Technology - Level 12 ($1001 - $1100)	T		"$1,050.50"	.	$210.10		
1550	New Technology - Level 13 ($1101 - $1200)	T		"$1,150.50"	.	$230.10		
1551	New Technology - Level 14 ($1201- $1300)	T		"$1,250.50"	.	$250.10		
1552	New Technology - Level 15 ($1301 - $1400)	T		"$1,350.50"	.	$270.10		
1553	New Technology - Level 16 ($1401 - $1500)	T		"$1,450.50"	.	$290.10		
1554	New Technology - Level 17 ($1501-$1600)	T		"$1,550.50"	.	$310.10		
1555	New Technology - Level 18 ($1601-$1700)	T		"$1,650.50"	.	$330.10		
1556	New Technology - Level 19 ($1701-$1800)	T		"$1,750.50"	.	$350.10		
1557	New Technology - Level 20 ($1801-$1900)	T		"$1,850.50"	.	$370.10		
1558	New Technology - Level 21 ($1901-$2000)	T		"$1,950.50"	.	$390.10		
1559	New Technology - Level 22 ($2001-$2500)	T		"$2,250.50"	.	$450.10		
1560	New Technology - Level 23 ($2501-$3000)	T		"$2,750.50"	.	$550.10		
1561	New Technology - Level 24 ($3001-$3500)	T		"$3,250.50"		$650.10		
1562	New Technology - Level 25 ($3501-$4000)	T		"$3,750.50"	.	$750.10		
1563	New Technology - Level 26 ($4001-$4500)	T		"$4,250.50"	.	$850.10		
1564	New Technology - Level 27 ($4501-$5000)	T		"$4,750.50"	.	$950.10		
1565	New Technology - Level 28 ($5001-$5500)	T		"$5,250.50"	.	"$1,050.10"		
1566	New Technology - Level 29 ($5501-$6000)	T		"$5,750.50"	.	"$1,150.10"		
1567	New Technology - Level 30 ($6001-$6500)	T		"$6,250.50"	.	"$1,250.10"		
1568	New Technology - Level 31 ($6501-$7000)	T		"$6,750.50"	.	"$1,350.10"		
1569	New Technology - Level 32 ($7001-$7500)	T		"$7,250.50"	.	"$1,450.10"		
1570	New Technology - Level 33 ($7501-$8000)	T		"$7,750.50"	.	"$1,550.10"		
1571	New Technology - Level 34 ($8001-$8500)	T		"$8,250.50"	.	"$1,650.10"	*	
1572	New Technology - Level 35 ($8501-$9000)	T		"$8,750.50"	.	"$1,750.10"	*	
1573	New Technology - Level 36 ($9001-$9500)	T		"$9,250.50"	.	"$1,850.10"	*	
1574	New Technology - Level 37 ($9501-$10000)	T		"$9,750.50"	.	"$1,950.10"	*	
1575	"New Technology - Level 38 ($10,001-$15,000)"	S		"$12,500.50"	.	"$2,500.10"	*	
1576	"New Technology - Level 39 ($15,001-$20,000)"	S		"$17,500.50"	.	"$3,500.10"	*	
1577	"New Technology - Level 40 ($20,001-$25,000)"	S		"$22,500.50"	.	"$4,500.10"	*	
1578	"New Technology - Level 41 ($25,001-$30,000)"	S		"$27,500.50"	.	"$5,500.10"	*	
1579	"New Technology - Level 42 ($30,001-$40,000)"	S		"$35,000.50"	.	"$7,000.10"	*	
1580	"New Technology - Level 43 ($40,001-$50,000)"	S		"$45,000.50"	.	"$9,000.10"	*	
1581	"New Technology - Level 44 ($50,001-$60,000)"	S		"$55,000.50"	.	"$11,000.10"	*	
1582	"New Technology - Level 45 ($60,001-$70,000)"	S		"$65,000.50"	.	"$13,000.10"	*	
1583	"New Technology - Level 46 ($70,001-$80,000)"	S		"$75,000.50"	.	"$15,000.10"	*	
1584	"New Technology - Level 47 ($80,001-$90,000)"	S		"$85,000.50"	.	"$17,000.10"	*	
1585	"New Technology - Level 48 ($90,001-$100,000)"	S		"$95,000.50"	.	"$19,000.10"	*	
1589	"New Technology - Level 38 ($10,001-$15,000)"	T		"$12,500.50"	.	"$2,500.10"	*	
1590	"New Technology - Level 39 ($15,001-$20,000)"	T		"$17,500.50"		"$3,500.10"	*	
1591	"New Technology - Level 40 ($20,001-$25,000)"	T		"$22,500.50"	.	"$4,500.10"	*	
1592	"New Technology - Level 41 ($25,001-$30,000)"	T		"$27,500.50"		"$5,500.10"	*	
1593	"New Technology - Level 42 ($30,001-$40,000)"	T		"$35,000.50"	.	"$7,000.10"	*	
1594	"New Technology - Level 43 ($40,001-$50,000)"	T		"$45,000.50"	.	"$9,000.10"	*	
1595	"New Technology - Level 44 ($50,001-$60,000)"	T		"$55,000.50"	.	"$11,000.10"	*	
1596	"New Technology - Level 45 ($60,001-$70,000)"	T		"$65,000.50"	.	"$13,000.10"	*	
1597	"New Technology - Level 46 ($70,001-$80,000)"	T		"$75,000.50"	.	"$15,000.10"	*	
1598	"New Technology - Level 47 ($80,001-$90,000)"	T		"$85,000.50"	.	"$17,000.10"	*	
1599	"New Technology - Level 48 ($90,001-$100,000)"	T		"$95,000.50"	.	"$19,000.10"	*	
1608	Etanercept injection	K		$790.781	.	$158.16		
1609	"Rho(D) immune globulin h, sd"	K		$31.416	.	$6.29		
1613	Trastuzumab injection	K		$89.811	.	$17.97		
1630	"Hep b ig, im"	K		$130.308	.	$26.07		
1643	"Y90 ibritumomab, rx"	K		"$59,793.847"	.	"$11,958.77"	*	
1656	Factor viii fc fusion recomb	K		$2.151	.	$0.44		
1658	"Injection, belinostat, 10mg"	K		$42.768	.	$8.56		
1660	"Injection, oritavancin"	K		$23.628	.	$4.73		
1662	Inj tedizolid phosphate	K		$1.598	.	$0.32		
1670	Tetanus immune globulin inj	K		$441.703	.	$88.35		
1675	P32 Na phosphate	K		$458.340	.	$91.67		
1683	Basiliximab	K		"$4,013.081"	.	$802.62		
1684	Corticorelin ovine triflutal	K		$9.673	.	$1.94		
1685	"Darbepoetin alfa, non-esrd"	K		$3.154	.	$0.64		
1686	"Epoetin alfa, non-esrd"	K		$8.153	.	$1.64		
1687	Digoxin immune fab (ovine)	K		"$4,128.191"	.	$825.64		
1688	Ethanolamine oleate	K		$444.099	.	$88.82		
1689	Fomepizole	K		$5.983	.	$1.20		
1690	Hemin	K		$26.644	.	$5.33		
1694	Ziconotide injection	K		$8.686	.	$1.74		
1696	Palifermin injection	K		$23.929	.	$4.79		
1700	Inj secretin synthetic human	K		$34.781	.	$6.96		
1701	Treprostinil injection	K		$59.681	.	$11.94		
1704	"Humate-P, inj"	K		$1.262	.	$0.26		
1705	Factor viia recomb novoseven	K		$2.326	.	$0.47		
1709	Azacitidine injection	K		$0.929	.	$0.19		
1710	Clofarabine injection	K		$53.149	.	$10.63		
1711	Vantas implant	K		"$5,166.292"	.	"$1,033.26"		
1712	Paclitaxel protein bound	K		$14.077	.	$2.82		
1745	Radium ra223 dichloride ther	K		$145.652	.	$29.14		
1746	Factor xiii recomb a-subunit	K		$15.866	.	$3.18		
1747	Monovisc inj per dose	K		$762.798	.	$152.56		
1748	Inj tbo filgrastim 1 microg	K		$0.456	.	$0.10		
1761	"Rolapitant, oral, 1mg"	K		$1.750	.	$0.35		
1809	"Injection, alemtuzumab"	K		"$2,086.319"	.	$417.27		
1822	"Injection, zarxio"	K		$0.318	.	$0.07		
1823	"Injection, dalbavancin"	K		$15.889	.	$3.18		
1824	"	Ceftaroline fosamil inj"	K		$3.509	.	$0.71		
1825	Ceftazidime and avibactam	K		$92.394	.	$18.48		
1826	Hyqvia 100mg immuneglobulin	K		$15.155	.	$3.04		
1827	Factor viii recomb obizur	K		$3.189	.	$0.64		
1829	"	Penicillin g benzathine inj"	K		$14.949	.	$2.99		
1832	Dimethyl sulfoxide 50% 50 ml	K		$637.111	.	$127.43		
1844	Factor viii pegylated recomb	K		$1.920	.	$0.39		
1846	Factor viii nuwiq recomb 1iu	K		$1.235	.	$0.25		
1847	"Injection, inflectra"	K		$41.188	.	$8.24		
1848	Artiss fibrin sealant	K		$156.842	.	$31.37		
1849	Foscarnet sodium injection	K		$72.863	.	$14.58		
1850	Gamma globulin 1 cc inj	K		$44.131	.	$8.83		
1851	Gamma globulin > 10 cc inj	K		$441.307	.	$88.27		
1852	Interferon beta-1a inj	K		"$2,293.850"	.	$458.77		
1853	Minocycline hydrochloride	K		$2.003	.	$0.41		
1856	Factor viii recomb novoeight	K		$1.505	.	$0.31		
1857	"Inj, factor x, (human), 1iu"	K		$8.199	.	$1.64		
1859	Argatroban nonesrd use 1mg	K		$1.203	.	$0.25		
1861	"Inj., bendeka 1 mg"	K		$19.646	.	$3.93		
1862	Gelsyn-3 injection 0.1 mg	K		$2.177	.	$0.44		
1901	"New Technology - Level 49 ($100,001-$115,000)"	S		"$107,500.50"	.	"$21,500.10"	*	
1902	"New Technology - Level 49 ($100,001-$115,000)"	T		"$107,500.50"	.	"$21,500.10"	*	
1903	"New Technology - Level 50 ($115,001-$130,000)"	S		"$122,500.50"	.	"$24,500.10"	*	
1904	"New Technology - Level 50 ($115,001-$130,000)"	T		"$122,500.50"	.	"$24,500.10"	*	
1905	"New Technology - Level 51 ($130,001-$145,000)"	S		"$137,500.50"	.	"$27,500.10"	*	
1906	"New Technology - Level 51 ($130,001-$145,000)"	T		"$137,500.50"	.	"$27,500.10"	*	
1907	"New Technology - Level 52 ($145,001-$160,000)"	S		"$152,500.50"	.	"$30,500.10"	*	
1908	"New Technology - Level 52 ($145,001-$160,000)"	T		"$152,500.50"	.	"$30,500.10"	*	
2024	"Generator, CCM, implant"	H 			.	.		
2025	"Cath, pressure,valve-occlu"	H 			.	.		
2026	"Orth/devic/drug bn/bn,tis/bn "	H 			.	.		
2027	"Probe, robotic, water-jet"	H 			.	.		
2028	Iris prosthesis	H 			.	.		
2029	"Endoscope, single, UGI"	H 			.	.		
2030	"Gen, neuro, carot sinus baro"	H 			.	.		
2031	"Hemostatic agent, GI, topic"	H 			.	.		
2032	Intravertebral fx aug impl	H 			.	.		
2033	"Cath, trans intra litho/coro"	H 			.	.		
2034	Personalized interbody cage	H 			.	.		
2035	Auto cell process sys	H 			.	.		
2036	Cardiac monitor sys	H 			.	.		
2616	"Brachytx, non-str,Yttrium-90"	U	211.0221	"$17,763.21"	.	"$3,552.65"	*	
2632	Iodine I-125 sodium iodide	U	0.4796	$40.37	.	$8.08		
2634	"Brachytx, non-str, HA, I-125"	U	1.7962	$151.20	.	$30.24		
2635	"Brachytx, non-str, HA, P-103"	U	0.5420	$45.62	.	$9.13		
2636	"Brachy linear, non-str,P-103"	U	0.6245	$52.57	.	$10.52		
2638	"Brachytx, stranded, I-125"	U	0.4537	$38.19	.	$7.64		
2639	"Brachytx, non-stranded,I-125"	U	0.4136	$34.82	.	$6.97		
2640	"Brachytx, stranded, P-103"	U	1.0643	$89.59	.	$17.92		
2641	"Brachytx, non-stranded,P-103"	U	0.8429	$70.95	.	$14.19		
2642	"Brachytx, stranded, C-131"	U	0.8716	$73.37	.	$14.68		
2643	"Brachytx, non-stranded,C-131"	U	0.9745	$82.03	.	$16.41		
2645	"Brachytx, non-str, Gold-198"	U	7.3252	$616.61	.	$123.33		
2646	"Brachytx, non-str, HDR Ir-192"	U	4.0595	$341.72	.	$68.35		
2647	"Brachytx, NS, Non-HDRIr-192"	U	2.4451	$205.82	.	$41.17		
2648	"Brachytx planar, p-103"	U	0.0557	$4.69	.	$0.94		
2698	"Brachytx, stranded, NOS"	U	0.4537	$38.19	.	$7.64		
2699	"Brachytx, non-stranded, NOS"	U	0.4136	$34.82	.	$6.97		
2731	"Immune globulin, powder"	K		$65.488	.	$13.10		
2770	Quinupristin/dalfopristin	K		$444.672	.	$88.94		
2993	"Gen, neuro, trans sen/stim"	H			.	.		
4001	Echo guidance radiotherapy	S	1.8323	$154.24	.	$30.85		
4002	Stereoscopic x-ray guidance 	S	0.6610	$55.64	.	$11.13		
4003	"Radiation treatment delivery, MeV <= 5; simple "	S	1.8197	$153.18	.	$30.64		
4004	"Radiation treatment delivery, 6-10 MeV; simple "	S	1.6356	$137.68	.	$27.54		
4005	"Radiation treatment delivery, 11-19 MeV; simple "	S	1.6356	$137.68	.	$27.54		
4006	"Radiation treatment delivery, MeV>=20; simple "	S	1.6356	$137.68	.	$27.54		
4007	"Radiation treatment delivery, MeV<=5; intermediate"	S	3.0121	$253.55	.	$50.71		
4008	"Radiation treatment delivery, 6-10 MeV; intermediate "	S	2.2506	$189.45	.	$37.89		
4009	"Radiation treatment delivery, 11-19 MeV; intermediate"	S	2.2464	$189.10	.	$37.82		
4010	"Radiation treatment delivery, MeV >=20; intermediate"	S	2.2339	$188.04	.	$37.61		
4011	"Radiation treatment delivery, MeV<=5; complex"	S	2.9828	$251.08	.	$50.22		
4012	"Radiation treatment delivery, 6-10 MeV; complex"	S	2.9786	$250.73	.	$50.15		
4013	"Radiation treatment delivery, 11-19 MeV; complex"	S	2.9870	$251.44	.	$50.29		
4014	"Radiation treatment delivery, MeV >=20; complex"	S	2.9703	$250.03	.	$50.01		
4015	Radiation tx delivery imrt	S	4.5348	$381.73	.	$76.35		
4016	Delivery comp imrt	S	4.5181	$380.32	.	$76.07		
5012	Clinic Visits and Related Services	V	1.4416	$121.35	.	$24.27		
5021	Level 1 Type A ED Visits	V	0.8801	$74.08	.	$14.82		
5022	Level 2 Type A ED Visits	V	1.5937	$134.15	.	$26.83		
5023	Level 3 Type A ED Visits	V	2.8078	$236.35	.	$47.27		
5024	Level 4 Type A ED Visits	V	4.4136	$371.52	.	$74.31		
5025	Level 5 Type A ED Visits	V	6.3351	$533.27	.	$106.66		
5031	Level 1 Type B ED Visits	V	0.8570	$72.14	.	$14.43		
5032	Level 2 Type B ED Visits	V	1.1612	$97.75	.	$19.55		
5033	Level 3 Type B ED Visits	V	2.1961	$184.86	.	$36.98		
5034	Level 4 Type B ED Visits	V	2.7745	$233.55	.	$46.71		
5035	Level 5 Type B ED Visits	V	3.8665	$325.47	.	$65.10		
5041	Critical Care	S	9.0374	$760.74	.	$152.15		
5045	Trauma Response with Critical Care	S	11.5583	$972.94	.	$194.59		
5051	Level 1 Skin Procedures	T	2.1788	$183.40	.	$36.68		
5052	Level 2 Skin Procedures	T	4.1936	$353.00	.	$70.60		
5053	Level 3 Skin Procedures	T	6.3543	$534.89	.	$106.98		
5054	Level 4 Skin Procedures	T	20.7807	"$1,749.26"	.	$349.86		
5055	Level 5 Skin Procedures	T	42.7221	"$3,596.22"	.	$719.25		
5061	Hyperbaric Oxygen	S	1.4469	$121.80	.	$24.36		
5071	Level 1 Excision/ Biopsy/ Incision and Drainage	T	7.5501	$635.54	.	$127.11		
5072	Level 2 Excision/ Biopsy/ Incision and Drainage	J1	17.0711	"$1,436.99"	.	$287.40		
5073	Level 3 Excision/ Biopsy/ Incision and Drainage	J1	28.7674	"$2,421.55"	.	$484.31		
5091	Level 1 Breast/Lymphatic Surgery and Related Procedures	J1	38.3121	"$3,225.00"	.	$645.00		
5092	Level 2 Breast/Lymphatic Surgery and Related Procedures	J1	67.1454	"$5,652.10"	.	"$1,130.42"		
5093	Level 3 Breast/Lymphatic Surgery and Related Procedures	J1	108.1817	"$9,106.41"	.	"$1,821.29"	*	
5094	Level 4 Breast/Lymphatic Surgery and Related Procedures	J1	181.0200	"$15,237.72"	.	"$3,047.55"	*	
5101	Level 1 Strapping and Cast Application	T	1.7141	$144.29	.	$28.86		
5102	Level 2 Strapping and Cast Application	T	2.9269	$246.38	.	$49.28		
5111	Level 1 Musculoskeletal Procedures	T	2.5007	$210.50	.	$42.10		
5112	Level 2 Musculoskeletal Procedures	J1	16.8990	"$1,422.51"	.	$284.51		
5113	Level 3 Musculoskeletal Procedures	J1	34.3595	"$2,892.28"	.	$578.46		
5114	Level 4 Musculoskeletal Procedures	J1	75.9952	"$6,397.05"	.	"$1,279.41"		
5115	Level 5 Musculoskeletal Procedures	J1	149.6049	"$12,593.29"	.	"$2,518.66"	*	
5116	Level 6 Musculoskeletal Procedures	J1	196.1742	"$16,513.36"	.	"$3,302.68"	*	
5151	Level 1 Airway Endoscopy	T	1.9972	$168.12	.	$33.63		
5152	Level 2 Airway Endoscopy	T	4.5604	$383.88	.	$76.78		
5153	Level 3 Airway Endoscopy	J1	18.1522	"$1,528.00"	.	$305.60		
5154	Level 4 Airway Endoscopy	J1	37.5825	"$3,163.58"	.	$632.72		
5155	Level 5 Airway Endoscopy	J1	70.6545	"$5,947.48"	.	"$1,189.50"		
5161	Level 1 ENT Procedures	T	2.5668	$216.07	.	$43.22		
5162	Level 2 ENT Procedures	T	5.4873	$461.90	.	$92.38		
5163	Level 3 ENT Procedures	J1	16.4123	"$1,381.54"	.	$276.31		
5164	Level 4 ENT Procedures	J1	33.1917	"$2,793.98"	.	$558.80		
5165	Level 5 ENT Procedures	J1	61.7065	"$5,194.27"	.	"$1,038.86"		
5166	Cochlear Implant Procedure	J1	418.1975	"$35,202.61"	"$7,683.79"	"$7,040.53"	*	
5181	Level 1 Vascular Procedures	T	6.5581	$552.04	.	$110.41		
5182	Level 2 Vascular Procedures	J1	17.0612	"$1,436.16"	.	$287.24		
5183	Level 3 Vascular Procedures	J1	34.7319	"$2,923.63"	.	$584.73		
5184	Level 4 Vascular Procedures	J1	57.8572	"$4,870.25"	.	$974.05		
5191	Level 1 Endovascular Procedures	J1	35.1820	"$2,961.52"	$864.64	$592.31		
5192	Level 2 Endovascular Procedures	J1	60.1339	"$5,061.89"	.	"$1,012.38"		
5193	Level 3 Endovascular Procedures	J1	121.8681	"$10,258.49"	.	"$2,051.70"	*	
5194	Level 4 Endovascular Procedures	J1	194.8550	"$16,402.31"	.	"$3,280.47"	*	
5200	Implantation Wireless PA Pressure Monitor	J1	349.9768	"$29,460.00"	.	"$5,892.00"	*	
5211	Level 1 Electrophysiologic Procedures	J1	13.5134	"$1,137.52"	.	$227.51		
5212	Level 2 Electrophysiologic Procedures	J1	73.7475	"$6,207.84"	.	"$1,241.57"		
5213	Level 3 Electrophysiologic Procedures	J1	260.3512	"$21,915.58"	.	"$4,383.12"	*	
5221	Level1 Pacemaker and Similar Procedures	T	41.7789	"$3,516.82"	.	$703.37		
5222	Level 2 Pacemaker and Similar Procedures	J1	98.9863	"$8,332.37"	.	"$1,666.48"	*	
5223	Level 3 Pacemaker and Similar Procedures	J1	126.1547	"$10,619.32"	.	"$2,123.87"	*	
5224	Level 4 Pacemaker and Similar Procedures	J1	225.9619	"$19,020.79"	.	"$3,804.16"	*	
5231	Level 1 ICD and Similar Procedures	J1	279.7777	"$23,550.85"	.	"$4,710.17"	*	
5232	Level 2 ICD and Similar Procedures	J1	398.5297	"$33,547.03"	.	"$6,709.41"	*	
5241	Level 1 Blood Product Exchange and Related Services	S	4.8157	$405.37	.	$81.08		
5242	Level 2 Blood Product Exchange and Related Services	S	16.5487	"$1,393.02"	.	$278.61		
5243	Level 3 Blood Product Exchange and Related Services	S	49.0687	"$4,130.46"	.	$826.10		
5244	Level 4 Blood Product Exchange and Related Services	J1	487.3894	"$41,026.98"	.	"$8,205.40"	*	
5301	Level 1 Upper GI Procedures	T	9.8173	$826.39	.	$165.28		
5302	Level 2 Upper GI Procedures 	J1	19.7062	"$1,658.81"	.	$331.77		
5303	Level 3 Upper GI Procedures	J1	37.2537	"$3,135.90"	.	$627.18		
5311	Level 1 Lower GI Procedures 	T	9.6283	$810.48	.	$162.10		
5312	Level 2 Lower GI Procedures 	T	12.5814	"$1,059.06"	.	$211.82		
5313	Level 3 Lower GI Procedures 	J1	29.6404	"$2,495.04"	.	$499.01		
5331	Complex GI Procedures	J1	61.0719	"$5,140.85"	.	"$1,028.17"		
5341	Abdominal/Peritoneal/Biliary and Related Procedures	J1	38.6014	"$3,249.35"	.	$649.87		
5361	Level 1 Laparoscopy and Related Services	J1	61.3908	"$5,167.69"	.	"$1,033.54"		
5362	Level 2 Laparoscopy and Related Services	J1	108.0635	"$9,096.46"	.	"$1,819.30"	*	
5371	Level 1 Urology and Related Services	T	3.2285	$271.77	.	$54.36		
5372	Level 2 Urology and Related Services	T	6.9801	$587.56	.	$117.52		
5373	Level 3 Urology and Related Services	J1	21.7239	"$1,828.65"	.	$365.73		
5374	Level 4 Urology and Related Services	J1	37.3028	"$3,140.04"	.	$628.01		
5375	Level 5 Urology and Related Services	J1	53.5288	"$4,505.89"	.	$901.18		
5376	Level 6 Urology and Related Services	J1	100.1321	"$8,428.82"	.	"$1,685.77"	*	
5377	Level 7 Urology and Related Services	J1	139.3488	"$11,729.96"	.	"$2,346.00"	*	
5378	Level 8 Urology and Related Services	J1	221.5929	"$18,653.03"	.	"$3,730.61"	*	
5401	Dialysis	S	7.9465	$668.91	.	$133.79		
5411	Level 1 Gynecologic Procedures	T	2.0670	$173.99	.	$34.80		
5412	Level 2 Gynecologic Procedures	T	3.4218	$288.04	.	$57.61		
5413	Level 3 Gynecologic Procedures	T	7.6918	$647.47	.	$129.50		
5414	Level 4 Gynecologic Procedures	J1	31.8325	"$2,679.56"	.	$535.92		
5415	Level 5 Gynecologic Procedures	J1	53.5002	"$4,503.49"	$902.82	$900.70		
5416	Level 6 Gynecologic Procedures	J1	82.3648	"$6,933.22"	"$1,405.70"	"$1,386.65"		
5431	Level 1 Nerve Procedures	J1	21.3040	"$1,793.31"	.	$358.67		
5432	Level 2 Nerve Procedures	J1	69.1869	"$5,823.95"	.	"$1,164.79"		
5441	Level 1 Nerve Injections	T	3.1699	$266.83	.	$53.37		
5442	Level 2 Nerve Injections	T	7.7043	$648.52	.	$129.71		
5443	Level 3 Nerve Injections	T	9.9877	$840.73	.	$168.15		
5461	Level 1 Neurostimulator and Related Procedures	J1	39.7464	"$3,345.73"	.	$669.15		
5462	Level 2 Neurostimulator and Related Procedures	J1	74.7882	"$6,295.45"	.	"$1,259.09"		
5463	Level 3 Neurostimulator and Related Procedures	J1	136.4195	"$11,483.38"	.	"$2,296.68"	*	
5464	Level 4 Neurostimulator and Related Procedures	J1	248.4354	"$20,912.55"	.	"$4,182.51"	*	
5465	Level 5 Neurostimulator and Related Procedures	J1	357.1460	"$30,063.48"	.	"$6,012.70"	*	
5471	Implantation of Drug Infusion Device	J1	206.7704	"$17,405.31"	.	"$3,481.07"	*	
5481	Laser Eye Procedures	T	6.1060	$513.98	.	$102.80		
5491	Level 1 Intraocular Procedures	J1	25.1953	"$2,120.86"	.	$424.18		
5492	Level 2 Intraocular Procedures	J1	47.5141	"$3,999.59"	.	$799.92		
5493	Level 3 Intraocular Procedures	J1	89.0298	"$7,494.26"	.	"$1,498.86"		
5494	Level 4 Intraocular Procedures	J1	202.6084	"$17,054.97"	.	"$3,411.00"	*	
5495	Level 5 Intraocular Procedures	J1	287.0890	"$24,166.29"	.	"$4,833.26"	*	
5501	"Level 1 Extraocular, Repair, and Plastic Eye Procedures"	T	3.1738	$267.16	.	$53.44		
5502	"Level 2 Extraocular, Repair, and Plastic Eye Procedures"	T	9.8252	$827.06	.	$165.42		
5503	"Level 3 Extraocular, Repair, and Plastic Eye Procedures"	J1	24.2786	"$2,043.70"	.	$408.74		
5504	"Level 4 Extraocular, Repair, and Plastic Eye Procedures"	J1	40.1140	"$3,376.68"	.	$675.34		
5521	Level 1 Imaging without Contrast	S	0.9814	$82.61	.	$16.53		
5522	Level 2 Imaging without Contrast	S	1.3209	$111.19	.	$22.24		
5523	Level 3 Imaging without Contrast	S	2.7917	$235.00	.	$47.00		
5524	Level 4 Imaging without Contrast	S	5.8624	$493.48	.	$98.70		
5571	Level 1 Imaging with Contrast	S	2.1672	$182.43	.	$36.49		
5572	Level 2 Imaging with Contrast	S	4.4678	$376.09	.	$75.22		
5573	Level 3 Imaging with Contrast	S	8.6802	$730.67	.	$146.14		
5591	Level 1 Nuclear Medicine and Related Services 	S	4.5736	$384.99	.	$77.00		
5592	Level 2 Nuclear Medicine and Related Services	S	5.9372	$499.78	.	$99.96		
5593	Level 3 Nuclear Medicine and Related Services 	S	15.8549	"$1,334.62"	.	$266.93		
5594	Level 4 Nuclear Medicine and Related Services	S	17.9569	"$1,511.56"	.	$302.32		
5611	Level 1 Therapeutic Radiation Treatment Preparation	S	1.5395	$129.59	$32.03	$25.92		
5612	Level 2 Therapeutic Radiation Treatment Preparation	S	4.1086	$345.85	.	$69.17		
5613	Level 3 Therapeutic Radiation Treatment Preparation	S	15.3209	"$1,289.67"	.	$257.94		
5621	Level 1 Radiation Therapy	S	1.4534	$122.34	.	$24.47		
5622	Level 2 Radiation Therapy	S	2.9328	$246.87	.	$49.38		
5623	Level 3 Radiation Therapy	S	6.5828	$554.12	.	$110.83		
5624	Level 4 Radiation Therapy	S	8.6069	$724.50	.	$144.90		
5625	Level 5 Radiation Therapy	S	15.6946	"$1,321.12"	.	$264.23		
5626	Level 6 Radiation Therapy	S 	21.0423	"$1,771.28"	.	$354.26		
5627	Level 7 Radiation Therapy	J1	94.3604	"$7,942.98"	.	"$1,588.60"	*	
5661	Therapeutic Nuclear Medicine	S	3.0700	$258.42	.	$51.69		
5671	Level 1 Pathology	S	0.6029	$50.75	.	$10.15		
5672	Level 2 Pathology	S	1.8095	$152.32	.	$30.47		
5673	Level 3 Pathology	S	3.5336	$297.45	.	$59.49		
5674	Level 4 Pathology	S	7.9510	$669.29	.	$133.86		
5691	Level 1 Drug Administration	S	0.4855	$40.87	.	$8.18		
5692	Level 2 Drug Administration	S	0.7522	$63.32	.	$12.67		
5693	Level 3 Drug Administration	S	2.4820	$208.93	.	$41.79		
5694	Level 4 Drug Administration	S	3.8685	$325.64	.	$65.13		
5721	Level 1 Diagnostic Tests and Related Services	S	1.6939	$142.59	.	$28.52		
5722	Level 2 Diagnostic Tests and Related Services	S	3.2110	$270.29	.	$54.06		
5723	Level 3 Diagnostic Tests and Related Services	S	5.9224	$498.53	.	$99.71		
5724	Level 4 Diagnostic Tests and Related Services	S	11.1623	$939.61	.	$187.93		
5731	Level 1 Minor Procedures	S	0.2997	$25.23	.	$5.05		
5732	Level 2 Minor Procedures	S	0.4107	$34.57	.	$6.92		
5733	Level 3 Minor Procedures	S	0.6754	$56.85	.	$11.37		
5734	Level 4 Minor Procedures	S	1.3681	$115.16	.	$23.04		
5735	Level 5 Minor Procedures	S	3.2928	$277.18	.	$55.44		
5741	Level 1 Electronic Analysis of Devices	S	0.4518	$38.03	.	$7.61		
5742	Level 2 Electronic Analysis of Devices	S	1.2180	$102.53	.	$20.51		
5743	Level 3 Electronic Analysis of Devices	S	3.3128	$278.86	.	$55.78		
5771	Cardiac Rehabilitation	S	1.4084	$118.55	.	$23.71		
5781	Resuscitation and Cardioversion	S	6.8157	$573.73	.	$114.75		
5791	Pulmonary Treatment	S	2.2806	$191.97	.	$38.40		
5801	Ventilation Initiation and Management	S	5.9107	$497.54	.	$99.51		
5811	Manipulation Therapy	S	0.3236	$27.24	.	$5.45		
5821	Level 1 Health and Behavior Services	S	0.3189	$26.84	.	$5.37		
5822	Level 2 Health and Behavior Services	S	0.9078	$76.42	.	$15.29		
5823	Level 3 Health and Behavior Services	S	1.6234	$136.65	.	$27.33		
5853	Partial Hospitalization (3 or more services) for CMHCs	P	1.6952	$142.70	.	$28.54		
5863	Partial Hospitalization (3 or more services) for Hospital-based PHPs	P	3.1596	$265.97	.	$53.20		
5871	Dental Procedures	S	16.8291	"$1,416.62"	.	$283.33		
5881	Ancillary Outpatient Services When Patient Dies	J1	146.9015	"$12,365.73"	.	"$2,473.15"	*	
7000	Amifostine	K		"$1,135.691"	.	$227.14		
7035	Teniposide	K		"$2,645.707"	.	$529.15		
7041	Tirofiban hcl	K		$3.828	.	$0.77		
7043	Infliximab not biosimil 10mg	K		$39.532	.	$7.91		
7046	Doxorubicin inj 10mg	K		$234.028	.	$46.81		
7048	Alteplase recombinant	K		$87.750	.	$17.55		
7308	Aminolevulinic acid hcl top	K		$392.478	.	$78.50		
8004	Ultrasound Composite	S	3.6191	$304.64	.	$60.93		
8005	CT and CTA without Contrast Composite	S	2.7210	$229.05	.	$45.81		
8006	CT and CTA with Contrast Composite	S	5.2813	$444.56	.	$88.92		
8007	MRI and MRA without Contrast Composite	S	6.3423	$533.88	.	$106.78		
8008	MRI and MRA with Contrast Composite	S	10.2303	$861.16	.	$172.24		
8010	Mental Health Services Composite	S	3.1596	$265.97	.	$53.20		
8011	Comprehensive Observation Services	J2	27.7024	"$2,331.90"	.	$466.38		
9002	Tenecteplase injection	K		$134.737	.	$26.95		
9003	Palivizumab	K		"$1,185.670"	.	$237.14		
9005	Reteplase injection	K		"$2,506.512"	.	$501.31		
9006	Tacrolimus injection	K		$219.325	.	$43.87		
9012	Arsenic trioxide injection	K		$13.114	.	$2.63		
9016	"Inj., triptorelin xr 3.75 mg"	K		"$3,120.112"	.	$624.03		
9018	"Inj, rimabotulinumtoxinB"	K		$12.052	.	$2.42		
9024	Amphotericin b lipid complex	K		$9.504	.	$1.91		
9028	Inj inotuzumab ozogam 0.1 mg	K		"$2,371.622"	.	$474.33		
9029	"Inj., guselkumab, 1 mg"	K		$82.560	.	$16.52		
9030	"Inj., copanlisib, 1 mg"	K 		$80.964	.	$16.20		
9032	Baclofen 10 MG injection	K		$177.434	.	$35.49		
9033	Cidofovir injection	K		$563.760	.	$112.76		
9034	"Inj cuvitru, 100 mg"	K		$14.496	.	$2.90		
9035	Axicabtagene ciloleucel car+ 	K		"$395,380.000"	.	"$79,076.00"	*	
9036	"Injection, renflexis"	K		$38.792	.	$7.76		
9038	Inj estrogen conjugate	K		$341.456	.	$68.30		
9042	Glucagon hydrochloride	K		$171.736	.	$34.35		
9043	"Inj, afstyla, 1 i.u."	K		$1.360	.	$0.28		
9044	Ibutilide fumarate injection	K		$205.061	.	$41.02		
9058	Buprenorphine implant 74.2mg	K		"$1,311.750"	.	$262.35		
9059	Vonvendi inj 1 iu vwf:rco	K		$1.852	.	$0.38		
9063	Rh ig minidose im	K		$151.410	.	$30.29		
9065	Argatroban esrd dialysis 1mg	K 		$1.203	.	$0.25		
9067	Lutetium lu 177 dotatat ther	K 		$274.328	.	$54.87		
9069	Phenobarbital sodium inj	K 		$40.217	.	$8.05		
9070	Inj luxturna 1 billion vec g	K 		"$2,953.713"	.	$590.75		
9071	Capsaicin 8% patch	K		$3.231	.	$0.65		
9073	Buprenorph xr 100 mg or less	K 		"$1,796.798"	.	$359.36		
9074	"Makena, 10 mg"	K		$16.815	.	$3.37		
9075	"Inj, kovaltry, 1 i.u."	K		$1.244	.	$0.25		
9077	Epoetin beta non esrd	K		$1.510	.	$0.31		
9078	Testosterone undecanoate 1mg	K		$1.630	.	$0.33		
9079	"Genvisc 850, inj, 1mg"	K		$16.918	.	$3.39		
9088	Peng benzathine/procaine inj	K		$11.787	.	$2.36		
9093	Plicamycin (mithramycin) inj	K		$115.400	.	$23.08		
9094	Radiesse injection	K		$257.370	.	$51.48		
9095	"Inj, sculptra, 0.5mg"	K		$2.490	.	$0.50		
9097	Inj retacrit non-esrd use	K		$8.655	.	$1.74		
9099	"Inj fosnetupitant, palonoset"	K		$571.221	.	$114.25		
9104	Antithymocyte globuln rabbit	K		$837.419	.	$167.49		
9108	Thyrotropin injection	K		"$1,837.246"	.	$367.45		
9120	"Injection, Fulvestrant"	K		$15.979	.	$3.20		
9122	Triptorelin pamoate	K		$379.904	.	$75.99		
9125	"Risperidone, long acting"	K		$11.042	.	$2.21		
9126	Natalizumab injection	K		$23.237	.	$4.65		
9130	"Inj, Imm Glob Bivigam, 500mg"	K		$70.490	.	$14.10		
9131	"Inj, Ado-trastuzumab Emt 1mg"	K		$34.184	.	$6.84		
9132	Prothrombin complex kcentra	K		$1.987	.	$0.40		
9133	"Rabies ig, im/sc"	K		$267.300	.	$53.46		
9134	"Rabies ig, heat treated"	K		$287.376	.	$57.48		
9135	"Varicella-zoster ig, im"	K		"$1,965.970"	.	$393.20		
9139	"Rabies vaccine, im"	K		$327.532	.	$65.51		
9140	"Rabies vaccine, id"	K		$189.630	.	$37.93		
9171	Factor ix idelvion inj	K		$4.592	.	$0.92		
9172	"Injection, dexamethasone 9%"	G		$1.035	.	$0.00		*
9173	"Injection, fulphila"	G		$211.185	.	$42.24		*
9174	"Inj, durolane 1 mg"	K		$17.225	.	$3.45		
9178	"Inj., meropenem, vaborbactam"	K		$1.758	.	$0.36		
9179	"Inj., aristada initio, 1 mg"	G		$3.050	.	$0.61		
9180	"Inj., patisiran, 0.1 mg"	G		$97.750	.	$19.55		
9181	"Inj., perseris, 0.5 mg"	G		$10.687		$2.14		
9182	"Inj mogamulizumab-kpkc, 1 mg"	G		$210.045	.	$42.01		
9183	"Inj., plazomicin, 5 mg"	G		$3.047	.	$0.61		
9186	"Inj., rituximab, 10 mg"	K		$86.937	.	$17.39		
9187	"Injection, burosumab-twza 1m"	K		$369.108	.	$73.83		
9188	Inj crotalidae im f(ab')2 eq	K		"$1,189.809"	.	$237.97		
9189	"Inj., ibalizumab-uiyk, 10 mg"	K		$66.394	.	$13.28		
9192	"Inj, bortezomib, nos, 0.1 mg"	K		$18.307	.	$3.67		
9193	Nivestym	G		$0.325	.	$0.07		*
9194	Tisagenlecleucel car-pos t	K		"$434,337.596"	.	"$86,867.52"	*	
9195	"Injection, udenyca 0.5 mg"	G		$222.375	.	$44.48		*
9196	"Inj, trivisc 1 mg"	K		$19.117	.	$3.83		
9197	"Inj., fremanezumab-vfrm 1 mg"	G		$2.344	.	$0.47		*
9198	"Inj andexxa, 10 mg"	G		$289.932	.	$57.99		*
9199	"Injection, caplacizumab-yhdp"	G		$691.289	.	$138.26		*
9207	"Inj., velcade 0.1 mg"	K		$45.164	.	$9.04		
9208	Agalsidase beta injection	K		$198.141	.	$39.63		
9209	Laronidase injection	K		$34.747	.	$6.95		
9213	Inj. pemetrexed nos 10mg	K		$74.929	.	$14.99		
9214	Bevacizumab injection	K		$70.412	.	$14.09		
9215	Cetuximab injection	K		$66.705	.	$13.35		
9217	Leuprolide acetate suspnsion	K		$139.090	.	$27.82		
9224	Galsulfase injection	K		$411.922	.	$82.39		
9225	Fluocinolone acetonide implt	K		$338.996	.	$67.80		
9230	Abatacept injection	K		$45.269	.	$9.06		
9231	Decitabine injection	K		$3.451	.	$0.70		
9233	Ranibizumab injection	K		$318.472	.	$63.70		
9234	Alglucosidase alfa injection	K		$117.070	.	$23.42		
9235	Panitumumab injection	K		$130.379	.	$26.08		
9236	Eculizumab injection	K		$229.228	.	$45.85		
9237	"Inj, lanreotide acetate"	K		$67.638	.	$13.53		
9239	Buprenorphine xr over 100 mg	K		"$1,796.798"	.	$359.36		
9240	"Injection, ixabepilone"	K		$112.116	.	$22.43		
9243	"Inj., treanda 1 mg"	K		$22.012	.	$4.41		
9245	Romiplostim injection	K		$83.466	.	$16.70		
9251	C1 esterase inhibitor inj	K		$58.926	.	$11.79		
9252	Plerixafor injection	K		$382.852	.	$76.58		
9253	Temozolomide injection	K		$10.405	.	$2.09		
9255	Paliperidone palmitate inj	K		$12.663	.	$2.54		
9256	Dexamethasone intra implant	K		$199.689	.	$39.94		
9257	"Inj., emicizumab-kxwh 0.5 mg"	K		$48.881	.	$9.78		
9258	Telavancin injection	K		$6.155	.	$1.24		
9259	Pralatrexate injection	K		$314.835	.	$62.97		
9260	Ofatumumab injection	K		$63.957	.	$12.80		
9261	"Ustekinumab sub cu inj, 1 mg"	K		$176.651	.	$35.34		
9263	Ecallantide injection	K		$503.878	.	$100.78		
9264	Tocilizumab injection	K		$5.553	.	$1.12		
9269	"C-1 esterase, berinert"	K		$57.389	.	$11.48		
9270	Gammaplex IVIG	K		$48.530	.	$9.71		
9271	Velaglucerase alfa	K		$359.291	.	$71.86		
9272	"Inj, denosumab"	K		$21.189	.	$4.24		
9273	Sipuleucel-T auto CD54+	K		"$53,017.576"	.	"$10,603.52"	*	
9274	Crotalidae Poly Immune Fab	K		"$2,743.364"	.	$548.68		
9276	Cabazitaxel injection	K		$188.997	.	$37.80		
9278	Incobotulinumtoxin A	K		$5.047	.	$1.01		
9281	"Injection, pegloticase"	K		"$2,960.910"	.	$592.19		
9284	Ipilimumab injection	K		$158.648	.	$31.73		
9286	Belatacept injection	K		$3.804	.	$0.77		
9287	Brentuximab vedotin inj	K		$189.335	.	$37.87		
9289	Erwinaze injection	K		$427.269	.	$85.46		
9294	"Inj, taliglucerase alfa 10 u"	K		$41.322	.	$8.27		
9295	"Injection, Carfilzomib, 1 mg"	K		$41.103	.	$8.23		
9296	"Inj, ziv-aflibercept, 1mg"	K		$8.420	.	$1.69		
9297	"Inj, Omacetaxine Mep, 0.01mg"	K		$3.302	.	$0.67		
9298	"Inj, Ocriplasmin, 0.125 mg"	K		"$1,046.927"	.	$209.39		
9299	Inj. jivi 1 iu	G		$2.103	.	$0.43		*
9300	Omalizumab injection	K		$37.668	.	$7.54		
9301	"Aminolevulinic acid, 10% gel"	K		$1.588	.	$0.32		
9302	"Inj daunorubicin, cytarabine"	K		$202.596	.	$40.52		
9304	"Inj., cemiplimab-rwlc, 1 mg"	G		$27.542	.	$5.51		*
9305	"Inj., lumoxiti, 0.01 mg"	G		$23.394	.	$4.68		*
9306	"Inj., tildrakizumab, 1 mg"	G		$134.075	.	$26.82		*
9307	Cocaine hcl nasal solution	G		$1.334	.	$0.00		*
9308	Dexametha opth insert 0.1 mg	G		$133.302	.	$0.00		*
9309	Inj. tagraxofusp-erzs 10 mcg	G		$290.367	.	$58.08		*
9310	"Inj., emapalumab-lzsg, 1 mg"	G		$376.033	.	$75.21		*
9311	"Inj., omadacycline, 1 mg"	G		$3.302	.	$0.67		*
9312	"Inj., ravulizumab-cwvz 10 mg"	G		$224.678	.	$44.94		*
9313	Inj. belrapzo/bendamustine	G		$21.470	.	$4.30		*
9314	"Inj. herceptin hylecta, 10mg"	G		$71.854	.	$14.38		*
9318	Inj hydroxyprogst capoat nos	K		$21.540	.	$4.31		
9320	Carbidopa levodopa ent 100ml	K		$211.697	.	$42.34		
9323	Gallium ga-68 dotatoc	G		$8.640	.	$0.00		
9327	Inj. romosozumab-aqqg 1 mg	G		$9.344	.	$1.87		*
9328	"Inj., yutiq, 0.01 mg"	K		$513.158	.	$102.64		
9329	Inj mvasi 10 mg	G		$44.557	.	$8.92		
9330	"Inj., kanjinti, 10 mg"	G		$53.183	.	$10.64		
9331	"Inj, polatuzumab vedotin 1mg"	G		$113.571	.	$22.72		
9332	Inj lefamulin 1 mg	G		$0.724	.	$0.15		
9333	"Inj., brexanolone, 1 mg"	G		$74.654	.	$14.94		
9334	"Injection, khapzory, 0.5 mg"	G		$1.863	.	$0.38		*
9336	Inj truxima 10 mg	G		$60.577	.	$12.12		
9337	"Synojoynt, inj., 1 mg"	G		$18.016	.	$3.61		
9339	Iodine i-131 iobenguane 1mci	G		$320.120	.	$64.03		
9340	"Inj, brolucizumab-dbll, 1 mg"	G		$312.010	.	$62.41		
9341	Inj  ogivri 10 mg	G		$59.906	.	$11.99		
9343	Inj givosiran 0.5 mg	G		$106.760	.	$21.36		
9345	Inj pegfilgrastim-bmez 0.5mg	G		$245.431	.	$49.09		
9346	Mometasone sinus sinuva	G		$10.560	.	$2.12		
9347	Inj luspatercept-aamt 0.25mg	G		$36.845	.	$7.37		
9348	"Inj., zirabev, 10 mg"	G		$52.369	.	$10.48		
9349	Inj herzuma 10 mg	G		$57.303	.	$11.47		
9350	"Inj., trazimera, 10 mg"	G		$59.931	.	$11.99		
9351	Inj bimatoprost itc imp 1mcg	G		$205.633	.	$41.13		
9352	Chloroquine injection	K		$165.220	.	$33.05		
9353	Inj fam-trastu deru-nxki 1mg	G		$24.267	.	$4.86		
9354	Inj recombin esperoct per iu	G		$2.227	.	$0.45		
9355	Inj. teprotumumab-trbw 10 mg	G		$315.880	.	$63.18		
9356	Inj golodirsen 10 mg	G		$166.209	.	$33.25		
9357	Inj. eptinezumab-jjmr 1 mg	G		$15.635	.	$3.13		
9359	Inj crizanlizumab-tmca 5mg	G		$123.291	.	$24.66		
9361	Inj. cetirizine hcl 0.5mg	G		$15.382	.	$3.08		
9362	Inj imip 4 cilas 4 releb 2mg	G		$2.323	.	$0.47		
9364	Inj enfort vedo-ejfv 0.25mg	G		$30.170	.	$6.04		
9367	"Inj ruxience, 10 mg"	G		$58.796	.	$11.76		
9370	Fluoroestradiol F 18	G		$644.833	.	$0.00		
9371	Inj. meloxicam 1 mg	G		$3.180	.	$0.00		
9372	"Inj. xembify, 100 mg"	K		$13.605	.	$2.73		
9374	Mitomycin instillation	G		$281.879	.	$56.38		
9375	"Inj., evomela, 1 mg"	K		$18.197	.	$3.64		
9376	Sacituzumab govitecan-hziy	G		$30.354	.	$6.08		
9377	Inj. isatuximab-irfc 10 mg	G		$67.598	.	$13.52		
9378	"Daratumumab, hyaluronidase"	G		$45.098	.	$9.02		
9381	"Inj. avsola, 10 mg"	G		$47.117	.	$9.43		
9382	Inj ontruzant 10 mg	G		$66.550	.	$13.31		
9383	Copper cu 64 dotatate diag	G		$918.205	.	$0.00		
9384	Inj belantamab mafodot blmf	G		$42.778	.	$8.56		
9385	"Inj., tafasitamab-cxix"	G		$12.619	.	$2.53		
9386	Inj. viltolarsen	G		$59.052	.	$11.82		
9387	"Inj. infugem, 100 mg"	G		$34.004	.	$6.81		
9388	Inj. fe derisomaltose 10 mg	G		$24.868	.	$4.98		
9389	"Inj. lurbinectedin, 0.1 mg"	G		$174.034	.	$34.81		
9390	"Pertuzu, trastuzu, 10 mg"	G		$72.149	.	$14.43		
9391	Brexucabtagene car pos t	G		"$395,380.000"	.	"$79,076.00"	*	
9392	Inj. asceniv	G		$481.770	.	$96.36		
9393	Inj codeine phosphate /30 mg	K		$135.640	.	$27.13		
9394	"Inj. inebilizumab-cdon, 1 mg"	G		$458.207	.	$91.65		
9395	Factor viia recomb sevenfact	G		$2.271	.	$0.46		
9396	"Afamelanotide implant, 1 mg"	K		"$3,218.897"	.	$643.78		
9397	Covid-19 Vaccine Admin Dose 1 of 2 	S	0.4752	$40.00	.	$0.00		
9398	"Covid-19 Vaccine Admin Dose 2 of 2, Single Dose Product or Additional Dose"	S	0.4752	$40.00	.	$0.00		
9406	"Inj, nyvepria"	G		$284.692	.	$56.94		
9407	"Inj. lumasiran, 0.5 mg"	G		$302.296	.	$60.46		
9408	"Inj. naxitamab-gqgk, 1 mg"	G		$539.065	.	$107.82		
9409	Gallium ga-68 psma-11 ucsf	G		$732.859	.	$0.00		
9410	"Gallium ga-68 psma-11, ucla"	G		$717.545	.	$0.00		
9411	"Inj. riabni, 10 mg"	G		$72.225	.	$14.45		
9412	"Injection, casimersen, 10 mg"	G		$166.472	.	$33.30		
9413	lisocabtagene car pos t	G		"$422,609.000"	.	"$84,521.80"	*	
9414	"Inj, cabote rilpivir 2mg 3mg"	G		$20.555	.	$4.12		
9415	"Injection, trilaciclib, 1mg"	G		$4.971	.	$1.00		
9416	"Inj, evinacumab-dgnb, 5 mg"	G		$165.625	.	$33.13		
9417	"Inj, melphalan flufenami 1mg"	G		$499.863	.	$99.98		
9418	"Inj. margetuximab-cmkb, 5 mg"	G		$42.993	.	$8.60		
9419	Inj fensolvi 0.25 mg	K		$126.277	.	$25.26		
9420	Eptifibatide injection	K		$1.987	.	$0.40		
9421	"Inj, granisetron, xr, 0.1 mg"	K		$6.938	.	$1.39		
9422	Idecabtagene vicleucel car	G		"$432,085.000"	.	"$86,417.00"	*	
9425	"loncastuximab-lpyl, 0.1 mg"	G		$242.050	.	$48.41		
9426	"Inj, cefiderocol, 10 mg"	G		$2.011	.	$0.41		
9427	"Injection, oritavancin 10 mg"	G		$41.921	.	$8.39		
9428	Inj romidepsin non-lyo 0.1mg	G		$33.905	.	$6.79		
9429	Inj romidepsin lyophil 0.1mg	K		$33.678	.	$6.74		
9430	"Piflu f-18, dia 1 millicurie"	G		$526.444	.	$0.00		
9431	"Inj, dostarlimab-gxly, 10 mg"	G		$213.609	.	$42.73		
9432	"Inj, amivantamab-vmjw"	G		$17.577	.	$3.52		
9433	Inj avalglucosid alfa-ngpt	G		$70.654	.	$14.14		
9434	"Inj, anifrolumab-fnia"	G		$15.795	.	$3.16		
9435	Inj cyclophosphamd auromedic	G		$7.519	.	$1.51		
9436	Inj pegfilgrast ex bio 0.5mg	K		$185.135	.	$37.03		
9437	"Inj, aspara, rylaze, 0.1 mg"	G		$45.217	.	$9.05		
9438	"Injection, aducanumab-avwa, 2 mg"	K		$11.536	.	$2.31		
9441	Inj ferric carboxymaltos 1mg	K		$1.120	.	$0.23		
9445	"Injection, ruconest"	K		$29.970	.	$6.00		
9448	"Oral netupitant, palonosetro"	K		$315.592	.	$63.12		
9449	"Injection, blinatumomab"	K		$123.879	.	$24.78		
9450	Fluocinol acet intravit imp	K		$490.947	.	$98.19		
9451	"Injection, peramivir"	K		$1.678	.	$0.34		
9452	Inj ceftolozane tazobactam	K		$6.637	.	$1.33		
9453	"Injection, nivolumab"	K		$28.863	.	$5.78		
9454	"Inj, pasireotide long acting"	K		$359.033	.	$71.81		
9455	"Injection, siltuximab"	K		$124.093	.	$24.82		
9456	"Injection, isavuconazonium"	K		$0.825	.	$0.17		
9460	"Injection, cangrelor"	K		$16.318	.	$3.27		
9463	"Inj., aprepitant, 1 mg"	K		$1.691	.	$0.34		
9466	"Inj., benralizumab, 1 mg"	K		$170.796	.	$34.16		
9467	"Inj rituximab, hyaluronidase"	K		$37.940	.	$7.59		
9468	Factor ix recomb gly rebinyn	K		$4.226	.	$0.85		
9469	Inj triamcinolone ace xr 1mg	K		$17.748	.	$3.55		
9470	Aripirazole lauroxil 1 mg	K		$2.994	.	$0.60		
9471	Hymovis injection 1 mg	K		$31.668	.	$6.34		
9472	Inj talimogene laherparepvec	K		$57.261	.	$11.46		
9473	"Injection, mepolizumab, 1mg"	K		$28.290	.	$5.66		
9474	Inj irinotecan liposome 1 mg	K		$57.196	.	$11.44		
9475	"Injection, necitumumab, 1 mg"	K		$5.737	.	$1.15		
9476	"Injection, daratumumab 10 mg"	K		$57.552	.	$11.52		
9477	"Injection, elotuzumab, 1mg"	K		$6.771	.	$1.36		
9478	Inj sebelipase alfa 1 mg	K		$539.911	.	$107.99		
9479	"Instill, ciprofloxacin otic"	K		$29.984	.	$6.00		
9480	Injection trabectedin 0.1mg	K		$325.029	.	$65.01		
9481	"Injection, reslizumab"	K		$10.114	.	$2.03		
9482	Sotalol hydrochloride IV	K		$17.582	.	$3.52		
9483	"Inj, atezolizumab,10 mg"	K		$79.749	.	$15.95		
9485	"Inj, olaratumab, 10 mg"	K 		$52.067	.	$10.42		
9487	"Ustekinumab, iv inject,1 mg"	K 		$11.680	.	$2.34		
9488	Conivaptan hcl	K 		$43.942	.	$8.79		
9489	"Inj, nusinersen, 0.1mg"	K 		"$1,122.125"	.	$224.43		
9490	"Inj, bezlotoxumab, 10 mg"	K 		$39.765	.	$7.96		
9491	"Injection, avelumab, 10 mg"	K 		$86.192	.	$17.24		
9492	"Inj., durvalumab, 10 mg"	K 		$76.863	.	$15.38		
9493	"Injection, edaravone, 1 mg"	K 		$20.510	.	$4.11		
9494	"Injection, ocrelizumab"	K 		$58.291	.	$11.66		
9495	Gemtuzumab ozogamicin inj	K 		$207.992	.	$41.60		
9500	"Platelets, irradiated"	R	1.7187	$144.68	.	$28.94		
9501	Platelet pheres leukoreduced	R	5.9031	$496.91	.	$99.39		
9502	Platelet pheresis irradiated	R	7.3370	$617.61	.	$123.53		
9503	Fr frz plasma donor retested	R	0.7894	$66.45	.	$13.29		
9504	RBC deglycerolized	R	5.2963	$445.83	.	$89.17		
9505	RBC irradiated	R	2.0536	$172.87	.	$34.58		
9507	"Platelets, pheresis"	R	3.9298	$330.80	.	$66.16		
9508	Plasma 1 donor frz w/in 8 hr	R	1.0026	$84.40	.	$16.88		
9509	"Frozen plasma, pooled, sd"	R	1.0812	$91.01	.	$18.21		
9510	Whole blood for transfusion	R	1.8196	$153.17	.	$30.64		
9511	Cryoprecipitate each unit	R	0.9686	$81.53	.	$16.31		
9512	RBC leukocytes reduced	R	2.2855	$192.39	.	$38.48		
9513	"Plasma, frz between 8-24hour"	R	0.8629	$72.64	.	$14.53		
9514	"Plasma protein fract,5%,50ml"	R	0.0970	$8.17	.	$1.64		
9515	"Platelets, each unit"	R	0.8647	$72.79	.	$14.56		
9516	Plaelet rich plasma unit	R	2.4259	$204.20	.	$40.84		
9517	Red blood cells unit	R	1.6694	$140.53	.	$28.11		
9518	Washed red blood cells unit	R	4.6075	$387.85	.	$77.57		
9519	"Plasmaprotein fract,5%,250ml"	R	1.9449	$163.72	.	$32.75		
9520	Blood split unit	R	1.7902	$150.69	.	$30.14		
9521	Platelets leukoreduced irrad	R	2.5858	$217.66	.	$43.54		
9522	RBC leukoreduced irradiated	R	3.1604	$266.03	.	$53.21		
9523	Cryoprecipitatereducedplasma	R	0.7969	$67.08	.	$13.42		
9524	"Blood, l/r, cmv-neg"	R	2.5741	$216.68	.	$43.34		
9525	"Platelets, hla-m, l/r, unit"	R	9.7664	$822.11	.	$164.43		
9526	Platelets leukocytes reduced	R	1.8184	$153.07	.	$30.62		
9527	"Blood, l/r, froz/degly/wash"	R	3.7685	$317.22	.	$63.45		
9528	"Plt, aph/pher, l/r, cmv-neg"	R	5.8226	$490.13	.	$98.03		
9529	"Blood, l/r, irradiated"	R	1.8698	$157.39	.	$31.48		
9530	Plate pheres leukoredu irrad	R	7.4880	$630.32	.	$126.07		
9531	"Plt, pher, l/r cmv-neg, irr"	R	5.4256	$456.71	.	$91.35		
9532	"RBC, frz/deg/wsh, l/r, irrad"	R	3.1607	$266.06	.	$53.22		
9533	"RBC, l/r, cmv-neg, irrad"	R	2.9579	$248.99	.	$49.80		
9534	Pathogen reduced plasma pool	R	0.6441	$54.22	.	$10.85		
9535	Pathogen reduced plasma sing	R	1.4897	$125.40	.	$25.08		
9536	Platelets pheresis path redu	R	7.0819	$596.13	.	$119.23		
9537	Blood component/product noc	R	0.0970	$8.17	.	$1.64		
9538	Plasma cryo redu path each	R	0.7969	$67.08	.	$13.42		
9539	Cryo fib comp path redu each	R	0.9686	$81.53	.	$16.31		
